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IM > IHD > Flashcards

IHD Flashcards

1
Q

Cornerstone in the diagnosis of acute and chronic IHD

A

ECG

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2
Q

MC underlying cause of myocardial ischemia and injury

A

obstruction of coronary arteries by atherosclerosis

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3
Q

Infection associated w/ ACCELERATED atherosclerosis

A

Chlamydophila pneumoniae

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4
Q

MC cause of anterior chest musculoskeletal pain

A

costochondral and chondrosternal syndromes

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5
Q

Myocardial perfusion occurs during this time

A

diastole

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6
Q

The initial lesion of atherosclerosis

A

fatty streak

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7
Q

Major features of METABOLIC SYNDROME

A 
central obesity
hyperglycemia
hypertriglyceridemia
hypertension
low HDL cholesterol
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8
Q

Age when lipid screening should start

A

> 20 years (fasting lipid profile: total cholesterol, TGL, LDL and HDL

repeated every 5 years

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9
Q

Key feature of metabolic syndrome

A

central adiposity

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10
Q

Most accepted and unifying hypothesis to describe pathophysiology of metabolic syndrome

A

Insulin resistance

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11
Q

Driving force behind metabolic syndrome

A

obesity

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12
Q

MC cause of myocardial ischemia

A

atherosclerotic disease of epicardial coronary artery

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13
Q

MC major vessel involved in MI

A

LAD artery

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14
Q

Sites of predilection for atherosclerotic plaques to develop d.t. increased turbulence

A

branch points in the EPICARDIAL ARTERIES

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15
Q

Time frame for REVERSIBLE damage in myocardium

A

< 20 mins for total occlusion in the absence of collaterals

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16
Q

Most widely used test for both the diagnosis of IHD and estimating the prognosis

A

electrocardiographic stress testing

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17
Q

MC pathophysiologic cause of UNSTABLE angina

A

plaque rupture or erosion w/ superimposed non-occlusive thrombus

18
Q

ABSOLUTE CONTRAINDICATIONS to NITRATE use

A

hypotension

sildenafil (or similar drug) in previous 24-48 hrs

19
Q

MC artery involved in Prinzmetal Angina

A

RCA

20
Q

Main agents for acute episodes and to abolish recurrent episodes of Prinzmetal’s angina

A

nitrates and calcium blockers (Nifedipine)

21
Q

Necrosis seen in MI

A

COAGULATION necrosis (preserved architecture, faded details)

22
Q

Earliest detectable feature of MYOCYTE NECROSIS

A

sarcolemmal membrane disruption (leads to leakage of cardiac enzymes into circulation)

23
Q

Time frame where GROSS changes in MI occur

A

12 hrs after the onset of symptoms

24
Q

Color changes in MI

A

4 hrs - mottling
1 wk - bright yellow
2 wks - surrounding red granulation tissue
2 mos - gray-white scar

25
Q

Fibrinous Pericarditis post MI

A

Dressler syndrome

26
Q

Sites of myocardial rupture in MI

A

free wall > IVS > papillary muscle

27
Q

Preferred biochemical markers for MI

A

cardiac specific troponin T and cardiac specific troponin I

28
Q

Preferred biochemical markers for re-infarction

A

CK-MB

29
Q

Level of coronary artery stenosis sufficient to produce ischemia

A

70% (critical stenosis)

30
Q

Primary cause of OUT-OF hospital deaths from STEMI

A

ventricular fibrillation

31
Q

Primary cause of IN hospital deaths from STEMI

A

pump failure

32
Q

Greatest delay usually occurs between

A

onset of pain and patient’s decision to call for help

33
Q

Principal goal of FIBRINOLYSIS

A

prompt restoration of full coronary arterial patency

34
Q

Extent of LV involvement that results in cardiogenic shock

A

infarction > 40%

35
Q

MC complication of ANGIOPLASTY

A

restenosis

36
Q

MC thrombi found in NSTEMI (composed mainly of platelets)

A

white thrombi

37
Q

MC thrombi found in STEMI (composed mainly of cells and fibrin )

A

red thrombi

38
Q

MC cause of sudden cardiac death

A

CAD

39
Q

MC arrhythmia post-MI

A

PVC

40
Q

MC lethal arrhythmia post-MI

A

ventricular fibrillation

IM (66 decks)

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