Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

cardiology #2 > ischemic heart dz > Flashcards

ischemic heart dz Flashcards

1
Q

2 general causes of angina

A
  • demand is increased but theres inadequate flow d/t fixed obstruction (exertional angina, emotional upset angina)
  • demand is normal but supply decreased bc of a primary event
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

insufficient oxygen to supply the cardiac muscle

A

ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

pain/pressure caused by ischemia

A

angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

squeezing, grip like, suffocating heavy chest pain but NOT sharp or related to breathing; levine sign

A

typican angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

fist to chest d/t pain is what

A

levine sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

fist to chest d/t pain is what

A

levine sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

which group is more likely to feel atypical angina and what is that?

A
  • women more likely
  • no pain but nausea, burning, atypical location
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

things that may intensify ischemia

A
  • anemia
  • fever & infection
  • tachyarrhythmiaas
  • emotional stress
  • hypoxemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

sx of acute myocardial ischemia secondary to acute plaque rupture & carrying degrees of coronary artery thrombosis (occlusion)

A

ACS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

two ACS conditions of subtotal occlusion with ST depression &/or T wave inversions

A

UA, NSTEMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

positive cardiac enzymes is seen in which ACS conditions?

A

NSTEMI and STEMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

condition of total occlusion with ST elevation

A

STEMI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

most common cause of MI

A

atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

chest pain at rest with ACS indicates what level of occlusion

A

> 90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how does ECG progress with STEMI

A
  1. hyperacute T waves
  2. ST elevations
  3. pathologic Q wave
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

4 populations that troponin may be FALSELY elevated in

A
  • renal failure
  • advanced heart failure
  • acute PE
  • CVA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is OANM

A
  • oxygen
  • aspirin 325mg chewed
  • Nitroglycerin sublinual
  • Morphine IV NTG
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what test can be done to differntiate btwn UA and NSTEMI if you see ST depression &/or T wave inversion on ECG

A

cardiac enzymes
* will be + in NSTEMI and - in UA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

medication for cocaine related ACS

A

BZD for sx
standard therapies (aspirin, nitro)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

which class of med should be avoided in cocaine related ACS

A

beta blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

new onset severe chest pain < 2 month that is frequent (> 3x/day) should make you think of

A

unstable angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ischemic sx of ACS, negative cardiac markers +/- ECG ischemic changes

A

unstable angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

most common cause of unstable angina

A

plaque rupture causing incomplete coronary artery stenosis

24
Q

angina is unstable if it has any of these 3 things

A
  • rest angina lasting more than 20-30 mins
  • new onset angina
  • change in angina pattern
25
Q

what type of MI: type 1 or 2

spontaneous MI
* plaque rupture/erosion w/ occlusive or non-occlusive thrombus

A

type 1 MI

26
Q

what type of MI: type 1 or 2

something else triggers the problem (pneumonia, emotional upset, etc)
* atherosclerosis & oxygen supply/demand imbalance
* vasospasm or corooary microvascular dysfunction
* non-atherosclerotic coronary dissection
* o2 supply/demand imbalance alone

A

Type 2

27
Q
  • reduces events for pt w/ stabile angina
  • reduces short & long term odds of MI in Unstable angina
A

antiplatelet therapy

28
Q

what medication can be used if pt is intolerant to ASA but antiplatelet therapy is indicated

A

clopidogrel

29
Q

beta blockers are good as first line for control of ____ angina

A

exertional

CCB of equal efficacy too

30
Q

CCBs are mainstay therapy for ____ angina

A

vasospastic/Prinzmetal

31
Q

____ is effective in reducing exertional angina but can cause reflex tachycardia; works well with BB

A

nitrates

32
Q

unstable angina tx for admitted patients (3)

A
  • dual antiplatelets– Aspirin + P2Y12 receptor antagonist (Clopidrogrel)
  • anticoagulant– heparin
  • BB scheduled & nitrates PRN
33
Q

name the worst risk factor and also the most important modifiable risk factor for angina pectoris/stable angina

A
  • DM– worst risk factor
  • smoking– most modifiable risk factor
34
Q

substernal/retrosternal chest pain/discomfort that is poorly localized, exertional, short in duration; worse w/ activity and relieved with rest or nitroglycerin

A

angina pectoris/stable angina

35
Q

3 tests used in diagnosing stable angina

A
  • ECG
  • stress testing
  • coronary angiography
36
Q

most important noninvasive testing used in diagnosing stable angina

A

stress testing

37
Q

definitive diagnostic test for stable angina that defines location and extent of CAD

A

coronary angiography

38
Q

4 drugs used in secondary prevention tx regimen

A
  • aspirin + BB
  • sublingual nitroglycerin PRN
  • daily statin

should also reduce risk factors like HTN, DM, smoking, diet/exercise

39
Q

definitive management of stable angina (2)

A
  • percutaneous transluminal coronary angioplasty (PCTA)
  • coronary artery bypass graft

both are “revascularization”

40
Q

angina pectoris

which revascularization procedure is used with 1 or 2 vessel dz in non-DM not invoving left main coronary artery & w/ normal ejection fraction

A

PTCA

41
Q

which revascularization is used with left main coronary artery stenosis, 3 vessel dz or w/ 2 for DM, ejection fraction < 40%

A

coronary artery bypass graft

42
Q

when can you give morphine IV in patient w/ MI

A

when pain isnt responding to nitro

43
Q

pt w/ MI but w/o shock, pulmonary congestion or bradycardia should get what adjuctive tx?

A

IV BB

44
Q

pt w/ MI + bradycardia complications involving AV and sinus node should get what ?

A

atropine

45
Q

early complications of MI (5)

A
  • v. fib
  • ventricular aneurysm
  • cardiogenic shock
  • heart failure
  • LV wall rupture
46
Q

____ reduces angina but does not reduce mortality in stable patients compared to medical manage; does not lower long term risk for subsequent MI

A

PCI (PTCA)

47
Q

**best **w/in 3hrs of sx onset & superior to thrombolytics in tx of STEMI

A

PCI (PCTA)

48
Q

reperfusion via PCI or thrombolytics is best done w/in ____ of sx onset or if ongoing chest pain

A

12 hrs

49
Q

used when theres > 120 min delay from FMC to primary PCI or if PCI is not an option

A

fibrinolytic therapy

50
Q

what is the difference between antithrombotics and thrombolytics (fibrinolytics)

A
  • antithrombotics prevent new clots, the other dissolves them
51
Q

Spontaneous episodes of angina accompanied by transient ECG ischemic ST changes d/t epicardial coronary artery vasospasm, leading to transient myocardial ischemia

A

vasospastic/prinzmetals angina

52
Q

coronary artery vasospasm causing ST segment elevation & transmural ischemia; **endothelial dysfunction **

A

pathophys of vasospastic angina

53
Q

name 3 triggers of vasospastic angina

A
  • cold weather
  • alpha-agonists
  • hyperventilation
54
Q

Chest pain mainly at rest usually not triggered by exertion nor relieved with rest in younger patient w/ few or no CV risk factors; episodes last 5-15mins

A

vasospastic angina

55
Q

likely condition?

  • ECG shows Transient ST elevations in pattern of affected artery that resolve w/ sx resolution
  • Angiography r/o CAD & has no evidence of high grade stenosis
A

vasospastic angina

56
Q

this is used to treat what?

  • no smoking
  • CCB
  • SL nitroglycerin PRN
A

vasospastic angina

cardiology #2 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions