MNT 1 Exam 1 Redo

Foster-Nicholas LLU

What test measures calcium in coronary arteries?

Electron Beam Computed Tomography

Which test is invasive?

angiography

What was the name of the largest epidemiologic study on CVD?

Framingham Heart Study

The 7 risk factors of the Framingham Heart Study

age, sex, blood pressure, total and HDL cholesterol, smoking, glucose intolerance, and left-ventricular hypertrophy

What is emphasized for weight maintenance in children?

activity

What is an independent predictor of CHD risk?

fibrinogen

Factors associated with elevated fibrinogen

smoking, diabetes, hypertension, obesity, sedentary lifestyle, high TG, genetic factors

C-reactive protein is synthesized in the…

liver

Homocysteine increases chances of…

stroke

Smoking and oral contraceptives causes _____ for CVD

10 times

The effect of stress is comparable to…

hypertension

What is the leading cause of death?

heart disease

Atherosclerosis/fatty streak formation

Injury → artery lining more permeable → plaque and blood clots → MI (myocardial infarction) or CVA (cerebrovascular accident)

What does CVA mean?

cerebrovascular accident

What leads to a thrombus?

fatty streak → atheroma → thrombus

Name the 4 hyperlipidemias

Familial hypercholesterolemia, polygenic familial hypercholesterolemia, familial combined hyperlipidemia, familial dysbetalipoproteinemia

Which hyperlipidemia involves tendon xanthomas?

familial hypercholesterolemia

Risk factors that have to be present for familial dysbetalipoproteinemia

older age, hypothyroidism, obesity, diabetes, other dislipidemias, total cholesterol 300-600 mg/dL

TG of ____ has increased risk for premature ASCVD and PVD

400-800

Fiber recommendation

25-30 g/day

Mediterranean diet features a greater number servings of fruits and veggies- more than ___ servings a day

2

The Mediterranean diet emphasizes…

root veggies, green veggies, whole grains, fatty fish, less lean red meat, low-fat dairy products, nuts and legumes, olive oil and canola oil

DASH diet emphasizes…

high in fruits and veggies, low-fat dairy products, whole grains, fish, nuts, low in animal protein, low in sugar

What is the only type of diet alone consistently shown to reverse CVD in trials?

vegan diet

The AHA recommends less than _____% of calories should be saturated fat

7

Bile acid sequestrants (binds bile acids in gut) include…

Welchol, Colestid, Locholest, Prevalite

Why is fiber helpful for preventing CVD?

• Fiber binds bile acids, which lowers serum cholesterol

• Bacteria in the colon ferment the fiber to produce acetate, propionate, and butyrate, which inhibit cholesterol synthesis

Nicotinic acid meds inhibit lipoprotein synthesis and include…

Niacor, Niaspan, Slo-Niacin

HMG-CoA reductase inhibitors (statins) lower blood cholesterol by inhibiting the rate-limiting enzyme in cholesterol synthesis. These include…

Lipitor, Crestor, Zocor, Pravachol, Mevachor, Livalo

Fibric acid derivatives lower triglycerides by inhibiting production of VLDL in the liver. These include…

Tricor, Antara, Triglide, Lopid

What medical intervention involves a catheter/balloon inserted through artery to break up plaque deposits?

PCI (percutaneous coronary intervension)

Systolic BP = ____, diastolic BP = _____

during contraction, during relaxed phase

Normotensive BP

less than 120/80

Recommended physical activity

30-40 minutes of moderate intensity aerobic exercise 3-4 days of the week

Thiazide diuretics inhibit reabsorption of Na and Cl, and include…

Hydrochlorothiazide, chlorothiazide, metolazone, chlorthalidone

Loop diuretics inhibit the reabsorption of Na. Include…

Lasix, Bumetanide, Torsemide

Potassium sparing diuretics do not promote the secretion of potassium into the urine, and include…

Spironolactone, amioloride, triamterene

Beta blockers manage cardiac arrhythmias, cardioprotection after a heart attack, and HNT. Include…

Propranolol, Atenolol, Metoprolol

ACE inhibitors block conversion of angiotensin I to angiotensin II, and include…

Benezapril, Ramipril Enalapril

Angiotensin receptor blockers inhibit angiotensin II from interacting with receptor. Include…

Candesartan, Valsartan, Losartan

Calcium channel blockers include…

Diltiazem, Verapamil, Bepridil

Each ____ of wt loss leads to reduction of 1 mn Hg of systolic BP and Diastolic BP

kg

Magnesium rich foods include…

Leafy greens, nuts, seeds, legumes, and whole grains

Potassium rich foods include…

Leafy greens, bananas, beets, legumes

Low sodium = ____ mg/serving

140

Foods high in sodium

Soup, instant mashed potatoes, frozen meals, processed meats, condiments and dressings, pickles and green olives, snacks

Systolic HF: heart cannot ____ blood efficiently out of the heart

pump/eject

Diastolic failure: heart cannot ___ with blood as it should

fill

Classifications of heart failure

• Class I: no undue symptoms, no limitation of physical activity

• Class II: slight limitation of physical activity, patient comfortable at rest

• Class III: marked limitation of physical activity, patient comfortable at rest

• Class IV: inability to carry out physical activity without discomfort, symptoms of cardiac insufficiency or chest pain at rest

Symptoms of HF

Orthopnea, syncope, fatigue, dyspnea, edema

Orthopnea

shortness of breath while lying down

Syncope

loss oxygen/consciousness, fainting

HF restricted sodium intake of ___ and restricted fluid intake of ___ initially and ____ when severe

<2000mg/day, <2000mL/day, 1000-1500mL/day

What is the treatment for end stage HF?

cardiac transplantation