Cardiovascular Disease

Question 1

In atherosclerosis what compound is deposited in artery walls?

Answer 1

lipids

Question 2

What does the rupture of an atherosclerotic plaque result in?

Answer 2

acute coronary syndrome

Question 3

What assessment is used for the primary prevention of cardiovascular disease? And what is the first line medication?

Answer 3

QRISK3 - risk of stroke or MI in next 10 years
>10% - offer atorvastatin 20mg

Question 4

What patients are offered a statin?

Answer 4

QRISK >10%
CKD
type 1 diabetes for >10 years or >40

Question 5

How do statins work?

Answer 5

lower cholesterol production in the liver by inhibiting HMG CoA reductase

Question 6

What protocols must be taken after starting a patient on a statin?

Answer 6

check lipids 3 months after starting and increase dose to achieve a 40% decrease
check LFTs as can cause a rise in ALT and AST

Question 7

What are the side effects of statins?

Answer 7

myopathy
rhabdomyolysis
type 2 diabetes
haemorrhage stroke

Question 8

What is the key drug interaction to be aware of with statins?

Answer 8

interaction with macrolide antibiotics
- stop statin when on clarithromycin or erythromycin

Question 9

If a patient cannot tolerate a statin or it is not sufficient, which other drug can be given?

Answer 9

ezetimibe

Question 10

What medications are given for the secondary prevention of cardiovascular disease?

Answer 10

aspirin/ clopidogrel (anti platelet)
ACE inhibitor
atenolol
atorvastatin 80mg

Question 11

After a MI, what drugs are patients offered?

Answer 11

dual anti platelet therapy
- aspirin 75mg indefinitely
- clopidogrel for 12 months

Question 12

What type of condition is familial hypercolesterolaemia? What is the effect of this condition? And how is it managed?

Answer 12

autosomal dominant condition
causes high cholesterol (LDL)
can cause tendon xanthomata
managed using statins