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Cardiovascular > Atherosclerosis > Flashcards

Atherosclerosis Flashcards

1
Q

NICE staging of hypertension (clinical measurements)

A

Stage 1: >140/90
Stage 2: >160/100
Stage 3: >180/120

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2
Q

NICE staging of hypertension (ABPM measurements)

A

Stage 1: 135/85

Stage 2: 150/95

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3
Q

Causes of secondary hypertension

A 
Renal disease
Endocrine
Drugs
Vascular
Apnoea
Pregnancy
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4
Q

How is end organ damage risk quantified before starting hypertension treatment?

A

ASSIGN risk calculator

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5
Q

Target blood pressure for hypertensive patients

A

135/85 for those under 80 years old

145/85 for those over 80 years old

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6
Q

What combination drug therapy technique is used for treating hypertension?

A

Low doses of several drugs

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7
Q

Step 1 hypertension treatment

A

Over 55 or afrocaribbean: antihypertensive with calcium channel blocker or thiazide diuretic

Under 55: ACE inhibitor/ARB (not safe in pregnancy)

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8
Q

Step 2 hypertension treatment

A

Add thiazide diuretic to calcium channel blocker/ACEI/ARB

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9
Q

Step 3 hypertension treatment

A

Add calcium channel blocker, ACEI, ARB all together

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10
Q

Treatment of Stage 1 hypertension

A

Promote lifestyle change (as always)
Offer antihypertensive only to patient with one of:
target organ damage, CVS disease, renal disease, diabetes, >80 years old

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11
Q

Treatment of Stage 2 hypertension

A

Offer antihypertensive drug to all stage 2 patients and follow stepped approach

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12
Q

Treatment of resistant hypertension

A

Consider compliance issues
Consider higher doses
Consider further diuretics

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13
Q

Difference between hypertensive emergency and urgency

A 
Emergency= evidence of organ damage
Urgency= no evidence of organ damage
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14
Q

Atheroma definition

A

Formation of plaques in intima of large/medium sized arteries

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15
Q

Arteriosclerosis definition

A

Age related change in muscular arteries

Smooth muscle hypertrophy, intimal fibrosis and therefore reduced vessel diameter

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16
Q

What makes an atheroma compicated?

A

Haemorrhage into plaque
Plaque rupture/fissuring
Thrombosis

17
Q

Most important cause of atheroma

A

Hypercholesterolaemia

18
Q

3 features of plaque vulnerable to rupture

A

Thin fibrous cap
Large lipid core
Prominent inflammation

19
Q

Virchow’s triad

A

Changes in vessel wall
Changes in blood constituents
Changes in blood flow

20
Q

What is virtually the only cause of mitral stenosis?

A

Rheumatic heart disease

21
Q

Transmural infarction definition

A

Ischaemic necrosis affects full thickness of myocardium

22
Q

Subendocardial infarction definition

A

Ischaemic necrosis mostly limited to zone of myocardium under lining on heart

23
Q

Investigations for angina

A 
Bloods
ECG
CXR
Exercise tolerance test
Invasive angiography
24
Q

Angina definition

A

Discomfort in chest and/or adjacent areas with myocardial ischaemia but without myocardial necrosis

25
Q

Angina severity scoring

A

1: angina only on significant exertion
2: slight limitation in normal activity, symptoms on climbing> 1 flight of stairs
3: marked limitation, symptoms on climbing 1 flight of stairs
4: symptoms on any activity

26
Q

Medical treatments for stable angina

A 
ACE inhibitors
Statins
Aspirin
Beta blockers
Calcium channel blockers
27
Q

Percutaneous coronary intervention vs CABG in terms of symptoms and prognosis

A

PCI effective for symptoms but no prognostic benefit

CABG can have prognostic benefits

28
Q

What conditions count as acute coronary syndrome

A
28
Q

What conditions count as acute coronary syndrome

A

Unstable angina
NSTEMI
STEMI
Sudden cardiac death

29
Q

Stroke definition

A

Neurological deficit of sudden onset which lasts more than 24 hours and is of vascular origin

30
Q

What is a TIA?

A

Same as stroke but less than 24 hours

31
Q

Percentage of strokes that are caused by infarction vs haemorrhage

A

Infarction: 85-90%
Haemorrhage: 10-15%

32
Q

Most important risk factor for stroke

A

Hypertension

33
Q

Penumbra definition

A

Part of ischaemic stroke at risk of progressing to infarction but is still salvageable if reperfused

34
Q

What thrombolytic is used for stroke treatment?

A

Alteplase

35
Q

Difference between type A and B aortic dissection

A

Type A involves ascending aorta

Cardiovascular (4 decks)

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