Mer Scott
Quiz by , created more than 1 year ago

PHCY310 Quiz on L41,42 Background/Pathology IHD, created by Mer Scott on 19/05/2019.

13
0
0
Mer Scott
Created by Mer Scott over 5 years ago
Close

L41,42 Background/Pathology IHD

Question 1 of 17

1

Ischaemic heart disease (IHD) is the same thing as coronary artery disease (CAD) and coronary heart disease (CHD).

Select one of the following:

  • True
  • False

Explanation

Question 2 of 17

1

Atherosclerosis, a deposition in the subendothelial space, causes IHD. There is endothelial dysfunction with production of NO, less , increased risk of platelet . An influx of lipid scavenger cells () cause inflammation, calcification and of the blood vessel by increasing plaque formation.

Drag and drop to complete the text.

    lipid
    decreased
    vasodilation
    adhesion
    macrophages
    narrowing

Explanation

Question 3 of 17

1

Atherosclerotic plaque rupture causes a release of factor (TF) and von Willebrand factor (vWF)
vWF. More adhere, activate, and aggregate. The coagulation cascade activates resulting in binding platelets to one another causing clot () formation.

Drag and drop to complete the text.

    tissue
    platelets
    fibrinogen
    thrombus

Explanation

Question 4 of 17

1

Which of these is not a risk factor for IHD?

Select one of the following:

  • Diabetes

  • Obesity

  • Smoking

  • Being a woman over 45

  • Alcohol overconsumption

  • Being a man over 45

Explanation

Question 5 of 17

1

Choose the incorrect statement.

Select one of the following:

  • Stable angina is a chronic form of IHD.

  • Unstable angina is an acute coronary syndrome.

  • Acute coronary syndromes are forms of IHD.

  • A STEMI is an acute coronoary syndrome while and NSTEMI is a chronic form of IHD.

Explanation

Question 6 of 17

1

Chronic stable angina is the initial manifestation of IHD in about 50% of patients. It is often caused by obstructive lesions in the coronary arteries. Vasospasm at the site of an atherosclerotic plaque may further blood flow and contribute to angina.
Stable angina is characterised by a plaque with a thick fibrous cap and relatively lipid core.
Patients are generally in no acute distress and describe stable angina pain as a sensation of pressure, heaviness, tightness, or squeezing in the anterior area. Pain may radiate to the neck, jaw, shoulder, back, or arm and may be accompanied by dyspnoea, nausea, vomiting, or diaphoresis. Pain lasts a few and is often provoked by (e.g. walking, climbing stairs, gardening) or emotional stress; and relieved within minutes by or with sublingual nitroglycerin.

Drag and drop to complete the text.

    atherosclerotic
    constrict
    small
    chest
    minutes
    exertion
    rest

Explanation

Question 7 of 17

1

Acute coronary syndrome is the first sign of IHD in about 50% of patients.

Select one of the following:

  • True
  • False

Explanation

Question 8 of 17

1

Principles of treatment:
1. Angina:
Increase myocardial O2 supply (by the cardiac vasculature) and
decrease O2 demand (by decreasing heart , myocardial , and afterload)
2. ACS:
Re-vascularisation/re-perfusion with mechanical or chemical Tx.
- Mechanical:
Percutaneous coronary intervention () = Angiography or (using a balloon or a stent), or Coronary artery bypass graft (CABG)
- Chemical:
Anti-platelets or
Anti-coagulants or
Fibrinolytics

Drag and drop to complete the text.

    dilating
    rate
    contractility
    PCI
    angioplasty

Explanation

Question 9 of 17

1

Match the drug treatment to the purpose for IHD.
- Dilate blood vessels and reduce cardiac load:
- Stabilise atherosclerotic plaques:
- Prevent platelet aggregation:
- Prevent propagation of thrombus:
- Break down thrombus:
- Pain relief:

Drag and drop to complete the text.

    nitrates, CCBs, ACEIs/ARBs, B-blockers
    statins and other lipid-lowering meds
    anti-platelets
    anti-coagulants
    fibrinolytics
    morphine

Explanation

Question 10 of 17

1

Nitrates are that donate nitric oxide, NO. NO increases intracellular , which relaxes muscle cells and causes vasodilation. Frequent or high doses are associated with .

Drag and drop to complete the text.

    prodrugs
    cGMP
    smooth
    tolerance

Explanation

Question 11 of 17

1

Which of these is not a side effect of nitrates?

Select one of the following:

  • Hypotension

  • Flushing

  • Headache

  • Dizziness

  • Hypertension

Explanation

Question 12 of 17

1

Common DHP CCBs are . Non-DHP CCBS are .
can cause headache, flushing, dizziness/postural hypotension, peripheral oedema, and constipation. can cause bradycardia (caution if patient is on a beta blocker).

Drag and drop to complete the text.

    amlodipine and felodipine
    verapamil and diltiazem
    CCBs
    Non-DHP CCBs

Explanation

Question 13 of 17

1

ACE inhibitors can cause cough due to the build up of bradykinin (which is broken down by ACE).

Select one of the following:

  • True
  • False

Explanation

Question 14 of 17

1

If we give a β-blocker then we anticipate an increase in HR, and bronchial relaxation.

Select one of the following:

  • True
  • False

Explanation

Question 15 of 17

1

Anti-platelets:
1. Aspirin: Inhibits which decreases meaning less activation and aggregation.
2. Thienopyridines (e.g. ): Inhibits receptor P2Y12 to decrease
3. GPIIb/IIIa inhibitors (e.g. ): Inhibit receptor to decrease

Drag and drop to complete the text.

    COX-1
    TxA2
    clopidogrel, ticagrelor
    ADP
    activation
    abciximab, tirofiban
    aggregation
    GPIIb/IIIa

Explanation

Question 16 of 17

1

Anti-coagulants inhibit formation and propagation of thrombi in arteries and veins. In ACS mainly the heparins are used.
1. Unfractionated heparin (UFH) increases the action of anti-thrombin (AT) on factors (and to some extent XIIa, XIa, and IXa).
2. Low molecular weight heparins (LMWHs) increase the inhibitor action of AT on factor . LMWH (e.g. enoxaparin) have a molecular weight than UFH, a longer , and can be administered (self-administered).

Drag and drop to complete the text.

    inhibitory
    Xa and IIa
    Xa >> IIa
    smaller
    half-life
    subcutaneously

Explanation

Question 17 of 17

1

Fibrinolytics break down fibrin stabilised clots. They are used more in pulmonary or stroke than in IHD. Examples are , synthetic tissue plasminogen activators ().

Drag and drop to complete the text.

    embolism
    alteplase and reteplase
    tPAs

Explanation