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CMS > Cardiovascular Disease > Flashcards

Cardiovascular Disease Flashcards

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Introductory Sommelier Exam (CMS) flashcards
1
Q

What is ischaeimia?

A

Reduction of blood supply

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2
Q

What is infarction?

A

Thrombus formation and occlusion of blood supply

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3
Q

What are the stages of atherosclerosis?

A 
Foam cell
Fatty streak
Intermediate lesions
Atheroma
Fibrous plaque
Complicated lesion/ rupture
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4
Q

What are the big 5 risk factors for atherosclerosis?

A 
Smoking
High cholesterol
High bp
Diabetes
Genetics
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5
Q

With regards to smoking, what medication could be offered re. Smoking management?

A

Bupropion ( zyban)

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6
Q

What predisposes a person to high cholesterol?

A

Poor lifestyle/ diet

Genetic contribution - family hypercholosterolaemia

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7
Q

How is high cholesterol managed?

A

Drugs- statins

Dietary modification

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8
Q

What is systolic bp at normal?

A

120

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9
Q

What is diastolic bp at normal?

A

80

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10
Q

When is it considered high bp?

A

160/90

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11
Q

What can high bp be related to?

A

Obesity
Alcohol
High salt intake
Genetic

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12
Q

What can be secondary’s causes of high bp?

A

Endocrine- hormone excess

Renal- poor kidney function

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13
Q

Is high bp normally symptomatic?

A

Not unless very high

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14
Q

What indicated very high bp?

A

250/130

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15
Q

What signs might there be of very high bp?

A 
Fits
Confusion
Headache
Breathlessness
Chest pain
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16
Q

What is the management of high bp?

A

If untreated.. Postpone surgery requiring anaesthetic until controlled.

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17
Q

What drugs are used in management of high bp?

A 
Beta blockers- bisoprolol, atenalol
Diuretics- bendroflumethiazde
ACE inhibitors- ramapril
Angiotensin ll antagonists- valsartan
Calcium channel blockers- amlodopine
18
Q

How can you identify those at risk from family hx?

A

Score system

19
Q

What indicates…the healthy individual?

A 
Non smoker
30 mins physical activity x5 weekly
Healthy diet
Not overweight 
Bp less than 140/90
Total cholesterol less than 5 mmol 
Normal glucose metabolism
Avoidance of stress
20
Q

What is peripheral vascular disease?

A

Atherosclerosis affecting peripheral vessels

  • lower limbs
  • abdominal aorta
21
Q

What are the chronic symptoms of peripheral vascular disease?

A

Intermittent Claudication- leg pain in calf when walking a distance

22
Q

What are the acute symptoms of peripheral vascular disease?

A

Ischaemic limb
Pain at rest
Pale, cold and numb limb
No sensation or movement

23
Q

What is the management of peripheral vascular disease?

A 
Risk factor modification
Exercise program
Surgery
- bypass graft
-stent
24
Q

What is an abdominal aortic aneurysm?

A

Damage to vessel wall from atherosclerosis

- dilated aorta

25
Q

What are the risks of abdominal aortic aneurysm?

A

Rupture or tear

26
Q

What are the symptoms of abdominal aortic aneurysm?

A 
Vague abdominal pain 
- acutely
Severe ab pain
Collapse
High mortality
27
Q

Who is screening offered to re. Abdominal aortic aneurysms?

A

Males over 60

28
Q

Name clinical manifestations of ischaemic heart disease

A

Angina
Acute coronary syndromes- heart attack/ unstable angina
Heart failure
Arrhythmias

29
Q

What is angina?

A

Visceral pain caused by lack of blood supply to the heart due to narrowing of arteries

30
Q

What are symptoms of angina?

A

Central chest pain, down left arm
Atypically- jaw pain, upper abdomen, back
Sometimes perceived as heaviness or breathlessness
Often related to effort

31
Q

What are warning signs of unstable angina?

A

Angina at rest
Unpredictable onset
Increasing frequency
Reduction of exertion

32
Q

What is unstable angina a warning sign for?

A

Heart attack

33
Q

What investigations can be done re. Ischaemic heart disease?

A

Electrocardiogram
Exercise testing
Coronary angiography

34
Q

What is a coronary angiography?

A

Access via femoral arteries
Visualises blood vessels of the heart
Can be combined with intervention- stents, balloon dilation

35
Q

How is stable angina managed?

A 
Anti platelets- aspirin, clopidogrel
Cholesterol- statins
Symptom relief- beta blockers
Calcium antagonists- amlodopine
Nitrates- GTN, isosprbide mononitrate

Surgical- coronary angioplasty
Coronary artery bypass grafting

36
Q

What can be described as a cute coronary syndromes?

A

Myocardial infarction

Unstable angina

37
Q

What are symptoms of mi?

A 
Crushing central chest pain
Sweating
Nausea
Light headed
Feeling of impending doom
Cardiac arrest
38
Q

How would you manage acute coronary syndrome?

A

Hospitalisation
O2, morphine, nitrates
Diagnose- ecg, angiography
Clear clot- thrombolysis, angioplasty

39
Q

When would you not operate re. Symptoms of uncontrolled angina?

A

New onset
Angina at rest
Worsening

40
Q

Describe the basic pathology of atherosclerosis

A

Accumulation of lipid rich plaques in arterial walls

CMS (14 decks)

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