Exam Heart

Question 1

What is the initial trigger for atherosclerosis?

Answer 1

Damage to the endothelial lining (e.g., smoking, hypertension, lipids)

Question 2

What cells turn into foam cells during atherosclerosis?

Answer 2

Macrophages

Question 3

What does the fibrous cap do in atherosclerosis?

Answer 3

Covers the fatty streak and releases calcium, hardening the plaque

Question 4

Mnemonic for atherosclerosis progression?

Answer 4

D-I-F: Damage → Inflammation → Fibrosis

Question 5

What is a critical complication of plaque rupture?

Answer 5

Thrombosis leading to myocardial infarction or stroke

Question 6

Define hypertension in terms of systolic/diastolic values?

Answer 6

Systolic >140 mmHg or Diastolic >90 mmHg

Question 7

What are common causes of secondary hypertension?

Answer 7

Renal disease, endocrine disorders, medications

Question 8

What system regulates blood pressure via sodium and water?

Answer 8

RAAS – Renin-Angiotensin-Aldosterone System

Question 9

Mnemonic for local blood pressure control?

Answer 9

PENS: Prostaglandins, Endothelin, Nitric oxide, Sympathetic NS

Question 10

What is a key diagnostic clue of secondary hypertension?

Answer 10

Sudden onset or uncontrolled BP despite therapy

Question 11

What causes 90% of myocardial ischemia?

Answer 11

Atherosclerotic obstruction of coronary arteries

Question 12

What is the pathophysiology of ischemia?

Answer 12

Imbalance between oxygen supply and myocardial demand

Question 13

What are classic symptoms of myocardial ischemia?

Answer 13

Chest pain, radiating arm/jaw pain, nausea, cool clammy skin

Question 14

What lab test confirms myocardial infarction?

Answer 14

Elevated serum troponin

Question 15

Mnemonic for ischemia-related angina types?

Answer 15

SCO: Stable, Chronic, Occasional (silent)

Question 16

What is the difference between STEMI and NSTEMI?

Answer 16

STEMI shows ST elevation on ECG; NSTEMI does not but still involves infarction

Question 17

What ECG is necessary for ACS diagnosis?

Answer 17

12-lead ECG

Question 18

What does MONA stand for in ACS treatment?

Answer 18

Morphine, Oxygen, Nitrates, Aspirin

Question 19

What intervention reopens blocked arteries in ACS?

Answer 19

PCI (Percutaneous Coronary Intervention)

Question 20

Mnemonic for ACS progression?

Answer 20

U-A-MI: Unstable Angina → Acute MI

Question 21

What is the pathophysiology of heart failure?

Answer 21

Ventricular dysfunction leading to decreased cardiac output and poor perfusion

Question 22

What system compensates in heart failure but worsens it long-term?

Answer 22

SNS and RAAS (increase workload and fluid retention)

Question 23

What is the difference between systolic and diastolic HF?

Answer 23

Systolic: can’t pump out; Diastolic: can’t fill properly

Question 24

What medication improves survival in HF by blocking remodeling?

Answer 24

ACE inhibitors or β-blockers

Question 25

Mnemonic for HF management?

Answer 25

DO-LOAD: Daily weights, O2, Low sodium, ACE/ARB, Diuretics

Question 26

What is the sign of right-sided heart failure?

Answer 26

Peripheral edema, JVD, hepatomegaly

Question 27

What is the hallmark of left-sided heart failure?

Answer 27

Pulmonary edema, dyspnea, crackles in lungs

Question 28

What is used in end-stage heart failure?

Answer 28

Heart transplant or VAD (ventricular assist device)

Question 29

During Atherosclerosis reduced blood flow to the myocardium leading to reduced O2 delivery which causes what type of metabolism?

Answer 29

Anaerobic metabolism

Question 30

Reduced O2 to the heart and reduced ATP production increases what? Hint: This causes chest pain

Answer 30

Lactic Acid

Question 31

Why can chest pain radiate to other parts of the body? (Neck, jaw, arm)

Answer 31

They share the same pain pathway, to take the impulses up to the brain.

Question 32

What is the difference between systolic and diastolic heart failure?

Answer 32

Systolic is when the heart fails to contract. Diastolic is when the heart fails to relax.