Coronary Artery Disease: Pathophysiology, Risk Factors, and Clinical Implications

Question 1

What is the hallmark of plaque formation in the coronary arteries?

Accepted Answer

Accumulation of cholesterol and other lipids

Answer

Response to infections

Answer

Genetic mutations

Answer

Immune activation

Question 2

What is the pathophysiological mechanism underlying the chest pain in angina pectoris?

Accepted Answer

Ischemia of the heart muscle

Answer

Inflammation of the coronary arteries

Answer

Thrombosis of the coronary arteries

Answer

Vasospasm of the coronary arteries

Question 3

Which medication is commonly prescribed to reduce the risk of clot formation in coronary artery disease?

Accepted Answer

Aspirin

Answer

Statins

Answer

Beta-blockers

Answer

Diuretics

Question 4

What is the significance of collateral circulation in individuals with coronary artery disease?

Accepted Answer

It provides an alternative pathway for blood flow to the heart muscle.

Answer

It promotes the formation of new blood vessels.

Answer

It decreases the risk of heart attack.

Answer

It prevents the development of angina.

Question 5

Which of the following is a modifiable risk factor for coronary artery disease?

Accepted Answer

Smoking

Answer

Genetics

Answer

Age

Answer

Gender

Question 6

Which of the following is NOT a risk factor for coronary artery disease that you can change?

Accepted Answer

Age

Answer

Smoking

Answer

High blood pressure

Answer

High cholesterol levels

Question 7

Which of the following is NOT a major risk factor for developing coronary artery disease?

Accepted Answer

Excessive physical activity

Answer

Hypertension

Answer

Smoking

Answer

High cholesterol

Question 8

Which type of acute coronary syndrome is characterized by complete blockage of a coronary artery, leading to irreversible damage to the heart muscle?

Accepted Answer

Myocardial infarction

Answer

Stable angina

Answer

Unstable angina

Answer

Silent ischemia

Question 9

A key consequence of reduced blood flow to the myocardium in coronary artery disease is:

Accepted Answer

Ischemia

Answer

Infarction

Answer

Arrhythmias

Answer

Heart failure

Question 10

The development of collateral circulation in coronary artery disease:

Accepted Answer

Can provide alternative pathways for blood flow to ischemic areas, improving tissue perfusion

Answer

Increases the risk of myocardial infarction by promoting plaque rupture

Answer

Is a sign of stable coronary artery disease and reduced disease severity

Answer

Is not clinically significant and does not impact the course of the disease

Question 11

What is the primary mechanism by which cholesterol-laden macrophages contribute to plaque formation in coronary arteries?

Accepted Answer

They accumulate in the arterial wall, forming a core of lipid-rich material.

Answer

They release inflammatory cytokines that promote plaque instability.

Answer

They trigger thrombosis by activating platelets and the coagulation cascade.

Answer

They constrict blood vessels, reducing blood flow to the myocardium.

Question 12

Which of the following clinical manifestations is characteristic of unstable angina?

Accepted Answer

Chest pain that occurs at rest or with minimal exertion and lasts more than 30 minutes.

Answer

Chest pain that is relieved by rest or nitroglycerin.

Answer

Sudden cardiac arrest.

Answer

Dyspnea.

Question 13

What is the primary pathophysiological event that triggers an acute myocardial infarction?

Accepted Answer

Complete occlusion of a coronary artery.

Answer

Myocardial ischemia.

Answer

Heart failure.

Answer

Arrhythmia.

Question 14

Which of the following laboratory markers is the most sensitive and specific indicator of myocardial injury?

Accepted Answer

Troponin.

Answer

Creatine kinase.

Answer

Aspartate aminotransferase.

Answer

White blood cell count.

Question 15

What is the primary role of inflammation in coronary artery disease?

Accepted Answer

Contributing to endothelial dysfunction and plaque rupture.

Answer

Promoting plaque stability.

Answer

Reducing the risk of thrombus formation.

Answer

Inhibiting vascular smooth muscle proliferation.

Question 16

What is the most common long-term complication of coronary artery disease?

Accepted Answer

Heart failure.

Answer

Stroke.

Answer

Peripheral artery disease.

Answer

Kidney disease.

Question 17

Which of the following is considered a modifiable risk factor for coronary artery disease (CAD)?

Accepted Answer

Smoking

Answer

Age

Answer

Family history of CAD

Answer

Vitamin C deficiency

Question 18

The initial step in the development of an atherosclerotic plaque is:

Accepted Answer

Endothelial cell activation and dysfunction

Answer

Lipid accumulation in the arterial wall

Answer

Thrombus formation

Answer

Smooth muscle cell proliferation

Question 19

The primary goal of coronary angiography is to:

Accepted Answer

Visualize the coronary arteries and identify any blockages

Answer

Measure the ejection fraction of the heart

Answer

Assess the severity of valvular heart disease

Answer

Detect congenital heart defects

Question 20

Which of the following medications is a beta-blocker used in the management of CAD?

Accepted Answer

Metoprolol

Answer

Warfarin

Answer

Amiodarone

Answer

Digoxin

Question 21

The primary goal of lifestyle modification in the management of CAD is to:

Accepted Answer

Reduce risk factors and improve cardiovascular health

Answer

Completely reverse the disease process

Answer

Prevent complications

Answer

Eliminate all symptoms

Question 22

Which of the following nursing interventions is appropriate for a patient with acute coronary syndrome (ACS)?

Accepted Answer

Administering oxygen

Answer

Performing a cardiac catheterization

Answer

Inserting an intra-aortic balloon pump

Answer

Discharging the patient home with a prescription for aspirin

Question 23

The most serious complication of coronary artery disease is:

Accepted Answer

Myocardial infarction

Answer

Stroke

Answer

Heart failure

Answer

Peripheral artery disease

Question 24

What is the primary mechanism of atherosclerotic plaque formation in CAD?

