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General Practice > CVS Risk > Flashcards

CVS Risk Flashcards

1
Q

Hi Dr since being the man put me at greater risk of having heart problems

A

Yes

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2
Q

Hi Dr what was the problem with using Framingham to calculate the risk of cardiovascular disease?

A

Framingham overestimates the risk of cardiovascular disease where the incidence of coronary heart disease is low and underestimates the risk where incidence of coronary heart disease is high

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3
Q

Hi Dr what do NICE guidelines say about the minimum Q risk score to have a statin

A

A QRISK2 score of equal to or greater than 10%

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4
Q

Hi Dr I heard there was a drug called bupropion which can help me stop smoking how does it work

A

Is not fully understood but it was originally designed as an antidepressant

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5
Q

Hi Dr I have epilepsy and I’ve been recommended a drug called bupropion buy a friend who quit smoking can I take this as well

A

Unfortunately not epilepsy mean you can’t take bupropion

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6
Q

Hi Dr I have heard that there are some drugs you can give to help me stop smoking cold bupropion and varenicline can I buy these over the counter

A

No they are prescription only

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7
Q

Hi Dr if I am breastfeeding can I take the anti smoking drug bupropion

A

No

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8
Q

Hi Dr I was told that to her in the cleaners more effective than bupropion so why isn’t it prescribed more

A

Tyrannoking in has more side effects than bupropion

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9
Q

Hi Dr can I get a prescription for an e-cigarette please

A

Nope these aren’t covered under the NHS

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10
Q

Hi Dr how high does a patient’s blood pressure need to be before it is considered severe hypertension

A

A clinical blood pressure reading of greater than or equal to 180 / 110

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11
Q

Hi Dr what is ambulatory blood pressure monitoring

A

A patient is fitted with a blood pressure monitoring device at the GP which will take a reading every 30min to 60min of their blood pressure throughout the day for 24 hours

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12
Q

Hi Dr what is Stage 2 hypertension according to NICE guidelines

A

A blood pressure reading in clinic of greater than 160 / 100 but less than 180 / 110

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13
Q

Hi Dr what is Stage 1 hypertension according to NICE guidelines

A

A blood pressure reading of greater than 140 / 90 but less than 160 / 100

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14
Q

Hi Dr I am currently being managed within ace inhibitor and a calcium channel blocker but it’s not really helping my blood pressure are there any other medications that you could add

A

Yep we can add a thiazide like diuretic

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15
Q

Hi Dr my current blood pressure medications aren’t working I’m on an Ace inhibitor or calcium channel blocker and thiazide diuretic is there any other medication that you can add

A

Yep we could try it adding the beta blocker and alpha blocker or using a different diuretic

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16
Q

Hi Dr I was given ramipril that I found that I have a really dry cough with it is there any other blood pressure medication I could try

A

Yep we can try a drug called losartan which is an angiotensin II receptor blocker

17
Q

Hi Dr how high is too high for total cholesterol levels

A

Greater than 7.5 mmol / L

18
Q

Hi Dr how high is too high for total cholesterol

A

Greater than 9mmol / L

19
Q

Hi Dr how high is too high for triglycerides

A

Greater than 10 mmol/L

20
Q

Hi Dr how high is too high for triglycerides if total cholesterol levels are greater than 7.5

A

4.5

21
Q

Hi Dr what is the current first line statin for patients with high cholesterol and how much

A

Atorvastatin 20 mg

22
Q

Hi Dr I’ve heard that sometimes you can get Side Effects with statins what side effects do you typically get

A

GI upset

23
Q

Hi Dr if I start experiencing GI upset with atorvastatin 20 mg what would you do

A

Stop the atorvastatin and see if the GI upset resolves and then we started to see if the problems come back if the problems come back then we could try using the lower dose or switching to a milder Staton

24
Q

Hi Dr I don’t like that over statin is there any other statin you can give me that won’t upset my tummy

A

We can try simvastatin

25
Q

Hi Dr so ok from what you told me I have high cholesterol when will I need to come back to check whether or not my cholesterol has gone down

A

3 months later we will do a full lipid profile

26
Q

Hi Dr ok you have told me I have high cholesterol and that we can try using a statin because I meet the criteria

are there any tests that you need to do before I start the statin

A

Yes
liver function blood test specifically an enzyme
called transaminase to get a baseline

27
Q

Hi Dr I have recently been put on a statin and was told to come back for a check-up of my liver function when and how often does this need to be checked

A

We check your liver function before putting you on a statin, at 3 months and after one year

28
Q

Hi Dr I came for my 1 year check up after being put on atorvastatin 20 mg and I was told that my transaminase levels are more than three times higher than normal what does this mean

A

It means we would need to stop your statin

29
Q

Hi Dr I was given a diagnosis of primary hypercholesterolemia what medication can I take

A

Ezetimibe

30
Q

Hi Dr I was given a diagnosis of familial dyslipidemia which group of medications can I take

A

Fibrates

31
Q

Hi Dr what does secondary prevention actually involve

A

Taking an ace inhibitor low dose 75mg aspirin a beta blocker and a statin 80 mg atorvastatin

32
Q

Hi Dr I was diagnosed with coronary heart disease last year and was told to come back for an annual check up for a specific reason but I can’t remember what

A

Patients diagnosed with coronary heart disease need an annual flu vaccine

33
Q

Hi Dr I was diagnosed with coronary heart disease last week and I was told I would need a vaccination but I can’t remember which

A

Pneumococcal vaccine

34
Q

Hi Dr I was diagnosed with coronary heart disease a couple of years ago and I have been trying to improve my lifestyle but I can’t remember how much exercise I’m supposed to be doing can you tell me

A

Every Week
Two and a half hours of moderate intensity aerobic activity or you can do an hour and 15 minutes of vigorous aerobic activity

35
Q

Hi Dr when calculating cardiovascular risk what is the prevention paradox

A

The prevention paradox essentially describes the majority of cardiovascular events occur in low or average risk patients where has the majority of high risk patients do not experience a cardiovascular event

36
Q

Hi Dr I was told to monitor my blood pressure at home how often do I have to do this

A

Twice to four times daily for a week

37
Q

What is the DVLA guidance following a heart attack in regards to driving

A

Stop for 4 weeks

General Practice (8 decks)

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