Naplex- Ihd

Front 1

Ischemia is LACK of oxygen caused from what

Back 1

inbalance between oxygen supply and demand!!

Front 2

What causes ischemia heart diseae

Back 2

atheroscoleosis

Front 3

What are the types of ACS

Back 3

Unstable Angina
NSTEMI
STEMI

Front 4

What are the 3 components that affect mycardial oxygen demand

Back 4

HR, Contractility, and Wall Tension

Front 5

Myocardial Oxygen supply is dependent on the following:

Back 5

Oxygen satruation, and Coronary FLOW

Front 6

The vascular endorthelium will release NO, and vasodilate when needed expect when damaged by

Back 6

cigarrets, LDL or HTN

Front 7

Athersclerosis the MOST common cause of IHD, and it causes a decrease in the lumen, and reduced mycardial perfusion and ultimately

Back 7

ISCHEMIA

Front 8

What drugs interfere with Exercise tolerance tests

Back 8

Digoxin BB, and Nitrates

Front 9

What medications are used for pharmacologic stress testing

Back 9

Dobutamine, adenosine, dipyridamole,

Front 10

The symptoms of Chornic Stable Angina is result of what mecanism

Back 10

decrease O2 to HEART (occulation and stenosis)

Front 11

Angina is considere stable is SYMPTOMS have been occurs for weeks without worsening

Back 11

YES

Front 12

What are signs/symptoms of STABLE angina

Back 12

pain in sterum, heavy weight on chest, and duration up to 30 minutes

Front 13

What causes Chronic stable angina symptoms

Back 13

exercise, cold weath, STRESS, sexual acitvity

Front 14

What relieves pain Chornic Stable Angina

Back 14

REST or NTG

Front 15

What type of anti-platelt therapy should all pt with chronic stable angina receive

Back 15

ASA 81 mg qd

Front 16

What is MOA of why BB are effective in reducing Myocardial oxygen demand

Back 16

Decrease sympathetic response lowering MVO
Decrease HR/ and Intory

Front 17

Dosing of BB in Chonric stable angina, go slow and tirate to what HR

Back 17

55-60 bpm

Front 18

Beta Blockers are 1st agents for what pts

Back 18

PRIOR MI, ACS, or history of HF

Front 19

Should BB be avoided in Prinzmental's angina

Back 19

YES

Front 20

What is MOA of Nitrates and reducing Myocardial oxygen demand

Back 20

Lower Preload/Afterload

Front 21

What is MAIN role of Nitrates in IHD

Back 21

immediate relief of angina (SL NITRO)

Front 22

What is ROLE of long-acting NITRATES

Back 22

only if BB are contraindicated or CCB are contraindicted or ADD ON therapy

Front 23

What is the preferred DRUG treatment in Prinzmetal's angina

Back 23

NITRATES

Front 24

What is MOA of CCB in reducing mycocardial oxygen demand

Back 24

NON-DHP--Lower HR, Inotropy and Afterload

DPH--Afterload/Preload

Front 25

What is ROLE of CCB in stable angina

Back 25

alternative to BB or add on therapy

Front 26

What combination of CCB/ BB should be USED cautiosuly

Back 26

BB and NON-DHP

Front 27

Ranolazine is indicated as first-line or add on in chronic stable angina

Back 27

YES

Front 28

What is MOA of Ranolazine

Back 28

inhibits Na channels

Front 29

Does Ranolazine have any effect on BP or HR

Back 29

NO

Front 30

Should all pts with CAD be on ACE inhibitor after BB

Back 30

YES (add-on therapy)

Front 31

Chronic Stable Angina thearpy consist mainly of

Back 31

ASA, BB, Lipid lowering thearpy

Front 32

Can you BB in Prinzmetal's angina

Back 32

NO

Front 33

Are CCB more effective in Prinzmetal's

Back 33

YES

Front 34

IN STEMI there is COMPLETE and PERSISENT OCCULATION OF Coronary ARTERY

Back 34

YES

Front 35

What is UA/NSTEMI

Back 35

partial occulusion

Front 36

What is UNSTABLE Angina/NSTEMI signs/symptoms versus stable angina

Back 36

CHEST PAIN NOt RELIVED be rest or NGT

Front 37

What type of ACS have presence of biomarkers

Back 37

only STEMI/NSTEMI

b/c have necrosis

Front 38

What is thearpy all pts should get for ACS

Back 38

BONA

BETA BLOCKERS
oxygen
nitrates
ASA and ANTICOAGULATION/ ACE I/ Anti-Platlet)

