Midterm Study Material Flashcards
1
Q
What is a natural supplement for lowering cholesterol and a common drug used?
A
Red yeast rice, Lipitor (statin)
2
Q
Target serum HDL level for males and females? According to Elkington’s notes..
A
Males: >45 mg/dL
Females: >55 mg/dL
3
Q
Interestingly in the notes, a way to raise HDL levels?
A
Drink 1-3 alcoholic drinks/day w/meals. (Red wine probably best?)
4
Q
Optimal ratio for TC:HDL?
A
<5 (:1)
5
Q
A normal, healthy BMI?
A
19-24
6
Q
A BMI > or = ____ is considered OBESE
A
30
7
Q
High risk waist size for men/women?
A
Men: >/= 40”
Women: >/= 35”
8
Q
Higher risk waist:hip ratio in men/women?
A
Men: > .9
Women: >/= .85
9
Q
This indicates inflammation and a number >5-7 is associated w/elevated cardiovascular risk, including stroke.
A
Homocysteine
10
Q
This is a non-specific marker of inflammation. Recently it has been associated w/increased CV risk. May be important to check in women w/CAD symptoms, but negative coronary angiogram.
A
C-Reactive Protein
11
Q
What vitamins may be good for lowering inflammation markers? (Homocysteine, CRP)
A
B Vitamins
12
Q
What illegal drug is most commonly associated w/CVD?
A
Cocaine
13
Q
What Vitamin deficiency is recently associated with CVD? “Probably more important than any other vitamin for CV health”
A
Vitamin D
14
Q
Almost __% of deaths from heart disease occur before the patient experiences symptoms of heart disease.
A
50%
15
Q
What arrhythmia is common among healthy, young adults?
A
Sinus arrhythmia (speeds up with inspiration, slows down with expiration)
16
Q
What enzymes are important to check after suspected MI?
A
CPK-MB
AST, one other i forgot
17
Q
Normal blood oxygen saturation?
A
95-100%
18
Q
<90% blood oxygen saturation is called?
A
Hypoxemia
19
Q
This is a commonly used device to check blood oxygen level. It clips on a finger
A
Pulse oximeter
20
Q
The most common test to evaluate the coagulability of blood?
A
International Normalized Ratio (INR)
21
Q
What is normal INR? (Coagulability of blood)
A
1
22
Q
This is a hormone secreted by the heart when it is overworked. High levels in the blood may suggest congestive heart failure.
A
BNP (B-type natriuretic peptide)
23
Q
A goal INR for patients taking anticoagulant meds (blood thinners)?
A
2-4
24
Q
Name a few “electrolytes”
A
Potassium, calcium, magnesium
25
An ECG during exercise is called?
Stress ECG (stress test)
26
A scale used to grade the patient’s exertion level during a stress test. From 6 (very, very light) to 20 (very, very hard)
Borg Perceived Exertion Scale
27
This device is worn for 24-72 hours to read ECG over time. Used when dysrhythmias occur only sporadically.
Holter monitor
28
This is a non-invasive, extremely useful diagnostic ultrasound of a heart interpreted by a computer.
Echocardiography (and stress echo)
29
The gold standard for diagnosing coronary artery disease?
Angiography/Catheterization
30
In this test, a contrast medium is injected into the coronary arteries through a catheter. X-ray motion pictures will be taken to determine location and degree of obstruction.
Coronary Angiography
31
This is like an “internal ECG”. It is useful for locating the source of arrhythmias and then catheter ablation is used to destroy/eliminate it.
Electrophysiology studies
32
The inability (failure) of the heart to pump blood at levels sufficient to maintain health, function, life. i.e. the heart is worn out. It becomes a dam instead of a pump!
Congestive Heart Failure (CHF)
33
Most common reason for hospitalizations in people >65 yo.
CHF
34
This type of heart failure is due to HTN, aortic stenosis, mitral regurgitation. Fluid accumulates in the LUNGS which causes the cardinal sign: Dyspnea on Exertion (DOE)
LEFT heart failure
35
In this type of heart failure, fluid accumulates in the BODY (back-up). Leads to swollen veins and tissues (neck/face/legs/feet/abdomen).
RIGHT heart failure
36
On an echocardiogram of a patient with CHF, it would show decreased ____
Ejection Fraction (EF)
37
It heart failure it would be important to attempt to reduce the effects of ____ (hormone)
Adrenaline
38
Dick Cheney had this device before his heart transplant. To help w/heart failure.
Left Ventricular Assist Device (LVAD)
39
Defects in the development of the heart walls, septa, valves, great vessels. Occurs in about 0.7% of newborns.
Congenital Heart Disease
40
The MCC of blue baby syndrome? Usually 3 defects present in the heart. There is not a complete wall between the two ventricles so blood will mix before exiting heart.
Tetralogy of Fallot
41
This occurs when the great vessels are basically flipped (i.e. aorta comes from RIGHT ventricle, etc.)
Transposition of great vessels
42
A congenital defect in which a small artery exits the arch of the aorta and empties blood into the pulmonary artery (oxygenated blood joining the deoxygenated blood traveling TO the lungs)
Patent ductus arteriosus
43
“Pinching” of the aorta which occurs in the arch AFTER the vessels to the head and arms have already exited.
Coarctation of the aorta
44
A valve disorder which impedes the forward flow of blood
Stenosis
45
A valve disorder in which backwards flow of blood is allowed
Regurgitation
46
The two most common valves of the heart that dysfunction? (Due to pressure)
Aortic, mitral (left side of heart)
47
Symptoms of this heart disease usually occur late, they will show signs of a stressed heart, especially on exertion. A heart murmur will be produced and you may be able to feel a palpable thrill.
