Comorbidities: CVD and resp, neuro and nutrition

Question 1

CARDIOVASCULAR AND RESPIRATORY DISEASE

Answer 1

Yes

Question 2

Do you need to know about general stroke complications, by body part?

Answer 2

Yes

Question 3

What are 2 chronic complications of stroke?

Answer 3

Recurrent stroke

Death

Question 4

RRecurrent stroke:

• Occurs in what % of stroke patients?
• Recurrent strokes are ikely to be more _____ or result in ______

Answer 4

10%

Severe, death

Question 5

Do you need to know stroke survival by stroke type?

Answer 5

Yes

Question 6

What is a key acute complication of stroke?

Answer 6

Pneumonia

Question 7

What is the mechanism through which stroke increases bacteria in the lungs

Answer 7

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.

Question 8

Do you need to know the mouse and human studies that show that there’s increased bacteria in lungs following stroke?

Answer 8

Yes

Question 9

Two ways to prevent post stroke lung infections?

Answer 9

Sympathetic nervous system inhibition

Antibiotics

Question 10

Does sympathetic nervous system inhibition work in rats? Do you need to know the study?

Answer 10

Yes

Yes

Question 11

Do antibiotics work in rat and human studies? Do you need to know about studies?

Answer 11

Only in rat studies.

Yes

Question 12

CARDIOVASCULAR AND NEUROLOGICAL DISEASE

Answer 12

:D

Question 13

Describe mechanism through which stroke activates immune system to cause further infarction.

Answer 13

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.

Question 14

Is spleen smaller or larger in stroke mice and why?

Do you need to know studies?

Answer 14

Smaller, as immune cells ahve left it.

Yes

Question 15

What is the order of immune cells infiltrating the brain?

Do you need to know more details?

Answer 15

AStrocytes
Innate immune cells 
Adaptive immune cells 
Recovery 
Yes

Question 16

Have clinical trials of anti inflammatory drugs in treating ischemic stroke been successful?

Answer 16

No, all have failed.

Question 17

Can stroke harm the immune system?

Answer 17

Yes

Question 18

Do you need to know how stroke leads to systemic and pulmonary hypertension?

Answer 18

Yes

Question 19

What is the mechanism through which ischemic stroke alters vascular reactivity, leading to hypertension?

Answer 19

Stroke –> increased sympathetic output –> increased leukocytes.
Leukocytes adhere to endothelial cells and release ROS, which soak up NO
Less VSMC relaxation –> hypertension

Question 20

Do you need to know vascular reactivity studies in rats?

Answer 20

Yes

Question 21

Can stroke cause epilepsy?

Answer 21

Yes

Question 22

Do you need to know epidemiology of post stroke epilepsy?

Answer 22

Yes

Question 23

Can anti epileptic drugs cause CV complications and increase risk of stroke? Do you need to know more information?

Answer 23

Yes

Question 24

CARDIOVASCULAR DISEASE AND NUTRITION

Answer 24

:D

Question 25

Do you need to know what the good and bad bacteria are?

Answer 25

Yes

Question 26

Western diet: impact on good and bad bacteria, and risk of chronic illness

Answer 26

Increases bad bacteria, decreases good bacteria | Increases chronic illness risk

Question 27

Effect of mediterranean diet on good bacteria and chronic disease risk?

Answer 27

Increases good bacteria | Decreases chronic disease risk

Question 28

2 ways in whichpoor diet leads to CVD

Answer 28

Weakens GI integrity, enabling bad bacteria to leak into circulation Increases bad : good bacteira ratio, activates immune system --> CVD

Question 29

Do you need to know vehicle vs AngII and conventional vs germ free mice studies?

Answer 29

Yes

Question 30

How does fibre decrease hypertension?

Answer 30

In colon, commensal bacteria ferment fibre to release short chain fatty acids, which diffuse into bloodstream and act on receptors to decrease blood pressur

Question 31

Do you need to know what the short chain fatty acids are and what receptors they act on?

Answer 31

Yes

Question 32

What are the first line and second line treatments for hypertension?

Answer 32

First line: lifestyle changes. | Second line: ACE/angiotensin antagonists, beta blockers, calcium channel antagonists, diuretics.

Question 33

What is resistant hypertension?

Answer 33

when blood pressure is not under 140/90, despite 3 BP lowering drugs being used (including 1 diuretic) at optimal dosage

Question 34

Do you need to know - Consequences of resistant hypertension - Risk factors - Evaluation of resistant hypertension - Other medicaions that can interfere with BP control?

Answer 34

Yes

Question 35

Do you need to know about current and future treatments of resistant hypertension

Answer 35

Yes

Question 36

Do you need to know link between hypertension and Alzheimer's disease?

Answer 36

Yes