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MAP II Midterm > pathophysiology > Flashcards

pathophysiology Flashcards

1
Q

What is the number one cause of death in the world and the leading cause of death in the US?

A

Heart disease

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2
Q

What are the nine factors significantly associated with acute MI worldwide?

A

1) current smoking
2) diabetes
3) hypertension
4) abdominal obesity
5) psychosocial index
6) fruits/vegetables
7) exercise
8) alcohol
9) ApoB-ApoA1 (LDL-HDL)

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3
Q

Which type of angina is the least life threatening among acute coronary syndromes?

A

unstable angina

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4
Q

What are the 3 layers of the arterial walls?

A
  • tunica intima – endothelium that lines the lumen of all vessels
  • tunica media – smooth muscle cells and elastic fibers
  • tunica adventitia – collagen fibers
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5
Q

What is the initial cause of atheroclerosis damage to the blood vessel endotherlium?

A

high levels of LDL

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6
Q

What happens when LDL oxidizes?

A

releases anions (oxidative stress)

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7
Q

What occurs during oxidative stress due to the endothelium being damaged?

A
  • LDL migrate into the vessel (subendothelial layer)
  • monocytes migrate into the subendothelium
  • LDL’s are taken up by monocytes which forms into a foam cell
  • the foam cell is the initial start to a fatty streak in the vessel wall
  • the fatty streak becomes plaque which begins to build up in the vessel
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8
Q

foam cell production activates what?

A

activates some of the smooth muscle cells to migrate from the middle layer in towards the lumen into the subendothelial space –> leading to plaque formation

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9
Q

smooth muscle cells adhere to what to form plaque?

A

adhere to foam cells

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10
Q

What are referred to as lipid enhanced macrophages?

A

foam cells

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11
Q

What type of plaque remains on the vessel wall causing a narrowing of the lumen?

A

stable plaque

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12
Q

What type of blood flow does stable plaque cause?

A

turbulent blood flow

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13
Q

What type of plaque is more likely to rupture and if so, releases plaque into the blood causing a stroke or MI?

A

unstable plaque

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14
Q

When does myocardial perfusion occur?

A

during periods of muscle relaxation (diastole)

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15
Q

When does the heart muscle receive the most blood?

A

diastole

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16
Q

What type of heart disease is caused by an imbalance of myocardial supply and demand?

A

ischemic heart disease – the heart is NOT getting the oxygen it needs

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17
Q

What anatomical region of the heart is supplied by the right coronary artery?

A

inferior and posterior (right atrium and ventricle) regions

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18
Q

What anatomical region of the heart is supplied by the left anterior descending artery (anterior interventricular artery)?

A

anteroseptal region

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19
Q

What anatomical region of the heart is supplied by the distal portion of LAD?

A

anteroapical region (left ventricle)

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20
Q

What anatomical region of the heart is supplied by the circumflex artery?

A

anterolateral region

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21
Q

What are the 2 branches of the left coronary artery?

A

LAD and circumflex

22
Q

What are the 5 symptoms/signs of MI in a male?

A
  • crushing pain
  • “elephant on my chest”
  • nausea
  • left arm pain
  • jaw pain
23
Q

What are the 5 symptoms/signs of MI in a woman?

A
  • nausea/vomiting
  • fatigue
  • anxiety
  • midback tightness
  • discomfort
24
Q

What symptoms/signs are associated with stable angina?

A
  • substernal chest pain radiating to elbow
  • crushing/pressure
  • associated with SOB, nausea, diaphoresis
  • relieved by rest or nitroglycerin
  • occurs with predictable level of activity
25
Q

What is the equation for rate pressure product?

A

HR x SBP = workload of the heart

26
Q

What is known as the presence of angina in the absence of increased demand (workload)?

A

unstable angina

27
Q

Lack of what can lead to tissue cell death?

A

lack of oxygen (blockage)

28
Q

Scar tissue is the result of what?

A

tissue cell death

29
Q

Does scar tissue conduct electricity?

A

NO – will normally see a change in the QRS complex

30
Q

ST segment change indicates what?

A

the presence of scar tissue in the heart – due to a change in the QRS complex

31
Q

What biomarker is specific to heart muscle?

A

troponin

32
Q

Will you see an increase or decrease in troponin when there is damage to cardiac muscle cells?

A

increase

33
Q

Will you see an increase or decrease in creatine kinase levels due to the occurrence of MI?

A

increase

34
Q

What 2 EKG changes do you see with MI?

A
  • ST segment elevation

- Q waves

35
Q

ST segment depression represents what?

A

ischemia

36
Q

What does NSTEMI represent?

A

non-ST segment elevation myocardial infarction

37
Q

What occurs at the ST segment during NSTEMI?

A
  • not receiving an ST segment elevation from a MI

- the whole wave form has shifted, making it appear that the ST segment has been depressed

38
Q

What does STEMI represent>

A

ST segment elevation myocardial infarction

39
Q

What occurs at the ST segment during STEMI?

A
  • the wave has shifted downward, making the ST segment appear to be elevated
40
Q

Which classification of MI is subendocardial (below the surface of the cardiac muscle)?

A

NSTEMI

41
Q

Which classification of MI is transmural (throughout the entire muscle)?

A

STEMI

42
Q

Exercise test responses suggesting myocardial ischemia?

A
  • ST segment depression
  • multifocal PVC or runs of V-tach
  • peak exercise HR > 2 SD below age predicated HR
  • exertional hypotension
43
Q

What type of PVC originates in various locations and contraction occurring in the ventricle before the SA node can fire?

A

multifocal PVC

44
Q

What medication reduces LDL?

A

Statin

45
Q

What does PAD represent?

A

peripheral artery disease

46
Q

What does ABI represent?

A

Ankle-brachial index

47
Q

What are normal ABI levels?

A

ABI > 0.90

48
Q

What are the 2 main risk factors for PAD?

A

smoking and diabetes

49
Q

Signs of intermittent claudication?

A
  • achy, cramping feeling in legs
  • occurs w/ walking or exercise
  • decreases w/ rest
  • onset of pain is predictable
50
Q

Main sign of intermittent claudication?

A

cramping, aching pain in legs

MAP II Midterm (10 decks)

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