Advanced Pathophysiology Exam 4 Exam Latest
2025/2026
CAD Risk Factors: Non-modifiable - answer-age
genetic disposition
family history
ethnic background
gender
CAD risk factors - answer-Age >55
male
fam hx
personal hx peripheral vasc/Cerebrovascular disease
smoking
lipid abnorm
DM
HTN
obesity
sedentary
cocaine
estrogen use
dyslipidemia - high LDL, low HDL, high triglycerides
,what happens when LDL becomes oxidized - answer-becomes oxidized when
exposed to endothelial cells and smooth muscle cell
then exposed to macrophages
becomes foam cell
makes up atherosclerotic plaque
what does HDL do - answer-reverse cholesterol transport
returns excess cholesterol from the tissue to the liver where it binds to hepatic
receptors and is processed or eliminated as bile or converted to cholesterol-
containing steroids
protects LDL from oxidation
clinical features of STEMI - answer--prodromal symptoms: unstable angina,
general malaise, exhaustion
-pain is variable in intensity, quality, and location
-pain lasts longer than angina, unrelieved by rest and NTG
-may present as symptoms of acute LV failure, weakness, or syncope
physical exam of STEMI - answer--anxious and resltess
-cold perspiration and skin pallor (d/t blood supply being diverted away from skin)
-variable HR and BP responses
-fourth heart sound (reduction in LV compliance)
-third heart sound (LV Dysfunction)
,-systolic murmur (mitral regurgitation)
EKG findings of STEMI - answer-Elevation of:
-CK
-CK-MB
-Myoglobin (peak 1-4 hrs)
-troponin (begin to rise at 3 hours from onset)
-elevation of LDH1
EKG findings in STEMI - answer--ST segment elevation
-T wave inversion
-Q waves (leads that reflect injured myocardium) - Q wave often the permanent
marker of injury and necrosis
what are the key characteristics of stable angina that set it apart from unstable
angina? - answer--chest discomfort caused by myocardial ischemia = brought on
by exertion (predictable)
-ischemia without necrosis
-relieved by rest and/or NTG
-pathop - imbalance between myocardial requirements/demand and supply -
demand may be elevated when HR increases, LV wall stress
what are key characteristics of unstable angina that set it apart from stable
angina? - answer--patho - atherosclerotic plaque that is prone to rupture
-signals that the atherosclerotic plaque has become a complicated lesion; sign
that MI is imminent
, -management requires hospitalization and MONA (morphine, oxygen, NTG,
aspirin)
-unrelieved by rest/NTG
What does MONA stand for? - answer-Morphine
Oxygen
Nitroglycerin
Aspirin
used in unstable Angina
Class I angina - answer-new onset - severe or accelerated angina
class II angina - answer-angina at rest, subacute (angina at rest within the
preceding month but not within the preceding 48 hours
class III angina - answer-angina at rest, acute (angina at rest within the preceding
48 hours)
What are the common complications of myocardial infarction? - answer-
dysrhythmias
LV failure
RV infarction
Cardiogenic shock
Papillary muscle rupture
Pericarditis
LV Aneurysm
2025/2026
CAD Risk Factors: Non-modifiable - answer-age
genetic disposition
family history
ethnic background
gender
CAD risk factors - answer-Age >55
male
fam hx
personal hx peripheral vasc/Cerebrovascular disease
smoking
lipid abnorm
DM
HTN
obesity
sedentary
cocaine
estrogen use
dyslipidemia - high LDL, low HDL, high triglycerides
,what happens when LDL becomes oxidized - answer-becomes oxidized when
exposed to endothelial cells and smooth muscle cell
then exposed to macrophages
becomes foam cell
makes up atherosclerotic plaque
what does HDL do - answer-reverse cholesterol transport
returns excess cholesterol from the tissue to the liver where it binds to hepatic
receptors and is processed or eliminated as bile or converted to cholesterol-
containing steroids
protects LDL from oxidation
clinical features of STEMI - answer--prodromal symptoms: unstable angina,
general malaise, exhaustion
-pain is variable in intensity, quality, and location
-pain lasts longer than angina, unrelieved by rest and NTG
-may present as symptoms of acute LV failure, weakness, or syncope
physical exam of STEMI - answer--anxious and resltess
-cold perspiration and skin pallor (d/t blood supply being diverted away from skin)
-variable HR and BP responses
-fourth heart sound (reduction in LV compliance)
-third heart sound (LV Dysfunction)
,-systolic murmur (mitral regurgitation)
EKG findings of STEMI - answer-Elevation of:
-CK
-CK-MB
-Myoglobin (peak 1-4 hrs)
-troponin (begin to rise at 3 hours from onset)
-elevation of LDH1
EKG findings in STEMI - answer--ST segment elevation
-T wave inversion
-Q waves (leads that reflect injured myocardium) - Q wave often the permanent
marker of injury and necrosis
what are the key characteristics of stable angina that set it apart from unstable
angina? - answer--chest discomfort caused by myocardial ischemia = brought on
by exertion (predictable)
-ischemia without necrosis
-relieved by rest and/or NTG
-pathop - imbalance between myocardial requirements/demand and supply -
demand may be elevated when HR increases, LV wall stress
what are key characteristics of unstable angina that set it apart from stable
angina? - answer--patho - atherosclerotic plaque that is prone to rupture
-signals that the atherosclerotic plaque has become a complicated lesion; sign
that MI is imminent
, -management requires hospitalization and MONA (morphine, oxygen, NTG,
aspirin)
-unrelieved by rest/NTG
What does MONA stand for? - answer-Morphine
Oxygen
Nitroglycerin
Aspirin
used in unstable Angina
Class I angina - answer-new onset - severe or accelerated angina
class II angina - answer-angina at rest, subacute (angina at rest within the
preceding month but not within the preceding 48 hours
class III angina - answer-angina at rest, acute (angina at rest within the preceding
48 hours)
What are the common complications of myocardial infarction? - answer-
dysrhythmias
LV failure
RV infarction
Cardiogenic shock
Papillary muscle rupture
Pericarditis
LV Aneurysm
