RAAS

Question 1

What does RAAS stand for?

Answer 1

Renin angiotensin aldosterone system

Question 2

How does renin affect angiotensin

Answer 2

Renin -> angiotensinogin -> angiotensin I -> angiotensin II -> vasoconstriction

Question 3

How can the system be interrupted to lower BP

Answer 3

ACE inhibitors stop conversion of angiotensin I into angiotensin II and prevents vasoconstriction

Question 4

Why might a pt struggle to cope on ACE inhibitors

Answer 4

Persistent cough maybe due to breakdown of substances in endothelium of the lung

Question 5

What to prescribe if patient struggles on ACE inhibitors

Answer 5

ARBs

Question 6

How to ARBs work

Answer 6

Block angiotensin II receptors

Question 7

What does atrial natriuretic peptide (ANP) do?

Answer 7

Secretes NaCl and H20 from kidneys

Vasodilation effect

Fluid movement into extracellular space

Question 8

Why is ANP measured?

Answer 8

Can suggest HF if levels are high due to stretching of the heart and increased workload seen in HF and increased blood vols

Question 9

What is the classification system used for HF

Answer 9

NY heart association

Question 10

NICE guidelines for HF treatment

Answer 10

ACE inhibitors
B blockers
Mineralocorticoid receptor blocker
Diuretics

Question 11

What does an echo show in HF?

Answer 11

EF <50% suggests impaired LV

Question 12

What does a chest X ray show in HF

Answer 12

Cardiothoracic ratio >50% (heart is 50% of cardiothoracic space)