Lecture review 3

Question 1

Chylomicron

• made by what
• rich in what?

Answer 1

○ Made by GI tract after you digest cholesterol
○ Super triglyceride rich
○ Large, light, buoyant, fluffy particles

Question 2

VLDL

• rich in what?
• progress to what?

Answer 2

○ Triglyceride rich
○ Usually progresses to LDL and has a spectrum of size
○ Looks similar to chylomicron but not as light and fluffy

Question 3

LDL

- rich in what?

Answer 3

Primarily cholesterol

Question 4

HDL

- rich in what?

Answer 4

○ Little triglyceride

○ Decent cholesterol + protein

Question 5

4 groups that benefit from Statin

Answer 5

1. indiv w. known clinical ASCVD
2. Indiv w. LDL > 190 mg/dl
3. Indiv w. diabetes (>40 and ldl >70)
4. Indiv (>40 and ldl >70) w/o ASCVD or diabetes but has estimated 10 year ASCVD risk > 7.5

Question 6

How do these interact w/ VCAM-1

CD11c:
VLA-4:

Answer 6

CD11c cross links the VCAM-1

VLA-4 Binds to VCAM-1

Question 7

Which artery has a predilection for atherosclerosis (PAD)?

Answer 7

Superficial femoral

Question 8

Risk Factors of PAD:

Answer 8

○ Diabetes (4x increase)
○ Smoking (2-3x increase)
○ Lipids (2x increase)
○ Hypertension (2x increase)

Question 9

Mechanism of Aneurysm Formation:

Proteolytic enzymes found

Answer 9

○ ↑ MMP-2, MMP-9
○ ↑ uPa, tPa
○ ↓ TIMPs

Question 10

What % of pts with AAA are asymptomatic?

What % of VTE are asymptomatic?

Answer 10

70%!!! - then present with sudden death O.O
• 30% present with abdominal discomfort or severe pain radiating to the back, then die

VTE: 2/3s are asymptomatic

Question 11

AAA with 5cm diameter has what 5 year risk?

Answer 11

25 %

Question 12

What % of pts w/ depression have CV problems?

Answer 12

25%

30% for PAD

Question 13

cyclothymia

Answer 13

presented w/:
hypomania
subsyndromal depression

Question 14

What % of pts w/ depression have CV problems?

how many times more likely are they to die from HD?

Answer 14

25%
(30% for PAD)

3x more likely

Question 15

How much is Depression is under-recognized and under-treated in CV patients

Answer 15

75.5% unrecognized

Question 16

If PHQ9 is >10 what does that indicate?

what if you answer yes to one of the 2 main questions?

Answer 16

○ Score >10 is 88% sensitive and 88% specific for Major Depression

○ “YES” to one = 90% sensitive, 70% specific
“NO” to both effectively rules out depression

Question 17

Does Glycemic control in indiv with diabetes reduce MI outcomes?

Answer 17

does not reduce MI outcomes, and may cause harm

Question 18

• Smokers have _____ higher rates of all cause and cardiac mortality
  * Smoking confers ____ higher absolute rates of mortality among those with a prior MI

Answer 18

60%

6-10%

Question 19

Metabolic syndrome:

Answer 19

• Central obesity (apple shaped)
  
  • ↑ BP
  • ↑ TG
  • ↓ HDL cholesterol
  • Insulin resistance

Question 20

Blood flow

1. Umbilical vein
2. The Vitelline vein
3. The Cardinal vein

Answer 20

1. Umbilical vein- from the placenta (Disappears after birth) into the embryo
2. The Vitelline vein - nutrients from the yolk sac to the embryo
3. The Cardinal vein - drains the embryo

Question 21

Wall stress is inversely proportional to _______ and directly proportional to ______

Answer 21

Ventricular wall thickness (bc F is spread over a greater muscle mass)

Radius of LV (bc LV filling will raise wall stress and O2 consumption)

Question 22

Ischemic Threshold

Answer 22

RPP where signs of myocardial ischemia occur

• More severe ischemia occurs at a lower RPP !

Question 23

T/F exercise training in coronary disease patients improves myocardial blood flow

Answer 23

False. It only improves total body exercise capacity