CVD

Question 1

Conditions

Answer 1

CHD
TIA
Stroke
Aortic disorders
Peripheral arterial disease

Question 2

SIGN 2017

Answer 2

Salt <6g/d
Overweight -3kg + maintain
Fish 2x140g/wk (one oily)
Mediterranean diet pattern for high risk/developed
Low sat fat - men <30g/d and women <20g/d

Question 3

Non-modifiable RFs

Answer 3

Male
Increasing age
Body build

Question 4

Other RFs

Answer 4

Stress
Low socioeconomic class
Climate

Question 5

Modifiable RFs

Answer 5

Obesity
Smoking
P.A
High Hcy
Hypertension
Dyslipidaemia

Question 6

Top priorities (6)

Answer 6

Diet change (salt, sat fat)
Blood pressure + lipid management
Weight management
Smoking cessation
Physical activity

Question 7

Prevention

Answer 7

Support whole person
Educate on modifiable RFs
Diet change
Screening
Drug therapies
Health promotion at all stages
Education - food labels/food prep tech/portion control
Exercise programmes

Question 8

Mediterranean Diet

Answer 8

High F+V, wholegrains, oily fish, unsaturated fat
Low sat + trans fat
Assessment with Med diet score tool

Influences - artery injury risk, plaque formation, thrombosis

Question 9

Dietary cholesterol

Answer 9

Eggs, liver, shellfish
Large quantities may increase serum levels
Reduce intake if high levels
Always ask in diet history

Question 10

Lipid profile (high risk)

Answer 10

Total chol <4
LDL <2
HDL >1.0
TAG <1.7

Question 11

Signs of high lipid
High TAG
High chol x2

Answer 11

High TAG - eruptive xanthoma (skin nodules)

High chol

• corneal arcus (white ring in eye)
• xanthelasma (eyelid deposits)

Question 12

Hypertension

Normal v stage 1 b.p

Answer 12

Normal = 130/85

Stage 1 = 140-149/90-99

Question 13

Soluble fibre

Answer 13

Encourage high intake
F+V, beans, pulses, oats, barley
Lowers total + LDL chol

Question 14

CHO

Answer 14

Ensure adequate % energy (keep fat low)

Refined CHO may increase TAG (swap to low GI foods)

Question 15

Dietary fat

Answer 15

Sat fat <10% energy
Trans fat <2% energy
Reduction not always necessary
MUFA - olive oil/rapeseed oil/nuts/avocado
PUFA - oily fish/soybeans/margarines

Practical - cooking method/cut fat off meat/low dairy options/popcorn>crisps

Question 16

N-3 FAs

Answer 16

Anti-thrombotic
Anti-inflammatory
Prevention - 1 portion/wk
Treatment - 2-4 portions/wk
Veggie sources - walnuts, kidney beans, edamame, flaxseed

Question 17

Alchohol

Answer 17

May increase TAG
<14u/wk
Direct relationship with increase blood pressure (regular, heavy, binge)

Question 18

Plant sterols

Answer 18

Inhibit chol absorption so reduce circulating chol levels
Lowers LDL 6-15%
Max effects at 2-3g/d
Nuts/seeds/grain/veg oils
Health claim: reduces chol

SIGN: no evidence long-term

Question 19

Salt

Answer 19

<6g/d

DASH diet - high F+V, wholegrains, fish, low sat, trans fat, salt

Question 20

Soya protein

Answer 20

Low GI
Interferes with LDL chol synthesis
Use to replace sat fat + animal protein when in mixed diet
Practical 1/2 and 1/2
SIGN: no recommendations for use

Question 21

Dietary management

Answer 21

Cheap/safe/alter lipid profile BUT low compliance
Keep advice practical + achievable

Consider - motivation, lifestyle, social circumstances, other medical conditions

Question 22

Cardiac failure

Causes

Answer 22

Prolonged HT
Injury
Alcohol abuse
MI/IDH
Viral damage

Question 23

Cardiac failure

S+S

Answer 23

Oedema
SOB
Fatigue
Fluid imbalance
Poor cardiac failure

Question 24

Cardiac failure
Medical…
Surgical…

Answer 24

Oxygen + drugs

Dialysis, heart transplants, cardiomyopathy, mechanical support

Question 25

Cardiac Cachexia

Answer 25

Abnormally low weight
Loss skeletal + heart muscle, fat + bone tissue
Poor prognosis
symptoms - fatigue, anorexia, chronic infection

Question 26

Cardiac failure

Dietetic intervention

Answer 26

Maximise energy intake if malnourished
Fluid restriction
Na restriction
Alcohol
Smoking
Weight loss for obese