Health check Flashcards
The NHS Health Check can tell you whether you’re at higher risk of getting certain health problems such as what?
Heart Disease
Diabetes
Kidney Disease
Stroke
During the check-up you also discuss how to reduce the risk of these conditions and what other condition?
Dementia
If you are over what age will you be told the signs and symptoms of dementia to look out for?
65
Is everyone at risk of developing heart disease, stroke, type 2 diabetes, kidney disease and some types of dementia?
Yes
Is Cardiovascular risk the same for everyone?
No it varies from person to person
How long does the NHS Health Check take?
20-30 mins
What questions are asked by a health professional - often a nurse or healthcare assistant in an NHS Health Check?
Questions about your lifestyle
Questions about family history
What examinations are done by a health professional - often a nurse or healthcare assistant in an NHS Health Check?
Measurement of height and weight - calculate BMI
Take blood pressure
Do blood test - done either before or at the check
What can the personalised advice to improve your risk given in an NHS Health Check include?
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
Where do you have an NHS Health Check?
Usually at GP surgery or local pharmacy
Could happen at local library or leisure centre
Some areas they are offered from mobile units to passers-by and in workplace
Why might NHS Health Checks be paused in some areas?
At the moment may be paused due to COVID-19
Local council should be contacted to find out if programme is available in area
If you are between what age are you invited to have a free NHS Health Check every 5 years?
40-74 and do not already have a pre-existing condition
What should a patient do if they are eligible for a check but have not had one in the last 5 years or if they are not sure if they are eligible?
Ask at a GP surgery for an appointment
Do NHS Health Checks work?
Health conditions picked up by NHS Health Check, when added together are the biggest cause of preventable deaths in the UK with about 7 million people affected by them
In its first 5 years, how many heart attacks or strokes has the NHS Health Check been estimated to have prevented?
2,500 As a result of people receiving treatment after their Health Check
For every how many people having an NHS Health check is one person diagnosed with High Blood Pressure?
30-40
For every how many people having a Health check is 1 person diagnosed with Type 2 Diabetes Mellitus?
80-200
For every 6 in how many people having an NHS Health Check is 1 person identified as being at high risk for CVD?
10
Who runs the NHS Health Check Programme in a patient’s area?
Their local authority
What test on the NHS website assesses your risk of getting heart disease or stroke?
online Heart Age test
How do you find out if you are a healthy weight on the NHS website?
Health Weight Calculator
What does the How Are You quiz on the NHS website show?
How healthy you are
Equation to calculate cardiac output
Cardiac output= stroke volume*heart rate
Why does arterial pressure lead to vascular function and structural changes?
arterial pressure–>peripheral vascular resistance–>vascular function and structural changes
Why is it important to recognise hypertension?
Important to recognise hypertension as it is usually silent
What are 10 effects of hypertension?
Cardiac- coronary artery disease, left ventricular hypertrophy
Systemic vascular- TIA, stroke
Microvascular- Atherosclerosis (could increase risk of aneurysm), aneurysm
Renal- glomerulosclerosis (microvascular effects in kidney, will lead to kidney failure if left untreated), kidney failure
Visual- retinopathy, optic neuropathy (optic nerve damage)
Why is first BP measurement usually higher than normal and how do you avoid this?
Can be due to stress- ‘white coat’ hypertension when they see a healthcare professional
Best out of 3 measurements taken
If BP still high even after best of 3, what is done?
24 hour ambulatory blood pressure monitoring in the comfort of the patients home, can help avoid the white coat effect
Usually goes off 2x in a day and once in night which can be scary and so if this happens you can use BP monitor yourself at home 2x in day and once in night
If you still have high BP after 24 hour ambulatory blood pressure monitoring, what is done next?
Lifestyle advice
exercise (circulation to skin and muscles for vasodilation and increased Renal function)
Diet
stop smoking
Give an example of lifestyle advice to do with diet
Usually hypertensive individual has high salt and vulnerable to renin so salt intake should be controlled
If BP still high after lifestyle changes, what should be done?
Give medication
What 4 things should be offered to all patients with hypertension?
Test for presence of protein in urine by sending a urine sample for estimation of albumin: creatinine ratio and test for haematuria using a reagent strip
Take a blood sample to measure glycated haemoglobin (HbA1c), electrolytes, creatinine, estimated glomerular filtration rate, total cholesterol and HDL cholesterol
Examine the fundi for the presence of hypertensive retinopathy
Arrange for a 12 lead ECG to be performed
((all test for end organ damage))
Describe the order of the 5 electrical events in the cardiac cycle
SA node signal
Atrial contraction
AV node signal
Ventricular depolarisation
Ventricular repolarisation
What is the name of the cell types in the SA node?
Autorhythmic myocytes
What is the name of the wave created by the SA node?
P-wave
How is the AVN signal represented on ECG and is this a slow or fast signal?
Isoelectric line
Slow transduction to allow ventricular filling before contraction
What wave does the depolarisation of the Bundle of His show on ECG and is this slow or fast signal?
Isoelectric line
Fast as it is insulated
What occurs in the Q wave?
Shows septal depolarisation via bundle branches
What does the R wave show?
Ventricular depolarisation by Purkinje fibres
What does the S wave show?
Late ventricular depolarisation and this is in opposite direction to lead II
What does the T wave show and why is this positive deflection on ECG?
Ventricular repolarisation which occurs in opposite direction to lead II but since it it is repolarisation in the opposite direction, it has positive deflection (depolarisation in opposite direction would have had negative depolarisation)
The part that depolarises first is what repolarises last
Summary diagram for ECG tracing
Where do each of the chest electrodes go?
V1- right sternal border in the 4th intercostal space
V2- left sternal border in the 4th intercostal space
V3- Halfway between V2 and V4
V4- Mid-clavicular line in the 5th intercostal space
V5- Anterior axillary line at the level of V4
V6- Mid axillary line at the level of V4
Which direction does electrical conduction travel from and to?
From negative electrode to positive electrode as depolarisation leads to a lower intracellular charge compared to extracellular charge
What direction do each of leads I-III go from in relation to the limbs?