Ischemic Heart Disease and ACS Flashcards

1
Q

_____ angina: discomfort which is new in onset, increased in duration, frequency, or intensity with less exertion or at rest

A

Unstable

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2
Q

_____ angina: present when there is increased demand for myocardial oxygen in a reproducible fashion

A

Stable

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3
Q

_____ plaque: cause angina and claudication (exertional ischemia) if obstructive (>70%)

A

Stable

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4
Q

_____ plaque: cause MI and stroke

A

Unstable

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5
Q

_____ plaque: less biologically active

A

Stable

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6
Q

_____ plaque: less fibrous tissue, less calcified, more lipid content, more inflammation, more apoptosis

A

Unstable

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7
Q

_____ plaque: less likely to cause thrombotic or embolic events

A

Stable

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8
Q

_____ plaque: more biologically active

A

Unstable

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9
Q

_____ plaque: more likely to cause damage via thrombotic or embolic mechanisms

A

Unstable

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10
Q

_____ plaque: rich in fibrous tissue, calcified, less lipid content, less inflammation, less apoptosis

A

Stable

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11
Q

______ artery is most susceptible to atheroembolism from a carotid bifurcation lesion.

A

Ophthalmic

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12
Q

BNP is good at ruling __ (in/out) ACS.

A

out

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13
Q

Cardiac peptide released in response to increased stretch or ventricular volume

A

BNP

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14
Q

Complications of aneurysm (2)

A

Thromboembolism, Dissection

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15
Q

Determinants of Myocardial Oxygen Demand (3)

A

Heart Rate, Wall Tension, Inotropic state

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16
Q

Determinants of Myocardial Oxygen Supply (4)

A

Perfusion Pressure, Perfusion Time, Vascular Resistance, Oxygen Content of Blood

17
Q

EKG changes in NSTEMI

A

ST depression; possible T wave inversion

18
Q

EKG changes in STEMI

A

ST elevation

19
Q

EKG changes in UA

A

May have ST depression

20
Q

Heart Disease Drugs: Anti-anginal agents

A

Nitrates, Beta-Blockers, Ca-Channel Blockers

21
Q

Heart Disease Drugs: lipid-lowering medications

A

statins

22
Q

Heart Disease Drugs: LV dysfunction

A

ACEIs or ARBs

23
Q

Ischemic Response manifestation on ECG

A

ST depression

24
Q

MI tissue changes: 1 day

A

Gross: Pallor, Micro: Neutrophils

25
Q

MI tissue changes: 1 week

A

Gross: Pallor, Micro: Macrophages

26
Q

MI tissue changes: 10 days

A

Gross: yellow, soft, sunken, Micro: Granulation tissue

27
Q

MI tissue changes: 2 months

A

Gross: firm gray scar, Micro: fibrosis

28
Q

MI tissue changes: 4 hours

A

Gross: N/A, Micro: coagulation necrosis

29
Q

Most important serum biomarkers in MI

A

TnI and TnT

30
Q

Time when rupture of ventricular wall is most likely following AMI

A

Within 2 weeks

31
Q

Treatment of NSTEMI and UA (other than cath lab)

A

Anticoagulation (Heparin, etc.), Anti-platelet (aspirin, P2Y12 Inhibitor), Oral Beta-blockers or Nitrates (Reduce myocardial oxygen demand)

32
Q

What pathology? ______ myocardial infarction (______MI): partial coronary vessel occlusion with myocardial necrosis

A

Non-ST Elevation; NSTEMI

33
Q

What pathology? ________ myocardial infarction (_____MI): complete coronary vessel occlusion

A

ST Elevation; STEMI

34
Q

What pathology? calcification of muscular arteries

A

Monckeberg’s medial calcific sclerosis

35
Q

What pathology? claudication and acute limb ischemia

A

Peripheral Arterial Disease

36
Q

What pathology? partial coronary vessel occlusion, escalating symptoms, no myocardial necrosis

A

Unstable Angina

37
Q

What pathology? vasospasm causing chest pain at rest (sleep)

A

Prinzmetal’s (Variant) Angina