Ineffective Tissue Perfusion: Coronary Artery Disease Flashcards
What is the primary cause of coronary artery disease (CAD)?
A) Hypertension
B) Atherosclerosis
C) Valvular stenosis
D) Pulmonary embolism
B) Atherosclerosis
Rationale: Atherosclerosis leads to the narrowing or blockage of coronary arteries, reducing blood flow and oxygen supply to the heart muscle, which can cause ischemia and angina.
What happens to the heart when blood flow temporarily diminishes in the coronary arteries?
A) The heart rate increases permanently
B) Myocardial oxygen supply increases
C) Ischemia occurs, leading to lactic acid buildup and chest pain
D) The heart stops immediately
C) Ischemia occurs, leading to lactic acid buildup and chest pain
Rationale: Reduced blood flow to the heart leads to ischemia, which causes anaerobic metabolism, leading to lactic acid accumulation and chest pain.
What are the four types of angina associated with coronary artery disease (CAD)?
A) Stable, unstable, Prinzmetal, silent
B) Acute, chronic, metabolic, nonmetabolic
C) Thrombotic, embolic, stenotic, hypertrophic
D) Systolic, diastolic, ischemic, nonischemic
A) Stable, unstable, Prinzmetal, silent
Rationale: The types of angina include:
Stable angina – occurs with exertion, relieved by rest
Unstable angina – occurs at rest, more severe, high risk of MI
Prinzmetal angina – caused by coronary vasospasm, occurs unpredictably
Silent ischemia – asymptomatic, detected via EKG changes
Which laboratory test is most specific for diagnosing myocardial infarction (MI) in a patient with suspected CAD?
A) BNP (B-type natriuretic peptide)
B) D-dimer
C) Troponin
D) Creatinine
C) Troponin
Rationale: Troponin is the most sensitive and specific cardiac biomarker for detecting myocardial infarction and cardiac muscle damage.
Application-Based
Question: A patient presents with chest pain, nausea, sweating, and dyspnea. His EKG shows ST-segment depression, and his troponin levels are normal. What is the most likely diagnosis?
A) Stable angina
B) Myocardial infarction (MI)
C) Heart failure
D) Pulmonary embolism
A) Stable angina
Rationale: ST-segment depression without troponin elevation suggests ischemia without infarction, which is consistent with stable angina.
Knowledge-Based
Question: Which diagnostic tests are commonly used to assess coronary artery disease (CAD)?
A) Pulmonary function tests and ABGs
B) Colonoscopy and barium swallow
C) Echocardiogram, EKG, stress test, troponin
D) Brain MRI and EEG
C) Echocardiogram, EKG, stress test, troponin
Rationale: CAD is diagnosed using an EKG (for ischemic changes), echocardiogram (for heart function), stress testing (for exertional ischemia), and troponin levels (for myocardial damage).
Application-Based
Question: A 55-year-old patient with a history of hypertension and hyperlipidemia presents with chest pain that occurs during exercise but is relieved with rest. What is the most likely diagnosis?
A) Pulmonary embolism
B) Stable angina
C) Unstable angina
D) Aortic dissection
B) Stable angina
Rationale: Stable angina is exertional chest pain caused by temporary ischemia, which improves with rest and nitroglycerin.
Which of the following statements about unstable angina is true?
A) It is relieved by rest and nitroglycerin
B) It occurs unpredictably, even at rest
C) It is caused by a temporary vasospasm
D) It has no association with myocardial infarction
B) It occurs unpredictably, even at rest
Rationale: Unstable angina occurs at rest or with minimal exertion and indicates a high risk of myocardial infarction (MI).
A patient presents with chest pain, diaphoresis, and nausea. He has ST-segment elevation on EKG. What is the most appropriate initial intervention?
A) Administer nitroglycerin and send home
B) Order a stress test
C) Activate emergency response and prepare for reperfusion therapy
D) Give ibuprofen for pain management
C) Activate emergency response and prepare for reperfusion therapy
Rationale: ST-segment elevation suggests an acute myocardial infarction (STEMI), requiring emergency reperfusion therapy (PCI or thrombolytics).
Which medications are commonly used to reduce the risk of myocardial infarction (MI) in patients with CAD?
A) Statins, beta-blockers, aspirin
B) Antibiotics, antivirals, antifungals
C) Diuretics, insulin, corticosteroids
D) Proton pump inhibitors, laxatives, acetaminophen
A) Statins, beta-blockers, aspirin
Rationale: Statins reduce cholesterol, beta-blockers lower heart workload, and aspirin prevents clot formation, all reducing the risk of MI.
A 48-year-old female presents with jaw pain, nausea, and fatigue but no chest pain. What should the healthcare provider suspect?
A) Acid reflux
B) Migraine headache
C) Atypical presentation of myocardial infarction (MI)
D) Panic attack
C) Atypical presentation of myocardial infarction (MI)
Rationale: Women with MI often have atypical symptoms like jaw pain, nausea, fatigue, and dyspnea instead of classic chest pain.
Prinzmetal angina is caused by:
A) Atherosclerosis
B) Coronary vasospasm
C) Aortic stenosis
D) Pulmonary embolism
B) Coronary vasospasm
Rationale: Prinzmetal angina (variant angina) is caused by sudden vasospasms of the coronary arteries, often occurring at rest.
A 60-year-old patient is diagnosed with coronary artery disease and is prescribed statins. What is the primary purpose of this medication?
A) Lower LDL cholesterol
B) Increase heart rate
C) Reduce blood sugar
D) Treat chest pain
A) Lower LDL cholesterol
Rationale: Statins reduce LDL cholesterol, slowing the progression of atherosclerosis and decreasing the risk of MI and stroke.
