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Pathoma: Cardiac Pathology – Questions & Solutions
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Pathoma: Cardiac Pathology – Questions & Solutions
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Pathoma: Cardiac Pathology – Questions & SolutionsHow much of the vessel must be occluded before stable angina occurs?
Right Ans - 70%
How does a stable angina patient present? Right Ans - chest pain <20
minutes, radiates to jaw, diaphoretic, SOB
What is seen on EKG when there is subendocardial ischemia? Right Ans -
ST-segment depression
Why does nitroglycerin relieve chest pain associated with ischemia? Right
Ans - dilates veins which decreases preload which reduces cardiac output
which reduces O2 demand
What is unstable angina caused by? Right Ans - ruptured atherosclerotic
plaque with thrombosis formation, BUT incomplete occlusion
This has angina at rest and high risk of MI? Right Ans - unstable angina
Which CAD has ST-segment depression on EKG? Right Ans - stable and
unstable angina
Chest pain unrelated to exertion Right Ans - prinzmetal angina
What is on EKG during transmural ischemia? Right Ans - ST-segment
elevation
Besides NG, what can be given to a patient with coronary artery vasospasm?
Right Ans - CCB
How is MI different from other causes of angina? Right Ans - it has
complete occlusion of the vessel causing necrosis of myocytes
This presents with chest pain >20 minutes, diaphoresis, dyspnea, and sxs not
relieved by NG? Right Ans - MI
What artery is occluded when there is anterior wall MI and anterior 2/3 of the
IV septum? Right Ans - LAD
, What artery is occluded when there is a posterior wall MI and posterior 1/3
IV septum involvement? Right Ans - RCA
What artery is occluded when there is a lateral wall of the left ventricle MI?
Right Ans - left circumflex artery
On initial MI, what and why is the EKG reading? Right Ans - ST-segment
depression due to damage to <50% of the subendocardial wall
What is the most sensitive and specific marker for MI? Right Ans -
Troponin I
What is the time course for tronponin I after MI? Right Ans - elevated in 4-6
hours; peaks at 24 and stays high for 5-12 days
What cardiac marker is useful for detecting an MI a few days after an initial
MI? Right Ans - CK-MB
What is the time course for CK-MB after MI? Right Ans - elevated in 4-6
hours; peaks at 24 hours returns to normal in 2-3 days
What should be given with aspirin prior to PCI? Right Ans - prasugrel
Following an acute MI, what 5 treatments need to be started? Right Ans -
ASA+heparin, oxygen, nitrates, B-blocker, ACEI
What are 2 outcomes of fibrinolysis or angioplasty following MI? Right Ans
- contraction band necrosis and reperfusion injury
Where does contraction band necrosis occur following acute tx of MI?
Right Ans - reperfusion of irreversibly damaged myocytes causing influx of
calcium producing contraction and subsequent bands
Why would cardiac enzymes continue to rise following acute tx of MI (angio,
PCI...)? Right Ans - reperfusion injury causing free radicals to form and
damaging more myocytes
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