Cardiorespiratory Flashcards
Patient pathway
First contact (GP) –> referral –> completion of treatment
What does secondary prevention for MI include
Advice and support for medications and rehabilitation (exercise and psych support)
Barriers to gaining help for MI
Personal: Expected and experienced Sx differ, interfere with life
Geographical: Transport
Socio-economic: Finances/time off work
Organisational: Long waiting times
Methods to overcome MI barriers
Public health Sx Efficient transport Interpreter Paid sick leave Reduce waiting times
What are performance indicators used for?
Made publicly available (e.g. mortality following surgery) to improve quality
4 benefits of performance indicators
Focusses attention on improving patient care
Public reassurance about effectiveness and safety
Competition will boost performance
Facilitate informed consumer choice
4 limitations of performance indicators
Negative impact on public trust
Case-mix: some areas only receive patients with poor prognosis, more complex cases have poorer prognoses.
Data manipulation: just treat healthier patients/ send them to other hospitals
Unmeasured performance will suffer
Which ethnicities are at a higher risk for IHD
South Asians - metabolic syndrome
African Caribbean - T2DM HTN
What is metabolic syndrome
HTN
High blood sugar
Excess body fat around the waist
Abnormal cholesterol
Differences in IHD between men and women
Develops later in women
Risk factors for IHD
- biggest
- non-modifiable and modifiable
BIGGEST: smoking
Non-modifiable: age, gender, FHx, ethnicity, socioeconomic
Modifiable: smoking, obesity, diet, alcohol, low exercise, high cholesterol
Scores to assess CVD risk
Framingham cohort charts
Q-Risk
10 year risk
How does smoking impact CVD
Increases risk by 50%, mortality is 60% higher
Passive smoking increases by 25%
% of CVD due to increased BMI
25-50%
Define central obesity
40 inch in men
35 inch in female
How much can exercise reduce CVD risk
30%