2.1 Path Cad

Front 1

Questions to ask a person with chest pain in the ER?(7)

Back 1

1. Do you smoke?
2. Diabetic?
3. High BP?
4. Family history?
5. Cholesterol elevated?
6. History of stroke?
7. Leg pain when walking?

Front 2

What are the conventional risk factors for CAD(4) and how many do people normally have?

Back 2

1. Hypertension, smoking, inc cholesterol and DM
2. Most have 0-1

Front 3

What would you rather have low total cholesterol or high HDL?

Back 3

1. Low total is the best
2. High HDL increases survival
3. Low HDL and high cholesterol is the worst

Front 4

What is metabolic syndrome?(6)

Back 4

1. Insulin resistance syndrome
2. DM
3. Obesity
4. Hypertension
5. Dyslipidemia
6. Amenorrhea

Front 5

What is dyslipidemia?

Back 5

1. Low HDL and high LDL

Front 6

How do DM and coronary atherosclerosis relate to each other?(3)

Back 6

1. Dyslipidemia
2. Endothelial dysfunction by oxLDL
3. Thrombogenesis

Front 7

What causes thrombogenesis in atherosclerosis?

Back 7

1. Inc PAI, factor 7, TF and Fibrinogen

Front 8

What is type 2 hyperlipoproteinemia?

Back 8

1. Absence of LDL receptors
2. Means LDL is just floating around to get stuck to endothelial walls

Front 9

At what age does MI surpass breast cancer mortality in women?

Back 9

1. around 60

Front 10

What does estrogen and progestins do to plasma lipids?

Back 10

1. E2e decreases LDL and lipoprotein, inc HDL and TG,
2. Progestin Increases LDL and decreases HDL, TG and lipoprotein

Front 11

What does estrogen do to endothelial cells?

Back 11

1. Inc NO and dialation and endothelial cell growth
2. decreases athersclerosis, vascular injury

Front 12

What is NAFLD? NASH? Problem?

Back 12

1. Non alcoholic fatty liver Dz
2. Non alcholic steatohepatitis
3. Liver injury with increased transaminase

Front 13

What does E2 do to platelets?

Back 13

1. Increases clotting
2. HRT can cause CAD

Front 14

What does tamoxifen do?

Back 14

1. Decreases E2 receptor in breast ductal epithelium
2. We use aromatase inhibitors now

Front 15

What are other CAD causing events besides the big ones?(6)

Back 15

1. Chest irradiation
2. HAART
3.Elevated Homocysteine
4. Thrombophillic disorder
5. Systemic inflammation with increase phase rxt
6. Vasculitis

Front 16

Where do you see HAART induced CAD?

Back 16

AIDS Patients

Front 17

How does spasm cause MI?

Back 17

1. Emotional trauma releases NE
2. Causes sudden death

Front 18

Where do you see irradiation MI?(2) and why?

Back 18

1. Breast cancer
2. Hodgkins lymphoma
3. Irradiate chest can hit coronary arteries and damage them

Front 19

how can systemic inflammation cause MI?

Back 19

1. UTI or insignificant infection
2. Increase phase Rxt

Front 20

What types of vaculitis increase MI risk? Types of coronary arterial anomalies?

Back 20

1. PAN and Churg strauss
2. LAD may come from right cusp so it gets compressed

Front 21

How does periodontal dz increase MI risk?

Back 21

1. Increase fibrinogen
2. Increase media thickness
3. Inflammation and phase rxt

Front 22

How does Homocystein work?(3)

Back 22

1. Premature athersclerosis if you are missing it
2.Decreased level of CBS in homocysteinemia
3. B12 and folic acid are needed to supply the methyl group to reduce THF

Front 23

What are the pathalogic effects of homocysteine?(4)

Back 23

1. Endothelial apoptosis
2. Increases factor 7 and 5 activity
3. reduces activity of protein C and TPA
4. Induces vascular SM proliferation

Front 24

What is Fabry Dz?(4)

Back 24

1. Galactosidase deficiency(XR)
2. Ceramide trihexoside accumulates
3. Neuropathy of hands and feet
4. CV Dz

Front 25

What is a major factor to location of atherosclerosis?

Back 25

1. Turbulence at the bifurcations
2. Lumber has more plaque than aorta because of this

Front 26

How is chlamydia pneumonia associated with CAD?(4)

Back 26

1. Increasing phase rxts
2. Activating macrophages and cytokines
3. Increasing serum lipids
4. The bacterial inflammatory response

Front 27

What does atherogenic mean?

Back 27

Referring to the ability to initiate or accelerate atherogenesis—the deposition of atheromas, lipids, and calcium in the arterial lumen

Front 28

How is CRP an atherogenic agent?(7)

Back 28

1./ As good a marker for CAD as LDL
2. Induces ICAM
3. Endothelin secretion
4. Up regulates foam cells
5. Inhibits eNOS
6. Increases macrophage uptake of LDL
7. SM cell migration

Front 29

If you test for both CRP and cholesterol what happens?(2)

Back 29

1. Each on its own will indicate atherosclerosis equally
2. Together if they are elevated willl give you a higher probability

Front 30

Is rejection of implants in the heart caused by inflammation or lymphocytes?

Back 30

1. Inflammation

Front 31

What is Frank's sign?

Back 31

A crease in the ears that indicated a proclivity towards CAD

Front 32

What is transudation have to do with CAD?(5)

Back 32

1. The macrophages slip through the endothelial cells
2. go inside and eat LDL
3. Turn into Foam cells
4. Explode and release cytokines
5. Causes injury

Front 33

What are the atherogenic effects of oxLDL?(4)

Back 33

1. Induces enothelial apoptosis
2. Chemotaxis of monocytes/macrophages
3. Inhibits NOS
4. Receptor is upregulated by Ang 2, ROS and cytokines

Front 34

What happens during SM migration?

Back 34

1. The muscle migrates to become myofibroblasts
2. Can become calcified

Front 35

What do statins do?(5)

Back 35

1. Decrease Cholesterol
2. Prevent LDL oxidation
3. Upregs NOS
4. Decrease TXA2
5. Inhibits SM migratoipn

Front 36

Where does the fibrous plaque form in CAD?

Back 36

Over the intima

Front 37

What are foam cells?

Back 37

Macrophages that have ingested LDL

Front 38

When do the cornonary arteries fill?

Back 38

During diastole

Front 39

With tachycardia where does the heart spend more times?

Back 39

In systole ... so if you increase exertion you get MI

Front 40

What is the difference between a concentric and eccentric plaque and what is the danger?

Back 40

1. Concentric plaques are in the middle
2. Eccentric plaques are to one side
3. The danger is the SM on the non plaque side can produce a spasm and complications

Front 41

What is Mockeburgs sclerosiss?

Back 41

is a form of arteriosclerosis or vessel hardening, where calcium deposits form in the middle layer of the walls of medium sized vessels

Front 42

Why is calcification a late finding in CAD?

Back 42

Because it is the tombstone of injury

Front 43

What is the positive and negative remodeling of lumens?

Back 43

1. Dialation vs Constriction

Front 44

How do you find calcification and what does it look like on an xray?

Back 44

1. Find with a CT
2. Railroad tracks

Front 45

What is PCI?

Back 45

1.Per cutaneous intervention or balloon angioplasty
2. Catheter up femoral go into coronary arteries