Comorbidities: CVD and resp, neuro and nutrition Flashcards
CARDIOVASCULAR AND RESPIRATORY DISEASE
Yes
Do you need to know about general stroke complications, by body part?
Yes
What are 2 chronic complications of stroke?
Recurrent stroke
Death
RRecurrent stroke:
- Occurs in what % of stroke patients?
- Recurrent strokes are ikely to be more _____ or result in ______
10%
Severe, death
Do you need to know stroke survival by stroke type?
Yes
What is a key acute complication of stroke?
Pneumonia
What is the mechanism through which stroke increases bacteria in the lungs
After stroke, there is increased adrenergic nerve output and more adrenaline.
Adrenaline passes through GIT epithelium and alters GIT microbiota compositoin.
This increases bacteria in the lung.
Do you need to know the mouse and human studies that show that there’s increased bacteria in lungs following stroke?
Yes
Two ways to prevent post stroke lung infections?
Sympathetic nervous system inhibition
Antibiotics
Does sympathetic nervous system inhibition work in rats? Do you need to know the study?
Yes
Yes
Do antibiotics work in rat and human studies? Do you need to know about studies?
Only in rat studies.
Yes
CARDIOVASCULAR AND NEUROLOGICAL DISEASE
:D
Describe mechanism through which stroke activates immune system to cause further infarction.
Stroke happens, and sympathetic output increass.
This activates lymphoid organs, which release immune cells. Immune cells infiltrate the brain (in stroke, BBB is leaky). Here, immune cells release ROS and cytokines –> neuron death.
Is spleen smaller or larger in stroke mice and why?
Do you need to know studies?
Smaller, as immune cells ahve left it.
Yes
What is the order of immune cells infiltrating the brain?
Do you need to know more details?
AStrocytes Innate immune cells Adaptive immune cells Recovery Yes
Have clinical trials of anti inflammatory drugs in treating ischemic stroke been successful?
No, all have failed.
Can stroke harm the immune system?
Yes
Do you need to know how stroke leads to systemic and pulmonary hypertension?
Yes
What is the mechanism through which ischemic stroke alters vascular reactivity, leading to hypertension?
Stroke –> increased sympathetic output –> increased leukocytes.
Leukocytes adhere to endothelial cells and release ROS, which soak up NO
Less VSMC relaxation –> hypertension
Do you need to know vascular reactivity studies in rats?
Yes
Can stroke cause epilepsy?
Yes
Do you need to know epidemiology of post stroke epilepsy?
Yes
Can anti epileptic drugs cause CV complications and increase risk of stroke? Do you need to know more information?
Yes
CARDIOVASCULAR DISEASE AND NUTRITION
:D
Do you need to know what the good and bad bacteria are?
Yes
Western diet: impact on good and bad bacteria, and risk of chronic illness
Increases bad bacteria, decreases good bacteria
Increases chronic illness risk
Effect of mediterranean diet on good bacteria and chronic disease risk?
Increases good bacteria
Decreases chronic disease risk
2 ways in whichpoor diet leads to CVD
Weakens GI integrity, enabling bad bacteria to leak into circulation
Increases bad : good bacteira ratio, activates immune system –> CVD
Do you need to know vehicle vs AngII and conventional vs germ free mice studies?
Yes
How does fibre decrease hypertension?
In colon, commensal bacteria ferment fibre to release short chain fatty acids, which diffuse into bloodstream and act on receptors to decrease blood pressur
Do you need to know what the short chain fatty acids are and what receptors they act on?
Yes
What are the first line and second line treatments for hypertension?
First line: lifestyle changes.
Second line: ACE/angiotensin antagonists, beta blockers, calcium channel antagonists, diuretics.
What is resistant hypertension?
when blood pressure is not under 140/90, despite 3 BP lowering drugs being used (including 1 diuretic) at optimal dosage
Do you need to know
- Consequences of resistant hypertension
- Risk factors
- Evaluation of resistant hypertension
- Other medicaions that can interfere with BP control?
Yes
Do you need to know about current and future treatments of resistant hypertension
Yes
Do you need to know link between hypertension and Alzheimer’s disease?
Yes
