CVS

Question 1

Ischaemic heart disease AKA

Answer 1

Coronary artery disease

Question 2

Leading cause of death in western countries:

Answer 2

Ischaemic heart disease

Question 3

Risk factors for CVD:

Answer 3

• Hypertension
• Diabetes
• Smoking
• Weight loss
• Exercise

Question 4

Angina symptoms may be triggered by:

Answer 4

• Cold
• Exercise
• Worry
• Anger

Question 5

Chronic management of angina is via:

Answer 5

CCBs and beta blockers to reduce work and vasodilate vessels

Question 6

Dose for GTN for acute angina attck:

Answer 6

0.4mg sublingual spray, up to 3 doses

Question 7

How does GTN work?

Answer 7

Causes the release of Nitrix Oxide which causes vasodilation including the coronary arteries

Question 8

5 side effects of GTN

Answer 8

• Hypotension
• Dizziness
• Headache
• Flushing
• Reflex tachycardia

Question 9

Clinical to do list for angina attack:

Answer 9

• Reduce stress
• GTN
• Oxygen
• Be careful prescribing exercise
• Be aware of adrenaline in LA

Question 10

2 examples of 2nd gen (selective) betablockers

Answer 10

• Atenolol
• Metoprolol

Question 11

Beta blockers are used for what three CV conditions:

Answer 11

• Angina
• Tachycardia
• Hypertension (not first line)

Question 12

2 examples of cardiac CCBs:

Answer 12

• Verapamil
• Diltiazem

Question 13

What are CCBs used for:

Answer 13

• Angina
• Hypertension (not usually first line)
• Tachycardia and arrythmias

Question 14

CCBs and Beta blockers shouldn’t be used together. Why?

Answer 14

Can cause cardiac depression.

Question 15

Definition of hypertension:

Answer 15

Consistent reading over 140 systolic or 90 diastolic

Question 16

Why is controlling BP important

Answer 16

Damage to important organs esp those with small vessels eg eye, brain, kidney. Also major risk factor for CVS diseases.

Question 17

What proportion of patients with gum disease develop hypertension?

Answer 17

1/3

Question 18

Why is gum disease assoiated with HTN?

Answer 18

Plaques end up in the blood stream and build up in vessels

Question 19

Aim of diuretics for hypertension:

Answer 19

Reduce blood volume eg Thiazide

Question 20

Aim of CCBs in HTN

Answer 20

Vasodilation and reduce HR/CO

Question 21

Aim of RAAS modulators of HTN (ACE Inh and ARBs)

Answer 21

Reduce blood volume and vasodilate

Question 22

First instance tx for HTN:

Answer 22

Green script

• REgular daily exercise
• Reduce weight
• Salt restrictions
• Smoking
• REduce alcohol intake
• Control diabetes
• Reduce stress
• Increase sleep

Question 23

What HTN drug can cause gingival hyperplasia?

Name 3 examples

Answer 23

CCBs eg

• Nifedipine
• Verapamil
• Diltiazem

Question 24

What is ‘low dose’ aspirin

Answer 24

75-150mg per day

prophylactic

Question 25

What is INR for

• Normal individuals
• Therapeutic range for people at risk:

Answer 25

• Normal is 1
• Therapeutic range 2.0-4.5
• Anywhere above this is a hemorrhage risk