Accepted Answer

Deposition of cholesterol and lipids in the intima of the arteries

Answer

Inflammation and thickening of the arterial wall

Answer

Formation of blood clots in the arteries

Answer

Narrowing of the arteries due to spasm

Question 25

What is the primary cause of chest pain in stable angina?

Accepted Answer

Temporary reduction in blood flow to the heart

Answer

Obstruction of a coronary artery by a blood clot

Answer

Inflammation of the heart muscle

Answer

Rupture of an atherosclerotic plaque

Question 26

What is the primary goal of reperfusion therapy in acute myocardial infarction?

Accepted Answer

To restore blood flow to the affected area of the heart

Answer

To reduce inflammation and pain

Answer

To prevent further damage to the heart muscle

Answer

To dissolve blood clots in the arteries

Question 27

What is the primary mechanism responsible for plaque formation in CAD?

Accepted Answer

Monocyte infiltration and foam cell formation

Answer

Calcification of the arterial wall

Answer

Vasospasm

Answer

Endothelial dysfunction

Question 28

Which type of plaque is most likely to rupture and lead to acute coronary syndromes?

Accepted Answer

Unstable, lipid-rich plaque

Answer

Stable, fibrous plaque

Answer

Calcified plaque

Answer

Mixed plaque

Question 29

Which of the following is a symptom of stable angina?

Accepted Answer

Chest discomfort that is relieved by rest

Answer

Sudden, severe chest pain

Answer

Shortness of breath

Answer

Lightheadedness

Question 30

What is the primary goal of medical therapy for CAD?

Accepted Answer

Prevention of acute coronary events

Answer

Reversal of plaque formation

Answer

Restoration of normal myocardial function

Answer

Elimination of all symptoms

Question 31

What is the difference between a heart attack and sudden cardiac death?

Accepted Answer

A heart attack involves myocardial infarction, while sudden cardiac death does not.

Answer

Sudden cardiac death involves myocardial infarction, while a heart attack does not.

Answer

Heart attacks are always preceded by angina, while sudden cardiac death is not.

Answer

Sudden cardiac death is always preceded by angina, while heart attacks are not.

Question 32

What is the most important lifestyle modification for reducing the risk of CAD?

Accepted Answer

Smoking cessation

Answer

Weight loss

Answer

Dietary changes

Answer

Regular exercise

Question 33

Which acute coronary syndrome is characterized by sudden-onset chest pain lasting more than 20 minutes and is associated with ST-segment elevation on an electrocardiogram?

Accepted Answer

ST-elevation myocardial infarction (STEMI)

Answer

Stable angina

Answer

Unstable angina

Answer

Non-ST-elevation myocardial infarction (NSTEMI)

Question 34

What is the primary complication of coronary artery disease?

Accepted Answer

Myocardial infarction (heart attack)

Answer

Heart failure

Answer

Stroke

Answer

Peripheral artery disease

Question 35

Which diagnostic test provides direct visualization of the coronary arteries to detect blockages?

Accepted Answer

Coronary angiography

Answer

Electrocardiogram (ECG)

Answer

Chest X-ray

Answer

Echocardiogram

Question 36

What is the primary goal of medical treatment in coronary artery disease management?

Accepted Answer

Improve blood flow to the heart

Answer

Reduce inflammation

Answer

Lower blood pressure

Answer

Control cholesterol levels

Question 37

Formation of a blood clot (thrombus) within a coronary artery can lead to:

Accepted Answer

Myocardial infarction

Answer

Stroke

Answer

Pulmonary embolism

Answer

Aortic dissection

Question 38

Which electrocardiogram (ECG) finding is characteristic of acute myocardial infarction?

Accepted Answer

ST-segment elevation

Answer

T-wave inversion

Answer

QRS complex widening

Answer

Prolonged PR interval

Question 39

Elevated levels of cardiac enzymes in the bloodstream indicate:

Accepted Answer

Myocardial damage

Answer

Heart failure

Answer

Arrhythmia

Answer

Pericarditis

Question 40

In a patient presenting with chest pain and shortness of breath, which diagnostic test is the first step in assessing for coronary artery disease?

Accepted Answer

Electrocardiogram (ECG)

Answer

Echocardiogram

Answer

Cardiac catheterization

Question 41

What is the initial step in the process of plaque formation in CAD?

Accepted Answer

Endothelial damage

Answer

Thrombosis

Answer

Hypertrophy of smooth muscle cells

Answer

Vasospasm

Question 42

Which of the following is the leading cause of an acute coronary syndrome (ACS)?

Accepted Answer

Ruptured atherosclerotic plaque

Answer

Pericarditis

Answer

Myocarditis

Answer

Vasospasm

Question 43

Which of the following is a serious complication of myocardial infarction (MI)?

Accepted Answer

Cardiogenic shock

Answer

Stroke

Answer

Hypertension

Answer

Pulmonary embolism

Question 44

Which of the following procedures is used to visualize coronary arteries and identify stenotic lesions?

Accepted Answer

Cardiac catheterization

Answer

Blood pressure measurement

Answer

Coronary artery bypass grafting

Question 45

Which of the following risk factors for CAD can be modified through lifestyle changes?

Accepted Answer

Smoking

Answer

Age

Answer

Race

Answer

Family history

Question 46

The severity of CAD is primarily determined by:

Accepted Answer

The extent and location of coronary artery stenosis

Answer

Serum cholesterol levels

Answer

Age of the patient

Answer

Presence of hypertension