Cardiovascular - Chronic Conditions

Question 1

features of heart failure?

Answer 1

SOB
orthopnea
PND
fatigue
peripheral/sacral oedema
raised JVP

Question 2

causes of heart failure?

Answer 2

impaired LV
excessive preload
excessive afterload

Question 3

risk factors for heart failure?

Answer 3

CAD
MI
HT
DM
valvular disease
arrythmias

Question 4

Ix for heart failure?

Answer 4

ECG
CXR
Echo

Question 5

bloods for Ix in heart failure?

Answer 5

NT-proBNP
FBC
U+Es
LFTs
Coag

Question 6

difference between preserved and reduced ejection fraction?

Answer 6

preserved - less blood able to fill LV due to stiffness

reduced - LV unable to eject enough blood during systole

Question 7

basics drug treatment for heart failure?

Answer 7

BASHeD

Bblocker
ACE
spironolactone
hyralazine/nitrates
loop diuretics

Question 8

what is the definition of hypertension?

Answer 8

BP ≥140/90mmHg

Question 9

risk factors for HT?

Answer 9

>65yrs
alcohol
lack of exercise
FHx
DM
metabolic syndrome
renal disease
smoking

Question 10

features of HT?

Answer 10

headache
floaters
SOB
chest pain
asymptomatic

Question 11

how does salt increase BP?

Answer 11

salt increases renal blood flow

renin released from kidney

renin causes angiotensinogen -> angiotensin I

ACE causes angiotensin I -> angiotensin II

aldosterone released
causes Na and H20 retention

Question 12

what can cause secondary HT?

Answer 12

renal disease
conn's
cushing's
phaeochromocytoma
RAS
steroids

Question 13

diagnostic test for HT?

Answer 13

ABPM or HBPM with an average of 135/85

Question 14

other Ix for HT?

Answer 14

ECG
HDL, cholesterol, triglyc
U+Es, urinalysis (albumin: creatinine ratio)

Question 15

what is the recommended amount of exercise?

Answer 15

150mins moderate or 75 vigorous

strengthening activities 2 days a week

Question 16

<55yrs treatment pathway for HT?

Answer 16

ACE
+ CCB/diuretic
ACE + CCB + diuretic

Question 17

> 55yrs/black treatment pathway for HT?

Answer 17

CCB/diuretic
+ ACE
ACE + CCB + diuretic

Question 18

HT targets?

Answer 18

130/80

if DM, 135/85

Question 19

features of stable angina?

Answer 19

provoked
relieved by rest
predictable timing

Question 20

features of unstable angina?

Answer 20

no pattern
occurs at rest
can be prolonged or fleeting

Question 21

what is the pathology of atherosclerosis?

Answer 21

endothelial dysfunction

macrophages become foam cells by engulfing lipid

fatty streak forms (irreversible)

plaque

fibrosis and plaque formation

luminal size decreases

Question 22

Ix for angina?

Answer 22

exercise ECG
fasting lipid
FBC
angiography

Question 23

why is FBC important in angina?

Answer 23

anaemia can worsen angina

Question 24

treatment for angina?

Answer 24

GTN for symptomatic relief

75mg aspirin
Bblocker
statin
BP meds

Question 25

what should be monitored after starting an ACE?

Answer 25

Na
K
kidney function (GFR)

Question 26

what drugs should be avoided in those with reduced ejection fraction heart failure?

Answer 26

CCBs

verapamil and diltiazem

Question 27

what should be monitored at heart failure review?

Answer 27

fluid status
cardiac rhythm
cognition 
medications
renal function

Question 28

what two drugs need K monitored? why?

Answer 28

ACE
spironolactone

hyperkalaemia risk

Question 29

features of L sided heart failure?

Answer 29

SOB
pulonary congestion
fatigue
cyanosis
orthopnea
PND
tachycardia

Question 30

features of R sided heart failure?

Answer 30

fatigue
raised JVP
ascites
oedema

Question 31

what is cor pulmonale?

Answer 31

right sided heart failure due to a problem with the lungs (pulmonary hypertension)

Question 32

what heart sound is heard in heart failure?

Answer 32

s3 gallop rhythm

Question 33

acute heart failure Tx?

Answer 33

sit up 
oxygen 
furosemide
GTN (if systolic BP is high enough)
ECG
CPAP