pathology and cardio pharm

Question 1

which artery is known as the widowmaker?

Answer 1

left anterior descending artery

Question 2

which chamber of the heart is usually affected in myocardial infarction?

Answer 2

left ventricle (thicker muscle)

Question 3

what is acute coronary syndrome?

Answer 3

any condition that causes sudden, reduced blood flow to the heart

Question 4

what are the 3 types of angina?

Answer 4

1. chronic, stable angina
2. unstable angina
3. variant angina

Question 5

severe, crushing pain which may radiate to left arm, jaw, neck and shoulder which lasts a few minutes

what is this?

Answer 5

angina

Question 6

what is variant angina?

Answer 6

spasm of coronary artery

Question 7

caused by demand (eg. exercise) –> predictable
not acute coronary syndrome
what type of angina?

Answer 7

chronic, stable angina

Question 8

unpredictable thrombi formation –> partial occlusion of blood vessels –> ischaemia (including during rest)
what type of angina?

Answer 8

unstable angina

Question 9

what are some symptoms of atypical angina?

Answer 9

1. unusually fatigued
2. feelings of discomfort or squeezing in the chest
3. mid-shoulder back pain
4. sudden feeling of slowing down or weakness

Question 10

what is heart failure?

Answer 10

decreased cardiac output –> CO unable to meet metabolic demands

Question 11

impaired contraction
what kind of heart failure?

Answer 11

heart failure with reduced ejection fraction (systolic dysfunction)

Question 12

contraction okay, but impaired filling
what kind of heart failure?

Answer 12

heart failure with preserved ejection fraction (diastolic dysfunction)

Question 13

how does baroreflex respond to heart failure (decreased CO)?

Answer 13

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

Question 14

which endothelial layer does atherosclerosis occur in?

Answer 14

tunica intima layer

Question 15

what is matrix metallopeptidase (MMP)?

Answer 15

released by macrophage to degrade plaque

Question 16

irregularly irregular heart beat

Answer 16

atrial fibrillation

Question 17

no P waves

Answer 17

atrial fibrilliation (atrial fibrillating with no proper contraction)

Question 18

first line drug for atrial fibrillation

Answer 18

beta blockers followed by digoxin

Question 19

what drugs are indicated in bradyarrhythmia?

Answer 19

anti-muscarinics (eg. atropine)

Question 20

what drug is given for ventricular fibrillation?

Answer 20

lignocaine

Question 21

what is adenosine?

Answer 21

indicated in SVT by inhibiting AV nodal conduction

Question 22

what is amiodarone? and what is it indicated in?

Answer 22

K+ channel blocker
AF and VF (broad spectrum)

Question 23

what is the MOA of digoxin?

Answer 23

binds to K+ binding sites –> inhibit Na/K ATPase pump (indirectly increase myocardial intracellular calcium –> increase myocardial contractility)

Question 24

what is verapamil? and what is it indicated in?

Answer 24

Ca2+ channel blocker
atrial fibrillation

Question 25

what is lignocaine? and what is it indicated in?

Answer 25

Na+ channel blocker
ventricular fibrillation

Question 26

first line drug for supraventricular tachycardia

Answer 26

adenosine

Question 27

what is nitroglycerin/Glyceryl trinitrate?

Answer 27

vasodilator indicated in angina

Question 28

what is the MOA of atorvastatin?

Answer 28

HMG CoA-reductase inhibitor

Question 29

what is the MOA of Ezetimibe?

Answer 29

Inhibits cholesterol absorption across intestinal wall

Question 30

Which of the following anti-arrhythmic drugs is associated with thyroid dysfunction?

a. metoprolol
b. digoxin
c. amiodarone
d. sotalol
e. flecainide

Answer 30

c. amiodarone

Question 31

Tender red lesions in the finger pads

Answer 31

Osler’s nodes

Question 32

Which of these is not one of the MAIN three symptoms of aortic stenosis

a. Angina
b. Syncope
c. Dyspnoea
d. Palpitations

Answer 32

d. Palpitations

Question 33

What is the name given to the process of atherosclerosis building up in non-cardiac vessels, such as in the legs

Answer 33

peripheral vascular disease

Question 34

Which of the following doesn’t tend to cause mitral stenosis

a. Ageing + Calcification
b. Rheumatic Heart Disease
c. Hypertension
d. Endocarditis

Answer 34

d. Endocarditis
- tends to be tricuspid (first valve in contact with drug in IVDU)

Question 35

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

Answer 35

c. Stabbing/burning, leaning forward

Question 36

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

Answer 36

D. nitric oxide

Question 37

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.

Answer 37

c. The right coronary artery that supplies blood to the right ventricle and right atrium is blocked.