solid mass of platelets and/or fibrin that forms locally in avessel

Describe the MOA for spasms.

Spastic area cannot contract & move blood forward = ↓ blood flow, Plaques -> abnormal vasomotor tone → local spasm

Which statement about the presentation of chronic stable angina is TRUE?

Pain usually appears after exertion and resolves with rest

Which of the following is FALSE regarding plaque stability?

larger plaques = less stable = more likely to rupture

Which of the following is CORRECT regarding stable plaque occlusion?

Plaques that occlude lumen (>60-70%) limit effectiveness of vasodilation, Ischemic chest pain can occur

Define Hemorrhagic stroke.

weakened/diseased blood vessels rupture, blood leaks into brain tissue

Which of the following is INCORRECT regarding the types of ACS?

STEMI: sm vess myocard necrosis, partial artery occlu, ↑ troponin, CK-MB

mostoften a piece of thrombus that has broken free (thromboembulus)

Define Ischemic stroke.

blood clot stops the flow of blood to an area of the brain

Which of the following factors influence myocardial oxygen supply?

endothelial regulation (↑ NO = ↑ vasodilation = incr supply), hemoglobin levels (↑ levels = ↑ supply), coronary artery diameter (↑ diameter = ↑ supply)

What's the MOA for stable plaque occlusion in ischemia development?

↑ demand = ↑ smaller vessels vasodilate = ↑ blood flow

Which of the following factors influence myocardial oxygen demand (MVO2)?

Heart rate (↑ heart rate = ↑ demand), coronary wall tension- systole (↑preload=↑ intramyocardial wall tension...), contractility (↑ contractility = ↑ demand)

