pathology and cardio pharm Flashcards
which artery is known as the widowmaker?
left anterior descending artery
which chamber of the heart is usually affected in myocardial infarction?
left ventricle (thicker muscle)
what is acute coronary syndrome?
any condition that causes sudden, reduced blood flow to the heart
what are the 3 types of angina?
- chronic, stable angina
- unstable angina
- variant angina
severe, crushing pain which may radiate to left arm, jaw, neck and shoulder which lasts a few minutes
what is this?
angina
what is variant angina?
spasm of coronary artery
caused by demand (eg. exercise) –> predictable
not acute coronary syndrome
what type of angina?
chronic, stable angina
unpredictable thrombi formation –> partial occlusion of blood vessels –> ischaemia (including during rest)
what type of angina?
unstable angina
what are some symptoms of atypical angina?
- unusually fatigued
- feelings of discomfort or squeezing in the chest
- mid-shoulder back pain
- sudden feeling of slowing down or weakness
what is heart failure?
decreased cardiac output –> CO unable to meet metabolic demands
impaired contraction
what kind of heart failure?
heart failure with reduced ejection fraction (systolic dysfunction)
contraction okay, but impaired filling
what kind of heart failure?
heart failure with preserved ejection fraction (diastolic dysfunction)
how does baroreflex respond to heart failure (decreased CO)?
baroreflex activation –> decreased frequency of APs from baroreceptors –> sympathetic innervation
- increased HR and contractility
- peripheral arterial and venous constriction
- increase release of catecholamines (adrenaline)
- increased renin production from kidneys (activate renin-angiotensin system) –> increased BP
which endothelial layer does atherosclerosis occur in?
tunica intima layer
what is matrix metallopeptidase (MMP)?
released by macrophage to degrade plaque
irregularly irregular heart beat
atrial fibrillation
no P waves
atrial fibrilliation (atrial fibrillating with no proper contraction)
first line drug for atrial fibrillation
beta blockers followed by digoxin
what drugs are indicated in bradyarrhythmia?
anti-muscarinics (eg. atropine)
what drug is given for ventricular fibrillation?
lignocaine
what is adenosine?
indicated in SVT by inhibiting AV nodal conduction
what is amiodarone? and what is it indicated in?
K+ channel blocker
AF and VF (broad spectrum)
what is the MOA of digoxin?
binds to K+ binding sites –> inhibit Na/K ATPase pump (indirectly increase myocardial intracellular calcium –> increase myocardial contractility)
what is verapamil? and what is it indicated in?
Ca2+ channel blocker
atrial fibrillation
what is lignocaine? and what is it indicated in?
Na+ channel blocker
ventricular fibrillation
first line drug for supraventricular tachycardia
adenosine
what is nitroglycerin/Glyceryl trinitrate?
vasodilator indicated in angina
what is the MOA of atorvastatin?
HMG CoA-reductase inhibitor
what is the MOA of Ezetimibe?
Inhibits cholesterol absorption across intestinal wall
Which of the following anti-arrhythmic drugs is associated with thyroid dysfunction?
a. metoprolol
b. digoxin
c. amiodarone
d. sotalol
e. flecainide
c. amiodarone
Tender red lesions in the finger pads
Osler’s nodes
Which of these is not one of the MAIN three symptoms of aortic stenosis
a. Angina
b. Syncope
c. Dyspnoea
d. Palpitations
d. Palpitations
What is the name given to the process of atherosclerosis building up in non-cardiac vessels, such as in the legs
peripheral vascular disease
Which of the following doesn’t tend to cause mitral stenosis
a. Ageing + Calcification
b. Rheumatic Heart Disease
c. Hypertension
d. Endocarditis
d. Endocarditis
- tends to be tricuspid (first valve in contact with drug in IVDU)
The pain of pericarditis is _____ and relieve by _____
a. Crushing, leaning forward
b. Crushing, leaning back
c. Stabbing/burning, leaning forward
d. Stabbing/burning, leaning back
c. Stabbing/burning, leaning forward
The vasodilator effect of glyceryl trinitrate (GTN) is due to its ability to produce:
A. bradykinin
B. endothelin
C. hydrogen peroxide
D. nitric oxide
E. superoxide
D. nitric oxide
Which statement describes the MOST LIKELY cause for ischaemic heart disease?
a. The bicuspid valve located at the left side of the heart is damaged.
b. The left anterior descending artery that supplies the posterior 1/3 of the interventricular septum is blocked.
c. The right coronary artery that supplies blood to the right ventricle and right atrium is blocked.
d. There is a possibility of blockage of the circumflex artery which is a branch of the right coronary artery.
e. There is less oxygenated blood being carried by the pulmonary veins into the heart.
c. The right coronary artery that supplies blood to the right ventricle and right atrium is blocked.
