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MedSurge-CAD

MedSurge CORONARY ARTERY DISEASE review

QuestionAnswer
Three stages of CAD lesions usually present and age? 15 - fatty streak; 30 - raised fibrous plaque; >30 - complicated lesion
Non-modifiable risk factors for CAD? age, sex (males higher), hereditary (african american's highest; asian's lowest)
Pt. teaching for female with risks of CAD? CAD leading cause of death in women, higher mortality rate following MI than men
Most of the triglycerides are contained in? VLDL (very-low-density lipoproteins)
Most cholesterol is contained in? LDL (low-density lipoproteins)
The higher the level of _____, the lower the risk of CAD? HDL (high-density lipoproteins)
HDL's carry lipids away from _____ to the _____. arteries; liver
Increases in _____ are associated with obesity? VLDL (very-low-density lipoproteins)
High levels of _____ correlate most closely with CAD? LDL (low-density lipoproteins)
Therapeutic Lifestyle Changes diet recommendations emphasizes a reduction in? red meats, whole-milk products, eggs (alcohol and simple sugars - if triglycerides are high)
Diet therapy is indicated for? pts. without CAD; 2+ risk factors; LDL ≥ 130 mg/dL
Drug therapy is added to Diet therapy when? pts. LDL ≥ 160 mg/dL
A temporary and reversible MI is called? stable angina
Myocardial ischemia occurs as a result of? ↑ O2 demand / ↓ O2 supply
Prinzmetal's angina results in? ↓ O2 supply
Prinzmetal’s (Variant) angina almost always occurs? when a person is at rest, usually between midnight and early morning (in response to coronary artery spasms)
Triggers for Prinzmetal’s angina include? exposure to cold, emotional stress, smoking, cocaine use, or meds that cause the heart’s coronary arteries to narrow
Unstable angina is characterized by? being unpredictable, unrelieved at rest, progressive severity
Angina decubitus occurs when the person is in which position? recumbent
Chronic stable angina is characterized by? usually precipitated by exertion, occurs with same pattern of onset, duration, intensity
Drug class to promote - decreased preload nitrates
Drug class to promote - dilation coronary arteries nitrates, calcium channel blockers
Drug class to - prevent thrombosis of plaques anti-platelet aggregation agents (incl. aspirin)
Drug class to promote - ↓ HR calcium channel blockers, b-adrenergic blocking agents
Drug class to promote - ↓ afterload nitrates, b-adrenergic blocking agents
Drug class to promote - ↓ myocardial contractility calcium channel blockers, b-adrenergic blocking agents
In healing of myocardium after an infarct, early scar tissue results in an unstable heart wall for a period of? 4 to 10 days
NSTEMI is more frequently treated initially with? acute intensive drug therapy
Increased BNP would be an indication of? chronic heart failure
Increased CPK-MB would be an indication of? a myocardial infarction
A positive D-dimer would be indication of? a pulmonary embolus
A positive ventilation-perfusion (V/Q) scan, would be an indication of? a pulmonary embolus
Cardiac Enzymes - CPK-MB elevates within? 12 to 24 hrs
Cardiac Enzymes - LDH elevated within? 24 to 36 hrs
Cardiac Enzymes - Troponin elevates within 1 to 2 hrs
Pyrosis is? belching
Mid-epigastic pain and pyrosis are indication of? Peptic ulcer disease
A pt. with CAD should perform _____ exercises; to increase muscle tone isotonic
A typical early manifestation of mitral valve stenosis is? dyspnea on exertion
Traits of Type A personality include: individual often suppresses anger and hostility, has sense of time urgency, is impatient, often creates stress and tension
Traits of Type B personality include: more asygoing, takes upsets in stride, knows personal limitations, takes time to relax, not an overachiever
Homocysteine is produced by? the breakdown of the essential amino acid methionine, found in dietary protein
CAD can be indicated by a _____ level of Homocysteine in the blood increased
Examples of fruits packed with complex carbohydrates? apricots, oranges, plums, pears, grapefruits and prunes
Examples of vegetables packed with complex carbohydrates? broccoli, cauliflower, spinach, turnip greens, eggplant, potatoes, yams, corn, carrots, onions
HMG-CoA Reductase Inhibitors (Statins) mechanism of action? block synthesis of cholesterol and increase LDL receptors in liver
Niacin mechanism of action? inhibits synthesis and secretion of VLDL and LDL
Fibric Acid Derivatives mechanism of action? ↓ hepatic synthesis and secretion of VLDL; ↓ triglycerides by ↓ VLDL
Bile-Acid Sequestrants mechanism of action? bind with bile acids in intestine, forming insoluble complex and excreted in feces
Cholesterol Absorption Inhibitors mechanism of action? inhibits the intestinal absorption of cholesterol
S/S of rhabdomyolysis include? ↑ creatine kinase levels, muscle tenderness
Once a woman reaches menopause, her risk for MI? quadruples
Created by: fluency