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phase2a medicine > cardiovascular risk factors plus other stuff > Flashcards

cardiovascular risk factors plus other stuff Flashcards

Risk factors for various cardiovascular diseases. Plus some information on infarction, atherosclerosis, acute coronary syndrome, MI, and heart failure.

1
Q

infarction risk factors

A

obesity, smoking, cholesterol

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2
Q

atherosclerosis risk factors

A

poorly managed diabetes, smoking, HTN, hyperlipidaemia, FH, obesity (inflammatory cytokines), inflammatory conditions (cap weakened -> plaque ruptures)

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3
Q

acute coronary syndromes risk factors

A

coronary thrombosis, anaemia, bradycardia, tachycardia, diabetes, smoking

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4
Q

myocardial infarction risk factors

A

lack of exercise, smoking, diet high in fat

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5
Q

heart failure risk factors

A

valve disease, HTN, MI, CAD, connective tissue disease, infection, pericardial disease, cardiomyopathy, arrhythmias

myocardial dysfunction due to IHD, alcohol, valvular disease, endocardial disease

oestrogen protects against IHD

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6
Q

hypertension risk factors

A

family history, environment, hyperaldosteronism (as more salt is retained –> higher bp)

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7
Q

atrial fibrillation risk factors

A

IHD, HTN, PE, hyperthyroidism

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8
Q

atrial flutter risk factors

A

idiopathic, IHD, atrial dilation

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9
Q

1st and 2nd degree heart block risk factors

A

family history, athletes, sick sinus syndrome, IHD, acute myocarditis, drugs (e.g. digoxin)

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10
Q

3rd degree heart block risk factors

A

IHD, idiopathic (fibrosis), congenital, aortic valve calcification, surgery, trauma, digoxin, infiltration(abscesses, granulomas, tumours, parasites)

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11
Q

sinus tachycardia risk factors

A

pain, infection, exercise, system vasodilation

accessory pathway causes arrhythmias

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12
Q

supra ventricular tachycardia risk factors

A

genetic

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13
Q

ventricular tachycardia risk factors

A

CHD, aortic stenosis, MI electrolyte imbalance

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14
Q

ventricular ectopic beat risk factors

A

genetic, lifestyle (caffeine intake, potassium deficiency)

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15
Q

prolonged QT syndrome risk factors

A

inherited, low potassium/calcium, family history, pre-existing CVD

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16
Q

Wolff-Parkinson-White syndrome risk factors

A

Ebstein anomaly (genetic)

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17
Q

atherosclerotic aortic aneurysm risk factors

A

age, family history, inherited collagen defects

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18
Q

dissecting aortic aneurysm risk factors

A

systemic hypertension, Marfan’s syndrome (disorder of fibrillar expression)

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19
Q

berry aneurysm risk factors

A

HTN, smoking

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20
Q

capillary micro aneurysm (Charcot-Bouchard) risk factors

A

HTN, diabetes

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21
Q

infective mycotic aneurysm risk factors

A

bacterial or fungal infections of arterial walls

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22
Q

syphilitic aneurysm risk factors

A

tertiary syphilis

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23
Q

claudication risk factors

A

peripheral vascular disease

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24
Q

critical limb ischaemia risk factors

A

smoking, diabetes mellitus

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25
Q

pericarditis risk factors

A

idiopathic, pacemaker implant, post-MI, Dressler’s, post-surgery

26
Q

aortic stenosis risk factors

A

congenital, degenerative calcification, rheumatic heart disease

27
Q

mitral regurgitation risk factors

A

post MI, ischaemic heart disease, degenerative calcification, myxomatous degeneration, rheumatic heart disease, pure volume overload

28
Q

cardiomyopathy risk factors

A

inherited

29
Q

pathology of infarction

A

ischaemic necrosis of tissue –> inflammation

30
Q

signs of infarction

A

peripheral necrosis

gangrene

31
Q

complications of infarction

A

reperfusion in surgery

32
Q

treatment of infarction

A

lifestyle modifications
beta blockers
statins

33
Q

what is gangrene?

