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2 - Diseases Of The Human System > Chronic CV Diseases - 1 > Flashcards

Chronic CV Diseases - 1 Flashcards

(42 cards)

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1
Q

What is hypertension?

A

raised blood pressure

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2
Q

What are the values for hypertension?

A

systolic >140mmHg
diastolic >90mmHg

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3
Q

What do ambulances measure?

A

mean arterial pressure

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4
Q

What are the risk factors for hypertension?

A
  • Age
  • Race
  • Obesity
  • Alcohol
  • Family History
  • Pregnancy
  • Stress
  • Drugs
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5
Q

What drugs cause hypertension?

A
  • NSAIDs
  • corticosteroids
  • oral contraceptives
  • sympathomimetics
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6
Q

What can hypertension do to atherosclerosis?

A

accelerates it leading to
* Myocardial Infarction
* Stroke
* Peripheral Vascular disease

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7
Q

What can hypertension do to the kidneys?

A

renal failure

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8
Q

What are rare triggers that cause hypertension?

A
  • Renal Artery Stenosis
  • Endocrine Tumours
  • Phaeochromocytoma (adrenaline)
  • Conn’s Syndrome (aldosterone)
  • Cushing’s Syndrome (cortisol)
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9
Q

What is the most common reason hypertension occurs?

A

Likely genetic failure of autoregulation control of blood vessel wall constriction

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10
Q

What are the signs and symptoms of hypertension?

A
  • Usually NONE
  • May get headache
  • May get Transient Ischaemic Attacks ‘mini strokes’ with full recovery in 24 hours
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11
Q

What are indications for further investigation?

A
  • Young patient
  • Resistant hypertension despite ‘adequate’ treatment
  • Accelerated hypertension
  • ‘unusual history’
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12
Q

What is phaeochromocytoma?

A

adrenergic tumour that releases adrenaline excess causing vasoconstriction

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13
Q

How does cushing’s syndrome cause hypertension?

A

Cortisol creates salt and water retention

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14
Q

How does renal artery stenosis cause hypertension?

A

narrowing of artery causes reduced blood flow which causes autoregulation to promote renin > RAAS to correct precieved low blood pressure

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15
Q

What are tests to diagnose hypertension?

A
  • Urinalysis
  • Serum Biochemistry
    (electrolytes, urea & creatinine)
  • Serum Lipids
  • ECG
    occasionally
  • renal ultrasound, renal angiography, hormone estimations
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16
Q

What is the goal BP after treatment?

A

< 120/90 mm Hg

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17
Q

What are the treatments for hypertension?

Study These Flashcards
A
  • Modify risk factors - weight loss, exercise
  • Single daily drug dose – thiazidediuretic, betablocker, calcium channel antagonist, ACE inhibitor
18
Q

What are the individual side effects of the daily drugs?

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A
  • thiazidediuretic (gout)
  • betablocker (worsen COPD & Asthma)
  • Calcium Channel antagonist (gingival hyperplasia)
  • ACE inhibitor (cough)
19
Q

What is heart failure?

Study These Flashcards
A

output of the Heart is incapable of meeting the demands of the tissues

20
Q

What is high output failure and what are examples of it?

Study These Flashcards
A

High output failure – demands of the system have increased beyond the capacity of the pump
* anaemia, hyperthyroidism

21
Q

What is low output failure and what are examples of it?

Study These Flashcards
A

Low output failure – pump is failing and not strong enough to force liquid around the body
* cardiac defect e.g. MI, valve disease

22
Q

What are the sites of heart failure called?

Study These Flashcards
A
  • Left Heart Failure
  • Right Heart Failure
  • Congestive heart failure – both sides
23
Q

What are the causes of low output failure?

Study These Flashcards
A

Myocardial weakness (MI)
Pressure overload (hypertension)
Irregular heartbeat (arrythmias)
Drugs

24
Q

What are the drugs that can cause low output heart failure?

Study These Flashcards
A

anticancer drugs
corticosteriods
beta blockers

25
What are the symptoms and signs of heart failure (depending on side affected)?
**Left Heart** (lungs & systolic effects) dyspnoea (shortness of breathe) tachycardia (to compensate) fatigue low urine output (to maintain BP and as reduced BF in kidneys) build up of fluid in lungs due to backing up **Right Heart** (venous pressure elevated) swollen ankles (due to backing up of blood) ascites (fluid in abdomen) raised JVP tender enlarged liver (impaired blood flow to liver) poor GI absorption
26
What is pitting oedema?
Fluid accumulation in superficial tissues – can be squeezed out of the way by pressure The higher the ’pitting’ is found, the worse is the heart failure. Thigh > Calf > Ankle in severity
27
What is the acute treatment of heart failure?
emergency hospital management * Patient is acutely short of breath and gasping. Lungs filled with fluid (oedema) * Oxygen, morphine, frusemide (loop diureric to rapidly remove the fluid)
28
What are drugs used in treatment of chronic heart failure?
* Diuretics - increase salt and water loss * ACE inhibitor - reduce salt/water retention * Nitrates - reduce venous filling pressure * Inotropes - digoxin
29
What drugs are stopped for heart failure?
negative inotropes - beta blockers
30
What is the less common treatment of heart failure?
assist pumps heart transplant
31
What valves are under the highest pressure?
mitral and aortic valves
32
What are the causes of valve disease?
* Congenital abnormality * Myocardial infarction * Rheumatic Fever * Dilatation of the aortic root (syphilis, aneurysm formation)
33
What is the usual congenital abnormality?
bicuspid aortic valve instead of tricuspid
34
What side valves most commonly fail?
aortic and mitral
35
What does valve stenosis cause?
narrowing of the valve opening
36
What are the tests done for valve disease?
ultrasound scan doppler ultrasound scan
37
What is the treatment and when is it done?
prosthetic valve replacement done before there is evidence of heart failure to give highest long term success rate
38
If the prosethetic is mechanical, what is also prescribed?
anticoagulants to avoid clots (warfarin)
39
What are the two types of valves?
tissue valve (porcine, pig) metal valve
40
What valve lasts longer?
metal lasts up to 30 years tissue lasts less than 10 years
41
What valve makes a noise?
metal causes a ticking noise
42
To avoid endocarditis risk what is sometimes given before valve replacement?
antibiotic prophylaxis

2 - Diseases Of The Human System (19 decks)

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