HEART 2.2

Question 1

usually used in thrombolytic therapy

Answer 1

streptokinase or tissue-type plasminogen activator

Question 2

factors that contribute to reperfusion injury include:

Answer 2

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

Question 3

Microscopically, irreversibly damaged myocytes after

reperfusion develop

Answer 3

contraction band necrosis

Question 4

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

Answer 4

contraction bands

Question 5

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

Answer 5

stunned myocardium

Question 6

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

Answer 6

hibernation

Question 7

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

Answer 7

reperfusion

Question 8

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

Answer 8

thrombolysis

Question 9

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

Answer 9

angioplasty

Question 10

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

Answer 10

coronary artery bypass graft

Question 11

clinical diagnosis (MI)

Answer 11

troponin and CK MB (elevated)

Question 12

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

Answer 12

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

Question 13

STEMI

Answer 13

transmural

Question 14

NSTEMI

Answer 14

subendocardial

Question 15

earliest marker to become abnormal

Answer 15

myoglobin

Question 16

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

Answer 16

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

Question 17

is more sensitive than CK MB in coronary syndromes

Answer 17

troponin

Question 18

to induce vasodilation and reverse vasospasm

Answer 18

nitrates

Question 19

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

Answer 19

b blockers

Question 20

to salvage myocardium, by either fibrinolytic

medications or transcatheter interventions

Answer 20

prompt perfusion

Question 21

recommended initial therapy

Answer 21

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

Question 22

Early arryhthmia monitorung

Answer 22

morphine

ace inhibitors

Question 23

complications of MI

Answer 23

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

Question 24

Chaotic depolarization without functional

ventricular contraction

Answer 24

ventricular fibrillation

Question 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.

Answer 25

atrial fibrillation

Question 26

common cause

Answer 26

sick sinus syndrome
atrial fibrillation
heart block

Question 27

1st degree heartblock

Answer 27

prolongation of PR interval

Question 28

intermittent transmission of signal

Answer 28

2nd degree

Question 29

are the most important of the
primary abnormalities of the heart that predispose to
arrhythmias.

Answer 29

channelopathies

Question 30

are caused by mutations in
genes that are required for normal ion
channel function.

Answer 30

channelopathies

Question 31

Often due to accumulated ischemic myocardial

damage

Answer 31

chronic ischemic heart disease

Question 32

chronic ischemic heart disease microscopic findings

Answer 32

diffuse myocardial atrophy and

subendocardial vacuolization; diffuse interstitial fibrosis

Question 33

progressive congestive heart failure as a
consequence of accumulated ischemic myocardial
damage and/or inadequate compensatory responses

Answer 33

chronic IHD

Question 34

usually appears postinfarction due to the functional decompensation of hypertrophied non- infarcted myocardium

Answer 34

chronic IHD

Question 35

because of the progressive narrowing of the coronary vessels

Answer 35

insidious development of CHF

Question 36

leading cause of sudden cardiac death

Answer 36

CORONARY ARTERY DISEASE

Question 37

can be the first manifestation of ischemic heart disease

Answer 37

SCD