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CCC > Chronic conditions > Flashcards

Chronic conditions Flashcards

1
Q

HASBLED score

A

HTN
Abnormal LFTs or U&Es ( up to 2 points)
Stroke
Bleeding
Labile INRs
Elderly >65
Drugs and alcohol (up to 2 points) - antiplatelts, NSAIDs, 8 or more alcohol/week

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2
Q

CHA2DS2VASc score and what points

A 
CHD or LVEF <40%
HTN
AGE >75 - 2 points
DM
Stroke or TIA Hx - 2 points
Vascular disease
Age >65
Sex F

If male then anticoagulate if 1 point
If female then need 2 points

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3
Q

AF more common in males or females?

A

males

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4
Q

initial episode of AF definition

A

AF>/=30s diagnosed by ECG

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5
Q

paroxysmal AF

A

recurrent >/=2 episodes that terminate within 7 days (or <48hrs and terminated with cardioversion)

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6
Q

persistant AF

A

continuous >7 days or AF >48hrs in which decision made to perform cardioversion

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7
Q

long standing persistent AF

A

continuous AF of >12m

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8
Q

permanent AF

A

joint decision by pt and clinician to cease further attempts to restore or maintain sinus ryhthm

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9
Q

management of AF rate control

A

beta blocker or rate limiting CCB (eg diltiazem)

use digoxin in CHF

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10
Q

what is a rate limiting CCB contraindicated in

A

HF

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11
Q

definition of CKD

A

abnormality of kidney structure or function for >3 months that has implications for health

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12
Q

how to diagnose CKD

A

2x GFR <60 at least 3 months apart

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13
Q

definition of kidney failure

A

when GFR <15 or need for replacement

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14
Q

2 most common causes of CKD

A

diabetic nephropathy

glomerulonephritis

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15
Q

in a new finding of GFR <60 what do you do?

A

2nd sample within 2 weeks
3rd sample within 3 months

check ACR

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16
Q

what is defined by rapid progression of CKD

A

drop in GFR by 25% and in new category in <1yr
OR
drop in GFR by 15 in <1yr

17
Q

definition of COPD in terms of spirometry

A

FEV1/FVC ratio <0.7

18
Q

CXR in COPD signs

A
  • hyperinflation (>6 ant ribs, flat hemidiaphragms, floating heart sign)
  • large central pulmonary arteries (pulmonary HTN)
  • reduced peripheral vascular markings
  • bullae
19
Q

what is the MRC dyspnoea scale used for

A

COPD

20
Q

what is the BODE index used for and what are the components?

A

COPD

BMI
Airflow Obstruction
Dyspnoea
Exercise capacity

21
Q

people who you should not use QRisk 2 for

A 
>85yrs
T1DM
eGFR <60
prexisting CVD
familial hypercholesterolaemia
22
Q

when do you offer statin in T1DM

A

T1DM >40yrs, DM for >10yrs, established nephropathy or other CV risk factors

23
Q

bloods in statins

A

basline LFTs + 3m +12m
lipids at start and at 3m (40% reduction wanted)
renal function at start

ask if persistent muscle pain if yes measure serum CK

24
Q

interactions in statin

A

grapefruit

25
Q

stable angina

A

occurs predictably with physical exertion or emotional stress. lasts <10mins and is relieved within mins of rest as well as GTN spray

26
Q

unstable angina

A

new onset angina or abrupt deterioration in previously stable angina, often occuring at rest

27
Q

diagnosis of angina (3 features)

A
  • constricting discomfort at front of chest or in neck, shoulders, jaw or arms
  • precipitated by physical exertion
  • relieved by rest or GTN within 5 mins
28
Q

angina management

A 
GTN PRN
beta blocker or CCB (both second line)
consider 75mg aspirin 
consider ACEi if stable angina + DM
statins
Treat HTN

revascularisation - CABG or PCI

29
Q

DVLA angina rules

A

cars/motorbikes: dont need to tell DVLA. might need to stop driving if angina at rest or while driving

lorries buses: must not drive and must notify DVLA

30
Q

stage 1 HTN

A

> 140/90 clinic and ambulatory >130/85

31
Q

stage 2 HTN

A

> 150/90 and ambulatory >150/95

32
Q

severe HTN

A

> 180 systolic or >110 diastolic

33
Q

who to offer pharmacological HTN treatment

A

< 80 yrs with:
- target organ damage, establised CVD, renal disease, DM, QRisk2>20%

offer to everyone with stage 2 HTN

34
Q

what does beta blocker + thiazide incrrease risk of

A

DM

CCC (2 decks)

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