Cardiovascular Disease Flashcards

1
Q

What does the term ‘atherosclerosis’ mean?

A

Combination of atheromas (fatty deposits) and sclerosis (hardening)

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2
Q

What types of arteries are affected by atherosclerosis?

A

Medium and large arteries

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3
Q

What are the primary causes of atherosclerosis?

A

Chronic inflammation and activation of the immune system in the artery wall

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4
Q

List the consequences of atherosclerosis.

A
  • Stiffening
  • Stenosis
  • Plaque rupture
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5
Q

What condition can arise from the stiffening of artery walls due to atherosclerosis?

A

Hypertension

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6
Q

What is stenosis in the context of atherosclerosis?

A

Reduced blood flow

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7
Q

What can result from plaque rupture in atherosclerosis?

A

Thrombus formation leading to ischaemia

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8
Q

Identify the non-modifiable risk factors for cardiovascular disease.

A
  • Older age
  • Family history
  • Male
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9
Q

Identify the modifiable risk factors for cardiovascular disease.

A
  • Raised cholesterol
  • Smoking
  • Alcohol consumption
  • Poor diet
  • Lack of exercise
  • Obesity
  • Poor sleep
  • Stress
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10
Q

What are some medical co-morbidities that increase the risk of atherosclerosis?

A
  • Diabetes
  • Hypertension
  • Chronic kidney disease (CKD)
  • Inflammatory conditions
  • Atypical antipsychotic medications
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11
Q

What are the end results of atherosclerosis?

A
  • Angina
  • Myocardial infarction
  • Transient ischaemic attacks
  • Strokes
  • Peripheral arterial disease
  • Chronic mesenteric ischaemia
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12
Q

What are the two main categories of cardiovascular disease prevention?

A
  • Primary prevention
  • Secondary prevention
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13
Q

What does primary prevention of cardiovascular disease target?

A

Patients who have never had a diagnosis of cardiovascular disease

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14
Q

What does secondary prevention of cardiovascular disease involve?

A

Management after a diagnosis of cardiovascular disease

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15
Q

NICE guidelines recommend what percentage of total calories to be fat?

A

Less than 30%

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16
Q

What is the recommended weekly aerobic activity according to NICE guidelines?

A

At least 150 minutes at moderate intensity or 75 minutes at vigorous intensity

17
Q

What is the QRISK3 score used for?

A

Estimating the percentage risk of stroke or myocardial infarction in the next 10 years

18
Q

What medication is initially offered for primary prevention when QRISK3 score is above 10%?

A

Atorvastatin 20mg

19
Q

What are the rare but significant side effects of statins?

A
  • Myopathy
  • Rhabdomyolysis
  • Type 2 diabetes
  • Haemorrhagic strokes
20
Q

What is the mechanism of action of statins?

A

Inhibit HMG CoA reductase to reduce cholesterol production in the liver

21
Q

What is Ezetimibe used for?

A

Inhibiting cholesterol absorption in the intestine

22
Q

What is the ‘4 As’ mnemonic for secondary prevention of cardiovascular disease?

A
  • Antiplatelet medications
  • Atorvastatin 80mg
  • Atenolol (or alternative beta blocker)
  • ACE inhibitor
23
Q

What is familial hypercholesterolaemia?

A

An autosomal dominant genetic condition causing very high cholesterol levels

24
Q

What is the difference between heterozygous and homozygous familial hypercholesterolaemia?

A
  • Heterozygous: one abnormal gene copy (1 in 250 people)
  • Homozygous: both abnormal gene copies (very rare, high cholesterol)
25
Q

What are the three important features for the diagnosis of familial hypercholesterolaemia?

A
  • Family history of premature cardiovascular disease
  • Very high cholesterol
  • Tendon xanthomata
26
Q

What are the management steps for familial hypercholesterolaemia?

A
  • Specialist referral for genetic testing
  • Statins