atheroscelrosis

Question 1

what is one of the most common causes of death in scotland?

Answer 1

cardiovascular disease- atherosclerosis

Question 2

what is the most common cause of cardiovascular disease in the developing world?

Answer 2

atherosclerosis

Question 3

is atherosclerosis a multi-system disorder?

Answer 3

YES

Question 4

how does atherosclerosis affect the brain?

Answer 4

causes cerebral vascular disease leading to a stroke (cerebral infarction)

Question 5

how does atherosclerosis affect the heart?

Answer 5

affects coronary arteries- causing ischemic heart disease (little blood/oxygen to cardiac muscle) and myocardial infarction (no blood/oxygen to cardiac muscle)

Question 6

how does atherosclerosis affect the aorta?

Answer 6

causes abdominal aneurysm

Question 7

how does atherosclerosis affect the kidneys?

Answer 7

causes renal vascular disease

Question 8

how does atherosclerosis affect the gut?

Answer 8

causes mesenteric ischemia (abdominal pain after eating)

Question 9

how does atherosclerosis affect the legs?

Answer 9

causes peripheral vascular disease- leading to claudication in legs (pain in calves when walking due to little blood supply to legs)

Question 10

describe the pathogenesis of atherosclerosis.

Answer 10

• progresses overtime
  -damage to inner lining of endothelium
  -chronic inflammation
  -formation of atherosclerotic plaque due to accumulation of fats/platelets/cholesterol and fibrous tissue
  -causing narrowing of lumen= reduced blood/oxygen to tissues- leading to ischemic symptoms

Question 11

what are the symptoms of ischemic heart disease?

Answer 11

angina- chest pain as not enough o2 to cardiac muscle
- stable- chest pain on exertion
-unstable- chest pain at rest

Question 12

what are the symptoms of peripheral vascular disease?

Answer 12

claudication in calves when walking

Question 13

what are the symptoms of mesenteric ischemia (in gut) ?

Answer 13

abdominal pain after eating

Question 14

what happens when plaque ruptures?

Answer 14

-platelets accumulate
-thrombus forms over plaque (blood clot)
-artery blocked
-leads of symptoms of infarction (tissue death)

Question 15

how does plaque rupture affect the heart, brain, legs and gut?

Answer 15

heart- myocardial infarction
brain- cerebral infarction (stroke)
legs- acute gangrene
gut- mesenteric infarction

Question 16

what can risk factors be categorised into?

Answer 16

modifiable and non-modifiable

Question 17

what are examples of non-modifiable risks?

Answer 17

-genetics
-age
-gender (more common in males)

Question 18

what are examples of modifiable risks?

Answer 18

• smoking
  -hypertension
  -high cholesterol
  -diabetes
  -overweight
  -alcohol

Question 19

how would you prevent the progression of atherosclerosis?

Answer 19

1- lifestyle modifications e.g smoking cessation
2-control of underlying contributory conditions e.g hypertension

Question 20

how is high cholesterol controlled?

Answer 20

statins
diet
exercise

Question 21

what is the normal blood pressure level

Answer 21

120/80 mmHg

Question 22

what is considered high blood pressure levels?

Answer 22

> 140/90 mmHg or >150/90 if 80 years +

Question 23

is hypertension symptomatic or asymptomatic?

Answer 23

asymptomatic- unless very high

Question 24

what is meant by primary hypertension?

Answer 24

NO single underlying cause- but is related to smoking, obesity, alcohol etc

Question 25

what is meant by secondary hypertension?

Answer 25

when hypertension is caused by another illness eg renal or endocrine illness

Question 26

what is malignant hypertension?

Answer 26

medical emergency- 160/100 mmHg

Question 27

what drugs are used to treat hypertension?

Answer 27

combination of meds to reduce blood pressure - ace inhibitors- "prils" -angeotensin II antagonist - "sartans" WILL BE TAKING AT LEAST 1 OF THE ABOVE -diuretics- bendroflumethazide -calcium channel blocks- amlodopine -beta blockers e.g bisoprolol -"orols"

Question 28

what is the target blood pressure level for patients with hypertension?

Answer 28

140/90 mmHg

Question 29

what should you do if someone has a genetic risk factor?

Answer 29

cant change genetics- so must modify other risk factors as the more risk factors you have the greater the risk.