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Health Assessment (Spring 2023) > Exam 4 (IHD & VHD) > Flashcards

Exam 4 (IHD & VHD) Flashcards

1
Q

Which drug class prolongs the life in patients with a history of coronary artery disease?

A) Beta-blockers
B) Calcium-channel blockers
C) Nitrates
D) Statins

A

A) Beta-blockers

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2
Q

Which diagnostic data correlates with the presentation of unstable angina? (SELECT 2)

A) Negative troponins
B) 12 lead ECG without ST-segment elevation
C) Positive troponins
D) 12 lead ECG with ST-segment elevation

A

A) Negative troponins
B) 12 lead ECG without ST-segment elevation

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3
Q

The MOST significant predictor of stent thrombosis is the discontinuation of:

A) P2Y12 inhibitors.
B) statins.
C) beta-blockers.
D) aspirin.

A

A) P2Y12 inhibitors.

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4
Q

A patient presents to pre-op with a history of active chest pain, hypertension, and diabetes mellitus type 2 for the removal of a left-hand cyst. The BEST plan the RRNA can anticipate is:

A) administering a nitroglycerin gtt IV.
B) the surgery being canceled.
C) performing a regional block.
D) consulting an endocrinologist.

A

B) the surgery being canceled.

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5
Q

A benefit of aortic valve replacement in patients with aortic stenosis is:

A) increased ventricular hypertrophy.
B) increased ejection fraction.
C) decreased cardiac output.
D) decreased stroke volume.

A

B) increased ejection fraction.

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6
Q

In mitral stenosis, decreased stroke volume is related to:

A) bradycardia.
B) pulmonary hypotension.
C) decreased right atrial pressure.
D) atrial fibrillation.

A

D) atrial fibrillation.

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7
Q

An anesthetic goal for mitral regurgitation is:

A) increasing the regurgitant fraction.
B) increasing the heart rate.
C) reducing the stroke volume.
D) maintaining slightly higher blood pressure.

A

B) increasing the heart rate.

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8
Q

The pulmonic valve is auscultated at the:

A) 2nd ICS, LSB.
B) 2nd ICS, RSB.
C) 5th ICS, LSB.
D) 5th ICS, RSB.

A

A) 2nd ICS, LSB.

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9
Q

What occlusion constitutes stable angina?

A

70%

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10
Q

What dermatomes are affected with angina pain?

A

C8 to T4 (nipple line)

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11
Q

Chronic stable angina is defined as?

A

CP that does not change in frequency or severity in a 2month period.

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12
Q

Unstable angina is defined as?

A

CP increasing in frequency and/or severity without increase in cardiac biomarkers

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13
Q

What cardiac diagnostic test has greater sensitivity?

A

Nuclear stress imaging

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14
Q

Nuclear stress testing can estimate & differentiate what?

A
  • Estimate LV systolic size & function
  • Differentiate between new & old MI
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15
Q

What med lights up during nuclear stress imaging?

A

Thallium

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16
Q

What nuclear stress imaging meds dilate the coronaries?

A
  • Adenosine (Brand names: Adenocard, and Adenoscan)
  • dipyridamole (brand names: Attia, Ofcram, Persantin, Persantin Retard, Trolactin)
17
Q

Relate PPI’s to P2Y12 inhibitors?

A

PPI’s decrease the function of P2Y12 inhibitors

18
Q

What meds are contraindicated in severe aortic stenosis & hypertrophic cardiomyopathy

A

Nitrates

19
Q

Why are statins used in IHD?

A

To stabilize plaque

20
Q

Troponin levels start increasing within ___ after an MI and can be elevated for up to___?

A
  • 3 hours
  • 7 to 10 days
21
Q

If tPA is indicated, when should it be started?

A

Within 2-3 hrs after onset of S/S

22
Q

Unstable angina lasts ____?

A

> 10mins at rest

23
Q

When is tPA therapy not recommended?

A
  • When the vessel is not fully occluded
  • Or when the occlusion broke thru the intima (But how would one know)?
24
Q

What anesthetic interventions are contraindication with DAPT?

A

Neuraxial anesthesia

25
Q

How long should one take DAPT after receiving a bare-metal stent?
What about a drug-eluting stent?
What about balloon angioplasty without stent?

A
  • 6 weeks
  • 1 year
  • 2 weeks
26
Q

What drug is preferred in IHD, atropine or glycopyrrolate (Robinul) & why?

A

Glycopyrrolate (Robinul) as it has less chances to cause arrhythmias

27
Q

What all results in 1 point on the cardiac risk index?

A
  • High risk Sx
  • IHD
  • CHF
  • Stroke
  • DM with insulin
  • Creatinine >2
28
Q

1 MET equals to ____ of energy consumption?

A

3.5 mL/kg/min

29
Q

Emergent Sx has to be within ____ hours?
Urgent Sx has to be within ____ hours?
Time-sensitive Sx has to be within ___ weeks?

A
  • 6 hours
  • 6 - 24 hours
  • 1 - 6 weeks
30
Q

What induction drugs are preferred in someone with severe LV dysfunction?

A

Opioids only (if possible)

31
Q

Direct laryngoscopy should be less or equal to ____?

A

15 seconds

Health Assessment (Spring 2023) (11 decks)

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