Heart Disease

Question 1

Which type of hypertension is very common, accounts for 90-95% of hypertensive patients and does not have an obvious cause?

Answer 1

Essential Hypertension

*likely caused by high sodium retention, causing increase pressure

Question 2

Which uncommon type of hypertension is caused by endocrine, drug, pregnancy, renal failure, sleep apnea or renal artery stenosis causing stress resulting in high pressure?

Answer 2

Secondary hypertension

*accounts for 5-10% of hypersensitive patients

Question 3

What are 5 risk factors for getting essential hypertension?

Answer 3

1-Increasing age
2-Black
3-Obesity/metabolic syndrome
4-High salt
5-Lack of physical activity

Question 4

What are 4 hypertension induced problems?

Answer 4

1-Accelerated atherosclerosis
2-Heart failure
3-Renal failure
4-Retinal/brain damage

Question 5

Hypertension causing the kidneys to become smaller and finely pitted is more common in what race?

Answer 5

Blacks

Question 6

Hypertensive brain hemorrhage is more common in what race?

Answer 6

Asians

Question 7

Hyperlipidemia is a risk factor for many atherosclerotic diseases. what are the 4 major lipoproteins of the blood?

Answer 7

1-High Density (HDL)-deliver peripheral lipids to liver
2-Low density (LDL) deliver lipids from liver to periphery
3-Very low density (VLDL) same as LDL
4-Chylomicrons (delivers lipids from gut to liver)

Question 8

Hardening of the arteries is called?

Answer 8

Arteriosclerosis

Question 9

Lipid deposits/plaques in arteries is the most common kind of arteriosclerosis and called what?

Answer 9

Atherosclerosis

Question 10

What are the 5 steps for developing Fibroatheroma with stenosis?

Answer 10

1-Endothelial dysfunction
2-Lipid deposit in vessel wall intima
3-Inflammation/foamy macrophages
4-Intimal smooth miscle,fibrosis
5-Fibroatheroma with stenosis causing angina, claudication etc.

Question 11

How is a thrombosis formed in atherosclerosis?

Answer 11

Lipid deposits in intima cause inflammation/foamy macrophages resulting in a plaque ulcer or rupture that thromboses

Question 12

___% stenosis clinically impedes the flow of blood and increases resistance ____ fold

Answer 12

75, 16 fold

Question 13

What are the 6 most common areas for arteriosclerosis to happen?

Answer 13

1-Aorta (most common)
2-Coronary arteries (biggest killer)
3-Iliac, femoral, popliteal arteries
4-Carotid/circle of willis (stroke)
5-Kidney
6-Pulmonary arteries

Question 14

Though the aorta does not become occluded, damage to the media can cause an aneurysm called what?

Answer 14

Abdominal aortic aneurysm

Question 15

What causes 80% of hear diseases such as angina, infarct, chronic ischemic heart disease and is hard to predict infarct risk for?

Answer 15

Coronary Atherosclerosis

Question 16

Claudication, ulcers and gangrene can be caused by what?

Answer 16

Peripheral artery disease (iliac, femoral, popliteal arteris)

Question 17

Erosions rather than ruptures of plaque is the more common cause of thrombus/stroke in what area?

Answer 17

Carotid/Circle of willis

Question 18

An abrupt onset focal or global neurological symptom causing ischemia or hemorrhage is called?

Answer 18

Stroke

*symptoms for more than 24 hours causes brain damage. Transient Ischemic attack if less than 24 hours

Question 19

What is the most frequent stroke subtype?

Answer 19

Cerebral infarct (60-80%)

*Intracerebral and subarachnoid hemorrhage less common

Question 20

Hyaline arteriosclerosis and proliferative arteriolosclerosis (onion skin change) happen where?

Answer 20

Kidneys

Question 21

What are 6 main risk factors for atherosclerosis?

Answer 21

1- Age and gender (>45 m, >55 f, post menoposal/low estrogen)
2-Smoking
3-Diabetes/metabolic syndrome
4-Hypertension
5-Dyslipidemia
6-Genetic risk factors

Question 22

What oral disease does atherosclerosis have association with?

Answer 22

Periodontal disease

Question 23

What is the main cause of predictable pain like angina and claudication?

Answer 23

Stenosis

Question 24

____ causes gradual blood flow reduction, _____ is an abrupt stop of blood flow

Answer 24

Slow stenosis

Thrombus/disrupted plaque

Question 25

Paroxysmal attacks of chest pain, radiating pain and myocardial ischemia is characteristic of what?

Answer 25

Angina Pectoris

Question 26

Pain related to exertion relieved by rest or vasodilators usually due to fixed coronary stenosis is called?

Answer 26

Stable Angina

*S-T segment depression

Question 27

Classically occurring at rest, what is a brief reversible spasm chest pain called?

Answer 27

Variant or Prinzmetal’s Angina

*ST segment elevation or depression

Question 28

New or worsening prolonged chest pain at rest is called?

Answer 28

Unstable angina

Question 29

Chest pain, dyspnea (short of breath) diaphoresis, nausea, palpitations and anxiety are symptoms of what?

Answer 29

Myocardial Infarct

Question 30

What are the 4 criteria, 2 of which must be met to be a Myocardial infarct?

Answer 30

1-Ischemic type ches pain more than 20 min
2-Acute EKG changes
3-Rising, then falling serum cardiac biomarkers
4-Pathologic documentation of infarct at autopsy

Question 31

Unexpected death within 1 hour of cardiac event usually due to high grade coronary stenosis is called?

Answer 31

Sudden Cardiac Death