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PA40256 > CV Risk > Flashcards

CV Risk Flashcards

(49 cards)

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1
Q

What are the non-modifiable CV risk factors?

A 
Age
Family history
Gender
Ethnicity
Co-morbidities
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2
Q

What are the modifiable CV risk factors?

A 
HTN
Smoking
Abnormal blood lipids
Physical inactivity
Obesity
Unhealth diet
Stress
Alcohol use
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3
Q

What are the 3 main components of cigarette smoke?

A

Tar
Carbon monoxide
Nicotine

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4
Q

What is the half life of nicotine in the blood?

A

90-120 minutes

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5
Q

What does ‘AAA’ stand for?

A

Ask Advise Act

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6
Q

What are the 3 licensed medications for smoking cessation?

A

NRT
Bupropion
Varenicline

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7
Q

What was Bupropion originally developed as?

A

An antidepressant

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8
Q

When should Bupropion be started?

A

1 week before the quit date

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9
Q

What is the dosing regime for Bupropion?

A

1 x 150mg OD first week

2x 150mg OD from quit date for 7-11 weeks

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10
Q

How does Vaernicline work?

A

Reduces cravings and withdrawal symptoms

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11
Q

Which has fewer side effects- Bupropion or Varenicline?

A

Varenicline

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12
Q

One unit of alcohol is equal to what?

A

1/2 pint of beer, lager or cider

50ml of fortified wine e.g. sherry or port

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13
Q

What are the BMI classes?

A 
<18.5 underweight
18.5-25 Desirable
25-30 Overweight
>30 Obese
30-35 Class 1 obese
35-40 Class 11 obese
>40 Morbidly obese
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14
Q

What should waist circumference be?

A

Men < 94cm

Women<80cm

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15
Q

What ages should QRISK2 be used for?

A

(25)40-85 years

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16
Q

Specialist assessment should be arranged if total cholesterol or non-HDL is over what?

A

TC: 9.0mmol/L
non-HDL: 7.5mmol/L
TGs: 20mmol/L

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17
Q

What should be done in people with TG concentration between 10 and 20 mmol/L?

A

Repeat with fasting test (5- 14 days later)

Review potential secondary cause

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18
Q

What are statins?

A

HMG CoA reductase inhibitors

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19
Q

What do NICE recommend for CV secondary prevention?

A

Atorvastatin 80mg

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20
Q

What do NICE recommend for CV primary prevention?

Study These Flashcards
A

Atorvastatin 20mg

21
Q

Statins should be offered to people with a CV risk of what?

22
Q

For people on high intensity statins, what is the aim for reduction in non-HDL cholesterol?

23
Q

What are the potential SEs for statins?

Study These Flashcards
A

Myopathy

Rhabdomyolysis

24
Q

Which statin does amlodipine interact with?

Study These Flashcards
A

Simvastatin

dose>20mg

25
How often should TC, HDL and non-HDL be monitored after initiation of a statin?
3 months | and annually thereafter
26
Atorvastatin does not have a license for primary prevention- true or false?
True | -some local formularies remain with simvastatin 40mg
27
5Kg weight loss equates with what BP reduction?
5mmHg
28
What are the low intensity statins?
Fluvastatin 20, 40 Pravstatin 10,20 40 Simvastatin 10
29
What are the medium intensity statins?
Fluvastatin 80 Simvastatin 20, 40 Atorvastatin 5
30
What are the high intensity statins?
Simvastatin 80 Atorvastatin 20, 40, 80 Rosivastatin 10,20, 40
31
What statin does amlodipine and diltiazem interact with?
Simvastatin
32
What is first line statin for people with >10% CV risk (primary prevention)?
Atorvastatin 20mg
33
Statins should be discontinued if creatine kinase is what?
> 5 times upper limit of normal
34
``` What % reduction do a) low intensity b)medium intensity c) high intensity statins cause? ```
a) 20-30% b) 31-40% c) >40%
35
What statin treatment should people with CVD have?
Atorvastatin 80mg
36
QRISK will underestimate risk in who?
People treated for HIV People with serious mental health problems People taking meds that can cause dyslipidaemia, such as antipsychotics, corticosteroids, or immunosuppressants. People with autoimmune disorders
37
Antiplatelet treatment should be prescribed for secondary prevention of CV events in people with what?
``` Angina Previous MI Previous stroke or TIA Peripheral arterial disease AF ```
38
Which antiplatelet is indicated for the following: a) MI b) Coronary or carotid interventions such as stenting c) Ischaemic stroke and TIA d) Peripheral artery disease e) Multivascular disease
a) Aspirin 75mg (Clopidogrel 75mg alternative) b) Aspirin 75mg with Clop 75, prasugel 10 or ticagrelor 90 bd c) Clop 75 d) Clop 75 e) Clop 75
39
What should be prescribed alongside clopidogrel if person has high risk of GI adverse effects?
Lansoprazole 15mg OD
40
What are appropriate first line PPIS?
Lansoprazole, omperazole, pantoprazole
41
If a smoker's attempt to quit is unsuccessful, do not offer a repeat prescription within how many months?
6 months
42
When should Ezetimibe be an option for reducing CV risk?
High risk patients who are intolerant to 3 statins
43
What should be done if LFTs are raised when wanting to initiate a statin?
Do not exclude people who have liver transaminase levels which are raised but are less than 3 x the upper limit of normal
44
What should be done if creatine kinase is raised when wanting to initiate a statin?
If more than 5 x the upper limit of normal, re-measure after 7 days. If still high, do not start statin treatment. If high but less than 5 x upper limit of normal, start or reduce to a lower dose of statin once symptoms have resolved.
45
QRISK2 risk assessment tool should be used to assess who?
For primary prevention of CVD in people 84 or under In people with type 2 diabetes
46
QRISK2 should not be used to assess who?
People with type 1 diabetes With an eGFR < 60ml/min and/or albuminuria Pre existing CVD At high risk of developing CVD because of familial hypercholesterolaemia
47
QRISK will underestimate risk in people with what?
HIV infection Serious mental health problems Taking meds that can cause dyslipidaemia e.g. antipsychotics, corticosteroids or immunosuppressant drugs Autoimmune disorders e.g. systemic lupus erythematosus and other systemic inflammatory disorders
48
What are the possible secondary causes of dyslipidaemia?
``` Excess alcohol Uncontrolled diabetes Hypothyroidism Liver disease Nephrotic syndrome ```
49
When should statins be stopped in pregnancy?
Advise women planning pregnancy to stop taking statins 3 months before they attempt to conceive and not to restart them until breastfeeding is finished

PA40256 (10 decks)

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