QUESTIONS WITH COMPLETE
SOLUTIONS 2025
,Describe coronary artery disease, how it develops, and the pathophysiological basis of
the various risk factors that can lead to this disorder - ANSWER- Caused: by the
narrowing of the arteries that supply the blood to they myocardium. this could be due to
plaque build up, and fatty mater
- most common is arthersclerosis.
- Risk factors: poor nutrtion/obesity, smoking, high LDL, and low HDL.
Myocardial Ischemia - ANSWER- the decrease in the blood supply to the heart which
leds to chest pain or angina.
- S/S: chest heaviness, possible pain in left arm, shoulder, jaw and neck, Nausea &
breathlessness
Myocardial infarction - ANSWERAKA: heart attack IRREVERSIBLE
- progressive ischemia with damage to myocardium (myoctye necrosis)
- Cause: cardiovascular disease
- S/S: dyspnea, decrease BP (scynocpe), nausea, diaphoresis, anxiety, sudden sever
chest pain that may radiate to left arm
- Women: jaw and back bain
- Men: chest discomfort, arm pain, and SOB.
- Tests: EKG
-- STEMI- indicates transmural MI
-- NON STEMI- indicates subendocardial MI
What are the two types of myocardial infarctions - ANSWER1. transmural
2. subendocardial
Transmural MI - ANSWERthrombus remains and myocardium involved transcend to
epicardium
- STEMI (ST elevation in MI)
-- Q- wave MI
Subendocardial MI - ANSWERthrombus dislodges and only myocardium directly
beneath endocardium involved.
- NON STEMI (no ST elevation in mycardial infarction)
-- non Q wave MI
Transmural Vs. Subendocardial MI - ANSWER
Transmural MI vs. Subendocardial EKG - ANSWERALSO REVIEW SLIDE 6
Test for MI - ANSWERBlood tests values increased
- TROPONIN I AND T: 12 hours- 2 weeks (most specific)
- LDH: (Lactate dehydrogenase): 72hrs-10 days
, -CK-MB (creatine phophonkiase- myocardial band : 10 -48 hrs
MYOGLOBIN: 2hrs- lasts 24 hrs.
* TROPONIN AND CK0MB ARE THE TWO MAIN LABS WE LOOK AT TO CONFIRM
HEART ATTACK.
** review slide 22
Treatment for MI - ANSWERANGIOPLASTY- with in 90 mins
- thrombolytic therapy- with in 3 hours
- cardioportection after MI
-- beta-blockers: blocks sympathetic innervation
-- ACE inhibitors
Angina Pectoris - ANSWERChest pain caused by REVERSIBLE myocardial ischemia
- S/S: sudden severe chest pain last *3-5 minutes*. pressure/squeezing, fatigue,
nausea, SOB.
- cause: cardiovascular disease or anemias
- tx: Rest, nitrates (dialte arteries and viens)
Tests for Angina pectoris - ANSWER-EKG- may be normal
- stress tests
- coronary ANGIOGRAPHY and cardiac catheterization
--- dye with x rays to show coronary lumen
- CBC
-- increased C REACTIVE PROTIEN (CPR) INDICATES INFLAMMATION
SOMEWHERE IN THE BODY.
-- ESR- erythrocyte sedimentation rate. shows how quickly red blood cells peel and rop
to the bottome
-
CABG - ANSWERcoronary artery bypass
- graft involves bypassing major blocks in the blood vessels of the heart to improve
blood flow to cardiac muscle
Define ischemia and consequences of prolonged ischemia and how it relates to
atherosclerosis (cell death). - ANSWER
Normal EKG - ANSWER
Hypokalemia EKG - ANSWER
Congestive heart failure - ANSWER- Decreased pumping ability of the heart to meet
demands of tissue
- decreased cardiac output, pooling in venous system/organs
- cause: Atherosclerosis- CAD, HTN, valvular disorders, arrhythmias, anemia, MI