IHD

Question 1

Cornerstone in the diagnosis of acute and chronic IHD

Answer 1

ECG

Question 2

MC underlying cause of myocardial ischemia and injury

Answer 2

obstruction of coronary arteries by atherosclerosis

Question 3

Infection associated w/ ACCELERATED atherosclerosis

Answer 3

Chlamydophila pneumoniae

Question 4

MC cause of anterior chest musculoskeletal pain

Answer 4

costochondral and chondrosternal syndromes

Question 5

Myocardial perfusion occurs during this time

Answer 5

diastole

Question 6

The initial lesion of atherosclerosis

Answer 6

fatty streak

Question 7

Major features of METABOLIC SYNDROME

Answer 7

central obesity
hyperglycemia
hypertriglyceridemia
hypertension
low HDL cholesterol

Question 8

Age when lipid screening should start

Answer 8

> 20 years (fasting lipid profile: total cholesterol, TGL, LDL and HDL

repeated every 5 years

Question 9

Key feature of metabolic syndrome

Answer 9

central adiposity

Question 10

Most accepted and unifying hypothesis to describe pathophysiology of metabolic syndrome

Answer 10

Insulin resistance

Question 11

Driving force behind metabolic syndrome

Answer 11

obesity

Question 12

MC cause of myocardial ischemia

Answer 12

atherosclerotic disease of epicardial coronary artery

Question 13

MC major vessel involved in MI

Answer 13

LAD artery

Question 14

Sites of predilection for atherosclerotic plaques to develop d.t. increased turbulence

Answer 14

branch points in the EPICARDIAL ARTERIES

Question 15

Time frame for REVERSIBLE damage in myocardium

Answer 15

< 20 mins for total occlusion in the absence of collaterals

Question 16

Most widely used test for both the diagnosis of IHD and estimating the prognosis

Answer 16

electrocardiographic stress testing

Question 17

MC pathophysiologic cause of UNSTABLE angina

Answer 17

plaque rupture or erosion w/ superimposed non-occlusive thrombus

Question 18

ABSOLUTE CONTRAINDICATIONS to NITRATE use

Answer 18

hypotension

sildenafil (or similar drug) in previous 24-48 hrs

Question 19

MC artery involved in Prinzmetal Angina

Answer 19

RCA

Question 20

Main agents for acute episodes and to abolish recurrent episodes of Prinzmetal’s angina

Answer 20

nitrates and calcium blockers (Nifedipine)

Question 21

Necrosis seen in MI

Answer 21

COAGULATION necrosis (preserved architecture, faded details)

Question 22

Earliest detectable feature of MYOCYTE NECROSIS

Answer 22

sarcolemmal membrane disruption (leads to leakage of cardiac enzymes into circulation)

Question 23

Time frame where GROSS changes in MI occur

Answer 23

12 hrs after the onset of symptoms

Question 24

Color changes in MI

Answer 24

4 hrs - mottling
1 wk - bright yellow
2 wks - surrounding red granulation tissue
2 mos - gray-white scar

Question 25

Fibrinous Pericarditis post MI

Answer 25

Dressler syndrome

Question 26

Sites of myocardial rupture in MI

Answer 26

free wall > IVS > papillary muscle

Question 27

Preferred biochemical markers for MI

Answer 27

cardiac specific troponin T and cardiac specific troponin I

Question 28

Preferred biochemical markers for re-infarction

Answer 28

CK-MB

Question 29

Level of coronary artery stenosis sufficient to produce ischemia

Answer 29

70% (critical stenosis)

Question 30

Primary cause of OUT-OF hospital deaths from STEMI

Answer 30

ventricular fibrillation

Question 31

Primary cause of IN hospital deaths from STEMI

Answer 31

pump failure

Question 32

Greatest delay usually occurs between

Answer 32

onset of pain and patient's decision to call for help

Question 33

Principal goal of FIBRINOLYSIS

Answer 33

prompt restoration of full coronary arterial patency

Question 34

Extent of LV involvement that results in cardiogenic shock

Answer 34

infarction > 40%

Question 35

MC complication of ANGIOPLASTY

Answer 35

restenosis

Question 36

MC thrombi found in NSTEMI (composed mainly of platelets)

Answer 36

white thrombi

Question 37

MC thrombi found in STEMI (composed mainly of cells and fibrin )

Answer 37

red thrombi

Question 38

MC cause of sudden cardiac death

Answer 38

CAD

Question 39

MC arrhythmia post-MI

Answer 39

PVC

Question 40

MC lethal arrhythmia post-MI

Answer 40

ventricular fibrillation