Heart Valve Disease
48
The two most common sources of murmur?
1. Aortic stenosis
| 2. Mitral regurgitation
49
Inadequately treated strep throat or scarlet fever can lead to _____: “vegetations” (scarring) on the heart valves. This affects the endocardial layer, especially over the valves.
Rheumatic fever
50
```
Symptoms of ____:
Fever, chills
Rapid heartbeat
Migratory polyarthritis
Fatigue, weakness, irritability
```
Rheumatic fever
51
A popular blood thinner?
Coumadin
52
This is by far the most common cause of deaths, disability, and economic costs due to heart disease. Leads to 1 million MI’s/year.
Coronary artery disease (CAD or CHD)
53
CAD is most often due to _____
Atherosclerosis
54
____ begins as fatty streaks at bifurcations of arteries, the streaks enlarge becoming plaques
Atherosclerosis
55
Arterial plaques have a firm shell of ____ and a center of soft ____
Calcium, cholesterol
56
In an MI, the calcium cap of the plaque in the artery _____ and a blood clot forms around it blocking the artery.
Ruptures
57
A type of chest pain caused by reduced blood flow to the heart
Angina
58
Means “squeezing of the chest” caused by myocardial ischemia
Angina pectoris
59
In this type of angina there is spasm of the coronary aa. It can occur at rest from stress, cold exposure or cigarette smoke. The symptoms are often severe, brief, and at night.
Variant (aka Prinzmetal’s)
60
>__% blockage of coronary artery is necessary to produce symptoms of MI
50%
61
Reduced blood flow
Ischemia
62
Also called “heart attack”
Myocardial Infarction
63
This occurs when coronary artery blockage is prolonged (>30-120 minutes). Causes myocardium to die. Should be suspected if patient’s symptoms last longer than 15 minutes!
MI
64
___ sign (clenched right fist over the heart/chest) is a sign of an MI
Levine’s
65
An ECG indicating (confirming) an MI with show abnormal what?
- Q wave (deep)
| - ST segment (elevated)
66
Proper name for a “balloon angioplasty”
Percutaneous Transluminal Coronary Angioplasty (PTCA)
67
Proper name for open heart surgery to treat CAD or MI?
Coronary Artery Bypass Graft (CABG)
68
What two “drugs” are immediately given to dilate coronary arteries?
Aspirin and nitroglycerin
69
___ therapy for non-acute CAD or PAD is considered experimental in the US right now. It uses EDTA to remove compounds found in atherosclerotic plaques (originally used to treat heavy metal poisoning)
Chelation
70
A treatment for heart failure, refractory angina, MI and cardiomyopathy in which cuffs are placed on the legs applying pressure during diastole. EECP
Enhanced External Counter-Pulsation (EECP)
71
There are 3 main types of cardiomyopathies. This type occurs in young (15-30) athletes. It sometimes produces a murmur that doesn’t go away during Valsalva.
Hypertrophic cardiomyopathy (HCM)
72
Other than HCM, what are the other two types of cardiomyopathies?
1. Dilated
| 2. Restrictive
73
HCM is hypertrophied myocardial tissue, often in the ______
Interventricular septum
74
HCM sometimes produces a ____ murmur
Systolic
75
A rare condition in which a blow to the chest can cause sudden death
Commotio Cordis
76
In commotio cordis, the blow to the chest occurs during a vulnerable phase of the heart cycle, the early ___ phase of an ECG
T (ventricular repolarization)
77
Abnormal heart RATE and/or RHYTHM
Arrhythmia
78
Also called a “heart block”. This occurs when there is a block of the cardiac impulse (CI) at this particular node.
AV block
79
An AV block in which the CI is DELAYED causing a long PR interval is known as a _____ heart block
1st degree
80
In 2nd degree heart blocks SOME CI’s don’t get through, and in 3rd degree NO CI’s get through (NO P-QRS)
Okay
81
In this type of conduction system abnormality there is a prolonged QRS on an ECG
Bundle Branch Block (BBB)
82
This type of bradycardia may be due to a tight neck tie/collar, straining during a bowel movement, urination, gagging, etc.
Parasympathetic
83
In this type of heart block the ventricles assume the role of generating the cardiac impulse (at a rate of 20-40 bpm) - usually a medical emergency
3rd degree AV block
84
Treatment of 3rd degree heart block?
Pacemaker
85
Chaotic beating of the atria at 300-400 bpm (SA node activity is shut off). This is VERY COMMON. The patient’s pulse is very irregular (from 60-150 bpm)
Atrial fibrillation
86
In this type of arrhythmia there are beats inserted between normal heartbeats. The patient may feel a “skipped beat”, followed by a “thump”
Tachycardia
87
In ____ syndrome an abnormal bridge of tissue connects the atria to the ventricles. This allows the cardiac impulse to bypass the AV node resulting in a very rapid heartbeat.
Wolff-Parkinson-White
88
This is a rapid, regular heartbeat originating in the ventricles, generating a pulse of 100-250 bpm. Usually a medical emergency.
Ventricular tachycardia
89
Absolutely the worst arrhythmia. There is no effective heartbeat. The heart muscle simply quivers. All circulation ceases (cardiac arrest)
Ventricular fibrillation
90
Obstruction from a thrombus or embolus in the extremities often produces the 5 P’s plus COLDNESS. Name the 5 P’s:
1. Pain
2. Paralysis
3. Pallor
4. Paresthesias
5. Pulselessness
91
This CV disease most often occurs in the legs and affects about 1/20 people over 50. It increases the risk of MI and CVA.
Peripheral Artery Disease (PAD)
