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Flashcards in Ch 27 Deck (41):
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Coronary atherosclerosis

Is the abnormal accumulation of lipid deposits and fibrous tissue within the arterial walls and lumen.
Blockages and narrowing of the coronary vessels reduce blood flow to the myocardium.

1

How can one prevent CAD

Control cholesterol
Dietary measures
Physical activity
Medications
Cessation of smoking
Manage HTN
Control diabetes

2

Name the 6 cholesterol medications

3-hydroxy-3- methylglutaryl coenzyme A (HMG-CoA) or ( statins)
Nicotinic acids
Fibric acids or (Fibrates)
Bile acid sequestrants (or resins)
Cholesterol absorption inhibitors
Omega-3 acid-ethyl esters

3

What lab should be monitored when atorvastatin ( Lipitor) is administered

Liver enzymes

Atorvastatin ( Lipitor) is a HMG CoA reductase inhibitor and is hepatotoxic therefor liver enzymes should be monitored

4

What are medications for angina pectoris

Nitroglycerin
Beta blockers
Calcium channel blockers
Anti platelet and anticoagulate medications
Aspirin
Clopidogrel and ticlopidine
Heparin
Glycoprotein IIB/IIIa agents

5

What is CRP

CRP is known to be an inflammatory marker for cardiovascular risk, including acute coronary events and stroke
The liver produces CRP in response to a stimulus such as tissue injury, high levels of this protein is likely to occur in ppl with diabetes and who are likely to have an acute coronary event

6

What are the four elements of fat metabolism

Total cholesterol
LDL
HDL
triglycerides
All are known to affect the developmEnt of heart disease

7

How is cholesterol processed

It is processed by the GI tract into lipo protein globules called chylomicrons. These are processed by the liver as lipoproteins

8

LDL levels

Less than 100
Less than 70 for very at risk patients

9

Total cholesterol levels

Less than 200

10

HDL levels

Greater than 40 for males
Greater than 50 for females

11

Triglyceride levels

Less than 150

12

What tests are clear predictors of coronary events

Total cholesterol
LDL

13

Triglycerides

Are made up of fatty acids and is transported through the blood by a lipoprotein
Although a level beyond 200 may be genetic, it can also be caused from obesity, physical inactivity, excessive alcohol intake, high carbohydrate diets, diabetes, kidney disease and certain meds such as oral contraceptives and corticosteroids.

14

What are therapeutic effects of statins

Lowers; total cholesterol, LDL, Triglycerides

Increases; HDL

15

What is the therapeutic effects of nicotinic acids

Lowers; HDL, triglycerides, and total cholesterol, lipolysis in adipose tissue and lipoprotein synthesis in liver

Increases; HDL

16

What are the therapeutic effects of fibric acids ( Fibrates)

Increases; HDL

Decreases; triglycerides, synthesis of triglycerides and other lipids

17

What are uses of bile acid sequestrants

Lowers; LDL,

Slight HDL increase
Oxidizes cholesterol into bile acids which decreases fat absorption

18

What are the therapeutic effects of cholesterol absorption inhibitors

Lowers LDL
Inhibits absorption of cholesterol in small intestine

19

What are the therapeutic effects of omega3 acid ethyl esters


Lowers triglycerides
Inhibits triglyceride production in the liver

20

What do catecholamines do

They increase BP, HR and myocardial workload

21

What does nitrates do as far as treating angina

They are for short and long term reduction of myocardial oxygen consumption through selective vasodilation

22

What do beta blockers do for the relief of angina

Reduction of myocardial oxygen consumption by blocking beta adrenergic stimulation of the heart.

23

Calcium channel blockers are indicated for angina, how are they used

Negative Inotropic effects
Indicated in patients not responsive to beta blockers
Used in primary treatment for vasospasm

24

Name anti platelet meds

Aspirin
Clopidogrel ( plavix)
Prasugrel ( effient)
Glycoprotein IIB/IIa agents;
Abciximab ( ReoPro)
Eptifibatide ( integrillin)

25

Name anticoagulant drugs

Heparin
Low molecular weight heparins;
Enoxaparin (lovenox)
Dalteparin ( fragmin)

26

What is used to diagnose a acute MI

Cardiac enzymes and biomarkers, which include troponin, creatinine kinase (CK) and myoglobin

27

Troponin

A protein found in myocardial cells, regulates the myocardial contractile process
Troponin I&T are specific for cardiac muscle these are critical markers for myocardial injury.
A increase in the level of troponin can be detected within a few hours of a MI, it remains elevated for as long as 3 weeks therefore making it can be used to detect recent myocardial damage.

28

CK-MB ( heart muscle)

Is the cardiac- specific isoenzyme it is found mainly in cardiac cells and therefore increases when There has been damage to these cells
Elevations of CK-MB is an indicator of an acute MI. The levels begin to peak within a few hours and peaks within 24 hours of an infarct

29

CK- BB

Brain tissue

30

CK-MM

Skeletal muscle

31

S&S of diverticulosis

Constipation
Seepage of stool

32

Treatment of diverticulosis

Antibiotics or resection
Hydration
Diet changes

33

Diagnostics of diverticulosis

Abdominal x Ray
Barium enema
ESR, WBC, CRP levels will b elevated
Heme positive for occult blood

34

What are s&s of a peptic ulcer

Sharp pain knife like
Heart burn
Coffee ground emesis
Weakness fatigue

35

What are s&s of RA

Pain stiffness

36

What are risk factors for RA

Female

37

What are diagnostics of RA

X-ray
RA factor
NAA factor
ESR, CRP, ANTI CC, are all elevated

38

What are s&s of MS

Bowel, bladder and sexual dysfunction
Fatigue, muscle weakness
Ataxic, Diplopia
Blurred vision
Loss of ability to walk
Constipation
Incontinence
Dysphagia

39

What are risk factors of MS

Genetic
Viruses
Age 30-40
Linked to Epstein Barr virus

40

What are diagnostics of MS

MRI
ELECTROPHORESIS OF SPINAL FLIUD
UNDERLYING BLADDER DYSFUNCTION DIAGNOSED BY URODYNAMIC STUDIES
NEUROPHYSIOLOGICAL STUDIES