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Phase 3a public health > Public health CVD > Flashcards

Public health CVD Flashcards

1
Q

Cardiac failure definition?

A

Clinic syndrome/ S&S suggestive that the efficacy of the heart as a pump is impaired so the is not able to match the metabolic demands of the body.

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2
Q

What are the 3 main types of cardiac failure and what causes them?

A
  1. LVSD - often due to IHD
  2. RVSD - secondary to LVSD
  3. Diastolic HF
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3
Q

Pathophysiology of cardiac failure in x4 steps:

A
  1. Sympathetic activation
  2. RAAS activation
  3. Natriuretic peptide release
  4. Ventricular hypertrophy
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4
Q

Cardinal symptoms of heart failure?

A
  1. SOB
  2. Fatigue
  3. Peripheral oedema
  4. PND
  5. Orthopnea
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5
Q

Signs of heart failure? (x4)

A
  1. Tachycardia
  2. Raised JVP
  3. Displaced apex beat
  4. Added heat sounds
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6
Q

Ix for HF?

A
  1. BNP
  2. CXR
  3. ECG
  4. Echo
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7
Q

Describe each of the NYHA classifications of cardiac failure?

A
  1. Class 1: no limitation, ASx.
  2. Class 2: slight limitation, mild HF
  3. Class 3: marked limitation, moderate HF
  4. Class 4: inability to carry out physical activity without discomfort, severe HF.
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8
Q

HF management:

A
  1. Lifestyle modification
  2. 1st line medication: ACEi, beta blockers
    2nd line medication: aldosterone agonists, ARB
    Diuretics to help with symptom relief
  3. Surgery: valve replacement, LV remodeling
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9
Q

Ramipril - what should be monitored?

A

Renal function: eGFR, U&E

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10
Q

What should be monitored in a patient taking beta blockers?

A

HR and BP

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11
Q

Someone with HTN what lifestyle modifications may be suggested?

A
  • Reduced salt intake
  • Reduce weight loss
  • Reduce alcohol intake
  • Stop smoking
  • Increase exercise
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12
Q

What are 3 SE of ACEi?

A
  1. Hypotension
  2. AKI
  3. Hyperkalemia
  4. Cough (ramipril dry cough)
  5. Rash
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13
Q

What are 3 ARB used in treatment of HTN?

A

Candesartan
Valsartan
Losartan

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14
Q

What 3 beta blockers can be used in the treatment of HTN?

A
  1. Atenolol
  2. Propranolol
  3. Bisoprolol
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15
Q

SE of beta blockers?

A
  1. Fatigue
  2. Headache
  3. Bradycardia
  4. Hypotension
  5. ED
  6. Cold peripheries
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16
Q

Name 3 CCB that could be used in the treatment of HTN:

A
  1. Dihydropyridines e.g. amlodipine and felodipine
  2. Diltiazem
  3. Verapamil
17
Q

What channels doe CCB act on?

A

L-type Ca2+ channels

18
Q

What diuretics are used in the treatment of HTN?

A

Thiazide-like diuretic e.g. Indapamide

19
Q

Definition of polypharmacy:

A

> =5 drugs taken regularly

20
Q

Name some complications with polypharmacy;

A
  1. Drug interaction
  2. Compliance and patient interaction due to too many medications
  3. Pill burden
21
Q

What is the 5 yr mortality of HF?

A

75%

22
Q

Give examples of primary prevention methods for heart failure?

A
  1. Healthy lifestyle
  2. Reduced alcohol intake
  3. Smoking cessation
  4. QRISK
  5. Statins
  6. Correct aggravating factors e.g. AF, HTN, DM
23
Q

QRISK >10 advice?

A

Start taking statins and modify their lifestyle

23
Q

QRisk purpose?

A

Determine patients risk of a CV event in the next 10 years.

24
Q

Give examples of secondary preventative methods for cardiac failure:

A
  1. Regularly check BP
  2. Regularly check blood cholesterol
25
Q

What is ED?

A

Inability to attain and maintain erection sufficient for satisfactory sexual performance

25
Q

Give examples of tertiary prevention methods for cardiac failure:

A
  1. Exercise based cardiac rehabilitation
  2. Revascularization procedures (e.g. PCI, CABD)
  3. Implantable defibrillators
26
Q

What might point towards a psychogenic cause of ED?

A
  1. Sudden onset
  2. Early collapse
  3. Problematic relationship
26
Q

What x5 may cause ED?

A
  1. Neuro: brain injury/spinal cord disease
  2. CVD
  3. Psychogenic: depression, anxious, psychosexual
  4. Endocrine: thyroid
  5. Meds: beta blocker, diuretic, anti-depressant
27
Q

RF for ED?

A
  1. Lifestyle e.g. smoke, fat, alcohol
  2. Hypercholesterolemia
  3. HTN
  4. DM
28
Q

What is tadalafil and how does it work?

A

Phosphodiesterase inhibitor for ED which increases the blood flow to the corpus cavernosum

28
Q

What may point towards an organic cause of ED?

A
  1. Gradual onset
  2. Normal ejaculation
  3. Normal libido
  4. RF present
28
Q

What Ix to determine cause of ED?

A
  1. FSH/LH/prolactin
  2. Fasting glucose
  3. HbA1c
  4. Lipid profile
29
Q

Management of ED?

A
  1. Treat RF
  2. Refer for counselling
  3. Phsophodiesterase inhibitor (tadalafil)
  4. Vacuum devices
  5. Injection
  6. Penile prosthesis

Phase 3a public health (7 decks)

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