Angina & athlerosclerosis Flashcards Preview

Yr 2 - Pharmacology > Angina & athlerosclerosis > Flashcards

Flashcards in Angina & athlerosclerosis Deck (109)
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1

What is angina?

A restriction in blood supply (most often talked about in heart but can even occur in the mouth!)

2

What is abdominal angina?

Post prandial (after eating) abdominal pain

3

What is ludwig's angina?

A serious infection of the floor of the mouth

4

What is vincent's angina?

trench mouth and necrotic gum tissue

5

What is angina tonsillaris?

An inflammation of the tonsils

6

What is herpangina?

Pharyngeal blisters caused by Coxsackie A virus or echovirus

7

What is angina pectoris?

Pain localised to the chest 

Acute or chronic (on tablets)

8

What causes angina?

  1. Restricted blood supply = increased metabolite build up = decreased oxygen supply and increased cardiac work 
  2. narrowing of the coronary artery (atheroma, thrombus etc.)
  3. vasospasm of the coronary artery (overly reactive vessels and drugs - e.g. cocaine & smoking)
  4. severe anaemia (cannot carry enough oxygen to the heart)

 

9

What are the 3 types of angina pectoris?

  • Chronic stable = exercise induced -> normally take medication
  • Unstable = sudden rupture of athleroscelrotic plaque -> blocks down stream arteries
  • Prinzmetal's (angina inversa) = vasospasm = oversensitivity to vasoconstrictors

10

From which age do athlerosclerotic plaques start to build up from?

10 years old

11

What are the risk factors for coronary heart disease (8)?

  • Diabetes
  • Family history
  • high blood pressure
  • High LDL cholestrol & low HDL cholestrol
  • male
  • Lack of regular exercise
  • Obesity
  • Smoking

12

What is coronary heart disease?

Athlerosclerosis in the coronary arteries 

(most common cause of death in UK)

13

Which is more important... having good (LDL) or bad (HDL) lipoproteins or having the right balance of LDL and HDL?

Having the right balance

14

What happens to the HDL:LDL ratio with age?

Decreases = increased MI risk

15

What happens to HDL:LDL ratio with statins?

Increases = less MI risk 

(although other drugs that increase the ratio )

16

Does eating fewer saturated fats in your diet increase or decrease your risk for CHD?

Decrease because less obese!

17

What are the 3 stages of developing atheroma?

  1. Damage to epithelia
  2. Cholesterol accumulation = inflammatory response -> produces foam cells
  3. Foam cell degeneration  = increased stiffness of artery wall = shear stress = continued worsening damage

18

What causes activation of platelets?

  • contact with intima matrix (sheds microparticles = attracts monocytes = proliferate & differentiate = phagocytes)

19

What is a coronary artery bypass graft?

takes a blood vessel from another part of the body

20

List 3 alternative treatments for surgical treatment of atheroma:

  • Rotational bur
  • Balloon
  • Stent (wire coil)

21

What diastolic blood pressure is required for someone to be hypertensive?

>95mmHg

22

What are the potential complications of hypertension (6)?

  • Stroke (athlerosclerosis)
  • kidney disease
  • eye disease
  • diabetes
  • pre-eclampsia (hypertension & protein in urea, swelling of feet, ankles, face & hands, severe headache, vision problems & pain just below ribs -> occurs if problem with placenta)
  • erectile dysfunction

23

What is primary hypertension:

what % of cases does it make up?

What are its two main causes?

  • 90-95% cases (essential/idiopathic)
  • obesity (BMI>25)
  • genetic

24

What is secondary hypertension:

what % of cases does it make up?

What are the 4 main causes?

  • 10% of cases

 

  • renal/renovascular disease
  • endocrine disease (e.g. phaeochomocytoma- tumour of adrenal medulla, cushings syndrome - excess cortisol, acromegaly - excess aldosterone, hypo/hyperthyroidism, pregnancy)
  • coarcation of aorta (malformation of aorta)
  • iatrogenic (hormonal/oral contraceptive & NSAIDs)

25

What are the consequences of hypertension?

Hypertrophy of ventricular (esp. left) wall -> muscle has to work harder for long time = increased risk of sudden cardiac death

26

What does ALLHAT trial stand for?

The antihypertensive and lipid lowering to prevent heart attack trial

27

why in the ALLHAT trial was the alpha blocker doxazosin discontinued?

There was an excess no. of deaths

28

In the ALLHAT trial what was discovered about the efficacy of the following drugs:

Thaizide diuretic (chlorthalidone)

ACE inhibitor (lisinopril)

Ca channel blocker (amlodipine)

All of equal efficacy

29

Which type of diabetes is hypertension often found in conjunction with?

Type II

30

Which % of type II diabetic patients die from cardiovascular disease?

70%