9.8- hypertension

Question 1

current lipid tests and age it should be done (4)

Answer 1

Serum cholesterol
HDL
LDL
TG

> 20 every 5 years

Question 2

how to perform a lipid profile

Answer 2

must be fasting for 12hrs before the test

no alc

Question 3

what increases/decreases LDL cholesterols

Answer 3

LDL increased by anabolic steroids, asprin

LDL decreased by oestrogens

Question 4

When does C reactive pro increase and ex

Answer 4

Produced in response to inflammation (arthritis, IBD, inf, autoimmune)

Question 5

When does high sensitivity CRP increase

Answer 5

increases in low grade vascular inflammation, atheromatous, plaque rupture

Question 6

When does Troponin I or T increase

Answer 6

In myocardial infarction

Question 7

What does high lvls of homocysteine lead to and what can bring it down

Answer 7

oxidizes LDL: have more infarcts

folic acid and B12 in diet brings levels to healthy range

Question 8

what do high lvls of Lipopro A lead to

Answer 8

associated w cardiovascular disease

interferes w plasminogen

Question 9

what inf has been linked to cardiobascilar infarctions

Answer 9

chlamydia pneumonae

Question 10

What is APO A and what does measuring it show

Answer 10

Activated enzymes that move cholesterol from tissues into HDL

(can be used to measure HDL)

Question 11

What does APO b48 do and what does measuring it indicate

Answer 11

part of chylomicrons and transports lipids to lover to combine w apob100 to make VLDL

(indicator of CAD risk)

Question 12

What is the most important risk factor of ischemic heart disease

Answer 12

LDL`

Question 13

if LDL increased what should u do

Answer 13

strict diet for 3-5m

consider use of statins

Question 14

Tests for atherosclerosis

Answer 14

Serum cholesterol
serum HDL
Serum LDL
Serum TG
Serum Apo B
urinalysis

Question 15

Ischemic heart disease tests

Answer 15

serum cholesterol
serum HDL
serum LDL
serum hsCRP

Question 16

what likely results would u see in lipid/lipopro diseases (3)

Answer 16

hypercholesterolaemia
hyper tryglyceridemia
Both increased w fasting

Question 17

What are the two primary causes of hypercholesteromlemias

Answer 17

familial combined hyperlipedimia

familial hyperlipdemia

Question 18

findings in familial combined hyperlipedimia

Answer 18

Cholesterol + trigluceride (LDL+VLDL increased)

Question 19

Findings in familial hyperlipidemia

Answer 19

cholersterol increased

LDL receptor lacking

Question 20

what are the 3 hypertriglyeridemias

Answer 20

Familial combined hyperltrygelremia

familial endogenous hypertriglyceridemia

hypercholyomicronemia

Question 21

Findings in familial endogenous hypertriglyceridemiaa

Answer 21

liver overproduces lipids (inherited disease

pink blood

Question 22

Findings in familial comboned hypertrylgeredemia

Answer 22

Serum VLDL incrreased

Question 23

Findings in hypercholomicronemia

Answer 23

Decreased LPL

Decreased insulin

Question 24

What is found in mixed hyperlipedemias (4) (familial combined)

Answer 24

Increased cholesterol
increased TG
Elevated LDL
elevated VLDL

(look for corneal aarcus)

Question 25

chest pain differentials

Answer 25

Atherosclerotic heart disease
Myocardial infarction
congestive heart failure
lung disease
pancreatic disease

Question 26

what are the 3 myocardial infarction tests

Answer 26

1. myoglobin
2. troponin
3. creatine kinase

Question 27

When does troponin icrease

Answer 27

more clinically sensitive than plasma CK

• increase at 3-6 hr after pain onset (max at 12-24 hrs)
• stays increased for 10-15days

Question 28

when does creatine kinase increase/ decrease

Answer 28

increase 3 hrs post paon

normal in 1-3 days (good for dx or resorbtion)

Question 29

what % of MI have no chest pain and sympotms

Answer 29

25% of infarctions have no chest pain

• pale
• anxiety
• sweating
• sob
• indigestion
• tightnessness

Question 30

Women presentation of MI

Answer 30

• sob
• nauseated
• upper back pressure
• jaw pain
• chest pain

Question 31

tx of MI (4)

Answer 31

• Asprin
• Heparin
• Tissue plasminogen activator
• platelet blockers

Question 32

management post MI

Answer 32

-serum CK/troponin followed over time

–check for reperfusion/reinfarction

Question 33

tests for congestive heart failure

Answer 33

ANP
brain natriuretic peptide
complete blood count

Question 34

cogestive heart failure s/s

Answer 34

increased venous pressure/increased jugular pressure

• breathlessness, cough, wheeze
• oedema
• hepatomegaly
• dizziness

Question 35

causes of CHF

Answer 35

ischemic heart disase (mc)

• alcoholoic myopathy
• hypertension