Coronary heart disease

Question 1

Metabolic syndrome must have 3 or more of

Answer 1

hypertriglyceridemia (>150mg/dl), low HDL (40mg/dl male or 130/85), high FPG (>100 mg/dl), HTN, central obesity

Question 2

Highest population with metabolic syndrome

Answer 2

Mexican american women

Question 3

Women vs men are more likely to have

Answer 3

women are more likely to have an increase in waist circumference, men are more likely to have high TG and HTN

Question 4

Risk factors for developing metabolic syndrome

Answer 4

overweight, central adiposity, sedentary lifestyle, aging (>50 yo), diabetes, coronary heart disease

Question 5

Clinical features of metabolic syndrome

Answer 5

asymptomatic, increased waist circumference, elevated BP, lipoatrophy, acanthosis nigricans

Question 6

What laboratory tests would you do on a pt with suspected Metabolic syndrome

Answer 6

lipid panel, CBC

Question 7

CAD risk factors

Answer 7

cholesterol >240, BP >140/90, smoking, diabetes, history of MI, family history

Question 8

Best approach for screening CHD

Answer 8

exercise EKG

Question 9

ECG findings of MI

Answer 9

ST elevation (except V2 and V3, non-ST elevation or unstable angina including down sloping ST depression or T inversion; reciprocal ST segment depressions can occur in STEMI

Question 10

Questions to ask MI pt

Answer 10

CP worsen w/ activity, describe pain, has it happened before, does it radiate, HA, dizziness, nausea, blurred vision

Question 11

What population of people have atypical symptoms of MI

Answer 11

elderly, women, diabetics

Question 12

How to assess pt with MI

Answer 12

check edema, crackles, increased JVP, ascites, attach cardiac monitor, check O2, IV assess, systemic hypotension, check neuro

Question 13

What labs to order for MI pt

Answer 13

CKMB, lipid, BNP, tryponin, ECG

Question 14

Management of STEMI pt

Answer 14

MONABAH: morphine sulfate, oxygen, nitro, aspirin, BB, ACEI, heparin, PCI, ventricular arrhythmia treatment if necessary

Question 15

Management of NSTEMI

Answer 15

ASA 325mg, Ticagrelor 180 mg, if PCI in 4-48 hours start on hepain IV bolus 60-70 units, with 12 units to achieve aPTT of 1.5-2 times control; if no PCI enoxaparin 1 mg/kg q12h; possible statin

Question 16

Classification of unstable angina severity

Answer 16

Class 1: new onset, severe or accelerated; Class 2: angina at rest and subacute; Class 3: angina at rest and acute

Question 17

Classification of UA clinical circumstances

Answer 17

Class A: secondary UA (infection etc), Class B: primary UA, Class C: post MI angina