Flashcards Cardiology 1-5 and 6-10 and 11-15 and 16-20 focused

A patient presents with chest pain and is diagnosed with impaired blood flow to the heart muscle due to atherosclerosis. Using your understanding of cardiovascular conditions, explain how this condition could lead to a heart attack and what underlying process is responsible.

• The impaired blood flow deprives the heart muscle of oxygen, leading to tissue death, which can result in a heart attack; atherosclerosis narrows the arteries.

• The impaired blood flow increases blood pressure, causing the heart to beat faster and eventually stop.

• The impaired blood flow causes the heart valves to malfunction, leading to arrhythmias and heart attack.

• The impaired blood flow increases the amount of blood in the lungs, causing shortness of breath and heart attack.

Given a patient with abnormal heart rhythms who experiences fainting and palpitations, reason through the potential risks and explain why immediate intervention might be necessary.

• Abnormal heart rhythms can lead to sudden cardiac death, so immediate intervention is necessary to prevent fatal outcomes.

• Abnormal heart rhythms only cause mild discomfort and do not require urgent care.

• Abnormal heart rhythms are always temporary and resolve without treatment.

• Abnormal heart rhythms only affect blood pressure and are not life-threatening.

A patient is diagnosed with heart failure and is experiencing fluid buildup, shortness of breath, and fatigue. Strategically explain how the inability of the heart to pump effectively leads to these symptoms and what evidence supports this relationship.

• When the heart cannot pump effectively, blood backs up in the veins, causing fluid to accumulate in tissues (edema), leading to shortness of breath and fatigue.

• Heart failure only affects the heart rate and does not cause fluid buildup or fatigue.

• The inability of the heart to pump effectively increases oxygen delivery to tissues, reducing symptoms.

• Heart failure is unrelated to fluid buildup and only causes chest pain.

A patient with heart failure is already on diuretics and beta-blockers but continues to have symptoms. Based on current pharmacological strategies, which additional class of drugs could be considered, and what is the rationale for this choice?

• Angiotensin II receptor blockers (ARBs), as they reduce afterload and improve cardiac function.

• Nitrates, as they are primarily used for arrhythmias.

• Sodium channel blockers, as they are the mainstay for heart failure.

• Potassium channel blockers, as they directly increase cardiac output.

A patient with angina is not responding to nitrates. Using your understanding of antianginal pharmacology, suggest an alternative or adjunctive drug class and explain your reasoning.

• Beta-blockers or calcium channel blockers, as they reduce myocardial oxygen demand and improve symptoms.

• Diuretics, as they are the primary treatment for angina.

• Sodium channel blockers, as they are the first-line for angina.

• ARBs, as they are specifically indicated for angina.

A patient with hypertension is prescribed a medication that reduces systemic vascular resistance and decreases blood volume. Using your understanding of pharmacological mechanisms, explain how this medication helps in lowering blood pressure and discuss potential physiological consequences if systemic vascular resistance is reduced excessively.

• The medication lowers blood pressure by reducing the force against vessel walls, but excessive reduction may cause hypotension and inadequate organ perfusion.

• The medication increases blood pressure by constricting blood vessels, but excessive reduction may cause hypertension.

• The medication has no effect on blood pressure, but excessive reduction may cause arrhythmias.

• The medication increases heart rate, but excessive reduction may cause bradycardia.

A patient with heart failure is given a medication that improves cardiac output, reduces preload and afterload, and modulates neurohormonal systems. Strategically analyze how each of these actions contributes to improved heart function and why a combination of these effects is beneficial in heart failure management.

• Improving cardiac output increases oxygen delivery, reducing preload and afterload decreases cardiac workload, and neurohormonal modulation prevents further cardiac damage, making the combination effective for heart failure.

• Improving cardiac output decreases oxygen delivery, reducing preload and afterload increases cardiac workload, and neurohormonal modulation causes arrhythmias.

• Improving cardiac output has no effect, reducing preload and afterload increases blood pressure, and neurohormonal modulation is unnecessary.

• Improving cardiac output only affects the lungs, reducing preload and afterload only affects the kidneys, and neurohormonal modulation only affects the liver.

Consider a scenario where a patient develops an abnormal heart rhythm. Explain how antiarrhythmic medications work to restore normal rhythm and rate, and evaluate the potential risks if the electrical impulses within the heart are excessively modified.

• Antiarrhythmics restore normal rhythm by modifying electrical impulses, but excessive modification can lead to new arrhythmias or cardiac arrest.

• Antiarrhythmics increase blood flow, but excessive modification can cause hypertension.

• Antiarrhythmics decrease heart rate, but excessive modification can cause tachycardia.

• Antiarrhythmics have no effect on rhythm, but excessive modification can cause hypotension.

A patient with a history of hypertension is struggling to manage their cardiovascular condition. Develop a comprehensive management plan that incorporates both lifestyle and medical interventions, and justify your choices based on evidence.

• Recommend only surgical intervention without considering lifestyle or medication adherence.

• Advise a combination of lifestyle modifications (diet, exercise, smoking cessation, weight management), ensure medication adherence, and consider surgical interventions if necessary.

• Suggest medication adherence alone without lifestyle changes.

• Focus solely on stress tests and coronary angiography for ongoing management.

You are tasked with planning a treatment strategy for a patient diagnosed with arrhythmias and coronary artery disease. How would you prioritize and sequence interventions, and what reasoning supports your approach?

• Start with surgical interventions for all patients regardless of severity.

• Begin with lifestyle modifications and medication adherence, reserving surgical interventions such as angioplasty, stenting, or pacemakers for cases where non-surgical management is insufficient.

• Use only echocardiography for ongoing treatment.

• Ignore medication adherence and focus on diet alone.