Hypertension and hyper lipidemia

Question 1

How do ACEis work?

Answer 1

Inhibit conversion of angiotensin I to II. Angiotensin II is a vasoconstrictor, therefore ACEis causes vasodilation

Question 2

Main side effect of ACEis

Answer 2

Dry cough
Hyperkalemia

Question 3

what class of drug is ramipril, lisonipril

Answer 3

ACEis

Question 4

What tests need to be donw before start ACEi

Answer 4

Renal function and test 2 weeks later

Question 5

What class of drug are losartan, candasartan

Answer 5

Angiotensin receptor blockers

Question 6

Threshold for medication or serious intervention on CVS risk

Answer 6

10% risk in next 10 years of serious event

Question 7

Why are beta blockers contraindicated in asthma

Answer 7

Cause bronchoconstriction as acts on beta 2 receptors in bronchi

Question 8

What treatment to use for 1 year after MI

Answer 8

Clopidogrel

Question 9

Main side effects of Calcium channel blockers

Answer 9

Ankle oedema

Question 10

What do you do when a patient has ankle swelling for a CCB?

Answer 10

Change onto Mecandapine

Question 11

What is threshold for referral for resistant HPTN in a medicated patient? (how many meds)

Answer 11

Resistant HPTN after 4 medications

Question 12

What to use for hypercholesterolemia if statins contraindicated

Answer 12

Fibrates

Question 13

Mechanism of statins

Answer 13

Inhibit HMG-Coa reductase

Question 14

Role of HMG-CoA reductase

Answer 14

Rate limiting liver enzyme in cholesterol synthesis (mevalonate path)

Question 15

Tests to do before start a statin

Answer 15

Liver function and monitor - one at 3 months, one at 12

Question 16

Why are statins given at night

Answer 16

Fasting state is when cholesterol most synthesised - most effective in this time
Muscle pains easier to live with

Question 17

Main side effects statins

Answer 17

Leg cramps at night

Question 18

What class of drugs are clofibrate, fenofibrate and gemifibrozil?

Answer 18

Fibrates

Question 19

First line drug treatment for CVS prevention

Answer 19

20mg atorvastatin daily

Question 20

What group needs high intensity statin treatment and what dose

Answer 20

80mg atorvastatin - exisitng CVD

Question 21

What is the aim of statin treatment

Answer 21

40% reduction in non HDL-c levels

Question 22

What is most important cholesterol level for determining CVS risk + whether use lipid modifying treatment?

Answer 22

non-HDL-c

Question 23

What do you test for if muscle pain with statins

Answer 23

Creatinine kinase - rhabdomyolysis

Question 24

What is the additional treatment for primary hypercholesterolemia

Answer 24

Ezetemibe

Question 25

What other lipid lowering drug interacts with ezetimibe

Answer 25

Fibrates

Question 26

Mechanism of ezetimibe

Answer 26

Limits uptake of cholesterol in intestine

Question 27

Ezetemibe main side effects

Answer 27

GI problems

Question 28

What HPTN drug can cause renal stenosis

Answer 28

ACEis

Question 29

How does hypothyroidism affect BP

Answer 29

High diastolic - increased peripheral resistance

Question 30

How does hyperthyroidsim affect BP and why

Answer 30

High systolic- increase CO and decreased systemic resistance

Question 31

What disease do statins increase the risk of?

Answer 31

Diabetes

Question 32

Xanthelasma

Answer 32

Cholesterol deposits around eye

Question 33

Why is creatanine kinase and muscle pain important with statins?

Answer 33

Risk of rhabdomyolysis

Question 34

How does spirinalactone work?

Answer 34

K + sparing diuretic

Question 35

State the NICE guidelines for hypertension and hyperlipidemia