Week 2 Flashcards
(106 cards)
1
Q
risk factors for CHD
A
increasing age
family hx of CVD
gender (specifically male)
uncontrolled hypertension
elevated total cholesterol
uncontrolled diabetes
smoking
physical inactivity
obesity
poorly controlled DM
postmenopausal
uncontrolled stress
poor diet
alcohol use
2
Q
cholesterol is essential component for
A
cell walls/cell fluidity
precursor molecule for vitamin D, steroid hormones
3
Q
what level of cholesterol is desirable
A
<200 mg/dL
4
Q
for effective transport, cholesterol requires a carrier molecule–
A
a lipoprotein
5
Q
a lipid panel includes
A
the amount of total cholesterol, HDL, LDL, and trigylcerides present in the blood
6
Q
high density lipoproteins (HDL)
A
“good cholesterol”
mobilized to be used for energy
exercise increases HDL concentrations
7
Q
low density lipoproteins (LDL)
A
“bad cholesterol”
can invade the tunica interna of BV and remain there, forming an atheroma
8
Q
increased LDLs=
A
increased plaque formation and increased risk for CV disease
LESS IS BETTER
9
Q
VLDL cholesterol
A
difficult to measure
estimated as a percentage of your triglyceride value
10
Q
high levels of VLDL cholesterol have been associated with the development of
A
plaque deposits on artery walls
11
Q
lipoprotein A
A
high levels associated with atherosclerosis
independent risk factor for CAD and CHD
forms fatty plaques
12
Q
cholesterol ratios– a lower ratio means there is
A
a lower risk of heart disease
13
Q
cholesterol ratio is recommended to be
A
5 or less
14
Q
high levels of triglycerides in the blood stream have been linked to
A
atherosclerosis and therefore heart disease/stroke
15
Q
CIS fatty acids
A
unsaturated
GOOD for health
naturally occuring
16
Q
TRANS fatty acids
A
unsaturated
BAD for health
uncommon in nature
17
Q
triglycerides are managed by
A
medications (statins) and lifestyle changes
18
Q
diabetes is a disease of
A
hyperglycemia
19
Q
patients with DM commonly exhibit
A
LV diastolic dysfunction
20
Q
structural abnormalities that are characteristic of a diabetic heart
A
fibrosis
cardiac hypertrophy
impaired coronary microvascular perfusion
mitochondria dysfunction
impaired calcium handling
21
Q
CPK-MB
A
most specific of the three types of CPK for myocardial injury
22
Q
CPK-MM
A
most conclusive for skeletal muscle damage
23
Q
CPK-BB
A
most conclusive for brain tissue injury
24
Q
aspartate aminotransferase
A
AST
liver enzyme
25
lactate dehydrogenase
LDH
found in nearly every cell
26
TnC
binds to calcium
27
TnI
inhibits interaction between actin and myosin
28
TnT
links troponin complex to tropomyosin
29
troponin I peak
12-24 hours
30
troponin T peak
10-24 hours
31
myoglobin peak
3-15 hours after injury
32
how early can myoglobin be detected
as early as 2 hours after injury
33
atrial natriuretic peptide is secreted in response to
atrial distention (increased atrial volume)
34
ANP limits ___ and results in _____
limits activation of the RAAS system
results in vasodilation and diuresis leading to decreased preload/afterload and decreased workload on the heart
35
ANP serum levels increase with
increasing severity of heart failure
36
brain natriuretic peptide (BNP) is released in response to
excessive ventricular distention
caused by blood volume expansion and reduced GFR
37
BNP is the gold standard measurement of
HEART FAILURE
38
_____ levels of BNP are bad
HIGH
39
stage 1 of HF
no limitation of physical activity
activity does not cause undue breathlessness, fatigue, or palpitations
40
stage 2 HF
slight limitation of physical activity
comfortable at rest but ordinary physical activity results in undue breathlessness, fatigue, or palpitations
41
stage 3 HF
marked limitation of physical activity.
