Cardiovascular overview

Question 1

CVD accounts for approx. what percent of deaths world wide

Answer 1

30%

Question 2

why are we seeing more congenital heart disease in adults

Answer 2

because they are not dying when they are pediatrics

Question 3

what is epidemiological transition

Answer 3

shift in morbidity and mortality causes over last century

Question 4

what are factors for epidemiological transition

Answer 4

Reduction of pestilence and famine
Receding pandemics
Degenerative and human-made diseases
Delayed degenerative disease
Epidemic in inactivity and obesity

Question 5

What happens when we cure pestilence and famine and control infectious disease

Answer 5

we create degenerative human-made diseases

Question 6

what are the 5 stages of epidemiological transition

Answer 6

1. Pestilence and Famine
2. Pandemics
3. Degenerative & human-made disease
4. Delayed degenerative disease
5. Inactivity & obesity

Question 7

what % of pestilence and famine make up secondary CVD death

Answer 7

<10%

Question 8

what % of pandemics do deaths secondary CVD

Answer 8

10-35%

Question 9

what % of degenerative and human-made diseases deaths secondary CVD

Answer 9

35-65%

Question 10

what % of delayed degenerative diseases account for deaths secondary to CVD

Answer 10

40-50%

Question 11

what % of inactivity & obesity account for deaths secondary to CVD

Answer 11

possible reversal of age adjusted declines in mortality

Question 12

stage 1.pestilence and famine description

Answer 12

most deaths secondary malnutrition & infectious dieses

Question 13

stage 2.pandemics description

Answer 13

improvements in nutrition and public health

Question 14

stage 3. Degenerative & human-made disease

Answer 14

increased fat & caloric intake coupled with inactivity

increased life expectancy= increased mortality

Question 15

stage 4. delayed degenerative disease

Answer 15

better prevention/treatment results in delayed deaths
age-adjusted CVD mortality rate decreases.
CVD affecting older & older individuals

Question 16

what are the red flags for e-cigarettes

Answer 16

long term outcomes unknown
addiction rate likely to be as high or higher than cigarettes
Contents of cigarettes not published
Liquid nicotine is hazardous

Question 17

what happens with BP readings in regard to arm position

Answer 17

BP reading changes depending on position of Arm, arm should be level with heart.

Question 18

Assessment of BP take home message

Answer 18

measure BP bilaterally in sitting patient who has been resting for 5 minutes or more with properly sized BP cuff on upper arm with arm at level of heart

Question 19

what is the purpose of cardio ROS

Answer 19

to generate or narrow hypotheses about underlying. form or refinement of DDX

Question 20

labs can be divided into two main categories

Answer 20

Screening tests

Tests for Identifying or Evaluating disease

Question 21

They can be further divided into

Answer 21

Fasting vs. Nonfasting
AM vs. PM testing
Supine Vs. Sitting
Blood plasma vs. Urine
Procedure

Question 22

what is a fasting lab

Answer 22

nothing to eat or drink for 10-12 hours (but can have plain water and take regular meds)

Question 23

what is non-fasting

Answer 23

can be random or at specifically defined times

Question 24

what do you need fasting for

Answer 24

lipid testing

fasting glucose

Question 25

Homocysteine indication

Answer 25

strong FH of early onset vascular disease

also increase levels assoc. with B6, B12 or folate deficiency

Question 26

what do elevated levels of homocysteine tells us

Answer 26

representative of independent risk factors for heart disease, cerebrovascular dz, PVD.
Though to promote progression of Atherosclerosis by causing endothelial damage

Question 27

What is CRP indicated for?

Answer 27

to indicate inflammatory illness and to predict risk of coronary events

Question 28

what is BNP used for

Answer 28

Brain natriuretic peptide

useful for diagnosing CHF, predicting morbidity and mortality and maximizing