A

infarction of mixed tissues in bulk

34
Q

pathology of atherosclerosis

A

damage of endothelial cells (smoking, HTN, diabetes, lipids)

thrombus forms around tear and heals to leave fibrous tissue –> cumulative build up –> atheroma

35
Q

stages of atherosclerosis

A 
initial lesion 
fatty streak 
intermediate lesion 
atheroma lesion 
fibroatheroma
complicated lesion
36
Q

why are statins used to treat atherosclerosis?

A

cause foam cells to die

inhibit HMG CoS reductase during cholesterol synthesis

37
Q

treatment of atherosclerosis

A 
statins
diet 
surgery (percutaneous coronary intervention)
aspirin
clopidogrel
38
Q

action of clopidogrel

A

inhibits P2Y12 ADP receptor on platelets

39
Q

action of aspirin

A

irreversible inhibitor of platelet cyclo-oxygenase –> stops production of thromboxane

40
Q

causes of acute coronary syndromes

A 
rupture of plaque
coronary vasospasm
cocaine (causes coronary spasm)
dissection of coronary artery 
dissection of aorta descending into coronaries
41
Q

signs of acute coronary syndrome

A

chest pain radiating to jaw and left arm

42
Q

what is poor R wave progression a sign of?

A

myocardial ischaemia

43
Q

treatment of acute coronary syndrome

A

antihypertensives
quit smoking
anti-coagulants

44
Q

diagnosis of acute coronary syndrome

A

angiogram (give fondaparinux to pts waiting for angiogram)

ECG

45
Q

pathology of myocardial infarction

A

necrosis of heart muscle due to impaired blood flow
necrosis is followed by inflammatory infiltration and fibrous repair
enzymes are released from necrotic muscle and leucocytosis are diagnostic markers

46
Q

what does troponin indicate?

A

cardiac muscle injury

47
Q

what does an NSTEMI look like on an ECG?

A

small R wave and no Q wave

48
Q

signs of myocardial infarction

A

tight chest pain
pain in jaw
pain in left arm
tiredness

49
Q

complications of myocardial infarction

A 
arrhythmias
cardiac failure
mitral incompetence
myocardial rupture leading to haemopericardium 
mural thrombus leading to embolism 
cardiac embolism
50
Q

treatment of myocardial infarction

A 
lifestyle modification 
beta blockers
statins
revascularisation
ACEi
anticoagulants
antipaltelets
51
Q

initial management of MI

A 
MONA
Morphine
Oxygen
Nitrates (dilates arteries --> reduces bp)
Aspirin - 300mg oral
52
Q

definition of heart failure

A

an inability of the heart to deliver blood at a rate commensurate with the requirements of metabolising tissues, despite normal or increased cardiac filling pressures

53
Q

pathology of heart failure

A

ventricles unable to contract and relax normally

54
Q

neurohormonal changes in heart failure

A

sympathetic - increased afterload
RAAS - increased afterload/preload
vasopressin - increased afterload and preload

55
Q

signs of right sided heart failure

A 
raised JVP
hepatomegaly
ascites
pitting oedema
nausea
epistaxis
anorexia
56
Q

signs of left sided heart failure

A 
cardiomegaly
weight loss
tachycardia
murmur
exertional dyspnoea
orthopnoea
paroxysmal nocturnal dyspnoea
fatigue
pink frothy nocturnal cough
57
Q

heart failure signs (non-specific to which side)

A 
breathlessness
leg swelling
increased weight
fluid retention 
fatigue
cold peripheries
58
Q

complications of heart failure

A 
renal dysfunction
rhythm disturbances
systemic thrombo-embolism
DVT
PE
LBBB
bradycardia
hepatic dysfunction
neurological
59
Q

treatment of heart failure

A 
diuretics
ACEi
ARB
BB
spironolactone
digoxin
vasodilators (hydralazine and isosorbide dinitrate)
60
Q

diagnosis of heart failure

A 
CXR
bloods
B-type natriuretic peptide (elevated)
ECG
trans thoracic echocardiogram 
displaced apex beat
3rd heart sound
abnormally high noradrenaline, arginine, and renin

phase2a medicine (53 decks)

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