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Cardiovascular 01.15 > M.I. 01.15 > Flashcards

M.I. 01.15 Flashcards

1
Q

Conversion of arachadonic acid in cell membranes to prostaglandin h2 (prostoglandin precursor) is by which enzyme?

A

COX - cyclo oxygenase

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2
Q

This enzyme converts prostaglandin H2 into Prostacyclin, PGE2 and PGD/PGF

A

Cox 1

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3
Q

This enzyme in platelets converts prostaglandin H2 into Thromboxane A2

A

Cox 2

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4
Q

Thromboxane A2 is bad for the CVS in 2 ways

A
  1. Platelet agonist - promotes clots

2. Vasoconstrictor

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5
Q

Arachidonic acid is converted to Leukotrienes (causing broncho constriction) by which enzyme

A

Lipo oxygenase

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6
Q

Which prostaglandin is protective for the stomach

A

PGE2

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7
Q

What 3 groups of prostaglandins

are converted from prostaglandin H2 (PGH2) by COX1, & have what 3 main effects?

A
  1. PDG / PGF - pro inflammatory, pain fever
  2. PGE2 - protective for stomach
  3. PGI2/ Prostacyclin - protective for vasculature -platelet inhibition & vasodilation
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8
Q

What 3 main effects do non-selective NSAIDs have on body e.g. Aspirin, Ibuprofen

A
  1. Reduce inflammation
  2. Reduce stomach protection - GI irrit.
  3. Reduce thromboxane prod - prevent platelet function
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9
Q

Celecoxib, Meloxicam, Etodolal are all examples of what type of NSAID

A

Cox 2 selective

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10
Q

This is a pro-drug, activated by CYP450, which blocks ADP receptor on platelets, thus preventing platelet activation

A

Clopidogrel

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11
Q

How do ACE inibitors control BP

A

Prevent conversion of angiotensin I to angiotensin II

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12
Q

Digoxin is an example of what type of inotrope

A

Positive - increases contractility of heart

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13
Q

Bisoprolol is an example of what type of inotrope

A

Negative - decreases contractility of heart

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14
Q

Familial hypercholesterolaemia (IIa) is associated with disorder of which chromasome?

A

19

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15
Q

These lipoproteins carry fat from the intestine - they release triglycerides & some cholesterol in the liver.

A

Chylomicrons

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16
Q

These lipoproteins transport cholesterol back to the liver for excretion and are associated with better health outcomes.

A

HDL

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17
Q

Unburned food metabolites are converted into this and secreted into the plasma by the liver

A

VLDL

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18
Q

3 main ingredients of chylomicrons?

A

Long chain f.a.s
Cholesterol
Protein

19
Q

Frederickson type II lipid disorder assoc with what condition

A

Lipoprotein lipase deficiency

20
Q

Frederickson type IIa lipid disorder assoc with what condition? (among others)

A

Familial hypercholesterolaemia

21
Q

Frederickson type IIb lipid disorder assoc with what condition

A

Familial combined

hyperlipidemia

22
Q

Frederickson type III lipid disorder assoc with what condition

A

Dysbetalipoproteine

mia

23
Q

Frederickson type IV lipid disorder assoc with what condition (among others)

A

Familial

hypertriglyceridemia

24
Q

Frederickson type V lipid disorder assoc with what condition

A

Diabetes

25
Q

Diff between primary and secondary hyperlipidaemia?

A

1ary - inherited / genetic

2ary - assoc with other conditions e.g diabetes

26
Q

These 3 conditions (and many more) are assoc with 2ary hyperlipidaemia

A

DM
Hypothyroidism
Nephrotic syndrome

27
Q

Why should pregnant women be aware of their cholesterol

A

Risk of hyperlipidaemia

28
Q 
What 2 conditions may be assoc with these signs:
•tendinous xanthomas
•corneal arcus
•premature CAD
•family history of hypercholesterolemia
A
  1. Heterozygous familial hypercholesterolaemia

2. Familial defective apolipoprotein B

29
Q 
What condition is assoc with:
•usually >30 yr old
•often overweight
•usually no xanthomas
•premature CAD
•different generations have different lipoprotein abnormalities
A

Familial combined hyperlipidemia

30
Q

What condition is assoc with:
•premature CAD
•no xanthomas
•no family history of hypercholesterolemia

A

Polygenic hypercholesterolemia

31
Q

yellow palmar creases assoc with what condition?

A

Dysbetalipoproteinemia

32
Q 
•often overweight
•>30 yr old
•often diabetic
•hyperuriaemic
•may or may not have premature CAD
•determined by family history and HDL-C 
Assoc with what condit?
A

Familial hypertriglyceridemia

33
Q 
usually middle-aged
•often obese
•often hyperuricaemic
•usually diabetic
•risk for recurrent pancreatitis
assoc with ?
A

Severe hypertriglyceridemia

34
Q

What 3 criteria are definitive for familial hypercholesteraemia diagnosis?

A
  1. Total cholesterol above 7.5
    mmol/l (in adults)
  2. or LDL cholesterol above 4.9 mmol/l (in adults)
  3. PLUS tendon xanthomata in the patient or in a first- or second degr relative
35
Q

Receptor for what substance is coded for on chromos. 19

A

LDL

36
Q

Mutations in what receptor cause problems in FamHyperchol

A

LDL receptor

37
Q

What drugs are HMG CoA reductase inhibitors - used for lowering cholesterol

A

Statins

38
Q

ciprofibrate, gemfibrizil, bezafibrate, fenofibrate are examples of what triglyceride-lowering drugs

A

Fibrates

39
Q

What are 2 types of atheromatous plaque

A

Concentric - fills whole lumen

Eccentric - sticks out into lumen

40
Q

What initiates plaque formation in arteries (3 egs of causes)

A

Endothelial damage (smoking, hypertension, DM)

41
Q

Once arterial damage occurs what is the next stage in atherosclerosis

A

Activation of platelets and monocytes - migrate to endothelial space. Smooth muscle cells proliferate here “remodelling”, cholesterol accumulates, WBCs absorb lipid & convert to fatty “foam cells”.

42
Q

What forms the “fibrous cap” of a plaque

A

Collagen and smooth muscle cells

43
Q

What would you see on ECG in a complete occlusion of coronary artery MI?

A

STEMI - st elevation

44
Q

What would you see on ECG in a partial occlusion of coronary artery MI?

A

NSTEMI - st depression

Cardiovascular 01.15 (5 decks)

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