Cardio Wk 4
Terms in this set (157)
Which class of lipoproteins is associated with ApoB-48?
This apolipoprotein is unique to HDL
This apolipoprotein is associated with VLDL, IDL, LDL (but not chylomicrons)
This protein, found on the surface of chylomicrons, activates LPL and allows removal of fatty acids
This protein is important for the binding of chylomicron remnants to the LDL-R in the liver
This protein allows binding of LDL to the LDL-R of the liver
Name three classes of medications that cause high TG levels in the blood
How does T2DM cause elevated TG levels?
Mutations in either of these genes can cause
Familial Chylomicronemia Syndromes
C-2 and LPL
This condition is characterized by eruptive xanthomas, lipemia retinalis, and turbid plasma
What was mentioned as being one of the main clinical consequences of FCS (familial chylomicronemia syndrome)?
The molecular etiology of this condition is not known, but it is known that it involves
impaired VLDL metabolism
If a "second hit" occurs in someone with FH (high VLDL), what other lipoprotein can also become elevated?
What are the clinical consequences if a person with FH takes a "second hit" (type 4 becomes type 5)?
Homozygosity for ApoE2 (Cys-Cys)
Tuberoeruptive xanthomas are pathognomonic for this condition
You see orange coloration in a patient's palms. This is pathognomonic for which condition?
This condition is associated with increased levels of
(both of chylomicrons and VLDL) and causes an increased risk of
AKA Familial Dysbetalipoproteinemia
Progestins (OCP) can raise levels of this lipoprotein
Hypothyroidism can lead to elevated levels of this lipoprotein
What is the inheritance of
Familial Hypercholesterolemia (FH)
A young adolescent presents with cutaneous xanthomas and exertional angina. What syndrome comes to mind?
What is the molecular etiology of Familial Hypercholesterolemia (FH)
Describe the clinical manifestations of
What is the inheritance of ApoB mutations (causing hypercholesterolemia)?
Genetic defects in ApoB-100 would cause elevations of which lipoprotein?
This is the protein that tends to cause destruction of LDL receptors
This class of genetic disorder is particularly associated with
normal TG levels
This disease is characterized by Liver VLDL
. The exact genetic mechanism is unclear
What is the significance of lipoprotein(a)?
What is the most common cause of
What are the two organs that produce "lipid-poor apoA-1" (precursor to ApoA-1)?
Mutations in this gene can impair the
of HDL in the liver and intestine
Mutations in ABCA1 (important for HDL synthesis) produce this disease
This disease is characterized by
enlarged orange tonsils
Tangier Disease (defects in ABCA1 lead to zero HDL production)
Which organ is responsible for the catabolism of lipid-poor ApoA-1?
This enzyme is important for esterifying free cholesterol in HDL
Are low HDL-C levels that are due to mutations associated with increased CV disease risk?
Which enzyme is inhibited by statins?
What effect do statins on the number of LDL receptors in the liver?
What are the adverse effects of statins?
How is myalgia different than
What is the mechanism of
Is ezetimibe effective for lowering TG levels?
How do bile acid sequestrants work?
This class of cholesterol-lowering drug has the potential to
raise TG levels
What is the mechanism and use of
What is the mechanism of the
Describe some of the effects of PPAR-alpha activation (via
These drugs are a good choice for a patient with
hypertriglyceridemia who is at risk for
This class of drug may
potentiate the action of oral anticoagulants
What is the main benefit of taking omega-3 fatty acids?
This class of drug, meant to increase HDL levels, really has not shown much benefit in clinical trials
What is the action of CETP?
Are the largest atherosclerotic plaques the ones most likely to rupture?
What is suggested by a
What were the results of the COURAGE trial?
Describe how foam cells are made
Aside from macrophages, which other cell type can become
Which cell type is responsible for
Are higher amounts of neovascularization associated with vulnerable or stable plaques?
What is the biggest risk factor for CHD?
How does glycemic control in patients with T2DM affect risk of CHD?
These are four groups of patients for which you should start statin therapy (probably not too important right now)
What is the gold standard for visualizing atherosclerotic plaques?
Which inflammatory markers have been shown to be causal for CHD?
This disease produces what is classified as a Carpentier Type 3 MR and often coexists with MS
What is meant by
What happens to afterload in the context of an acute MR?
What happens to LV preload in the contextof an acute MR?
Sudden onset of CHF is associated with this valve disease
Which atrial pressure waveform is dramatically increased in size in the context of acute MR?
What type of hypertrophy is seen in chronic MR?
How does afterload change from acute MR to chronic compensated MR?
In the progression from acute MR to chronic MR, the RF (increases/decreases/stays the same) while the RV (increases/decreases/stays the same)
Describe ejection fraction in acute and chronic compensated MR
From acute MR to chronic compensated MR there is
change in RF. What about from chronic compensated to decompensated MR?
