lecture 10 cardiac consequences of atheroma

Question 1

ethnicity predisposed to atheroma

Answer 1

south east asians

Question 2

risk factors you can change

Answer 2

smoking, diabetes mellitus, obesity, lipids, hypertension, diet, pollution, stress and exercise

Question 3

risk factors you cant change

Answer 3

family history, gender, age and ethnicity

Question 4

what forms on the fatty streak of the atheroma

Answer 4

fibrous cap

Question 5

what is at the core of the atheroma

Answer 5

lipid core

Question 6

what does the vessel do at first when there is an atheroma

Answer 6

dilates to compensate

Question 7

what happens when the cap ruptures

Answer 7

lipid are exposed to circulation which initiates thrombotic cascade

Question 8

where may angina radiate

Answer 8

arms
jaw
neck and teeth

Question 9

how is stable angina relieved

Answer 9

rest and nitrites

Question 10

how is stable angina confirmed

Answer 10

stress testing

Question 11

what does the ECG look like for stable angina

Answer 11

normal at rest

ST depression on walking

Question 12

unstable angina pathology

Answer 12

myocardial necrosis

Question 13

symptom of unstable angina

Answer 13

random pain

Question 14

diagnosis of unstable angina

Answer 14

troponin

Question 15

ST elevation cause

Answer 15

complete occlusion of a coronary artery

Question 16

how do you treat complete occlusion of a coronary artery

Answer 16

thrombolysis or angioplasty stent implantation

Question 17

isoelectric line

Answer 17

flat line on the ECG

Question 18

first sign of a STEMI on ECG

Answer 18

slight peak in the T wave

Question 19

what happens after T wave peak in STEMI

Answer 19

ST elevation
loss of R wave
big Q wave

Question 20

what supplies the inferior wall

Answer 20

right coronary artery

Question 21

left coronary artery divides into

Answer 21

LAD and the left circumflex

Question 22

what supples the anterior wall

Answer 22

LAD

Question 23

what supplies the lateral wall

Answer 23

left circumflex

Question 24

what coronary dominance do most people have

Answer 24

right

Question 25

MI of right coronary artery ECG

Answer 25

inferior ST elevation MI

Question 26

MI of the LAD ECG

Answer 26

anterior ST elevation

Question 27

MI of the circumflex

Answer 27

lateral ST elevation

Question 28

things to bear in mine after an MI

Answer 28

troponin falls during the following week - not another MI

Question 29

what is troponin

Answer 29

protein

Question 30

what is troponin attatched to

Answer 30

tropomyosin

Question 31

what binds to the troponin

Answer 31

calcium

Question 32

other causes of elevated troponin

Answer 32

PE, pulmonary hypertension, septicaemia

Question 33

MI treatment

Answer 33

antiplatelets, heparin, statin and anti ischemics

STENTs

Question 34

examples of antiplatelets

Answer 34

aspirin

clopidogrel

Question 35

anti ischemic medications

Answer 35

vasodilators

such as beta blockers and nitrates

Question 36

what happens between the healthy and necrotic tissue

Answer 36

there is rupture = death

PEA

Question 37

how will you see left ventricular dysfunction

Answer 37

enlarged heart shadow on radiograph

Question 38

where do the leads of a defib go

Answer 38

through the subclavian vein

apex LV and right atrium