Test 3 Study Guide

Question 1

What are the goals of drug therapy for heart failure? (Preload, afterload, sympathetic tone and cardiac contractility)

Question 2

Which drugs are used for heart failure and what do they do?

Question 3

How and why would you decrease preload?

Question 4

How and why would you reduce sympathetic tone?

Question 5

How and why would you reduce preload and afterload together?

Question 6

How and why would you increase cardiac contractility?

Question 7

Digoxin:

Describe the dangers
How toxicity happens
What to monitor in case of toxicity/reaction
What happens when toxicity occurs
Signs/symptoms of toxicity
Actions to take in case of toxicity

Question 8

Describe biomarkers of CAD risk

Answer 8

High-sensitivity C-reactive proteins (hs-CRP)

Question 9

Describe modifiable and non-modifiable risk factors

Answer 9

Modifiable: dyslipidemia (high lipid/cholesterol, low LDL), hypertension, smoking cigaretes, diabetes, sedentary lifestyle, obesity, bad diet

Nonmodifiable: advanced age, male, females after menopause, family history

Question 11

o Describe and differentiate different forms of myocardial ischemia and acute coronary syndromes

Question 12

o Describe and differentiate stable and unstable plaques

Question 13

o Describe what happens when a plaque ruptures

Question 14

o Explain myocardial ischemia
 what is the main issue?
 what is the pathophysiology?
 what are the causes?
 what are the consequences?
 what happens at the cellular level during ischemia?
 what are the clinical manifestations?
 what would you see on exam or an ECG?
 how would it be diagnosed?
 how would it be treated?

Question 15

o Describe and differentiate various types of angina
 what is the main issue?
 what is the pathophysiology?
 what are the causes?
 what are the consequences?
 what are the clinical manifestations?
 what are the different types?

Answer 15

Stable Angina: Stable plaque partially obstructs coronary blood flow causing myocardial ischemia

Unstable Angina: Unstable plaque rupture and causes a thrombus to form which makes the vessel completely occluded. This causes acute coronary syndrome. Unstable angina is caused when A TRANSIENT OCCULUSION instead of a sustained occlusion s blocking coronary flow. This causes myocardial ischemia NOT INFARCTION.

NSTEMI/STEMI: Acute coronary syndrome w/ sustained occlusion causes sudden cardiac death

Question 16

o Explain reperfusion injury.

Question 17

o Describe the various effects of an MI (what can happen to the myocardium and how might the function change)?

Question 18

What organ regulates lipid levels in blood? What are the lipids the organ regulates?

Answer 18

Liver: makes lipoproteins.
LDL: very damaging. delivers cholesterol to tissues, causes endothelial damage
HDL: Good cholesterol. Reverses damage LDL helped cause by reversing cholesterol transport from tissues to liver/bile. Repairs endothelial cells. Want HIHG levels, not low levels
VLDL(triglycerides): bad cholesterol.

Question 19

optimal level of LDL

Answer 19

<100, >189 VERY HIGH

Question 20

optimal level of HDL

Answer 20

40 is LOW

60 is HIGH OPTIMAL

Question 21

optimal level of total cholesterol

Answer 21

less than 200 desirable

240 HIGH

Question 22

optimal level of triglycerides

Answer 22

less than 150

500 VERY HIGH