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Cardiology Internal Med. > Ischemic Heart Diseases > Flashcards

Ischemic Heart Diseases Flashcards

1
Q

Name 2 predisposing condition for CAD

A

Atherosclerosis

Metabolic syndrome

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2
Q

What are the 8 major risk factors for atherosclerosis.

A 
Age
Smoking
HPN
DM
Decreased HDL(<40 mg/dl)
Age(F>55&amp;M>45)
Dyslipidemias
Family history of CAD
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3
Q

6 Emerging risk factors for Atherosclerosis?

A 
Hyperhomocystenimia
Increased CRP
Increased fibrinogen 
Increased Lp(a)
Sub clinical atherogenesis
Increased fasting glucose.
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4
Q

Explain the cause of hyperhomocytenemia?

A

Homocysteine is converted into methionine with the help of methionine synthase and vitamin B12 and folic acid.
So deficiency of VIT.B12 AND FOLIC ACID will cause increased homocysteine levels.

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5
Q

Metabolic syndrome/syndrome x/ insulin resistance syndrome can cause?

A

CAD AND DM

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6
Q

NCEP:ATP 3 CRITERIA FOR DIAGNOSING METABOLIC SYNDROME?

A

3/5 factors is enough to diagnose.

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7
Q

5 factors included in NCEP:ATP 3 CRITERION

A
  1. Central obesity/waist:hip ratio= male>102 cm and females>88cm
  2. HPN(135/85 mm of Hg)
  3. hypertriglyceridemia(>150mg/dl)
  4. Fasting plasma glucose(>100mg/dl)
  5. HDL (<40mg/dl)
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8
Q

Dietary distributions for fats in atherosclerotic patients?

A

Saturated-less than 7% of total calories
Monounsaturated- less than 10% of Total calories
Polyunsaturated-less than 20% of total calories.

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9
Q

Carbohydrates dietary distribution in atherosclerotic patients?
Protein dietary distributions?

A

50-60% carbs and 15% proteins.

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10
Q

Fiber allowance in atherosclerotic patients and its action in body?

A

20-30g/day

It decreases LDL and Total cholesterol

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11
Q

Salt allowance for atherosclerotic patients

A

6gm/day

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12
Q

Omega3FA action

A

Decrease TG

Decrease platelets aggregation.

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13
Q

Why omega3 FA is an important intake in atherosclerotic patients.

A

Platelet aggregation can cause thrombus formation and cause CAD and omega 3 FA helps in decreasing platelet aggregation.

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14
Q

Phytosterols and soy protein action?

A

Phytosterols decreases total cholesterol and soy proteins decrease triglycerides
Both decrease LDL.

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15
Q

Vitamin E action?

A

Its has oxidative susceptibility property and it also lowers down LDL.

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16
Q

Vitamin c action

A

It recycle vitamin e which is lowers down LDL and has oxidative susceptible properties.

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17
Q

According to American heart association when is alcohol anti atherogenic.

A

2 drinks for males and 1drinks for female per day.

1 drink=30ml

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18
Q

Alcohol action

A

Increases HDL

Decrease blood clotting factors

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19
Q

8 predictors for risk of CAD?

A

Increased- myeloperoxidase, Lp(a), CRP, homocysteine, fibrinogen, size of LDL, PAF-1, lipoprotein associated phospholipase A2

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20
Q

Best predictor for CAD

A

HsCRP
<1-low risk
1-3- moderate risk
>3 high risk

21
Q

2nd best predictor of CAD

A

LDL:HDL ratio

22
Q

Which Microbial organism is a risk factor for atherosclerosis?

A

Chlamydia pneumonia

23
Q

Explain values for LDL

A

<100 mg/dl optimal
100-129 near optimal
130-159 borderline high
160-189 high
>190 mg/dl Very high.

24
Q

HDL normal range

A

40-60mg/dl
<40(low)
>60( high)

25
Total cholesterol values
<200mg/dl Desirable 200-239. Borderline >240mg/dl. High
26
List the reasons for secondary dyslipidemias?
``` Smoking, alcohol, obesity Nephrotic syndrome Chronic kidney disease Obstructive chloestatic liver disease Type 2DM Hypothyroidism Drugs(thiazides, beta blockers, estrogen) ```
27
Name 5 types of hyperlipidemias
1. Familial hyperchylomicronemia 2a. Familial hypercholesterolemia 2b. Familal mixed hyperlipidemia 3. Familal dysbetalipoprotinemia 4. Familial hypertriglyceridemia 5. Familial mixed hypertriglyceridemia
28
Name 2 types of hyperlipidemias which are not risk factor for CAD?
Type 1. Familial hyperchylomicronemia | Type 5. Familial mixed hypertriglyceridemia (because LDL here is either decreased or normal but VLDL is high)
29
Name 2 renal pathology that causes secondary dyslipidemias?
Nephrotic syndrome(synthetic capabilities of liver increased due to protein loss >3500 mg/dl causing increased LDL synthesis) Chronic kidney disease (absence of lipoprotein lipase enzymes)
30
Name 2 endocrine pathology causing secondary dyslipidemias
Type 2DM | Hypothyroidism(due to decreased lipolysis)
31
Set of questions asked to patient who presents with angina
WHO Rose Angina Questionnaire
32
Which type of angina has recurrent type of pain
Prinizimental/vasospastic/variant angina
33
Sublingual nitrates are given in which type of angina?
Stable angina/angina of effort
34
Duration of chest pain in stable angina ?
5-10minutes
35
Duration of chest pain in unstable angina
>10 minutes
36
Duration of chest pain in vasospastic angina ?
5-15 minutes
37
Crescendo pattern of chest pain occurs in what type of angina?
Unstable angina
38
Explain wellen syndrome?
An ecg finding (deep T wave inversion of >2 mm) A medical emergency Indicates preinfaction stage
39
Left anterior descending artery stenosis is manifested in which condition?
Wellen syndrome(unstable angina)
40
Management of wellen syndrome
Angiogram and angioplasty
41
Tratment for vasospastic angina?
``` CaNFaSt Calcium channel blockers Nitrates Fasudil (a Rho kinase inhibitor) Statins And smoking cessation ```
42
Pathology of vasospastic angina?
Focal spasm of coronary artery smooth muscle (tunica media)
43
Which coronary artery is most commonly affected in Vasospastic angina?
Right coronary artery
44
Ecg finding that indicates vasospastic angina?
Transient ST elevations.
45
2 types of wellen syndrome
Type1- shows deep t wave inversion of >2 mm | Type2 shows biphasic t wave inversion
46
2 provocation tests for varient angina patients?
Acetylcholine injection test | Hyperventilation test
47
Most common times when varient angina patients experience pain?
Nights | Early morning
48
What type of angina shows deepT wave elevationsof >2mm (wellen syndrome)?
Unstable angina
49
What all dietary elements decreases LDL?
``` VitaminE Vitamin C Fiber Phytosterols Soy protein ```

Cardiology Internal Med. (10 decks)

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