studbud

Pathophysiology - Stroke/IHD

28 termsStudBud Administration25 plays

2021, Pathophysiology, IHD/Stroke Lecture, Dr. Cross, Exam 2 Material

Flashcards28 cardsFPractice quizPHost liveL

Questions 28

Answers

1
Define Thrombus:
mostoften a piece of thrombus that has broken free (thromboembulus)
solid mass of platelets and/or fibrin that forms locally in avessel
2
Describe the MOA for spasms.
Spastic area contracts and moves blood forward, ↑ blood flow
plaques do not correlate to spasms
Spastic area cannot contract & move blood forward = ↓ blood flow
Plaques -> abnormal vasomotor tone → local spasm
3
Which statement about the presentation of chronic stable angina is TRUE?
Caused by plaque rupture and thrombus formation
Pain usually appears after exertion and resolves with rest
Commonly precipitated by extremely warm environments
Myocardial necrosis present around large blood vessels
4
What's the usual mechanism behind chronic stable angina?
embolus development
none of the above
thrombus development
stable plaque occlusion
5
Identify chronic stable angina (CSA) definition & characteristics.
Predictable + responds to nitroglycerin, oxygen demand > supply
all of the above
Positive exercise tolerance (stress) test
Stable intensity/frequency/duration for ≥3 months
6
Which of the following is FALSE regarding plaque stability?
smaller plaques = less stable = more likely to rupture
larger plaques = less stable = more likely to rupture
larger plaques have a thick fibrous cap and are stable
larger plaques more prevalent in CSA, smaller plaques more prevalent in ACS
7
What's the correct duration of angina?
usually 0.5-30 minutes
usually 5-10 minutes
usually 10-20 minutes
usually up to an hour or more
8
Which of the following is NOT a precipitating factor for angina?
exercise
illicit drugs
strong emotions (upset, fright, anger)
warm environment
9
Which of the following are symptoms of angina?
Pressure/burning over/near sternum, radiating to left arm/shoulder/jaw
SOB, chest tightness
all of the above
A reproducible pattern of pain in angina, appears after exertion in CSA.
10
Which is TRUE regarding Hemorrhagic Stroke?
all of the above
Subarachnoid or intracerebral
Often associated w/uncontrolled HTN (weakened blood vessels)
none of the above
11
Which of the following is TRUE regarding hemorrhagic stroke?
blood in brain causes tissue damage + ↑ intracranial pressure
30-day fatality: 2-6X higher
↑ intracranial pressure -> herniation
all are true
12
Which is FALSE regarding Ischemic Stroke?
30% due to cardiogenic emboli
Can be caused by atrial fibrillation
Stroke symptoms >24 hr vs TIA sx ~30 min
most common
13
Which of the following factors is MOST IMPORTANT for influencing MVO2?
coronary wall tension
heart rate
coronary perfusion pressure
contractility
14
Which of the following is CORRECT regarding stable plaque occlusion?
Plaques that occlude lumen (>60-70%) limit effectiveness of vasodilation
decreased blood flow can occur
Plaques that occlude lumen (<60-70%) limit effectiveness of vasodilation
Ischemic chest pain can occur
15
Which of the following can cause a thrombus to develop? (acute coronary syndrome)
all of the above
plaque rupture
platelets adhering, activating, & aggregating (after plaque rupture)
accumulation of RBCs & clotting factors (especially fibrin)
16
Ischemia is caused by plaque rupture/thrombus formation.
True
False
17
Define acute coronary syndromes.
pain may awaken person from sleep
has symptoms similar to chronic stable angina + N/V, diaphoresis, SOB
all of the above
Most often occurs at rest, new onset or increasing angina >20 min
18
Define Hemorrhagic stroke.
blood clot stops the flow of blood to an area of the brain
weakened/diseased blood vessels rupture, blood leaks into brain tissue
19
What type of ACS is likely present in a pt w/partially occluded artery, (-) ST elevation, and 3 elevated CK-MB levels?
chronic stable angina
NSTEMI
STEMI
unstable angina
20
Which of the following is INCORRECT regarding the types of ACS?
STEMI: sm vess myocard necrosis, partial artery occlu, ↑ troponin, CK-MB
UA: no myocardial necrosis, no ECG changes, no cardiac biomarkers
STEMI: lg vess myocard necrosis, fully occluded artery, ↑ troponin + CK-MB
NSTEMI: partial artery occlu, sm vess myocard necrosis, ↑ troponin, CK-MB
21
Define Embolus:
mostoften a piece of thrombus that has broken free (thromboembulus)
solid mass of platelets and/or fibrinthat forms locally in a vessel
22
Which of the following affects coronary blood flow?
smaller arterioles
smaller arteries
large epicardial vessels
all of the above
23
Which of the following would most likely increase myocardial oxygen demand (MVO2)?
Decreased heart rate
Increased nitric oxide
Increased cardiac preload
Decreased collateral circulation
24
Symptoms associated with stroke include...
slurred speech
weakness to 1 side (facial droop, uneven smile, arm weakness/numbness)
all of the above
HA, vertigo, falling, vision defects
25
Define Ischemic stroke.
weakened/diseased blood vessels rupture, blood leaks into brain tissue
blood clot stops the flow of blood to an area of the brain
26
Which of the following factors influence myocardial oxygen supply?
endothelial regulation (↑ NO = ↑ vasodilation = incr supply)
Heart rate (↑ heart rate = ↑ supply)
hemoglobin levels (↑ levels = ↑ supply)
coronary artery diameter (↑ diameter = ↑ supply)
27
What's the MOA for stable plaque occlusion in ischemia development?
↑ demand= ↓ larger vessels vasodilate = ↑ blood flow
↑ demand = ↑ smaller vessels vasodilate = ↑ blood flow
↓ demand = ↑ smaller vessels vasodilate = ↑ blood flow
↓ demand = ↓ larger vessels vasodilate = ↓ blood flow
28
Which of the following factors influence myocardial oxygen demand (MVO2)?
Heart rate (↑ heart rate = ↑ demand)
coronary wall tension- systole (↑preload=↑ intramyocardial wall tension...)
hemoglobin levels (↑ levels = ↑ demand)
contractility (↑ contractility = ↑ demand)

Pathophysiology - Stroke/IHD Flashcards | StudBud