NHS health check Flashcards
what is the NHS health check?
free check-up of your overall health
can tell you whether you’re at higher risk of getting certain health problems
- heart disease
- diabetes
- kidney disease
- stroke
discuss how to reduce risk of these conditions and dementia
what happens during an NHS health check?
ask you some questions about your lifestyle and family history
measure your height and weight
take your blood pressure and do a blood test
if over 65 years, be told the signs and symptoms of dementia to look out for
what advice is given at an NHS health check?
personalised advice to improve your risk
how to improve your diet and the amount of physical activity you do
taking medicines to lower your blood pressure or cholesterol
how to lose weight or stop smoking
what are the effects of hypertension on the brain?
transient ischaemic attack
stroke
what are the effects of hypertension on the heart?
coronary artery disease
what are the effects of hypertension on the eyes?
retinopathy
optic neuropathy
what are the effects of hypertension on the kidneys?
glomerulosclerosis
kidney failure
what are the effects of hypertension on the peripheral vessels?
atherosclerosis
aneurysm
what are the next steps after a hypertensive BP reading according to NICE guidelines?
recheck BP
24 hr ambulatory BP monitoring
lifestyle advice
recheck BP
start medication
what is offered to all people with hypertension in order to look for evidence of target organ damage?
test for proteinuria (urine sample for ACR estimation)
test for haematuria (reagent strip)
blood sample
- measure HbA1c
- electrolytes
- creatinine
- eGFR
- total cholesterol, HDL cholesterol
examination of fundi (presence of hypertensive retinopathy)
12-lead ECG
what are leads II, III and aVF called?
inferior leads
II, III, aVF
right coronary
I, aVL, V, VI
lateral leads
I, aVL, V, VI
left circumflex artery
I, II
septal
I, II
left anterior descending artery
III, IV
anterior
III, IV
left anterior descending artery
where are ECG electrodes placed?
right and left arm - outwardly on shoulders (preferentially over bone, not muscle)
right leg (ground lead) and left leg - below umbilicus
V1 and V2 - 4th intercostal space (1 on right, 2 on left)
V3 - halfway between V2 and V4
V4 - 5th intercostal space, midclavicular line
V5 - horizontal line with V4 and V6, anterior axillary line
V6 - horizontal line with V4 and V5, mid-axillary line
what factors can cause left ventricular hypertrophy in hypertension?
sympathetic nervous system activation - adrenergic and non-adrenergic pathways
pressure and volume overload in vena cava
insulin, insulin growth factor, lipids
angiotension - II, aldosterone, endothelin
why may blood pressure still be raised after taking medication?
non adherence
side effects
multiple drugs required
ethnicity
white coat syndrome
