Ch 27

Question 0

How can one prevent CAD

Answer 0

Control cholesterol
Dietary measures
Physical activity
Medications
Cessation of smoking
Manage HTN
Control diabetes

Question 1

Coronary atherosclerosis

Answer 1

Is the abnormal accumulation of lipid deposits and fibrous tissue within the arterial walls and lumen.
Blockages and narrowing of the coronary vessels reduce blood flow to the myocardium.

Question 2

Name the 6 cholesterol medications

Answer 2

3-hydroxy-3- methylglutaryl coenzyme A (HMG-CoA) or ( statins)
Nicotinic acids
Fibric acids or (Fibrates)
Bile acid sequestrants (or resins)
Cholesterol absorption inhibitors 
Omega-3 acid-ethyl esters

Question 3

What lab should be monitored when atorvastatin ( Lipitor) is administered

Answer 3

Liver enzymes

Atorvastatin ( Lipitor) is a HMG CoA reductase inhibitor and is hepatotoxic therefor liver enzymes should be monitored

Question 4

What are medications for angina pectoris

Answer 4

Nitroglycerin 
Beta blockers
Calcium channel blockers
Anti platelet and anticoagulate medications
Aspirin
Clopidogrel and ticlopidine 
Heparin
Glycoprotein IIB/IIIa agents

Question 5

What is CRP

Answer 5

CRP is known to be an inflammatory marker for cardiovascular risk, including acute coronary events and stroke
The liver produces CRP in response to a stimulus such as tissue injury, high levels of this protein is likely to occur in ppl with diabetes and who are likely to have an acute coronary event

Question 6

What are the four elements of fat metabolism

Answer 6

Total cholesterol
LDL
HDL 
triglycerides
All are known to affect the developmEnt of heart disease

Question 7

How is cholesterol processed

Answer 7

It is processed by the GI tract into lipo protein globules called chylomicrons. These are processed by the liver as lipoproteins

Question 8

LDL levels

Answer 8

Less than 100

Less than 70 for very at risk patients

Question 9

Total cholesterol levels

Answer 9

Less than 200

Question 10

HDL levels

Answer 10

Greater than 40 for males

Greater than 50 for females

Question 11

Triglyceride levels

Answer 11

Less than 150

Question 12

What tests are clear predictors of coronary events

Answer 12

Total cholesterol

LDL

Question 13

Triglycerides

Answer 13

Are made up of fatty acids and is transported through the blood by a lipoprotein
Although a level beyond 200 may be genetic, it can also be caused from obesity, physical inactivity, excessive alcohol intake, high carbohydrate diets, diabetes, kidney disease and certain meds such as oral contraceptives and corticosteroids.

Question 14

What are therapeutic effects of statins

Answer 14

Lowers; total cholesterol, LDL, Triglycerides

Increases; HDL

Question 15

What is the therapeutic effects of nicotinic acids

Answer 15

Lowers; HDL, triglycerides, and total cholesterol, lipolysis in adipose tissue and lipoprotein synthesis in liver

Increases; HDL

Question 16

What are the therapeutic effects of fibric acids ( Fibrates)

Answer 16

Increases; HDL

Decreases; triglycerides, synthesis of triglycerides and other lipids

Question 17

What are uses of bile acid sequestrants

Answer 17

Lowers; LDL,

Slight HDL increase
Oxidizes cholesterol into bile acids which decreases fat absorption

Question 18

What are the therapeutic effects of cholesterol absorption inhibitors

Answer 18

Lowers LDL

Inhibits absorption of cholesterol in small intestine

Question 19

What are the therapeutic effects of omega3 acid ethyl esters

Answer 19

Lowers triglycerides

Inhibits triglyceride production in the liver

Question 20

What do catecholamines do

Answer 20

They increase BP, HR and myocardial workload

Question 21

What does nitrates do as far as treating angina

Answer 21

They are for short and long term reduction of myocardial oxygen consumption through selective vasodilation

Question 22

What do beta blockers do for the relief of angina

Answer 22

Reduction of myocardial oxygen consumption by blocking beta adrenergic stimulation of the heart.

Question 23

Calcium channel blockers are indicated for angina, how are they used

Answer 23

Negative Inotropic effects
Indicated in patients not responsive to beta blockers
Used in primary treatment for vasospasm

Question 24

Name anti platelet meds

Answer 24

``` Aspirin Clopidogrel ( plavix) Prasugrel ( effient) Glycoprotein IIB/IIa agents; Abciximab ( ReoPro) Eptifibatide ( integrillin) ```

Question 25

Name anticoagulant drugs

Answer 25

Heparin Low molecular weight heparins; Enoxaparin (lovenox) Dalteparin ( fragmin)

Question 26

What is used to diagnose a acute MI

Answer 26

Cardiac enzymes and biomarkers, which include troponin, creatinine kinase (CK) and myoglobin

Question 27

Troponin

Answer 27

A protein found in myocardial cells, regulates the myocardial contractile process Troponin I&T are specific for cardiac muscle these are critical markers for myocardial injury. A increase in the level of troponin can be detected within a few hours of a MI, it remains elevated for as long as 3 weeks therefore making it can be used to detect recent myocardial damage.

Question 28

CK-MB ( heart muscle)

Answer 28

Is the cardiac- specific isoenzyme it is found mainly in cardiac cells and therefore increases when There has been damage to these cells Elevations of CK-MB is an indicator of an acute MI. The levels begin to peak within a few hours and peaks within 24 hours of an infarct

Question 29

CK- BB

Answer 29

Brain tissue

Question 30

CK-MM

Answer 30

Skeletal muscle

Question 31

S&S of diverticulosis

Answer 31

Constipation | Seepage of stool

Question 32

Treatment of diverticulosis

Answer 32

Antibiotics or resection Hydration Diet changes

Question 33

Diagnostics of diverticulosis

Answer 33

Abdominal x Ray Barium enema ESR, WBC, CRP levels will b elevated Heme positive for occult blood

Question 34

What are s&s of a peptic ulcer

Answer 34

Sharp pain knife like Heart burn Coffee ground emesis Weakness fatigue

Question 35

What are s&s of RA

Answer 35

Pain stiffness

Question 36

What are risk factors for RA

Answer 36

Female

Question 37

What are diagnostics of RA

Answer 37

X-ray RA factor NAA factor ESR, CRP, ANTI CC, are all elevated

Question 38

What are s&s of MS

Answer 38

``` Bowel, bladder and sexual dysfunction Fatigue, muscle weakness Ataxic, Diplopia Blurred vision Loss of ability to walk Constipation Incontinence Dysphagia ```

Question 39

What are risk factors of MS

Answer 39

Genetic Viruses Age 30-40 Linked to Epstein Barr virus

Question 40

What are diagnostics of MS

Answer 40

MRI ELECTROPHORESIS OF SPINAL FLIUD UNDERLYING BLADDER DYSFUNCTION DIAGNOSED BY URODYNAMIC STUDIES NEUROPHYSIOLOGICAL STUDIES