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