Brainscape's Knowledge GenomeTM

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


See full index

Patho Case Studies > MI > Flashcards

MI Flashcards

1
Q

What are the general risk factors for an MI?

A

Modifiable:
- Older adult age
- Family history/genetics
- Male Sex
Non-Modifiable:
- Hypercholesteremia
- Hypertension
- Obesity
- Physical inactivity
- Tobacco use
- Hyperlipidemia
- Hyperglycemia/diabetes

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

What are the risk factors for MI specific to the case study?

A

Smoking
Family history
Male sex

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

What are the general signs and symptoms of MI?

A

Diaphoresis (sweating)
Pallor/pale peripheries
Chest pain or discomfort
Shortness of breath
Anxiety like feeling
Pain/discomfort in shoulder, neck, arm, jaw

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

What are the signs and symptoms of MI specific to the case study?

A

Indigestion like pain developing into intense chest pain (angina)
Sweating
Pale peripheries & face (pallor)
Sore arm (like muscle ache)
Tingling sensation in arm/hand

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

What risk factors does Mikes elevated triglyceride levels, decreased HDL levels and higher than normal cholesterol/HDL levels indicate?

A

Hyperlipidemia/hypercholesteremia
Atherosclerosis

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

What other information from the ambulance report suggests that the patient had an MI?

A

Pain did not subside/reduce with use of medications (aspirin & GTN)
ECG Shows S-T elevation

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

What is the main cause of an MI? (patho)

A

Sustained myocardial ischemia due to blockage of a coronary artery. The prolonged ischemia leads to irreversible hypoxic damage to the affected section of the heart wall resulting in myocyte necrosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When does ischemia most commonly occur?

A

When a thrombus forms after an atherosclerotic plaque in the coronary artery ruptures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is myocardial stunning?

A

The temporary loss of contractility lasting hours to days after reperfusion

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

What is myocardial hibernation?

A

The prolonged loss of contractility when there is sustained ischemia

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

What is myocardial remodeling?

A

Permanent loss of contractility with cellular hypertrophy

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

Why are there different classifications of MI and what are the names?

A

Depending on how long the ischemia lasts, and the size of the infarct area. The two types are STEMI and NSTEMI

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

What is a STEMI?

A

A full thickness necrosis, S-T segment elevation on ECG

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

What is an NSTEMI?

A

A partial thickness necrosis (subendocardial), and there is no S-T elevation on the ECG

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

What is a transmural MI?

A

Full thickness necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of MI did the patient most likely experience?

A

STEMI due to the S-T elevation in his ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the expected lab tests that would be carried out on admission for a suspected MI?

A

Full blood count
Cardiac enzymes
Thyroid function tests
Urea and electrolytes
Blood glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the expected investigations that would be carried out on admission for a suspected MI?

A

Angiogram
Chest x-ray
ECG

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

What does the P wave on an ECG represent?

A

Atrial depolarisation

20
Q

What does the ORS complex on an ECG represent?

A

Ventricular depolarisation and atrial repolarisation (the repolarisation wave is overshadowed by the depolarisation wave.)

21
Q

What does the T wave on an ECG represent?

A

Ventricular repolarisation

22
Q

What does a peaked T waves on ECG suggest?

A

Ischemia in the endocardium

23
Q

What does a inverted T wave on ECG suggest?

A

Ischemia in the epicardium. Causing the wave of repolarisation to travel outwards

24
Q

What does a S-T segment depression on ECG suggest?

A

Subendocardial ischemia or infarction. Also seen in leads opposite an infarcted area

25
Q

What does a S-T segment elevation on ECG suggest?

A

Transmural infarction

26
Q

What are cardiac enzymes tested for?

A

Due to myocardial cell membrane breakdown, proteins leak out of myocytes and become detectable in blood and elevated cardiac enzymes are significant markers for MI

27
Q

What is troponin T

A

A contractile protein that is only released from myocytes when necrosis has occurred. They may not be detectable for up to 6 hours after the onset of myocardial cell injury

28
Q

What are some complications of an MI

A

Collapse
Ventricular fibrillation
- Cardiac arrest
Atrial fibrillation
Arrhythmias
Further ischemic injury

29
Q

What is involved in the immediate management of an MI?

A

Goals are to:
- Decrease heart workload
- Increase oxygen delivery to body tissues
- Re-perfuse the heart wall
In addition obs, ECG, and symptom control and the acronym MONA is used for the drugs involved.

30
Q

What does the acronym MONA stand for?

A

M - Morphine
O - Oxygen (O2)
N - Nitroglycerine
A - Aspirin

31
Q

Why is morphine administered in the management of an MI?

A

To relieve chest pain if chest pain doesn’t resolve with sublingual or I.V. nitroglycerin. It is an agonist

32
Q

Why is Oxygen (O2) administered in the management of an MI?

A

Given is the patient’s O2 saturation is below 92% to ensure adequate oxygen delivery

33
Q

Why is nitroglycerin administered in the management of an MI?

A

To reduce chest pain. It is a potent vasodilator, decreases myocardial oxygen consumption and cardiac workload.

34
Q

Why is aspirin administered in the management of an MI?

A

Slows platelet aggregation, reducing the risk of further occlusion or re-occlusion of the coronary artery or a recurrent ischemic event. It is an NSAID

35
Q

What is thrombolysis?

A

The dissolution of a blood clot, especially as induced artificially by infusion of an enzyme into the blood

36
Q

What did Mike recieve as his thrombolysis?

A

Enoxaparin (Clexane): a low molecular weight heparin that helps prevent the original arterial clot from expanding and allows it to break down
Tenecteplase: A fibrinolytic which binds to fibrin and converts plasminogen into plasmin, which then degrades fibrin.

37
Q

What is involved in the acute care of a patient with an MI?

A

Pt on the monitor, ECG and IV line is inserted
Nursing staff preparing thrombolysis incase of a sudden BP decrease
Electrolytes

38
Q

What is an angiogram?

A

Inject a contrast agent into the bloodstream this makes the blood vessels surrounding the heart visible on an x-ray.

39
Q

What is an angioplasty with stent?

A

A technique used to widen a narrowed or obstructed artery. A stent surrounding a collapsed balloon is passed into the vascular system using a guide wire (catheter). Once positioned the balloon is inflated expanding the stent and opening the blood vessel.

40
Q

What does discharge management involve?

A

Typically several medications are prescribed including:
- Aspirin
- Anti-coagulants
- Beta blockers
- Nitroglycerine
- Cholesterol lowering medications

41
Q

What medications was the patient put on?

A

Aspirin, Clopidogrel, glyceryl trinitrate (GTN) spray, metoprolol, and simvastatin

42
Q

What is clopidogrel?

A

Medication that inhibits platelet activation and aggregation; often used in combination with aspirin to prevent thrombosis after angioplasty

43
Q

What is GTN spray?

A

Medication that relaxes smooth muscle (potent vasodilator) & decreases cardiac workload; best used as required for angina or MI

44
Q

What is Metoprolol?

A

Beta-adrenorecptor antagonist (beta blocker) which reduces heart rate (HR), cardiac output (CO), and blood pressure through inhibition of catecholamines

45
Q

What is simvastatin?

A

A medication that inhibits cholesterol synthesis to lower cholesterol. This is recommended to be taken at night due to cholesterol synthesis mostly occuring at night and this being the more dangerous period.

46
Q

What kind of dietary and lifestyle modifications are important?

A

Dietary
- Low-fat, low-salt with plenty of fruit and vegetables

Patho Case Studies (4 decks)

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