Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CVPR exam 2 > Ischemic Heart Disease I > Flashcards

Ischemic Heart Disease I Flashcards

(60 cards)

Start Studying
1
Q

What are the untreatable risk factors for CAD?

A

male gender age genetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

What is the estimated lifetime risk of DM for persons in the US?

A

33%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

Diabetes and insulin resistance are associated with inflammation, oxidative stress, and dyslipidemia that predispose to _______.

A

atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

_____ are associated with inflammation, oxidative stress, and dyslipidemia that predispose to atherosclerosis.

A

Diabetes and insulin resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In the normal coronary circulation, autoregulation provides protection from _____.

A

moderate changes in perfusion pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What contributes to fibrous plaques and occlusive atherosclerotic plaques?

A

activated macs (foam cells) smooth muscle proliferation forms fibrous caps progressive lipid accumulation in core of plaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When is the LV perfused?

A

diastole only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When oxidized, ____ becomes pro-inflammatory and athrogenic.

A

LDL cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Factors that increase myocardial O2 demand?

A
  1. HR 2. wall tension 3. inotropic state
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

An _____ causes a drop in perfusion pressure.

A

epicardial coronary stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Tachycardia can compromise ______.

A

coronary flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The dyslipidemic triad includes ____, ____, and ____.

A

high HDL low LDL high triglycerides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the beneficial effects of HDL?

A
  1. inhibits oxidation of LDLs 2. inhibits tissue factor 3. enhances reverse cholesterol transport 4. stimulates NO production 5. inhibits endothelial adhesion molecules *** all oppose atherosclerosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Oxygen delivery (mol/min) = coronary flow rate (ml/min) x _______

A

arterial oxygen content (mol O2/ml blood)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the acute vascular events associated with plaque rupture/fissure and thrombosis?

A

unstable angina MI stroke critical leg ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Oxygen delivery (mol/min) = ______ x arterial oxygen content (mol O2/ml blood)

A

coronary flow rate (ml/min)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is a reperfusion injury?

A

early reperfusion that can provoke an additional injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

______ = coronary flow rate (ml/min) x arterial oxygen content (mol O2/ml blood)

A

Oxygen delivery (mol/min)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is O2 supply increased in chronic stable angina treated?

A

prevent HTN, give beta blockers, vasodilators, coronary angioplasty or bypass surgery, treat anemia and hypoxemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Smoking confers a 50% increase in ___ risk.

A

CAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is O2 demand reduced in chronic stable angina?

A

antihypertensive drugs, rate slowing drugs (beta-blockers, Ca++ channel blockers, limit preload (diuretics, nitrates), negative inotropes (beta blockers, Ca++ channel blockers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

______ limits coronary flow and cause myocardial ischemia (tissue blood flow insufficient to meet oxygen requirements), particularly when cardiac work and oxygen demand increase.

A

Obstructive coronary lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Oxygen supply may be compromised by ____ or ____.

A

anemia; hypoxemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the cardinal symptom of an MI?

