CVD

What information do you need for a QRISK calculation?
Age; Sex; Ethnicity; Postcode; smoking; diabetes; angina/ HA; kidney disease; BP; arthritis; blood sugar
1 of 50
What is the primary prevention treatment for CVD for people with greater than 10% QRISK score?
Atorvastatin 20mg
2 of 50
Who should you offer stating trt to?
Patients w/ diabetes; over 40; neuropathy; other CVD risk factors
3 of 50
What is the secondary prevention trt for CVD?
Atorvastatin 80mg
4 of 50
What is the monitoring required for patients on statins?
LFT within 3 months than annually; blood glucose levels (as may increase)
5 of 50
What are the symptoms of an ischaemic event?
chest pain; nausea; sweaty; breathlessness; palpitations
6 of 50
how do you diagnose a STEMI/NSTEMI/UA (3 ways)
ECG - type of ACS and area of damage; Blood test for troponin; CV scoring system (GRACE score)
7 of 50
what does the grace score show
6 month mortality
8 of 50
what would an ECG for a STEMI show
persistant longer than 20 mins ST segment elevation
9 of 50
what would an ECG for a NSTEMI show
non persistant ST segment elevation
10 of 50
risk factors for ACS
high BP; lack of exercise; diabetes; high cholesterol; high BMI; alcohol; smoking; stress
11 of 50
Initial manadement of ACS (once admitted/ in ambulance)
GTN spray; oxygen; metoclopramide 10mg (anti emetic); morphine 1-2mg; aspirin 300 mg
12 of 50
management of STEMI
stent and tricagrelor 180mg --> 90 mg/ clopidogrel 300mg --> 75mg
13 of 50
management of NSTEMI
tricagrelor 180 --> 90 mg & fondaparinux s/cut until angiogram/ discharge & isosorbide dinitrate IV for pain
14 of 50
Secondary prevention of ACS
antiplatelets (tricagrelor & aspirin); B-blocker; ACEi; GTN spray
15 of 50
monitoring of ACS medicine
BP; renal function; blood platelets; SE (cough); cardiac rehabitilation
16 of 50
complications of diabetes
retinopathy; neuropathy; CVD; kidney disease; ketoacidosis
17 of 50
hypoglycaemia treatment under 4mmol/L
eat fast acting carb 15-20 g such as jelly babies; sugary drink, then have a slow acting carb such as sanwhich. check glucose levels 20 mins after
18 of 50
Deep vein thromboembolism symptoms
unilateral; swelling; red; ache; heavy feeling; score is or above 2
19 of 50
pulmonary embolism
hypotension; fainting; tachycardia; concurrent; blood stained cough; chest pain; score is or above 4
20 of 50
tests to identify PE or DVT
positive D Dimer test; CTPA to determine PE; VQ visualises lungs
21 of 50
clotting risk factors
over 60; broken bones; cancer; immobility; obesity; smoking; CVD/ lung disease
22 of 50
bleeding risk factors
surgery; hypertension; impaired liver function
23 of 50
treatment PE/ DVT
LMWH; UFH; warfarin; NOAC/ DOACs; alteplase; stocking
24 of 50
monitoring parameters for LMWH (4)
platelet counts; renal function; potassium; bleeding
25 of 50
advantages of LMWH over UFH
longer more predictable half life; less intense monitoring;
26 of 50
monitoring parametes for warfarin
INR between 2.5-3.5 every 3 months; LFT; bleeding; blood counts
27 of 50
what to do in warfarin overdose
vitamin k; lower dose of warfarin; fresh frozen plasma
28 of 50
interactions of warfarin
hepatically metabolised by CYP450 e.g. tamoxifen; foods high in vit k
29 of 50
Example of DOACS
rixoraxaban; dabigatran
30 of 50
what should you not use DOACs with
Heparins
31 of 50
monitoring of DOACs
LFT; renal function; prothrombin time; BP. no routine monitoring required
32 of 50
what are the 4 terms assosciated with Atrial Fibrillation?
lone; permenent; persistent; paroxysmal
33 of 50
symptoms of Atrial fibrillation
palpitations; breathesses; exercise intolerance; fainting; irregular pulse; tachycardia
34 of 50
how do you diagnose AF
ECG; chest X ray; blood test
35 of 50
causes of AF
stress; caffeine; alcohol; drugs; hypertension and hyperthyroidism
36 of 50
explain the CHA2DS2VASc score and what score to watch out for
congestive heart failure; age over 75; diabetes; stroke; vascular disease; age 65-74; sex (female). Refer any patient with score of 2/more, refer male patient with score of 1
37 of 50
explain the HAASBLEDH bleeding score
Hypertension; abnormal liver function; abnormal renal function; stroke history; bleeding history; labile INR; elderly; drugs; harmful alcohol consumption
38 of 50
describe the rate control drugs someone with AF might be on
Digoxin; CCB; B-blocker
39 of 50
describe the rhythm control drugs someone with AF might be on
Amiodarone; dronadarone; B-blocker sotalol; pill in pocket
40 of 50
1st Line treatment for chronic heart failure
ACEi/ARB/hydralazine w nitrate + B-blocker
41 of 50
2nd Line treatment for chronic heart failure
spironlactone; ARB; hydralazine; sacubitril
42 of 50
3rd Line treatment for chronic heart faulure
digoxin; ivabradine
43 of 50
when should you refer a patient for hypertension?
BP above 140/90; CVD risk above 20%; high blood sugar/ cholesterol
44 of 50
explain the 3 stages of hypertension
at or above: 1 - 140/90; 2 - 160/100; 3 - 180/110
45 of 50
when is the target for patients 130/80?
if they have diabetes; other CVD risks; retinopathy; kidney disease
46 of 50
what lifestyle factors can someone with hypertension change
drink under 14 units per week; BMI between 20-25; reduce salt intake; 30 min exercise 3 times a week; stop smoking; oily fish; reduce sat fats
47 of 50
what is the 1st line treatment for patients with hypertension (include those under 55; over 55 and black people)
CCB for those over 55 and black; ACEi for under 55.
48 of 50
describe the 3 types of CCB
dihydropyridines (amlodopine); phenylalkamines (verapamil); benzothiazipine (diliazem)
49 of 50
treatment for afro-caribbean patients w/ other co-morbidities with hypertension
CCB/diuretic + ACEi
50 of 50

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Card 2

Front

What is the primary prevention treatment for CVD for people with greater than 10% QRISK score?

Back

Atorvastatin 20mg

Card 3

Front

Who should you offer stating trt to?

Back

Preview of the front of card 3

Card 4

Front

What is the secondary prevention trt for CVD?

Back

Preview of the front of card 4

Card 5

Front

What is the monitoring required for patients on statins?

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