Public Health
What is the Australian CVD Risk Calculator?
Tool used to estimate a person’s chance of having a heart attack or stroke in the next 5 years. Risk categorised into low, intermediate or high.
Which lipoprotein carries dietary fat from the intestine?
Chylomicron
According to standard clinical guidelines, a Body Mass Index (BMI) at or above this numerical value is the threshold for classifying a patient as obese.
30kg/m^2
This structure is the natural pacemaker of the heart and initiates each heartbeat through spontaneous depolarisation.
sinoatrial (SA) node
Most pulmonary thromboemboli originate from:____________________
Thrombi in the deep veins of the lower limbs
What is primordial prevention?
The earliest tier of prevention which targets the social and environmental conditions (housing, food access, smoke-free spaces) that allow risk factors to develop in the first place, rather than targeting the risk factors themselves
How are fatty acids absorbed into intestinal cells?
They form micelles, which carry them to enterocytes for absorption.
Under the 2017 AHA/ACC guidelines, Stage 1 Hypertension is diagnosed when the systolic blood pressure consistently reaches or exceeds this specific value in mmHg.
130/80mmHg
This phase of the ventricular action potential is unique to cardiac muscle and is produced mainly by slow calcium influx through L-type calcium channels.
Plateau phase (Phase 2)
What is a mural thrombus?
A non-occlusive thrombus attached to the wall of a cardiac chamber or large artery
What is a coronary artery calcium (CAC) score?
A low-dose CT scan that measures calcified plaque in the coronary arteries and can reclassify a person’s CV risk category.
How do foam cells form in an artery?
Macrophages take up too much modified LDL and become filled with cholesterol.
Chronic untreated hypertension often leads to this structural change in the heart, characterized by the thickening of the main pumping chamber's wall.
Left ventricular Hypertrophy
A clinically vital zone in the posteroinferior right atrium, bounded by the Tendon of Todaro, the septal leaflet of the tricuspid valve and the coronary sinus orifice. Used to locate the AV node.
Triangle of Koch
What are the 3 components of Virchow’s triad?
Abnormal blood flow
Hypercoagulability
Endothelial injury
What is the DASH diet?
(for full marks: what it stands for and what it involves)
Dietary Approach to Stop Hypertension.
Emphasises fruit, vegetables, wholegrains and low-fat dairy while limiting saturated fat, sodium and added sugars.
How does lipoprotein lipase deliver fat to tissues?
It breaks triglycerides into free fatty acids, which enter muscle or adipose tissue.
The reduction of which specific mineral is emphasized to help lower blood pressure and prevent fluid retention and WHY? (reason required for full points)
Sodium
High sodium intake leads to water retention and increased vascular resistance, both of with increase BP
A patient develops hypertension. This factor increases, causing stroke volume to decrease and end-systolic volume to increase.
Increased afterload
In the pharmacological management of HFrEF (heart failure with reduced ejection fraction), which four drug classes are recommended for all patients?
ARNI/ACE inhibitor, beta-blocker, MRA, SGLT2 inhibitor
What is the treatment for heart failure with reduced ejection fraction (HFrEF)?
Bonus: 500 pts What do these 4 drugs do?
Four-drug combination: RAS blockade (ACE inhibitor/ARB/ARNI), beta blocker, MRA and a SGLT2 inhibitor
What do these drugs do?
ARNI/ACE inhibitors stop maladaptive remodelling (e.g. fibrosis or hypertrophy) resulting from the body’s RAAS overactivation that can reduce CO and result in arrhythmias.
SGLT2 inhibitors do many things e.g. reduce cardiac workload, improve mitochondrial efficiency, limit arrhythmia risk.
MRAs prevent aldosterone-driven fibrosis,
Beta blockers prevent further receptor downregulation and desensitisation -> protect remaining ability of the heart to respond to adrenergic signalling.
How do statins lower blood LDL?
They block HMG-CoA reductase, so the liver makes more LDL receptors and removes more LDL from the blood.
How does smoking increase the risk of atherosclerosis? (3 aspects for full points)
Damaging the inner lining of blood vessels, triggering inflammation, and promoting the buildup of fatty plaque
A patient's ECG shows a prolonged P-R interval of 0.28 seconds. This indicates delayed conduction through this part of the heart and is consistent with first-degree heart block.
Atrioventricular (AV) node
Which antihypertensive combination should be used cautiously or avoided because of the risk of excessive cardiac conduction slowing and heart block?
Bonus: Explain why (500 pts)
Verapamil (Non-dihydropyridine Ca2+ blocker) and a β-adrenoceptor antagonist
Explanation: Vermapamil already slows AV nodal conduction. Combining it with a beta-blocker (which also slows heart rate) further suppresses cardiac conduction -> risks significant bradycardia or complete heart block