Exam 3 review sheet Flashcards
(221 cards)
CAD non-modifiable and modifiable risk factors
Non-modifiable
- Age:
- Increased age-disease process begins early and develops gradually.
- Gender:
- Highest for middle-aged white caucasian
- Race:
- Caucasian males highest risk
- Genetic:
- Inherited tendencies for atherosclerosis
Modifiable
- Tobacco
- Hypertension
- Physical Activity
- Obesity
- Dyslipidemia
- Diabetes
- Stress
- ETOH abuse
- HRT
Where do we want out patients with CAD for BP?
less than 120/less than 80
prehypertension
120-139/80-89
high blood pressure stage 1
140-159/90-99
high blood pressure stage 2
160 or higher/100 or higher
hypertensive crisis
higher than 180/higher than 110
what does exercise really help with regards to HDL, LDL, TG?
eally helps HDL and TG
How does diet affect LDL, HDL, TG
LDL: lowers it
HDL: little effect
TG: lowers it
what do omega fatty acids help with?
triglycerides
most used to treat lipid levels
Statins: effects LDL, HDL, and triglycerides
optimal total cholesterol and ldl, HDL,TC/HDL
total: less than 160
LDL: less than 100
HDL: above 45
TC/HDL: less than 3
Type of angina?
Pain w/exertion-relief w/rest
stable Angina
Type of Angina?
Pain onset w/ rest
Caused by vasospams
Prinzmetal’s
type of angina?
Pain onset w/rest
Precursor to AMI
unstable angina
type of angina?
Unrecognized symptoms
Silent agina
causative factors of Angina
- Physical exertion
- Temperature extremes
- Strong emotions
- Heavy meal
- Tobacco use
- Sexual activity
- Stimulants
- Circadian rhythm patterns
Treatment of stable angina?
- etiology: Myocardial ischemia
- Symptoms: episodic, aggravated with exercise, relieved w/NTG
- Treatment: NTG, beta blockers, ca+ channel blockers, ACE inhibitors
Unstable angina treatment
- etiology: ruptured or thickened plaque with platelet and fibrin thrombus
- symptoms: increasing episodes, occurs with rest and exercise, not relieved with NTG
- treatment: NTG, tPA, morphine (dilates vessels), ASA
Prinzmetals angina treatment
- etiology: Coronary vasospasams
- symptoms: Occurs at rest, Triggered with smoking, May have ST elevation,
- AV Block or Ventricular arrhythmias
- Treatment: Ca+ Channel Blockers
progressive inflammatory disorder of arterial wall that is characterized by focal lipid rich deposits of atheroma that remain clinically silent until they become large enough to impair tissue perfusion
atherosclerosis
Stemi vs NonStemi
ST elevation= stemi. Elevation in the t “firemans cap”
ST depression= non-stemi.
APQRST evaluation of chest pain
- A= Associated Symptoms Dyspnea, nausea, diaphoresis, palpitations, feeling of impending doom
- P= Precipitating Factors Exertion, Cold Exposure, meals, movement. Relieved by: rest, NTG, or position?
- Q= Quality Heaviness, tightness, sharp, stabbing, burning
- R= Region, Radiation, Risk Factors Radiates to: arm, jaw, back, below diaphram. Region: substernal, left lateral, right chest. Risk factors: HTN, DM, Obesity, Dyslipidemia, Smoking
- S= Severity Rate pain on scale 0-10
- T= Timing Onset and duration of pain, nocturnal?, constant? Intermittent?
CPK and Troponin
- CPK MB: rises 4-8 hours, peaks 12-24, remains elevated for a day
- Troponin: (breakdown in cardiac muscle) rises in 3 hours, peaks 12-18 hours, stays elevated for 14 days
- Troponin t: 0.1 or less micrograms per liter
- Troponin I: less than 10 micrograms
C-Reactive protein
- Produced by liver w/ inflammation
- Rules out stable angina
- Good o get pt. baseline
- Reference range
- Low- < 1.0 mg/dL
- Average- 1.0-3.0 mg/dL
- High- > 3.0 mg/dL