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PATHO > EXAM 2 MI > Flashcards

EXAM 2 MI Flashcards

1
Q

Risk factors of MI:

A
  1. Family history of CAD
  2. Hypertension
  3. High Cholesterol
  4. Obesity
  5. Diabetes
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2
Q

Smoking causes __% and diabetes causes __% of CAD

A

36; 20

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3
Q

Lack of exercise has been liked to __-__% of MI cases

A

7-12

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4
Q

Less common causes of MI include: (2)

A
  1. Job stress (3% of cases)

2. Chronic high stress levels

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5
Q

__ or _ exposure to high quantities of __ can increase the risk of MI

A

Alcohol; prolonged; alcohol

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6
Q 
Psychosocial factors including: (3) 
1
2
3
increase the risk of and are associated with worse outcomes after MI
A
  1. low socioeconomic status
  2. social isolation
  3. negative emotions
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7
Q 
Socioeconomic factos such as: 
1
2
3
are also correlated with MI
A
  1. shorter education
  2. lower income particularly in women
  3. unmarried cohabitation
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8
Q

MI occurs when:

A

myocardial tissue is abruptly and severely deprived by oxygen

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9
Q

When blood flow is quickly reduced by __-__%, ischemia develops

A

80-90

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10
Q

Ischemia can lead to: (2)

A
  1. Injury

2. Necrosis

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11
Q

Most MIs are the result of: (4)

A
  1. atherosclerosis of coronary arteries
  2. rupture of the plaque
  3. subsequent thrombosis
  4. occlusion of blood flow
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12
Q

Other factors that lead to MIs: (3)

A
  1. coronary artery spasm
  2. platelet aggregation
  3. emboli from mural thrombi or thrombi lining the cardiac chambers
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13
Q

Angina Pectoris =

A

chest pain

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14
Q

Angina pectoris occurs when there is a __ of __ to meet myocardial needs

A

deficit; oxygen

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15
Q

Chronic Stable Angina is chest discomfort that occurs with __ to __ __ in a pattern that is __ to the patient

A

moderate; prolonged exertion; familiar

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16
Q

In chronic stable angina, the frequency, duration, and intensity of symptoms remain the __ over __ __

A

same; several months

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17
Q

Chronic stable angina results in only __ __ of __ and is associated with a __ __ __. It is usually relieved by __ or by __ and is managed with __ __.

A

slight limitation; activity; fixed atherosclerotic plaque

nitroglycerin; rest; drug therapy

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18
Q

Unstable angina is chest pain at __ or __ and causes a __ __ __. An increase in the __ of attacks and in the __ of the pressure indicates unstable angina. The pressure may last longer than __ __ or may be __ relieved by rest or nitroglycerin

A

rest; exertion; severe activity limitation
number; intensity
15 min.; poorly

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19
Q

In someone without cardiac problems,

normal oxygen supply equals to that of

A

normal activity

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20
Q

If there is an increase in that activity, the oxygen supply is __

A

increased

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21
Q

In someone with myocardial ischemia, they have __ oxygen supply that doesn’t meet __ __

A

decreased; normal activity

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22
Q

The chest pain associated with MI is severe and immobilizing chest pain not relieved by: (3)

A
  1. rest
  2. position change
  3. nitrate administration
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23
Q

Ask the patient where pain is present:

what are the possibilities?) (6

A
  1. chest
  2. epigastric area
  3. jaw
  4. back
  5. shoulder
  6. arm
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24
Q 
In diabetics, they \_\_ have typical chest pain. Angina is presented as: 
1.
2.
3.
4.
A

don’t

  1. mid-scapular
  2. jaw
  3. lip
  4. gum pain
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25
Q

There may be __ and __ that can result from __ __ of the __ center by the severe pain

A

nausea; vomiting; reflex stimulation; vomiting

26
Q

B/c of ____ nervous system simulation, there is an increase in __ released in the initial phases of MI. This leads to _ and _.

A

sympathetic; catecholamines

diaphoresis; vasoconstriction

27
Q

Why do __ __ and __ tend to delay seeking treatment for MI and have higher mortality rates?
B/c the delay is a greater incidence of __ as an acute symptom among these groups rather than the __ __ typical of other groups

A

African Americans; women

dyspnea ; classical pain

28
Q

Only __ of elderly have classical clinical manifestations of MI

A

50%

29
Q

What are non classical clinical manifestations of MI? (5)

A
  1. Exertional dyspnea
  2. fatigue
  3. syncope
  4. nausea
  5. confusion
30
Q

What is the initial symptom for women having an MI?

