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Flashcards in EXAM 2 MI Deck (62):
1

Risk factors of MI:

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

2

Smoking causes __% and diabetes causes __% of CAD

36; 20

3

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

7-12

4

Less common causes of MI include: (2)

1. Job stress (3% of cases)
2. Chronic high stress levels

5

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

Alcohol; prolonged; alcohol

6

Psychosocial factors including: (3)
1
2
3
increase the risk of and are associated with worse outcomes after MI

1. low socioeconomic status
2. social isolation
3. negative emotions

7

Socioeconomic factos such as:
1
2
3
are also correlated with MI

1. shorter education
2. lower income particularly in women
3. unmarried cohabitation

8

MI occurs when:

myocardial tissue is abruptly and severely deprived by oxygen

9

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

80-90

10

Ischemia can lead to: (2)

1. Injury
2. Necrosis

11

Most MIs are the result of: (4)

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

12

Other factors that lead to MIs: (3)

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

13

Angina Pectoris =

chest pain

14

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

deficit; oxygen

15

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

moderate; prolonged exertion; familiar

16

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

same; several months

17

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

slight limitation; activity; fixed atherosclerotic plaque
nitroglycerin; rest; drug therapy

18

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

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

19

In someone without cardiac problems,
normal oxygen supply equals to that of

normal activity

20

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

increased

21

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

decreased; normal activity

22

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

1. rest
2. position change
3. nitrate administration

23

Ask the patient where pain is present:
(what are the possibilities?) (6)

1. chest
2. epigastric area
3. jaw
4. back
5. shoulder
6. arm

24

In diabetics, they __ have typical chest pain. Angina is presented as:
1.
2.
3.
4.

don't

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

25

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

nausea; vomiting; reflex stimulation; vomiting

26

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

sympathetic; catecholamines
diaphoresis; vasoconstriction

27

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

African Americans; women
dyspnea ; classical pain

28

Only __ of elderly have classical clinical manifestations of MI

50%

29

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

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

30

What is the initial symptom for women having an MI?

extreme fatigue

31

Women also complain of

epigastric discomfort

32

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

Heart disease; 35
6; breast cancer

33

Some lab studies that can be done are __ __

cardiac enzymes

34

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

rhythm abnormalities; ST elevation; T wave inversion

35

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

angiography

36

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

6; blue; swollen

37

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

4-6

38

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

gray; yellow; neutrophils; necrotic

39

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

granulation tissue

40

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

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

41

CK-MB
Onset:
Peak:
Duration:

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

42

Myoglobin
Onset:
Peak:
Duration:

1-2 hours
8-10 hours
24 hours

43

Lactic Dehydrogenase (LD)
Onset:
Peak:
Duration :

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

44

What are the most common lab tests?

Troponin
CKMB
myoglobin
LDH

45

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

Troponin

46

CKMB takes

4-12 hours

47

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

primary; muscle
high; specificity

48

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

90; ST elevation
ST segment elevation MI or STEMI

49

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

ST segment depression
T wave inversion

non ST elevation MI ; nonSTEMI

50

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

artery opening therapy

51

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

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

52

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

percutaneous transluminal coronary angioplasty

53

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

MONA

54

M =

Morphine

55

O =

Oxygen

56

N =

Nitroglycerin

57

A =

Aspirin

58

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

sulfate; unresponsive; nitroglycerin

59

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

myocardial oxygen demand; smooth muscle; circulating catecholamine

60

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

supplemental

61

(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 __

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

62

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

platelet aggregation; vasoconstriction
thrombosis
one hour; several days