Cardiovascular disease

Question 1

Define an atheroma

Answer 1

fatty deposit in an artery wall

Question 2

Atherosclerosis affects

Answer 2

Medium and large arteries

Question 3

Stiffening of artery walls causes

Answer 3

hypertension

Question 4

What co-morbidities increase the risk of atherosclerosis

Answer 4

Diabetes, hypertension, CKD, inflammatory conditions

Question 5

Non modifiable risk factors for atherosclerosis

Answer 5

Old age, male, family history

Question 6

What drug class increases the risk of atherosclerosis

Answer 6

atypical antipsychotics

Question 7

New NICE guidelines suggest that total fat should make up what percentage of total calories

Answer 7

less than 30

Question 8

total fats should mainly be made up of

Answer 8

monounsaturated and polyunsaturated fats

Question 9

saturated fat should make up what percentage of total calories

Answer 9

less than 7

Question 10

according to NICE guidelines how many portions of fish should be eaten a week

Answer 10

2

Question 11

according to NICE guidelines how many portions of legumes should be eaten a week

Answer 11

4

Question 12

according to NICE guidelines how much moderate intensity exercise should be done a week

Answer 12

150 minutes

Question 13

according to NICE guidelines how much vigorous exercise should be done a week

Answer 13

75

Question 14

according to NICE guidelines strength training activities should be done

Answer 14

twice a week

Question 15

What score is used to determine if a patient requires primary prevention for cardiovascular disease

Answer 15

QRISK3

Question 16

What does the QRISK3 score estimate

Answer 16

percentage risk of stroke or MI in 10 years

Question 17

QRISK3 above what percentage indicates a patient should be commenced on a statin

Answer 17

10

Question 18

Initial statin for primary prevention

Answer 18

atorvastatin 20mg

Question 19

What two patient groups should be started on primary prevention regardless of QRISK score

Answer 19

CKD, T1DM for over 10 years or age over 40

Question 20

how do statins reduce cholesterol production

Answer 20

inhibit HMG CoA reductase

Question 21

After a statin is introduced when should lipid levels be checked

Answer 21

after 3 months

Question 22

When checking lipid levels after introduction of a statin what is the goal

Answer 22

greater than 40% reduction

Question 23

When a statin is commenced LFTs should be checked

Answer 23

at 3 and 12 months

Question 24

Statins should be stopped if ALT and AST rise

Answer 24

3 times the upper limit of normal

Question 25

Significant side effects of statins q

Answer 25

Myopathy, rhabdomyolysis, T2DM, Haemorrhagic stroke

Question 26

Which group of antibiotics interact with statins

Answer 26

Macrolides (clarithromycin and erythromycin)

Question 27

How does Ezetimibe work

Answer 27

reduces absorption of cholesterol

Question 28

evolocumab and alirocumab are examples of

Answer 28

PCSK9 inhibitors

Question 29

PCSK9 inhibitors are given by

Answer 29

s/c injection every 2-4 weeks

Question 30

4A’s of secondary prevention for cardiovascular disease

Answer 30

Antiplatelet
Atorvastatin
Atenolol
ACE inhibitor

Question 31

Antiplatelet after MI

Answer 31

Aspirin indefinitely and clopidogrel for 12 months

Question 32

Antiplatelet of choice post ischaemic stroke

Answer 32

clopidogrel