A

extreme fatigue

31
Q

Women also complain of

A

epigastric discomfort

32
Q

__ __ is the number one cause of death in women over __ and kills about __ times more women than __ __

A

Heart disease; 35

6; breast cancer

33
Q

Some lab studies that can be done are __ __

A

cardiac enzymes

34
Q

EKGs can be done to determine any __ __ like __ __ or __ __ ___.

A

rhythm abnormalities; ST elevation; T wave inversion

35
Q

What else can be done to determine if someone has an MI?

A

angiography

36
Q

Obvious physical changes do not occur in the heart until __ hours after the infarction when the infarction appears __ and __

A

6; blue; swollen

37
Q

These changes explain the need for intervention within the first __-__ hours of symptom onset

A

4-6

38
Q

After 48 hours, the infarcted area turns __ with __ streaks as __ invade the tissue and begin to remove the __ cells

A

gray; yellow; neutrophils; necrotic

39
Q

At 8-10 days after infarction, __ __ forms at the edges of the necrotic tissue

A

granulation tissue

40
Q

Troponin (I & T)
Onset:
Peak:
Duration:

A

4-6 hours
18-24 hours
Up to 10 days

41
Q

CK-MB
Onset:
Peak:
Duration:

A

4-12 hours
18-24 hours
24-36 hours

42
Q

Myoglobin
Onset:
Peak:
Duration:

A

1-2 hours
8-10 hours
24 hours

43
Q

Lactic Dehydrogenase (LD)
Onset:
Peak:
Duration :

A

6-12 hours
24-48 hours
6-8 days

44
Q

What are the most common lab tests?

A

Troponin
CKMB
myoglobin
LDH

45
Q

__ is the most sensitive and specific rising in about 4-6 hours

A

Troponin

46
Q

CKMB takes

A

4-12 hours

47
Q

Myoglobin is the __ oxygen carrying pigment of __ tissue. The problem with myoglobin is that it is __ when muscle tissue is damaged but it lacks __ for MI

A

primary; muscle

high; specificity

48
Q

__% of those suffering from an MI show __ __ changes. This is also known as an __ __ __ __ or __

A

90; ST elevation

ST segment elevation MI or STEMI

49
Q

__ __ ___ and/or __ __ ___can also occur in someone with an MI; This is known as a __ __ __ __ or ____

A

ST segment depression
T wave inversion

non ST elevation MI ; nonSTEMI

50
Q

The goal in those suffering from MI is to receive timely __ __ __

A

artery opening therapy

51
Q

Artery opening therapy can be done with __ or __ __ like __ __ __ (_) that should be given within __ min of hospital arrival

A

thrombolytic; clot busters; tissue plasminogen activator (TPA); 30

52
Q

Another procedure known as __ __ __ __ should be done within 90 minutes for an MI

A

percutaneous transluminal coronary angioplasty

53
Q

The term ___ is often used to describe the medications administered during an MI

A

MONA

54
Q

M =

A

Morphine

55
Q

O =

A

Oxygen

56
Q

N =

A

Nitroglycerin

57
Q

A =

A

Aspirin

58
Q

(M) Morphine __ is used to relieve discomfort that is __ to __

A

sulfate; unresponsive; nitroglycerin

59
Q

Morphine relieves MI pain, decreases __ __ __, relaxes __ __, and reduces __ __

A

myocardial oxygen demand; smooth muscle; circulating catecholamine

60
Q

(O) Oxygen - __ oxygen increase the amount of oxygen to myocardial tissue

A

supplemental

61
Q

(N) Nitroglycerin- Increases __ __ __ and __ the coronary arteries. It is typically given as a __ medication with the onset of chest pain. It decreases myocardial O2 __ by __ __ which decreases both __ and __

A

collateral blood flow; dilates
first
demand; peripheral vasodilation
preload; after load

62
Q

(A) - Aspirin therapy inhibits both __ __ and __ thereby decreasing the likelihood of __. The anti platelet effect of aspirin begins within __ __ of use and continues for __ __

A

platelet aggregation; vasoconstriction
thrombosis
one hour; several days

PATHO (15 decks)

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