IHD, AFib and HF

Question 1

For diagnosing T2 Diabetes
What are the values for diagnosis? :

a) HbA1c?
b) Fasting Plasma glucose ?
c) Random plasma blood glucose?

Answer 1

a) 48 mmol / L (6.5% or more)
b) 7 mmol or more
c) 11 mmol or more

Question 2

To diagnose T2 Diabetes if the pt is SYMPTOMATIC how many / which tests do you need for diagnosis ?

If patient ASYMPTOMATIC how many / which tests do you need for diagnosis?

Answer 2

SYMPTOMATIC:
Either abnormal HbA1c or Fasting plasma glucose

ASYMPTOMATIC:
2 abnormal tests

Question 3

Presentation of diabetic pt?

Answer 3

Hyperglycaemia
Polydipsia 
polyuria 
weight loss
tiredness
Acanthosis Nigricans

Question 4

What are some risk factors for Ischaemic Heart disease?

Answer 4

Obesity 
Metabolic syndrom 
Lack of exercise
High salt / fat diet 
Hyperlipidaemia 
High cholesterol / hypercholesteraemia 
smoking 
Type 2 diabetes
Increasing Age 
Male 
Long term stress

Question 5

How can Ischaemic Heart Disease lead to MI?

Answer 5

Build up of atheromas causing atherosclerosis. Narrowed lumen of arteries leading to angina and eventually MI when occluded.

Question 6

How would a pt with suspected MI present?

Answer 6

SOB
Chest pain (central crushing) 
Pain that radiates to jaw/ down left arm / shoulder
Nausea 
Sweating 
Clammy 
Vommitting
Syncope

Less common e.g. women
Epigastric pain
No pain - elderly / diabetes
Palpitations
Acute confusion

Question 7

What is the risk factor a ‘painless’ MI

Answer 7

Diabetes- due to autonomic neuropathy. Painless MI need to be very careful

Question 8

What two conditions can Ischaemic Heart Disease lead to? How would they present?

Answer 8

Stable Angina :
pain on exertion

Unstable:
Pain at rest

SOB / pain/ nausea