comfortable at rest but less than ordinary physical activity results in due breathlessness, fatigue, or palpitations
42
stage 4 HF
unable to carry on any physical activity without discomfort
symptoms at rest can be present
if any physical activity is undertaken, discomfort is increased
43
c reactive protein is produced in
the liver
44
CRP is increased during inflammatory states like
atherosclerosis, CHF, cancer, infection, or liver dysfunction
45
serum creatinine is filtered by
the kidneys
46
elevated serum creatinine may be an independent predictor of
cardiovascular mortality
47
indication:
rhythm abnormalities
tests:
holter monitor
12 lead ECG
exercise ECG
EPS mapping
48
indication:
ischemia
tests:
resting ECG
exercise ECG
pharmacologic stress testing
cardiac MRI
cardiac catheterization
contract echocardiogram
PET
49
indication:
valve integrity
echocardiography
contrast echocardiography
cardiac catheterization
50
indication:
ventricular size and EF
tests:
chest xray
echocardiography
51
indication:
cardiac muscle and pump function
tests:
echocardiography
ventriculography
MUGA
52
indication:
acute myocardial infarction
tests:
cardiac enzymes and markers
resting ecg
53
indication:
vascular diagnostic testing
tests:
ankle brachial index
segmental limb pressures
pulse volume recordings
arterial duplex ultrasonography
exercise studies
54
holter monitor is ordered to
detect and assess arrhythmias
also evaluates the effectiveness of antiarrhythmic therapy
55
echocardiogram
ultrasound images of the heart
56
echocardiogram provides
real time images of the beating heart and
information about blood flow
56
abnormalities seen on an echocardiogram
- size of ventricular cavity
- thickness and integrity of septa
- function of valves
- motions of individual segments of ventricular walls
- volumes of the L ventricle
- assessment of heart performance
- estimate stroke volume and EF
- analyze motion of valves and heart muscle
57
Surface or transthoracic echocardiography
the echo transducer is moved on the skin over the heart
basic model (pic in last slide)
58
Transesophageal Echocardiography
the echo transducer is swallowed
very clear images of heart structures and valves
59
Stress Echocardiography
Imaging is done while the patient during or after (or both) exercising
60
positron emission tomography (PET)
very expensive
uses radioactively labeled glucose
61
what does a PET scan measure
cardiac metabolism and blood flow of the heart
62
what does a PET scan detect
cardiac tissue viability, but not quality of movement nor anatomy
63
single photon emission computed tomography
detects and quantifies myocardial perfusion defects//contraction defects
64
radionuclide perfusion imaging
nuclear stress test
provides information on myocardial perfusion, viability, global and regional L ventricular systolic function
65
radionuclide perfusion imaging is used to
1. assess ongoing chest pain
2. dx CAD
3. look for post MI heart muscle damage
4. assess blood flow to areas of the heart that have undergone revascularization procedures
5. look for scar tissue in the heart from other diseases
66
barriers to MRI
pacemaker
artificial joint
metallic devices
67
magnetic resonance angiography
a type of MRI that looks specifically at the body's blood vessels
68
what is magnetic resonance angiography used for
arterial aneurysm
aortic dissection
carotid artery disease
69
left heart catheterization implication
- the femoral artery
- bed rest for 6-8 hours with involved LE straight
- knee immobilizer to minimize hip flexion
- monitor for groin hematomas and pain
70
right heart catheterization implication
- used to dx right ventricular, atrial, and pulmonary artery impairments
- the incision site is generally via the external jugular vein and there are no activity restrictions
71
computer tomography
machine takes 2D pictures and a computer assembles these slices to create a detailed iamge
72
CAT angiography
imaging test that looks at the arteries that supply blood to your heart
73
CAT angiography is used to dx
- aneurysms
- blockages
- blood clots
- congenital abnormalities of the cardiovascular system
- disorganized blood vessels (vascular malformations)
- vessel rupture or tears
74
cardiac calcium scan
uses special xray equipment to produce pictures of the coronary arteries to determine if they are blocked or narrowed by the buildup of plaque
75
cardiac calcium scan
when calcium is present...
the higher the score and the higher the risk of heart disease
76
cardiac calcium scan
score of 0
no plaque
77
cardiac calcium scan
score of 1-10
small amount of plaque
78
cardiac calcium scan
score of 11-100
some plaque
79
cardiac calcium scan
score of 101-400
moderate amount of plaque
80
cardiac calcium scan
score of over 400
large amounts of plaque
81
doppler ultrasound shows
- DVT
- blockages in arteries
- check blood flow in your veins, arteries, and heart
- locate aneurysms
82
MUGA scan
multigated acquisition scan
creates a video of the blood moving through the ventricles and out to systemic circulation to determine whether they are pumping properly and if blood is moving through them properly
inflow and outflow tracts
83
MUGA scan shows any abnormalities in
the size of the chambers and in the movement of blood through the heart to allow for calculation of EF
84
AEs of vasodilators
headache
dizziness
hypotension
**especially with sublingual forms
85
sublingual nitrogylcerin tablets
acts in 1-3 minutes
helps avoid the first pass effect
86
drugs that increase myocardial oxygen supply
thrombolytic agents
antiplatelet agents
anti coagulants
calcium-channel blockers
87
AEs of anti-clotting drugs
bruising
bleeding
88
pradaxa vs warfarin
pradaxa-- less monitoring involved
warfarin-- INR monitoring
89
positive iontropes
drugs that increase myocardial contractility
90
negative iontropes
drugs that decrease contractility
91
diuretics do what to preload
decrease
92
sodium channel blockers
decreases AP frequency
93
calcium channel blockers
good for arrhythmias and BP issues
94
AEs of cardiac arrhythmias
can cause/trigger different forms of arrhythmia
95
AEs of beta blockers
can cause fatigue, weakness, decreased libido
patients in BB respond differently during exercise
96
AEs of all antihypertensive drugs
can cause a drop in blood pressure resulting in orthostatic hypotension, dizziness, fainting, and falls
97
AEs of calcium channel blockers
can cause swollen ankles, arrhythmia, and MI in older adults
98
AEs of ACE inhibitors
can cause persistent dry cough
manifests as an allergy
99
AEs of diuretics
can cause electrolyte imbalance resulting in confusion, dizziness, unreasonably fatigue, and dehydration
100
what numbers qualify for postural hypotension
Decrease in SBP >20 mmHg or decrease in DBP of 10 mmHG
101
mechanism of statins
inhibit LDL synthesis
increase LDL catabolism
102
side effects of statins
constipation, diarrhea, gas heartburn, stomach pain, dizziness, headache, nausea, myopathy,
***rhabdomylosis, renal dysfunction, neuropathy, liver failure
103
classical symptoms of hyperglycemia
polyuria
polydipsia
polyphagia
104
AEs of diabetes mellitus medications
hypoglycemia, coma, death
105