What are the clinical consequences of a
This valve disease is associated with 1) fusion of commissures and 2) simultaneous development of stenosis and regurgitation
What results in a greater degree of hypertrophy: AR or MR?
What AR lead to an
in pulse pressure?
This condition is associated with
This valve condition is associated with
preserved effort tolerance
Explain why AR is associated with reduced myocardial O2
Describe the change in CO from
A patient with AR has an LVEF of 55%. Is surgery indicated?
What type of hypertrophy is seen in AR?
What organ systems can be adversely affected if a person follows a strict low-carbohydrate diet?
In a study of low-fat vs. low-carb diet, which was more beneficial in lowering cholesterol (total and LDL)?
What % of max VO2 generally qualifies as
intensity physical activity?
True or false: a person who is unfit should not attempt physical activity because it is too late to make any positive changes
This is the timeframe from initial presentation during which PCI has the greatest benefit for a STEMI patient
Which cell type was mentioned as being important to the
oxidation of LDL
Which cell type was mentioned as being particularly important in the
synthesis of ECM
proteins in blood vessels?
Atherosclerotic plaques are most likely to develop at which locations? And in which conditions?
This substance accounts for the bulk of restenotic lesions
This cytokine is especially important for the production of ECM secretion
This cytokine is especially important for
This drug, used in drug-eluting stents, arrests SMCs at the G1/S transition point
With which type of syndromic cardiomyopathy is
What is the inheritance of most forms of LQTS
This drug was the first to be found beneficial in terms of life expectancy for patients with Marfan syndrome
Microfibrils are an important component of this signaling pathway (part of pathogenesis of Marfan syndrome)
Mutations in fibrillin-1 (Marfan) lead to increased activity of _______, which can be crucial at early stages of development
Why was Losartan (ARB) thought to be potentially beneficial for patients with Marfan?
What is coronary flow reserve (CFR)?
Why is ischemia associated with ST segment
in ECG leads
the area of ischemia?
What happens to intracellular pH in an ischemic cell?
Describe the effects of ischemia on
Describe the locations of
in the context of contraction during ischemia
This is the term for prolonged contractile dysfunction, possibly seen after prolonged ischemia
Describe the typical symptoms of ischemia and their molecular cause
Subendocardial injury tends to produce ST (depression/elevation)?
List some of the drugs used to treat ischemia
What causes atherosclerotic plaques to rupture?
What tends to occur first in an MI: ST segment elevation or Q wave development?
Explain why ST elevations can be seen in an MI
What is Dressler's Syndrome?
Papillary muscle rupture tends to be associated with inferior or anterior MIs?
This class of drug has been shown to be effective in
altering the LV remodeling that occurs post-MI
Describe the components of the
of an atherosclerotic plaque
What type of necrosis is associated with ischemic heart disease?
What role does
play in the development of an MI?
MIs tend to be reversible up to ______ minutes
This type of MI was mentioned as a possible consequence of prolonged severe reduction in systemic BP (shock)
Describe the four steps in the structural changes that occur in heart tissue as a result of an MI
contraction band necrosis
Describe the mechanism of
What is the most common cause of sudden cardiac death?
Which sex is more at risk for having another MI (within 6 six of the first MI)?
Describe some of the symptoms of heart disease that may appear in women
Which sex tends to have the risk of CV disease be increased more by smoking?
Which sex tends to have higher LDL-C after age 55?
True or false: preeclampsia has no bearing on CV health once pregnancy is over
Describe what happens to central venous pressure and SVR during pregnancy
Is pregnancy a hyper- or hypocoagulable state?
Why is a mild anemia a normal consequence of pregnancy?
Pregnancy is associated with an (increase/decrease) in LV systolic function
Why is pregnancy associated with an increased risk of arrhythmia?
Describe what happens to preload and afterload during labor+delivery
True or false: orthopnea is a normal consequence of pregnancy
True or false: diastolic murmurs are a normal consequence of pregnancy
What are the four functional classes (NY heart association)?
True or False: the appearance of CHF or pulmonary edema due to MR during pregnancy is extremely worrisome and suggests a poor prognosis
Dissection of a coronary artery is especially common in which subgroup of patients?
What is peripartum cardiomyopathy?
What effect does estrogen have on TG levels?
What risks are increased for a patient undergoing a female ==> male transition?
What risks are increased for a patient undergoing a male ==> female transition?
ECG changes take longer to resolve in unstable angina or NSTEMI?
Describe the mechanism of clopidogrel
Is aspirin + clopidogrel a good combo for reducing the risk of ischemic events?
What has a greater risk for
: NSTEMI or STEMI?
Describe some physical findings during an MI
True or false: PCI and thrombolytics are equivalently effective treatments for MI
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