NS 832 Exam 2 Questions with Correct Answers Latest Update 2025/2026
CHD Epidemiology - Answers -attributed to more death and disability with greater economic
cost than any other illness in the developed world
-1/2 of middle aged mend and 1/3 of middle aged women in the US develop some
manifestation of CAD
When the diameter of an artery is
reduced by 50%
reduced by 80% - Answers 50%-patient may become symptomatic, particularly with exertion
80%- likely to have symptoms at rest or with minimal exertion
Risk factors for CHD - Answers HTN
Diabetes- often causes a silent infarction, >men
Artherosclerosis
Male > female
Age: male >45 Female >55
Family history- premature onset
Ethnicity- African American
Chronic Kidney Disease
unhealthy diet
smoking
Dyslipidemia
Overweight/obese
Sedentary lifestyle
Stress
Inflammation
Prevention of CHD - Answers Primary- therapeutic lifestyle changes
Secondary/Tertiary- lipid management, HTN management, Aspirin, ACE inhibitors, not smoking,
manage diabetes, fish oil (not primary prevention)
,Non-invasive markers indicating CHD - Answers -CRP
-interleukin-6
-monocyte-macrophage colony-stimulating factor
Cardiac catheterization is indicated if - Answers ECG changes and biomarkers indicate an acute
myocardial infarction
First-line testing for CHD - Answers Exercise Tolerance Test (ETT)
Who qualifies for a ETT? - Answers symptomatic patients (chest pain/dyspnea w/ exertion) who
are at intermediate risk of ACS
What type of ETT to use - Answers If the patient cannot adequately exercise, are morbidly obese,
have joint limitation, or have severe COPD ---> are there confounding things on EKG ---> if no
then they can do testing but if yes then they need imaging
Confounding things on EKG for CHD - Answers oreexcititaion syndrome
WPW >1 mm
resting ST depression
left bundle branch block
paced rhythm
What indicates a positive ETT? - Answers -EKG changes >.2mV ST segment depression at a low
workload or ST depression that persists >5 min after the termination of the exercise
-Angina
-Hypotension
Contraindications for ETT? - Answers -active endocarditis
-decompensated heart failure
-recent acute MI or stroke
-exercise intolerance
-persistent stable angina
-uncontrolled arrhythmia
-uncontrolled hypertension/tachycardia
, Medications used for pharmacologic stress testing - Answers -vasodilators (dipyridamole or
adenosine)
-inotropic-chronotropics (dobutamine)
False positives and False negatives for CHD - Answers False positives- women, patients with
low probability of CHD, patients taking digitalis or antiarrhythmic agents, patients with abnormal
serum potassium levels
False negatives- patients with circumflex disease since the lateral portion of the heart perfused
by this vessel is not well represented on an EKG, if the patient is obese imaging studies may be
a better choice
Cardiac imaging - Answers -echocardiogram augments stress treadmill
-echo by itself assess left ventricular ejection fraction and also valve function
-Nuclear perfusion study treadmill or chemical induced (pharmacological stress test)
-PET scan often done for people with BMI >40
-Some CT angiograms and calcium scoring
Diagnostic testing for CAD in women - Answers -CAD is leading cause of death in women
-testing isn't as accurate for women
-ETT is indicated for women with DM and PAD (high risk factors) and those who are
symptomatic but have a normal resting ECG, good exercise tolerance and no risk factors
-Stress test indicated if they are symptomatic but do not meet requirements for ETT (abnormal
ECG, known CAD, questionable exercise tolerance, coronary risk factors)
Women and CAD - Answers -present more often with GI symptoms than classic chest pain
-many who died suddenly of CHD had no previous symptoms
Coronary heart disease (CHD) includes: - Answers -MI
-angina pectoris
-atherosclerotic cardiovascular disease (ASCVD)
-chronic ischemic heart disease
Nonmodifiable risk factors for CHD - Answers -women
CHD Epidemiology - Answers -attributed to more death and disability with greater economic
cost than any other illness in the developed world
-1/2 of middle aged mend and 1/3 of middle aged women in the US develop some
manifestation of CAD
When the diameter of an artery is
reduced by 50%
reduced by 80% - Answers 50%-patient may become symptomatic, particularly with exertion
80%- likely to have symptoms at rest or with minimal exertion
Risk factors for CHD - Answers HTN
Diabetes- often causes a silent infarction, >men
Artherosclerosis
Male > female
Age: male >45 Female >55
Family history- premature onset
Ethnicity- African American
Chronic Kidney Disease
unhealthy diet
smoking
Dyslipidemia
Overweight/obese
Sedentary lifestyle
Stress
Inflammation
Prevention of CHD - Answers Primary- therapeutic lifestyle changes
Secondary/Tertiary- lipid management, HTN management, Aspirin, ACE inhibitors, not smoking,
manage diabetes, fish oil (not primary prevention)
,Non-invasive markers indicating CHD - Answers -CRP
-interleukin-6
-monocyte-macrophage colony-stimulating factor
Cardiac catheterization is indicated if - Answers ECG changes and biomarkers indicate an acute
myocardial infarction
First-line testing for CHD - Answers Exercise Tolerance Test (ETT)
Who qualifies for a ETT? - Answers symptomatic patients (chest pain/dyspnea w/ exertion) who
are at intermediate risk of ACS
What type of ETT to use - Answers If the patient cannot adequately exercise, are morbidly obese,
have joint limitation, or have severe COPD ---> are there confounding things on EKG ---> if no
then they can do testing but if yes then they need imaging
Confounding things on EKG for CHD - Answers oreexcititaion syndrome
WPW >1 mm
resting ST depression
left bundle branch block
paced rhythm
What indicates a positive ETT? - Answers -EKG changes >.2mV ST segment depression at a low
workload or ST depression that persists >5 min after the termination of the exercise
-Angina
-Hypotension
Contraindications for ETT? - Answers -active endocarditis
-decompensated heart failure
-recent acute MI or stroke
-exercise intolerance
-persistent stable angina
-uncontrolled arrhythmia
-uncontrolled hypertension/tachycardia
, Medications used for pharmacologic stress testing - Answers -vasodilators (dipyridamole or
adenosine)
-inotropic-chronotropics (dobutamine)
False positives and False negatives for CHD - Answers False positives- women, patients with
low probability of CHD, patients taking digitalis or antiarrhythmic agents, patients with abnormal
serum potassium levels
False negatives- patients with circumflex disease since the lateral portion of the heart perfused
by this vessel is not well represented on an EKG, if the patient is obese imaging studies may be
a better choice
Cardiac imaging - Answers -echocardiogram augments stress treadmill
-echo by itself assess left ventricular ejection fraction and also valve function
-Nuclear perfusion study treadmill or chemical induced (pharmacological stress test)
-PET scan often done for people with BMI >40
-Some CT angiograms and calcium scoring
Diagnostic testing for CAD in women - Answers -CAD is leading cause of death in women
-testing isn't as accurate for women
-ETT is indicated for women with DM and PAD (high risk factors) and those who are
symptomatic but have a normal resting ECG, good exercise tolerance and no risk factors
-Stress test indicated if they are symptomatic but do not meet requirements for ETT (abnormal
ECG, known CAD, questionable exercise tolerance, coronary risk factors)
Women and CAD - Answers -present more often with GI symptoms than classic chest pain
-many who died suddenly of CHD had no previous symptoms
Coronary heart disease (CHD) includes: - Answers -MI
-angina pectoris
-atherosclerotic cardiovascular disease (ASCVD)
-chronic ischemic heart disease
Nonmodifiable risk factors for CHD - Answers -women
