NHS health check Flashcards

1
Q

what is the NHS health check?

A

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

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2
Q

what happens during an NHS health check?

A

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

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3
Q

what advice is given at an NHS health check?

A

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

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4
Q

what are the effects of hypertension on the brain?

A

transient ischaemic attack

stroke

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5
Q

what are the effects of hypertension on the heart?

A

coronary artery disease

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6
Q

what are the effects of hypertension on the eyes?

A

retinopathy

optic neuropathy

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7
Q

what are the effects of hypertension on the kidneys?

A

glomerulosclerosis

kidney failure

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8
Q

what are the effects of hypertension on the peripheral vessels?

A

atherosclerosis

aneurysm

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9
Q

what are the next steps after a hypertensive BP reading according to NICE guidelines?

A

recheck BP

24 hr ambulatory BP monitoring

lifestyle advice

recheck BP

start medication

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10
Q

what is offered to all people with hypertension in order to look for evidence of target organ damage?

A

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

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11
Q

what are leads II, III and aVF called?

A

inferior leads

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12
Q

II, III, aVF

A

right coronary

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13
Q

I, aVL, V, VI

A

lateral leads

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14
Q

I, aVL, V, VI

A

left circumflex artery

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15
Q

I, II

A

septal

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16
Q

I, II

A

left anterior descending artery

17
Q

III, IV

A

anterior

18
Q

III, IV

A

left anterior descending artery

19
Q

where are ECG electrodes placed?

A

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

20
Q

what factors can cause left ventricular hypertrophy in hypertension?

A

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

21
Q

why may blood pressure still be raised after taking medication?

A

non adherence

side effects

multiple drugs required

ethnicity

white coat syndrome