Cardiac Diseases

Question 1

This is a progressive condition in which plaque builds up in the tunic intima of arteries.

Answer 1

Atherosclerosis

Question 2

Another name for the deposit of lipids and calcified cells found during atherosclerosis

Answer 2

Atheroma

Question 3

True or False: atherosclerosis can occur in any artery and is categorized by location

Answer 3

True

Question 4

List 3 modifiable risk factors

Answer 4

cigarette smoking, dyslipidemia, hypertension, DM, obesity, sedentary lifestyle

Question 5

True or False: atherosclerosis is more common in males than females

Answer 5

True

Question 6

What are the 5 risk factors for cardiovascular disease?

Answer 6

atherosclerosis, dyslipidemia, diabetes, htn, lifestyle factors

Question 7

Difference between type 1 and type 2 diabtes

Answer 7

type 1: early onset, beta cells of pancreas are destroyed and can’t make insulin
type 2: gradual onset, NOT autoimmune, person becomes insulin resistance

Question 8

3 P’s of Diabetes

Answer 8

1. polyuria - excessive urination
2. polydipsia - excessive thirst
3. polyphagia - excessive appetite

Question 9

Lab findings for Diabetes Patients

Answer 9

fasting BG greater than 126
glucose intolerance test greater than 200
elevated HgbA1C

Question 10

HgbA1C value for it to be considered diabetes?

Answer 10

greater than 6.5%

Question 11

Onset, Peak and Duration of Rapid Acting Insulin (humalog/novolog)

Answer 11

Onset: 15-30 min
Peak: 1-2 hours
Duration: 3-6 hours

Question 12

Onset, Peak and Duration of Short Acting Insulin (regular)

Answer 12

Onset: 30-60 min
Peak: 2-4 hours
Duration: 3-6 hours

Question 13

Onset, Peak and Duration of intermediate insulin (NPH)

Answer 13

Onset: 2-4 hours
Peak: 8-10 hours
Duration: 10-18 hours

Question 14

Onset, Peak and Duration of long acting insulin (LANTUS)

Answer 14

Onset: 1-2 hours
Peak: none
Duration: 19-24 hours

Question 15

LDL versus HDL

Answer 15

LDL - low density lipoproteins or “bad cholesterol”
HDL - high density lipoproteins or “good cholesterol”

Question 16

High levels of HDL inversely correlate with cardiovascular risk - T or F

Answer 16

True

Question 17

Normal LDL

Answer 17

Less than 100

Question 18

Normal HDL

Answer 18

greater than 60

Question 19

normal cholesterol

Answer 19

less than 200

Question 20

3 meds for lowering cholesterol

Answer 20

statins, nonstatins, and naicin

Question 21

Statin-associated muscle symptoms

Answer 21

weakness, aches and cramps

Question 22

Naicin is prescribed to do what for dyslipidemia?

Answer 22

ordered to increase HDL alongside other anti-lipid agents

Question 23

Examples of statins

Answer 23

Lipitor or Zocor

Question 24

Example of nonstatins

Answer 24

Zetia or Fenofibrate

Question 25

Primary (essential) HTN versus Secondary HTN

Answer 25

primary: unknown cause - coorelates with lifestyle factors secondary: known primary cause - medication, endocrine disorder

Question 26

Hypertensive Urgency Definition

Answer 26

BP > 180-110 without evidence of organ dysfunction

Question 27

Hypertensive Crisis

Answer 27

Systolic BP>180 and/or diastolic BP>120, with impending or progressive organ dysfunction

Question 28

DASH diet

Answer 28

high in fruits, veggies and lean meats, low in sugar and red meat suggested for those with HTN

Question 29

Classes of medications for HTN

Answer 29

ACE inhibitors ARBs Calcium Channel Blockers Thiazide diuretics

Question 30

True or False: HTN is more common in men less than 50 and woman over 50.

Answer 30

True

Question 31

Angina Pectoris

Answer 31

chest pain caused by narrowed coronary arteries and presents with negative trop, ST depression and T-wave changes

Question 32

Stable angina versus unstable

Answer 32

stable: resolves quickly, with rest or medications, can be triggered by exertion, large meals and hot/cold temperatures unstable: occurs any time, lasts longer than 20 minutes, more severe and not easily relieved

Question 32

Stable angina versus unstable

Answer 32

stable: resolves quickly, with rest or medications, can be triggered by exertion, large meals and hot/cold temperatures unstable: occurs any time, lasts longer than 20 minutes, more severe and not easily relieved

Question 33

Prinzmetal Angina/Variant Angina/vasoplastic

Answer 33

episodes of angina and TEMPORARY ST elevations caused by spasms of coronary artery - easily relieved by nitrates

Question 34

STEMI versus NSTEMI

Answer 34

STEMI: elevated ST (>1) = COMPLETE occlusion NSTEMI: ST depression or T-wave inversion

Question 35

Anterior Wall MI ST change location and artery affected

Answer 35

V1-V4; LAD

Question 36

LAD supplies what part of the heart

Answer 36

blood to anterior left atrium and ventricle

Question 37

Inferior Wall MI ST change location and artery affected

Answer 37

II, III, aVF; RCA

Question 38

Right ventricular MI ST change location and area affected

Answer 38

V4-V6; interior wall MI

Question 39

Lateral wall MI ST change location and artery affected

Answer 39

I, aVL, V5, V6; Left Circumflex

Question 40

posterior wall MI ST change location and artery affected

Answer 40

V7-V9 elevation and ST depression in V1-V4 RCA or left circumflex artery

Question 41

Issues after right ventricular MI

Answer 41

tachycardia, hypotension and JVD positive inotropes avoid pre-load reducing meds (beta blockers; diuretics; morphine, nitrates)

Question 42

Issues after inferior wall MI

Answer 42

bradycardia/hypotension increase in AV blocks increase risk for papillary muscle rupture avoid reducing preload

Question 43

Papillary muscle rupture

Answer 43

occurs 2-8 days post MI hemodynamic compromise, pulmonary edema and new LOUD systolic murmur requires EMERGENT repair

Question 44

issues after anterior wall MI

Answer 44

increased risk of left heart failure increased risk of 2nd degree blocks increased ventricular rupture

Question 45

Diagnostic tests to look for MI

Answer 45

elevated troponin (>0.1 ng/ml) elevated CK-MB (>2.5%)

Question 46

STEMI Process _______ min door to balloon _______ min door to fibrinolytic therapy

Answer 46

90 min 30 min

Question 47

NSTEMI meds

Answer 47

nitro - vasodilation beta blocker/calcium channel blockers - reduce myocardial oxygen demand heparin: improve blood flow morphine: pain not relieved with nitro

Question 48

If patient cannot take aspirin for managing MI, what is the other option?

Answer 48

Clopidogrel