Stable and Unstable Angina Quiz

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Questions and Answers

What characterizes stable angina?

It typically requires hospitalization for treatment.

It occurs with a consistent pattern and effort to trigger pain. (correct)

It leads to significant increases in cardiac biomarkers.

It varies in intensity and duration over time.

Which statement about unstable angina is accurate?

It occurs with increased frequency and duration compared to stable angina. (correct)

It is characterized by pain that is relieved by rest.

It is primarily triggered by physical activity.

It generally requires no medical intervention.

Which condition is connected to spasm of the coronary arteries?

Unstable angina

Acute coronary syndrome

Prinzmetal angina (correct)

Stable angina

What is a typical clinical presentation of acute coronary syndrome?

Rupture of an atherosclerotic plaque causing a thrombus. Signup and view all the answers

How does Prinzmetal angina typically respond to treatment?

It generally responds to coronary vasodilators. Signup and view all the answers

Which treatment strategy is NOT typically used for stable angina?

Surgical bypass grafting Signup and view all the answers

In unstable angina, what happens to biomarkers of myocardial necrosis?

They remain unchanged. Signup and view all the answers

What is the primary goal of anti-angina agents?

To balance cardiac oxygen supply and demand. Signup and view all the answers

What is the primary cause of classic angina pectoris?

Reduction of coronary perfusion from fixed obstruction Signup and view all the answers

Which of the following symptoms is NOT typically associated with classic angina pectoris?

Silent angina with no symptoms Signup and view all the answers

What type of angina is often characterized by ischemic episodes with extreme fatigue or nausea?

Silent angina Signup and view all the answers

Which of the following is a key component of guideline-directed medical therapy for patients with ischemic heart disease?

Management of modifiable risk factors Signup and view all the answers

When does typical angina pectoris generally occur?

During physical activity or emotional stress Signup and view all the answers

What is a common characteristic of unstable angina?

It occurs unpredictably and may happen at rest Signup and view all the answers

Which demographic is more likely to present atypical symptoms of angina?

Women, elderly patients, and those with diabetes Signup and view all the answers

What is the main effect of atherosclerotic lesions in coronary arteries?

Reduced myocardial oxygen supply and demand balance Signup and view all the answers

Which calcium channel blocker is primarily an arteriolar vasodilator?

Amlodipine Signup and view all the answers

What effect do non-dihydropyridine calcium channel blockers have on heart rate?

They decrease heart rate. Signup and view all the answers

Which of the following statements about organic nitrates is correct?

They decrease myocardial oxygen demand. Signup and view all the answers

Which calcium channel blocker is contraindicated in patients with depressed cardiac function?

Verapamil Signup and view all the answers

What is the primary mechanism of action of organic nitrates?

Activation of guanylate cyclase. Signup and view all the answers

Which dihydropyridine calcium channel blocker is associated with an increased risk of mortality after an myocardial infarction (MI)?

Nifedipine Signup and view all the answers

What is the effect of amlodipine on cardiac conduction?

It has minimal effect on cardiac conduction. Signup and view all the answers

What is a significant side effect of using non-dihydropyridine calcium channel blockers in heart failure patients?

Worsening of heart failure. Signup and view all the answers

What effect do B-adrenergic blockers have on myocardial oxygen demand?

Decrease myocardial oxygen demand at rest and during exertion Signup and view all the answers

Which statement is true regarding the use of B-blockers in patients with vasospastic angina?

B-blockers are contraindicated as they worsen symptoms. Signup and view all the answers

Which B-blocker is considered the prototype and is not cardioselective?

Propranolol Signup and view all the answers

What is a recommended practice when discontinuing B-blocker therapy?

Gradually taper off the dose over 2 to 3 weeks. Signup and view all the answers

What is a potential side effect of nonselective B-blockers in patients with asthma?

Worsening of asthma symptoms Signup and view all the answers

Which class of medications is effective as an initial anti-anginal therapy for most patients?

B-adrenergic blockers Signup and view all the answers

In patients with a history of myocardial infarction, what benefit do B-blockers provide?

They reduce the risk of death and myocardial infarction. Signup and view all the answers

What do calcium channel blockers inhibit to reduce myocardial ischemia?

Calcium entry into smooth muscle and cardiac cells Signup and view all the answers

What physiological response does elevated cGMP initiate in vascular smooth muscles?

Dephosphorylation of myosin light chains Signup and view all the answers

Which of the following nitrates has the quickest onset of action?

Sublingual nitroglycerin Signup and view all the answers

What adverse effect is most commonly associated with the use of nitrates?

Headache Signup and view all the answers

Why is sublingual nitroglycerin often preferred to oral administration?

It avoids the first-pass metabolism in the liver. Signup and view all the answers

How can tolerance to nitrates be managed effectively?

Establish a nitrate-free interval. Signup and view all the answers

What should be avoided when using nitrates due to the risk of dangerous hypotension?

Phosphodiesterase type 5 inhibitors Signup and view all the answers

What is a recommended duration for the nitrate-free interval in patients with variant angina?

In the late afternoon Signup and view all the answers

Which formulation of isosorbide provides an improved bioavailability due to stability against hepatic breakdown?

Isosorbide mononitrate Signup and view all the answers

Study Notes

Anti-Angina Agents

Atherosclerotic coronary artery disease (CAD) is a leading cause of death globally.
CAD results from an imbalance in myocardial oxygen supply and demand.
Angina pectoris is characterised by chest pain, possibly radiating.
Stable angina is typical, effort-induced pain.
Unstable angina is characterised by increasing frequency, duration, and intensity.
Prinzmetal or variant angina is rest-associated, not exertion-related muscle spasms.
Acute coronary syndrome (ACS) includes MI and unstable angina caused by coronary artery blockage.
Treatment strategies often include beta-blockers, calcium channel blockers, organic nitrates, and sodium channel blockers.
Beta-blockers reduce heart rate and contractility, lowering oxygen demand.
Calcium channel blockers relax smooth muscle, improving blood flow.
Organic nitrates convert to nitric oxide, which relaxes blood vessels.
Ranolazine inhibits sodium current, improving diastolic function, and is an anti-anginal/anti-arrhythmic treatment option.
Adverse effects of nitrates may include headache, hypotension, and tolerance.
Choice of medication and frequency depends on angina type and severity.

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Description

Test your knowledge on stable and unstable angina characteristics, symptoms, and treatment strategies. This quiz covers clinical presentations, biomarkers, and demographic considerations related to angina pectoris. Challenge yourself to distinguish between different types of angina and their management.