Cardiology

Question 1

Define cardiovascular disease

Answer 1

Diseases of the heart and circulation

Question 2

Why is cardiovascular disease more common in children and adults in the developed world?

Answer 2

Due to a high prevalence of obesity

Question 3

What is considered a good blood pressure?

Answer 3

120/80 mmHg

Question 4

What is considered a high blood pressure?

Answer 4

140/90 mmHg

Question 5

What is type hypertension is the most common?
What causes this disease?
Is it hereditary?

Answer 5

• Primary hypertension most common
• Multiple factors so direct cause unknown
• Can be hereditary

Question 6

How can secondary hypertension occur? (4)

Answer 6

• Result of renal diseases
• Result of endocrine diseases (hyperthyroidism)
• Coarctation of the aorta (narrowing)
• Excessive drug/alcohol intake

Question 7

Is hypertension symptomatic?

Answer 7

Usually asymptomatic until complications develop in target organs

Question 8

Severe or prolonged hypertension increases the risk of? (4)

Answer 8

• Coronary artery disease
• Heart failure
• Stroke (particularly haemorrhagic)
• Renal failure

Question 9

What are some complications linked with hypertension? (5)

Answer 9

• Arteriolosclerosis
• Narrowing of arteriolar lumen in kidney
• Increased after load leading to heart failure
• Thoracic aortic dissection
• Abdominal aortic aneurysms

Question 10

How would you investigate hypertension? (4)

Answer 10

• BP measurements with sphygmomanometers
• Urinalysis
• Blood tests
• Electrocardiogram (ECG)

Question 11

Dental Relevance of hypertension

Answer 11

• Patients with stable hypertension can be treated

- Hypertensive drugs can impact oral health

Question 12

What Atherosclerosis?

Answer 12

Atherosclerosis is a disease in which plaque builds up inside your arteries

Question 13

What does plaque contain? (4)

Answer 13

• Lipids
• Inflammatory cells
• Smooth muscle cells
• Connective tissue

Question 14

What is stable plaque

Answer 14

Plaque that may:

• Regress
• Remain static
• Grow slowly

Question 15

What is unstable plaque

Answer 15

Plaque which is vulnerable to spontaneous rupture, erosion or fissuring

Question 16

Stable exertional angina, transient ischaemic attacks and intermittent claudication can all result due to which plaque build up?

Answer 16

Stable Plaque

Question 17

Unstable angina, myocardial infarction and ischaemic stroke can all result due to which plaque build up?

Answer 17

Unstable Plaque

Question 18

How would you investigate Atherosclerosis? (3)

Answer 18

• CT angiography
• Blood tests
• Catether-based imaging tests

Question 19

What is Angina?

Answer 19

Chest pains due to the heart not getting enough oxygen (ischemia) due to narrowed arteries

Question 20

Describe stable angina

Answer 20

• Predictable

- Increased workload leads to ischaemia

Question 21

Where can symptoms of angina radiate to? (6)

Answer 21

• Left shoulder
• Inside left arm
• Back
• Throat
• Jaw
• Teeth

Question 22

How would you investigate Angina? (3)

Answer 22

• ECG
• Coronary artery angiography
• Intravascular ultrasonography

Question 23

What is a myocardial infarction

Answer 23

Myocardial necrosis (tissue death) resulting from acute obstruction of a coronary artery

Question 24

How can you temporarily relieve a myocardial infarction?

Answer 24

Rest or glyceryl trinitrate

Question 25

What is infective endocarditis?

Answer 25

Rare condition associated with microbial infection of the endocardial surface of the heart (heart valves)

Question 26

What increases the risk of infective endocarditis? (4)

Answer 26

- Prosthetic valves - Previous Infective endocarditis - Acquired valvular heart disease - Congenital heart defect

Question 27

How long does acute bacterial endocarditis take to occur?

Answer 27

Within 7 days of infection

Question 28

How long does sub-acute bacterial endocarditis take to occur?

Answer 28

Within 2-3 weeks of infection

Question 29

Which bacteria most commonly causes acute bacterial endocarditis?

Answer 29

Staphylococcus aureus

Question 30

Which bacteria most commonly causes sub-acute bacterial endocarditis?

Answer 30

Streptococcus viridans

Question 31

List some symptoms of infective endocarditis

Answer 31

- Flu-like symptoms - Fever - Anorexia - Malaise (discomfort) - Night sweats - Haematuria (blood in urine)

Question 32

Why isn't infective endocarditis treated?

Answer 32

- Very rare - Increased resistant bacteria - High costs

Question 33

Where does the the bacteria for infective endocarditis arise from?

Answer 33

Tooth brushing and chewing

Question 34

How can patients at risk of infective endocarditis reduce chance of infection? (4)

Answer 34

- Maintain good oral health - Receive intensive preventative oral healthcare - Informed of risks - Made aware of symptoms

Question 35

What is heart failure?

Answer 35

Syndrome of left and/or right ventricular dysfunction

Question 36

What are the causes of left ventricular heart failure? (7)

Answer 36

- Coronary artery disease - Diabetes mellitus - Hypertension - Obesity - Valvular heart disease - Hyperthyroid disease - Substance abuse

Question 37

What are the causes of right ventricular heart failure? (3)

Answer 37

- Previous left ventricular failure - Severe lung disorder - Multiple pulmonary emboli

Question 38

How many people with CVD live in the UK?

Answer 38

7.4 million people

Question 39

What % of deaths/year in the UK are CVD related?

Answer 39

27%

Question 40

How would you manage hypertension? (4)

Answer 40

- Weight loss - Smoking cessation - Dietary changes - Medication

Question 41

What is atherosclerosis initiated by?

Answer 41

Initiated by endothelial injury

Question 42

How would you investigate heart failure?

Answer 42

- Full blood count - Electrolyte and urea - Thyroid function test - ECG - Chest radiography - Echocardiography - Coronary angiography - Cardiac MRI