Front 39

Should all pts with ACS also get a Beta Blockers unless contraindidcations

Back 39

YES

Front 40

What are contraindications to Beta Blocker in ACS

Back 40

Bradycardia
acute Heart Failure
LOW BP (shock)

Front 41

Is there a mortality benefit with using CCB in ACS

Back 41

NO

Front 42

What type of CCB should be used if BB cannot be

Back 42

NON-DHP

Front 43

Should ACE-I be start within the 1st 24 hours in ALL pts with ACS and what

Back 43

HF, DM, CKD

Front 44

Should aldosterone antagoinsits also be ADDED to ACS upon discharge if HF and on ACE

Back 44

YES

Front 45

THeinopyridine include what medications

Back 45

Clopidorgrel, Ticlopidine, Prasugrel

Front 46

What is MOA of ADP inhibit

Back 46

inhibit platet aggrestion

Front 47

Clopidogrel is alternative agent for pts with ASA allergy and ACS

Back 47

YES

Front 48

When in BOTH clopidogrel and ASA indicted

Back 48

PCI or STENT and CONSERSATIVE MANAGMENT

Front 49

What is the MAIN ROLE of Glycoprotein IIb/IIIa inhibitors in ACS

Back 49

NONSTEMI and UA

controversial in STEMI

Front 50

SHOULD all pts be on anti-coagulant thearpy if suspected of ACS

Back 50

YES

Front 51

What is the preferred anti-coagulant prior to CABP

Back 51

heparin

Front 52

For Treatment of STEMI, what is general approach

Back 52

SAME as NSTEM/UA initally

BONA

ASA/Anticoagulants/ACE-1/ Anti-platlets

Front 53

What ACS gets Fibrinolytics?

Back 53

ONLY STEMI

STEMI MUST HAVE EITHER FIBRINOLYTICS OR PCI

Front 54

What are advantages of LMWH

Back 54

more predictable response, subq, fewer side effects less monitoring

Front 55

Are LMWH preferred in conservative approach

Back 55

YES

Front 56

UFH is preferred prior to PCI

Back 56

YES

Front 57

What agents should be avoided in RIGHT venticular wall infarcation or INFERIOR wall MI

Back 57

AGENTS that reduce PRELOAD

NTG, Diuretics

pts are dependent on pre-laoad

Front 58

What type of wall MI have the highest mortality

Back 58

anterior wall MIs

Front 59

Goals of acute MI include: limmiting infaract, reducing ischemia, and reducing mortality

Back 59

YES

Front 60

Do nirates have a mortality benefit

Back 60

NO

Front 61

Should Nitrates be used in RV or inferior wall MI

Back 61

NO

Front 62

What are other major contraindications of Nitrates

Back 62

Pt who have PDE-5 in last 24 hours

or 48 for tadalfil

tachcardia >100
SBP <90

Front 63

Should all pts with STEMI get PCI

Back 63

YES

Front 64

What is PCI

Back 64

process to reopen an occuleded coronary artey

Front 65

What is goal door to ballon time for PCI

Back 65

<90 minutes

Front 66

In pts who receive a stent how LONG should dual anti-platlet therapy be continue

Back 66

for 12 months

Front 67

What is main role of fibrinolytic thearpy (clot breaker therapy)q

Back 67

delay to PCI or not available

Front 68

Do you get anticoagulation with fibrinolytics

Back 68

YES

Front 69

Why is early BB theapy so important POST MI

Back 69

reduces infarct size, reduces mortality, and reinfarction rate

Front 70

Is ORAL BB thearpy preferred for treatment of MI

Back 70

YES

Front 71

The morality benefit of ACE-I in MI are seen in what pts

Back 71

pts LVEF <40%

why all pts with this need added with 24 hours

Front 72

Why is PCI preferred over fibrinolytic theapy

Back 72

PCI pt have lower short-term mortality rates

Front 73

Is anticoagulation MANDATORY during PCI

Back 73

YES

Front 74

What is main anti-coagulatant used in PCI

Back 74

UFH