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Flashcards in Cardiology Deck (40):
1

Who should be assessed for CV Risk?

Age>40, borderline hypertension, CKD, T2DM, FH of CVD, severe psoriasis, RA, mental health, SLE, migraines+aura, erectile drugs.

2

Who should be assumed high risk and should not get scored?

T1DM, CVD, >85y, familial hyperlipidaemia.

3

What goes into Q-Risk calculation?

age, gender, BMI, ethnicity, postcode, smoking status, PMH, FH, BP, TC:HDL.

4

How do you manage QRISK <10%?

lifestyle advice, review other comorbidities and treatment. Repeat in 5 years.

5

How do you manage QRISK >10%?

lifestyle advice + atorvastatin 20 mg

6

Treatment for T1DM w/out established CVD?

Offer atorvastatin 20mg if over 40y/o, DM for >10y, nephropathy or other CVD risk factors. Consider for everyone else.

7

Treatment for T1DM with CVD?

Offer atorvastatin 80mg

8

Managing >85y/o?

consider risk benefit

9

Mgt of familial hyperlipidaemia?

specialist care

10

CKD 3-5 or (ACR) >3 mgt?

atorvastatin 20mg

11

established CVD mgt?

atorvastatin 80mg

12

When do you initiate antihypertensive treatment?

EITHER stage 1 hypertension and end organ damage/CVD risk >20% OR Stage 2/Severe HT.

13

Step 1 Antihypertensive treatment for someone aged <55 years?

ACE inhibitor

14

Step 1 Antihypertensive treatment for someone aged >55 years or Black?

CCB (give thiazide diuretic like indapamide instead if HF)

15

Step 2 anti-hypertensive treatment?

ACE-I + CCB

16

Step 3 anti-hypertensive treatment?

ACE-I+CCB+Indapamide

17

Precaution with adding diuretic in step 2 anti-hypertensive treatment?

if they use beta blockers could increase risk of diabetes.

18

Step 4 anti-hypertensive treatment?

step 3 plus low dose spironolactone (if K<45) or alpha blocker or beta blocker.

19

When would you consider a beta blocker in young people?

can't use ACE-i, non menopausal women and increased sympathetic drive.

20

When do you refer for ambulatory BP Monitory?

if BP >140/90 at clinic

21

Investigations for end organ damage in people with suspected hypertension?

Urine (haematuria and ACR)
ECG
Fundoscopy
Bloods (gluc, U&Es, eGFR, cholesterol)

22

When do you do investigations for end organ damage?

If BP >140/90 at clinic

23

Normal ABPM reading and management?

<135/85. Monitor every 5 years (if above 60 then yearly monitoring)

24

Stage 1 Hypertension values?

>140/90 (ABPM >135/85)

25

Stage 2 Hypertension values?

>160/100 (ABPM >150/95)

26

Severe hypertension values?

>180/110

27

How would you manage a S1 HT patient aged <40 years with no evidence of organ damage, CV/renal disease or diabetes?

Seek specialist help for secondary causes of hypertension

28

What would make you offer anti hypertensive drug treatment to a patient under the age of 80 with S1 HT?

if they have:
target organ damage
CVD
Renal disease
Diabetes
QRISK >20%

29

Management for S2 HT?

offer anti-hypertensive drug treatment

30

Management for severe hypertension?

consider starting anti hypertensive therapy immediately.

31

When do you refer severe hypertension to specialist care?

if they have:
accelerated HT (>180/110) + retinopathy
Suspected phaechromocytoma

32

Guideline for alcohol intake?

14 units per week with no more than 3 units per session.

33

Secondary causes of hypertension?

OSA, hyperthyroid, hypothyroid, conn's, cushing's, phaeochromocytoma, RAS, CKD.
DRUGS: NSAIDS, Illegal drugs, caffeine, OCP

34

What would be first line for a patient with hypertension and diabetes and why?

ACE-I because it's cardio and renal protective

35

1st line treatment for patient with HT and CKD?

ACE-I (cardio and renal protective)

36

1st line treatment for a pt. with HT and HF

ACE-I (cardio and renal protective)

37

1st line treatment for a pt. with hypertension and coronary artery disease?

beta blockers to reduce cardiac load

38

1st line treatment for a pt. with HT and AF

CCB and beta blocker for rate control

39

1st line treatment for a pt. with HT and BPH?

doxasozin

40

1st line treatment for a pt. with HT and Raynaud's disease?

CCB for vasodilation