stable coronary art. disease

Question 1

what is diff between stable and unstable CAD

Answer 1

stable
- athersclerosis where blood can still pass
unstable
- athero, but a thrombus has formed - occlusion

Question 2

biggest risk factor

Answer 2

age

Question 3

7 major risk factors for CAD

Answer 3

1. age
2. gender
3. smoking
4. HT
5. dyslipidemia
6. diabetes
7. fam. Hx

Question 4

what is relationship to smkoing

Answer 4

quantity relevant

- risk reduction in 3 years

Question 5

what is Fam Hx importance

Answer 5

polygenic

- most important in younger patients

Question 6

what is angina

Answer 6

symptom due to myocardial ischemia from myocardial O2 demand that is not being met

Question 7

4 possible DDx of chest pain

Answer 7

1. MSK
2. GI
3. pulm and mediastinal
4. psych

Question 8

what is Sx of angina

Answer 8

not really pain

• pressure/tightness
• can radiate to arm and neck

Question 9

3 things NOT char of angina

Answer 9

1. location
   - only in middle lower abdo
   - localized to a fingertip
2. character
   - reproduced by movement or palpation
   - pleuritic
3. duration
   - few seconds or for many hours

Question 10

5 precipitantas

Answer 10

1. excercise
2. emotion
3. eating
4. cold
5. sex

Question 11

4 levels of chest pain by activity

Answer 11

1. normal
2. > 2 level blocks of > 1 flight
   3.

Question 12

def. of typical, atypical and noncardiac angina

Answer 12

Typical - all three
1. substernal chest dscomfort
2. provoked by exertion or emotion
3. releived by rest or nitro
Atypical
2/3
Non-caridac
1 or less

Question 13

who are the best people to give further testing to

Answer 13

those in the intermediate risk in PRE-test prob

Question 14

2 main types of diagnostic testing and their subtypes

Answer 14

1. funtional
   - exercise
   - nuclear
   - stress ECHO
2. structural
   - coronary angiogram
   - CT coronary angio

Question 15

2 main components of all functional testing

Answer 15

1. stress

2. test

Question 16

3 ways we can stress

Answer 16

1. excercise
2. vasodilators
   - persatine
   - adenosine
3. pharma
   - dobutamine

Question 17

what what amount of stenosis is there Sx

Answer 17

excercise - 70%

rest - 90%

Question 18

what is progression in terms of Sx

Answer 18

1. blood flow changes
2. wall motion abnormal
3. ECG changes
4. Pain - Sx - not till late

Question 19

what is excercise testing

Answer 19

65% accurate

- treadmill and ECG

Question 20

what is nuclear testing

Answer 20

85% accurate

• give radio tracer
• look at wall take up during rest and activity with SPECT tracer

Question 21

2 types of defect that can be seen in nuclear and what they mean

Answer 21

1. reversible - ischemia

2. fixed - infarct

Question 22

what is ECHO

Answer 22

90% accurate

• normal heart thickens when contracted by 50%
• look for this wall motion abnormalitiy

Question 23

what is gold standard

Answer 23

coronary angiography

• invasive
• 1/1000 risk of seriosu complication

Question 24

look at pre-test prob. stuff

Answer 24

do it

Question 25

4 non-pharma mgmt of CAD

Answer 25

1. excercise
2. weight loss
3. med. diet
4. smoking cess

Question 26

4 meds

Answer 26

1. antiplatelelt - ASA
Anti anginal
2. B-blockers
3. nitrates
4. CCBs

Question 27

3 interventions for CAD

Answer 27

1. percutaneous coronoary interventipon
2. stent - drug eluting
3. CABG - major