A

severe and unremitting chest discomfort at rest (although 30% of MI’s are “silent”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
In coronary heart disease, autoregulation may be exhausted when ______ across an epicardial coronary stenosis.
pressure drops
18
When is troponin elevated?
in an acute MI
19
What causes unstable angina?
Near-complete occlusion of vessel with thrombus
20
What is different about the coronary circulation?
1. the myocardium depends on aerobic metabolism for energy supply 2. Under resting conditions, a near-maximal amount of oxygen is extracted from coronary arterial blood; therefore, the only effective means of increasing myocardial O2 supply is to increase blood flow rate 3. the LV is perfused in diastole only
21
What attributes to a fatty streak?
endothelial injury lipid deposition mac and T cell recruitment
23
\_\_\_\_\_\_ (dental, respiratory, immunologic diseases) may also increase the risk of atherosclerotic cardiovascular events.
Extravascular inflammation
24
Autoregulation occurs at the level of \_\_\_\_\_.
the small arterioles
25
How does HTN contribute to CAD risk?
increased shear stress on arterial walls = - endothelial cell injury - initiates pathologic cell signaling program causing oxidant stress, cellular proliferation circulating hormones increased exert adverse affects on arterial wall (angiotensin, aldosterone, NE) LVH
27
Myocardial ischemia = imbalance between _____ and \_\_\_\_\_\_
coronary oxygen delivery; myocardial oxygen demand
28
How does smoking increase the risk of CAD?
thrombogenic tendencies platelet activation increased fibrinogen aryl hydrocarbons promote atherosclerosis endothelial dysfunction, vasospasms CO decreases myocardial O2 delivery decreased HDL
29
Smoking confers a _____ in CAD risk.
50% increase
30
In coronary heart disease, ______ may be exhausted when pressure drops across an epicardial coronary stenosis.
autoregulation
32
Name the 4 steps of atherosclerosis, starting from normal.
1. fatty streak 2. fibrous plaque 3. occlusive atherosclerotic plaque 4. plaque rupture/fissure and thrombosis
33
What happens w/I 1 hour of acute coronary occlusion?
Myocardial necrosis and infarction
34
What are the factors that are treatable, but whether the risk is reduced is unclear.
1. diabetes/insulin resistance 2. obesity 3. inflammation 4. psychological stress 5. sedentary lifestyle
36
Diabetes and insulin resistance are associated with \_\_\_\_\_, \_\_\_\_\_, and _____ that predispose to atherosclerosis.
inflammation, oxidative stress, and dyslipidemia
37
What will the biomarkers be for unstable angina?
negative, including troponin
38
Increased heart rate shortens the cardiac cycle, predominantly by \_\_\_\_\_\_.
shortening diastole
40
\_\_\_\_\_ = imbalance between coronary oxygen delivery and myocardial oxygen demand
Myocardial ischemia
41
What are some of the deleterious effects of LDL?
- injures vascular epi and impairs epi function - deposits into arterial wall... taken up by macs, which increases plaque volume - activates inflammatory cells that play a role in progression and instability of lesions - activates platelets = pro-thrombotic
42
\_\_\_\_\_ confers a 50% increase in CAD risk.
Smoking
43
At which stage of atherosclerosis does effort angina and claudication appear?
occlusive atherosclerotic plaque
45
What causes acute vascular events?
plaque rupture/fissure and thrombosis
46
\_\_\_\_\_ can compromise coronary flow.
Tachycardia
47
Lipid-laden macrophages in an arterial wall plaque are \_\_\_\_\_.
highly pro-inflammatory
49
\_\_\_\_ occurs at the level of the small arterioles.
Autoregulation
50
An epicardial coronary stenosis causes \_\_\_\_\_.
a drop in perfusion pressure
51
LV perfusion is predominantly diastolic because of \_\_\_\_\_\_.
compression of intramural coronary vessels in systole
52
What happens w.i minutes of an acute coronary occlusion?
1. Impaired calcium re-uptake into SR during diastole \> diastolic dysfunction (filling impairment) \> increased LV filling pressure \> pulmonary congestion and edema 2. Depletion of high energy phosphates, intracellular acidosis \> systolic dysfunction (contractile failure) 3. ECG signs of myocardial injury 4. Symptoms (chest pain, dyspnea, arrhythmias)
54
What are 3 treatable factors with CAD that reduce risk?
1. smoking 2. HTN 3. dyslipidemia
55
When oxidized, LDL cholesterol becomes ____ and \_\_\_\_\_.
pro-inflammatory and athrogenic
56
\_\_\_\_\_ in an arterial wall plaque are highly pro-inflammatory.
Lipid-laden macrophages
57
In coronary heart disease, autoregulation may be exhausted when pressure drops across an \_\_\_\_\_.
epicardial coronary stenosis
58
\_\_\_\_\_ shortens the cardiac cycle, predominantly by shortening diastole.
Increased heart rate
59
Name one circulating marker of inflammation.
CRP
60
Inflammation plays a key role in _____ and _____ of atherosclerosis.
initiation and progression

CVPR exam 2 (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions