HEART 2.2 Flashcards

1
Q

usually used in thrombolytic therapy

A

streptokinase or tissue-type plasminogen activator

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2
Q

factors that contribute to reperfusion injury include:

A
Mitochondrial dysfunction
Myocyte hypercontracture
Free radicals
Leukocyte aggregation
Platelet and complement activation
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3
Q

Microscopically, irreversibly damaged myocytes after

reperfusion develop

A

contraction band necrosis

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4
Q

intense eosinophilic bands of
hypercontracted sarcomeres are created by an influx
of calcium across plasma membranes that heightens
actin myosin interactions

A

contraction bands

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5
Q

state of prolonged contractile
dysfunction induced by short-term ischemia that
usually recovers after several days

A

stunned myocardium

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6
Q

Myocardium that is subjected to chronic, sublethal
ischemia can also enter into a state of lowered
metabolism and function called

A

hibernation

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7
Q

restoration of blood flow to
ischemic myocardium threatened by infarction; the
goal is to salvage cardiac muscle at risk and limit
infarct size

A

reperfusion

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8
Q

can remove a thrombus occluding a
coronary artery, but does not alter the underlying
atherosclerotic plaque

A

thrombolysis

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9
Q

percutaneous transluminal coronary
angioplasty with stent placement not only emanates a
thrombotic occlusion but also relieved some of the
original obstruction and instability caused by the
underlying disrupted plaque

A

angioplasty

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10
Q

provides a new conduit for flow by passing the area of blockage

A

coronary artery bypass graft

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11
Q

clinical diagnosis (MI)

A

troponin and CK MB (elevated)

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12
Q

The tempo and magnitude of appearance of these
serum markers after MI depends on several factors,
including the

A

volume of damaged myocardium, blood flow and lymphatic drainage in the area of the infarct,
the rate of elimination of the marker from the blood

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13
Q

STEMI

A

transmural

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14
Q

NSTEMI

A

subendocardial

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15
Q

earliest marker to become abnormal

A

myoglobin

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16
Q

CK-MB begins to rise within ______ hours of the onset
of MI, peaks at about __ hours, and returns to normal
within approximately ______hours

A

3-12 hrs;24hrs; 48-72 hrs

17
Q

is more sensitive than CK MB in coronary syndromes

18
Q

to induce vasodilation and reverse vasospasm

19
Q

to decrease myocardial oxygen demand and to
reduce the risk of arrhythmias, unless contraindicated
such as in heart failure

A

b blockers

20
Q

to salvage myocardium, by either fibrinolytic

medications or transcatheter interventions

A

prompt perfusion

21
Q

recommended initial therapy

A
o2 supplementation
Nitrates
Antiplatelet agents
Anticoagulant therapy
Bblockers
Prompt perfusion
Improve balance of supply vs demand for oxygen
22
Q

Early arryhthmia monitorung

A

morphine

ace inhibitors

23
Q

complications of MI

A
contractile dysfunction
Papillary muscle dysfxn
Right ventricular infarction
Myocardial rupture
Arryhthmia
Pericarditis
Chamber dilatation
Mural thrombus
Ventricular aneurysm
Progressive heart failure
24
Q

Chaotic depolarization without functional

ventricular contraction

A

ventricular fibrillation

25
``` If the atrial myocytes become “irritable” and depolarize independently and sporadically (as occurs with atrial dilation), the signals are variably transmitted through the AV node, leading to the random “irregularly irregular” heart rate. ```
atrial fibrillation
26
common cause
sick sinus syndrome atrial fibrillation heart block
27
1st degree heartblock
prolongation of PR interval
28
intermittent transmission of signal
2nd degree
29
are the most important of the primary abnormalities of the heart that predispose to arrhythmias.
channelopathies
30
are caused by mutations in genes that are required for normal ion channel function.
channelopathies
31
Often due to accumulated ischemic myocardial | damage
chronic ischemic heart disease
32
chronic ischemic heart disease microscopic findings
diffuse myocardial atrophy and | subendocardial vacuolization; diffuse interstitial fibrosis
33
progressive congestive heart failure as a consequence of accumulated ischemic myocardial damage and/or inadequate compensatory responses
chronic IHD
34
usually appears postinfarction due to the functional decompensation of hypertrophied non- infarcted myocardium
chronic IHD
35
because of the progressive narrowing of the coronary vessels
insidious development of CHF
36
leading cause of sudden cardiac death
CORONARY ARTERY DISEASE
37
can be the first manifestation of ischemic heart disease
SCD