Quiz1.CHD,StableAngina,AtomicSpec,ACS

Question 1

What is the best description for myocardial infarction?

Answer 1

Reduced regional blood flow to the heart.

Question 2

What is one non modifiable risk factor for CHD?

Answer 2

Increasing age

Question 3

What is not a clinical manifestation of CHD?

Answer 3

Stroke

Question 4

What are some clinical manifestations of CHD?

Answer 4

Clinical manifestations of CHD are:
• stable and unstable angina
• acute MI
• sudden cardiac death
All of these are linked with ischaemia

Question 5

In atherosclerosis, what promotes differentiation of monocytes to macrophages?

Answer 5

Modified LDL promotes monocyte-macrophage differentiation.
When LDL becomes modified it does this.

Question 6

What is atherosclerosis?

Answer 6

Atherosclerosis is a progressive degenerative disease of the arteries. It is characterised by the asymmetric deposition of lipids and fibrous tissues in the arterial walls.

Question 7

What are the most common underlying causes of stable angina?

Answer 7

Progression of a coronary plaque which causes significant stenosis or partial occlusion.

Question 8

What are the most common causes of STEMI and NSTEMI?

Answer 8

Common causes of STEMI and NSTEMI are an ulceration or rupture of the plaque which will then lead to either complete and permanent occlusion (STEMI) or partial or intermittent occlusion (NSTEMI or unstable angina).

Question 9

What are the causes of variant angina and micro vascular angina?

Answer 9

Variant angina is caused by vasospasms of the artery, and micro vascular dysfunction causes MV angina.

Question 10

Absorbance is proportional to what according to Beer-Lambert Law?

Answer 10

Absorbance is proportional to the concentration of the sample.

Question 11

What does Beer-Lambert Law apply to?

Answer 11

Only to dilute solutions, absorbance less than 1.5.

Question 12

What are 2 disadvantages to atomic absorption spec?

Answer 12

1. You have to use a large sample volume (5mL)
2. It is not possible to analyse solid samples

Question 13

What are 3 causes of high detection limit?

Answer 13

1. There is a short resonance time in flame.
2. There is rapid dilution in flame.
3. Poor nebulisation efficiency.

Question 14

What are two differences between atomic absorption spec and atomic emission spec?

Answer 14

1. Absorption spec uses acetylene flame whereas emission spec uses propane flame
2. Cooler flame increases sensitivity in absorption spec whereas it decreases in emission spec.

Question 15

What are the clinical subtypes of ACS?

Answer 15

Unstable Angina, NSTEMI, STEMI

Question 16

What are the 5 factors of the initial management of ACS?

Answer 16

1. 300mg aspirin (loading dose)
2. Supplemental oxygen
3. IV opioid (morphine)
4. Anticoagulant/antiplatelet (heparin)
5. GTN (buccal or sublingual)

Question 17

What is not a clinical symptom of stable angina?

Answer 17

Symptoms lasting longer than 10 mins

Question 18

What are 4 common triggers for stable angina?

Answer 18

Physical exertion, cold exposure, stress, heavy meal

Question 19

How would you counsel a GTN?

Answer 19

This is a GTN spray for angina. You can use this for rapid pain relief or prior to activities which may cause some pain eg exercise. Common side effects include throbbing headache or flushing. When using for pain relief, dose is 1-2 sprays every 5 minutes, if 15 mins and pain remains, call 999! Take while sat down to avoid postural hypotension (dizziness)

Question 20

What is an example of a beta 1 selective beta blocker ?

Answer 20

Bisoprolol- this is a cardioselective beta blocker

Question 21

What is an example of a non selective beta blocker?

Answer 21

Non selective with vasodilation - carvedilol
Non selective without vasodilation - propranolol, timolol, sotalol

Question 22

Give three revascukarisatokn procedures

Answer 22

PCI METHODS:
1. Balloon angioplasty
2. Stenting (drug eluting stent or bare metal stent)
——————
3. CABG - bypass graft redirecting blood flow from one artery to the damaged artery

Question 23

When are drug eluting stents recommended?

Answer 23

NICE guidelines suggest use of DES when artery is less then 3mm or if the affected area is more than 15mm