4.2 CARDIAC
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Questions and Answers

What is the primary cause of endothelial damage leading to atherosclerosis?

  • Oxidized LDLs
  • Insulin resistance
  • Chronic infection
  • Hemodynamic shear stress (correct)

    • Which stage of atherosclerosis is characterized by the formation of a fibrous plaque?

  • Fatty streak
  • Fibrous plaque (correct)
  • Advanced lesion
  • Calcified plaque

    • What is the term for the abnormal lipid profile that is a predisposing risk factor for atherosclerosis?

  • Hypercholesterolemia
  • Atherogenic dyslipidemia (correct)
  • Hypertriglyceridemia
  • Familial hyperlipidemia

    • Which of the following is NOT a major risk factor for atherosclerosis?

    <p>Insulin resistance</p> Signup and view all the answers

    What is the term for the increased tendency to form blood clots that is a predisposing risk factor for atherosclerosis?

    <p>Prothrombotic state</p> Signup and view all the answers

    What is the result of the destructive effects of oxidized LDLs on the arterial wall?

    <p>Endothelial dysfunction</p> Signup and view all the answers

    What is the term for the abnormal accumulation of fat in the arterial wall that is the initial lesion of atherosclerosis?

    <p>Fatty streak</p> Signup and view all the answers

    Which of the following is a common consequence of the progression of atherosclerosis?

    <p>Impaired endothelial function</p> Signup and view all the answers

    What is the most common site of atherosclerotic lesions in the coronary arteries?

    <p>Branch points</p> Signup and view all the answers

    What is the estimated risk of MI or cardiac-related death in patients undergoing carotid endarterectomy?

    <p>1-5%</p> Signup and view all the answers

    What is the primary benefit of administering perioperative beta blockade in patients at risk for coronary disease?

    <p>Decreasing mortality and the incidence of cardiovascular complications</p> Signup and view all the answers

    What type of patients are most likely to require vascular surgery and have atherosclerotic lesions at multiple locations?

    <p>Generally sick people</p> Signup and view all the answers

    What is the name of the study that investigated the administration of Atenolol in patients at risk for coronary disease?

    <p>Mangano Study</p> Signup and view all the answers

    What is the primary location of atherosclerotic lesions in the abdominal aorta?

    <p>Along the outer surfaces of arterial curves</p> Signup and view all the answers

    What is the estimated risk of MI or cardiac-related death in patients undergoing peripheral vascular surgery?

    <p>5% or greater</p> Signup and view all the answers

    What is the duration of the benefit of administering perioperative beta blockade in patients at risk for coronary disease?

    <p>For as long as 2 years following surgery</p> Signup and view all the answers

    What is the effect of perioperative bisoprolol on short- and long-term cardiac death and MI?

    <p>Significantly reduced</p> Signup and view all the answers

    What is the recommended duration of beta-blocker treatment before surgery?

    <p>At least 30 days</p> Signup and view all the answers

    What is the effect of high-dose beta-blockade on cardiac outcomes?

    <p>Increased risk of cardiac death</p> Signup and view all the answers

    In which patient subgroup should beta-blockade be introduced according to the 2009 Guidelines?

    <p>All of the above</p> Signup and view all the answers

    What is the effect of beta-blockade on non-fatal stroke according to the recent meta-analysis?

    <p>27% increase</p> Signup and view all the answers

    Which beta-blocker is preferred for perioperative beta-blockade?

    <p>Bisoprolol</p> Signup and view all the answers

    What is the effect of beta-blockade on MACE in patients with anemia?

    <p>Marked increase</p> Signup and view all the answers

    What is the recommended approach to transfusion in beta-blocked patients with anemia?

    <p>Higher transfusion threshold</p> Signup and view all the answers

    What is the primary indication for surgery in an abdominal aortic aneurysm?

    <p>Diameter &gt; 5 cm</p> Signup and view all the answers

    What is the typical location of an abdominal aortic aneurysm rupture?

    <p>Left retroperitoneum</p> Signup and view all the answers

    What is the role of fluid resuscitation in the management of an abdominal aortic aneurysm rupture?

    <p>Deferred fluid resuscitation until the aorta is controlled</p> Signup and view all the answers

    What is the benefit of combined general anesthetic with epidural analgesia in elective AAA repair?

    <p>Improved postoperative course</p> Signup and view all the answers

    What is the primary cause of intermittent claudication in peripheral arterial disease?

    <p>Metabolic demands exceeding oxygen delivery during exercise</p> Signup and view all the answers

    What is the characteristic ankle-brachial index in patients with rest pain?

    <p>&lt; 0.4</p> Signup and view all the answers

    What is the risk factor shared by peripheral arterial disease and coronary artery disease?

    <p>Similar to CAD</p> Signup and view all the answers

    What is the benefit of neuraxial analgesia in peripheral arterial disease?

    <p>Very useful for pain management</p> Signup and view all the answers

    What is the primary cause of mortality in patients with atherosclerosis?

    <p>Cardiovascular ischemic events</p> Signup and view all the answers

    Which of the following is a sign of peripheral artery disease?

    <p>Dependent rubor</p> Signup and view all the answers

    What is the primary indication for surgical intervention in peripheral artery disease?

    <p>All of the above</p> Signup and view all the answers

    What is the primary risk of peripheral artery disease surgery?

    <p>Ischemic heart disease</p> Signup and view all the answers

    What is the management of Raynaud's phenomenon in anesthesia?

    <p>All of the above</p> Signup and view all the answers

    What is the most common etiology of carotid artery disease?

    <p>Embolic problem</p> Signup and view all the answers

    What is the primary correlate of surgical outcome in carotid endarterectomy?

    <p>All of the above</p> Signup and view all the answers

    What is the ranking of carotid artery disease in terms of cause of disability in the U.S.?

    <p>1st</p> Signup and view all the answers

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