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PATHO > EXAM 2 MI > Flashcards

EXAM 2 MI Flashcards

(62 cards)

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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
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

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