NHS Health Check Flashcards
What is a NHS Health check and what type of diseases can it screen for
Free check-up of your overall health and can tell you whether you’re at a higher risk of getting conditions like:
- Heart disease
- Diabetes
- Kidney disease
- Stroke
You will be told how to reduce risk of getting these conditions and dementia
if you’re over 65, dementia will also be screened and oyu would be told what signs and symptoms to look out for.
How does the NHS Health Check help?
Your individual cardioV risk is calculated and explained to you.
Risk vary from person to person but everyone is at risk of developing heart disease, stroke, type 2 , kidney disease and some types of dementia
it gives advice on how to prevent them; can detect potential health problmes before they do damage
Desciribe what happens at the Health check
lasts 20-30 min
Health care professional (HCA or nurse) ask about:
- FH
- SH
- Height and weight- BMI
- take BP
- Blood test
Blood test can be done before the check (meeting) or at the meeting time.
It will show chances of getting the diseases
During the NHS health check, you will receive personalised advice to reduce your risk. what could they be?
- improving diet and exercise
- Taking meds to lower BP/ cholesterol
- Losing weight and stop smoking
Where can you have your NHS check?
Depends on where you live
i.e. could be GP, local pharamcy, local library or leisure centre
In some areas the Checks are offered from mobile units to passers-by and in workplaces
What are theways someone could arrange to have an NHS Health check
You’ll be invited for a check every 5 years if you’re between 40-74 with no pre-existing conditions
You’re GP practice will automatically send one if they offer the Health check.
Local authority could also tell you where to get one
if you’re not sure just ask a GP surgery
What impact does the NHS health check have on society.
the Health Check have prvent 2.5k heart attack or stroke in it’s first 5 years due to the treatments given.
- 1 in (30-40) ppl who have check is diagnosed with high BP
- 1 in (80-200) diagnosed with type 2 diabetes
- 1 in (6-10) identified as being high risk of cardiovascular disease (usng the calculator)
One of the management of hypertension is to discuss lifestyle interventions. Explain in detail what this entails
Inform them about any local initatives and supplement advice with leaflets or audiovisual information.
The interventions could include :
- Healthy Diet
- Stopping Smoking
- Encourage Exercise
- Reduce Salt intajke
What are the recommendations for healthy diet
Weight should be reduced and maintain BMI between 18.5 and 24.9
Use wholegrain food
Reduce saturated fat and increase mono-unsaturated fats (olive or rapseed oil and spreads)
Reduce sugar and refined sugar intake
Eat 5 fruit and veg a day
Eat 2 portions of fish per week (include a portion of oily fish)
Eat 4-5 portions of unsalted nuts,seeds and legumes per week
low salt
keep alcohol levels low (14 units a week spread throughout the week with atleast 2 days alcohol free)
Ca, Mg and K not recommended
What specifc advice should you give regarding encouraging exercise?
Make physical activity part of everyday life (walk, cycle go up stairs) and build in enjoyable activities
Minimise sedentary activities like watching TV or playing video games
Join a local sporting group, take advantage of taster sessions and get used to exercising every week
What are the guidelines for salt reduction in diet
Salt reduction to 4.4g per day leads to a 4/2mmHg decrease in BP
No more than 5-6 grams of salt per day
Don’t add salt to food and avoid processed food. Look at food labelling to check salt content.
In Diagnosis of High bP, what are the stages of High BP
Stage 1 -
- BP in surgery/clinic is ≥140/90 mm Hg AND
- Ambulatory blood pressure monitoring (ABPM) or home blood pressure monitoring (HBPM) ranges from 135/85 mm Hg to 149/94 mm Hg.
Stage 2 -
BP in surgery/clinic is ≥160/100 mm Hg but less than 180/120 mm Hg and ABPM or HBPM is ≥150/95 mm Hg.
Stage 3 or severe hypertension -
- SBP in surgery/clinic is or greater than 180 mm Hg OR
- Diastolic BP is 120 mm Hg or higher.
in what group of people should you measure standing as well as sitting BP
Those with hIgh BP AND ONE OF THE FOLLOWING;
- Type 2 diabetes
- Symptoms of postural hypertension
- Aged 80 or over
Treatment targets should be based on standing blood pressure in people with significant postural drop or symptoms of postural hypotension.
There are people who choose to monitor their own BP. What should you offer them?
Advise them to use HBPM
What should you provide for people who choose to use HBPM?
Training and advice on using home blood pressure monitors.
Advice on what to do if they are not achieving their target blood pressure
What should you consider for people with High BP and also have White coat/masked hypertension?
Consider ABPM or HBPM as well as clinic BP.
Note that the corresponding readings for ABPM and HBPM are 5mmHg lower than for clinic measurements.
Once you have a pt in the clinic, what are overall procedure to manage and monitor BP
lifestyle is very important, re-inforce it everytime you meet the pt
what different ECG leads look at different sides of the heart?
what was the pathology found in Dr OKoye ECG. There are other abnormalites, how can you differentiate it from an acute coronary syndrome?
Enlarged QRS- suggests left ventricular hypertrophy..
There are others like ST depression, however to distinguish it from ischeamia, look at history and previous ECGs.
What are the potential reasons for Left Ventricular Hypertrophy?
Pressure overload
Volume overload
Angiotensin 2, Aldosterone and Endothelin
Insulin, Insulin growth factors and lipids
According to the guidelines what were the drugs prescribed for Dr Okoye. Explain why
what about comorbidites of angina / diabetes
Amlodipine- 5mg orally per day. This is a non-rate limiting CCB as it affects blood vessels. it’s better it doesn’t affect the heart so it doesnt cause adverse effects
