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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
Q

Total cholesterol values

A

<200mg/dl Desirable
200-239. Borderline
>240mg/dl. High

26
Q

List the reasons for secondary dyslipidemias?

A 
Smoking, alcohol, obesity 
Nephrotic syndrome 
Chronic kidney disease 
Obstructive chloestatic liver disease 
Type 2DM
Hypothyroidism 
Drugs(thiazides, beta blockers, estrogen)
27
Q

Name 5 types of hyperlipidemias

A
  1. Familial hyperchylomicronemia
    2a. Familial hypercholesterolemia
    2b. Familal mixed hyperlipidemia
  2. Familal dysbetalipoprotinemia
  3. Familial hypertriglyceridemia
  4. Familial mixed hypertriglyceridemia
28
Q

Name 2 types of hyperlipidemias which are not risk factor for CAD?

A

Type 1. Familial hyperchylomicronemia

Type 5. Familial mixed hypertriglyceridemia (because LDL here is either decreased or normal but VLDL is high)

29
Q

Name 2 renal pathology that causes secondary dyslipidemias?

A

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
Q

Name 2 endocrine pathology causing secondary dyslipidemias

A

Type 2DM

Hypothyroidism(due to decreased lipolysis)

31
Q

Set of questions asked to patient who presents with angina

A

WHO Rose Angina Questionnaire

32
Q

Which type of angina has recurrent type of pain

A

Prinizimental/vasospastic/variant angina

33
Q

Sublingual nitrates are given in which type of angina?

A

Stable angina/angina of effort

34
Q

Duration of chest pain in stable angina ?

A

5-10minutes

35
Q

Duration of chest pain in unstable angina

A

> 10 minutes

36
Q

Duration of chest pain in vasospastic angina ?

A

5-15 minutes

37
Q

Crescendo pattern of chest pain occurs in what type of angina?

A

Unstable angina

38
Q

Explain wellen syndrome?

A

An ecg finding (deep T wave inversion of >2 mm)
A medical emergency
Indicates preinfaction stage

39
Q

Left anterior descending artery stenosis is manifested in which condition?

A

Wellen syndrome(unstable angina)

40
Q

Management of wellen syndrome

A

Angiogram and angioplasty

41
Q

Tratment for vasospastic angina?

A 
CaNFaSt
Calcium channel blockers 
Nitrates 
Fasudil (a Rho kinase inhibitor)
Statins 
And smoking cessation
42
Q

Pathology of vasospastic angina?

A

Focal spasm of coronary artery smooth muscle (tunica media)

43
Q

Which coronary artery is most commonly affected in Vasospastic angina?

A

Right coronary artery

44
Q

Ecg finding that indicates vasospastic angina?

A

Transient ST elevations.

45
Q

2 types of wellen syndrome

A

Type1- shows deep t wave inversion of >2 mm

Type2 shows biphasic t wave inversion

46
Q

2 provocation tests for varient angina patients?

A

Acetylcholine injection test

Hyperventilation test

47
Q

Most common times when varient angina patients experience pain?

A

Nights

Early morning

48
Q

What type of angina shows deepT wave elevationsof >2mm (wellen syndrome)?

A

Unstable angina

49
Q

What all dietary elements decreases LDL?

A 
VitaminE
Vitamin C
Fiber
Phytosterols 
Soy protein

Cardiology Internal Med. (10 decks)

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