Lectures 1-6 Cardiovascular

Question 1

what are the 3 things listed under acute coronary syndromes

Answer 1

-unstable angina
- non ST segment elevation MI
- ST segment elevation MI

Question 2

describe primary prevention

Answer 2

no current disease, preventing the first event from happening

Question 3

what is another word for prinzmetal angina

Answer 3

vasospastic disease

Question 4

what are the 3 types of angina

Answer 4

Printzmetals variant
chronic stable
unstable

Question 5

of the 3 types of angina, which is considered “demand ischemia”

Answer 5

chronic stable

Question 6

“fixed stenosis” in other words

Answer 6

chronic stable angina

Question 7

“vasospasm” in other words

Answer 7

Printzmetal’s variant angina

Question 8

“thrombus” in other words

Answer 8

unstable angina

Question 9

angina has what effect on coronary blood flood

Answer 9

decrease

Question 10

an increase in HR contractility, afterload, and preload has what effect on oxygen consumption

Answer 10

raises it

Question 11

a decrease in contractility has what effect on O2 consumption?

Answer 11

lowers it, moving less=less need for O2

Question 12

Preload-LVEDV:
- ______ed by venodilation
- _______se leads to ______ in O2 consumption
- ______ leads to increase in myocardial perfusion (things being able to pass through)

Answer 12

decreased, decrease, decrease

Question 13

Afterload:
- Decreased by _______ of arteries
- decrease leads to decrease in ___ _______

Answer 13

dilation, O2 consumption

Question 14

what is stable angina pectoris usually associated with?

Answer 14

large single to multi vessel ASCAD

Question 15

what are the 4 main epicardial vessels?

Answer 15

Right coronary artery
Left main
Left anterior descending
Left circumflex

Question 16

Ischemia is NOT associated with what? ( from slides i know this can be a million things)

Answer 16

myocardial necrosis

Question 17

whats that pneumonic we talked about regarding clinical presentation?

Answer 17

PQRST
Precipitating Factors
Palliative measures
Quality and quantity of pain
Region and Radiation
Severity of the pain
Timing and temporal pattern

Question 18

Typical angina:
- _________
- duration: ____-____ min
- NTG/______ _____

Answer 18

substernal
0.5-20 min
rest reilef

Question 19

What are the normal ECG findings of a typical angina?

Answer 19

ST-segment depression (during an event)

Question 20

what is the most common procedure done in the US that is considered a “definitive assessment of coronary anatomy”?

Answer 20

Cardiac Catheterization and coronary angiography

Question 21

where is the most common site for cardiac catherization?

Answer 21

radial artery in wrist

Question 22

Each of the following statements regarding chronic coronary
disease is correct EXCEPT?
A. Stable angina is associated with pain that is increasing in
severity and not relieved by NTG
B. Women and patients with diabetes may experience atypical
symptoms
C. Angina is discomfort associated with ischemia
D. Prinzmetal’s or variant angina is associated with coronary
vasospasm
E. Chronic coronary disease is usually associated with
atherosclerosis

Answer 22

A

Question 23

give the treatment goals for the following risk factors:
Dyslipidemia:
htn:
Diabetes (A1C):

Answer 23

> 50% reduction in LDL
BP <130/80
A1C < 7%

Question 24

T or F: Low does aspirin decreases platelet aggregation

Answer 24

True

Question 25

what is the loading dose of aspirin?

Answer 25

162-325 mg (more often 325)

Question 25

Mechanism of aspirin (low dose)

Answer 25

irreversibly inhibit COX-1, blocking the formation of TXA2-> preventing platelet aggregation

Question 25

clopidogrel loading dose

Answer 25

300-600 mg

Question 25

Mechanism of aspirin (high dose)

Answer 25

inhibits COX-2, blocking formation of PGI2

Question 26

Prasugrel loading dose

Answer 26

60 mg

Question 27

ticagrelor loading dose

Answer 27

180 mg

Question 28

normal dose aspirin

Answer 28

75-162 mg

Question 29

normal dose clopidogrel

Answer 29

75 mg daily

Question 30

normal dose prasugrel

Answer 30

10 mg daily

Question 31

normal dose ticagrelor

Answer 31

90 mg BID

Question 32

normal dose Cangrelor

Answer 32

this is a trick, its IV only

Question 33

-
-

Answer 33

gastrointestinal bleeding
hematologic bleeding (intra and extracranial)
hypersensitivity

Question 34

T or F: Clopidogrel and Prasugrel require activation

Answer 34

True, they are both prodrugs

Question 35

T or F: in order to have the same effect as clopidogrel, you need a larger amount of prasugrel

Answer 35

false, you need more clopidogrel

Question 36

which P2Y12 inhibitor is more CYP dependent?

Answer 36

Clopidogrel

Question 37

-

Answer 37

bleeding, diarrhea, rash
~1% increase in major bleeding when added to ASA

Question 38

-

Answer 38

bleeding, diarrhea, rash
~-0.6% increase in major bleeding compared to clopidogrel

Question 39

Adverse effects Ticagrelor

Answer 39

bleeding, bradycardia, heart block, dyspnea ss