Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
121 Cards in this Set
- Front
- Back
|
What are modifiable lipoprotein risk factors for CVD?
|
LDL, HDL, and total TG
|
|
|
What are modifiable inflammatory markers for CVD?
|
fibrinogen
|
|
|
What are modifiable lifestyle risk factors for CVD?
|
tobacco use
poor diet stress excessive alcohol physical inactivity |
|
|
What related diseases are modifiable risk factors for CVD?
|
HTN
Diabetes Obesity Metabolic Syndrome |
|
|
What are non-modifiable risk factors for CVD?
|
age ( >45 for men, >55 for women)
menopausal status family history |
|
|
What hormone helps prevent against CVD?
|
estrogen
|
|
|
Family history of what in a male 1st degree relative is a risk factor for CVD? (women <65, men <55)
|
MI or sudden death
|
|
|
What is the function of the lipoprotein, chylomicrons?
|
transports dietary fat and cholestrol from SI to Liver
|
|
|
Can chylomicrons be atherogenic or not?
|
ATHEROGENIC
|
|
|
What % of total cholestrol is in LDL, HDL, and VLDL?
|
60-70% in LDL
20-30% in HDL 10-15% in VLDL |
|
|
What does the liver convert into LDL? is this lipoprotein atherogenic or not>
|
IDL
|
|
|
What is the main function of LDL?
|
it is the main cholesterol carrier in the blood
|
|
|
What type of apoprotein is mainly found in LDL?
|
Apo B"ad"
|
|
|
60% of LDL is taken up by receptors on what organ
|
liver
|
|
|
What determines the amount of LDL cholesterol in the blood?
|
# and activity of receptors
|
|
|
is LDL + apoB atherogenic or not?
|
ATHEROGENIC
|
|
|
What is LDL the product od>
|
VLDL catabolism
|
|
|
Which lipoprotein contains the most protein?
|
HDL
|
|
|
High HDL levels are associated with low levels of what lipoproteins?
|
chylomicrons, VLDL, and small dense LDL
|
|
|
What is the function of VLDL?
|
transports endogenous TG and cholestrol
|
|
|
What percent of VLDL is TG?
|
60% TG
|
|
|
Is VLDL atherogenic or not?
|
NOT ATHEROGENIC
|
|
|
What are the atherogenic remnants of VLDL?
|
IDL
|
|
|
What is the TLC diet low in in order to reduce blood cholesterol levels and chance of developing heart disease
|
low in sat fat and cholesterol
|
|
|
What happens your first visit to the doctor in regard to a TLC diet?
|
begin lifestyle therapies
- emphasized reduction in sat fat and chol - encourage moderate physical activity |
|
|
What happens your second visit to the doctor in regard to a TLC diet?
|
evaluate LDL response and if goal isnt achieved then intensify LDL-lowering tx
- increase fiber intake |
|
|
At what dr visit is adding plant sterols/ stanols to the diet considered?
|
2nd visit
|
|
|
What happens your third visit to the doctor in regard to a TLC diet?
|
evaluate LDL response and if goal not met consider adding drug tx
-intensify wt management and physical act -initiate tx for metabolic syndrome |
|
|
What happens at a follow up visit in regard to the TLC diet?
|
monitor adherence
|
|
|
How many weeks pass between the first and second dr visits?
|
6 weeks
|
|
|
When does a follow up visit usually happen?
|
between 4-6 months after 3rd visit
|
|
|
What nutrients have good effects on cholesterol levels?
|
omega-6 linoleic acid
omega-3 EPA and DHA monounsaturated fatty acids fiber stanols / sterols |
|
|
What effect does omega-6 have on lipoproteins?
|
decreases LDL and HDL
decreases synthesis of VLDL, HDL, and apoB |
|
|
Omega-3 decreases TG levels by inhibiting the synthesis of what?
|
LDL apo B
|
|
|
What lipoproteins does MUFA decrease?
|
cholesterol, LDL and TG
|
|
|
What lipoproteins does fiber decrease?
|
cholesterol and LDL
|
|
|
What do plant stanols/sterols inhibit the absorption of?
|
cholesterol
|
|
|
What does sat fat increase the levels of?
|
LDL cholesterol
|
|
|
Trans fat increases what and decreases what lipoproteins?
|
increases LDL
decreases HDL |
|
|
What parameter of BP defines HTN?
|
persistently high arterial BP >140 / 90
|
|
|
What BP defines stage 1 HTN?
|
140-159 / 90-99
|
|
|
What BP defines stage 2 HTN?
|
160-179 / 100-109
|
|
|
What BP defines stage 3 HTN?
|
>180 / >110
|
|
|
What is the short term regulator of HTN?
|
sympathetic nervous system
|
|
|
what is the long term regulator of HTN?
|
the kidneys
|
|
|
what vasoconstricting hormone does the SNS secrete when BP drops
|
norepinephrine
|
|
|
How does norepinephrine work on BP
|
increases peripheral resistance to raise BP by acting on small arteries and arterioles
|
|
|
What does the kidneys excrete to regulate BP?
|
Renin
|
|
|
what system does the renin excreted by the kidneys activate?
|
renin-angiotensin system
|
|
|
What abdominal measurements are a risk factor of metabolic syndrome?
|
men: >102 cm
women > 88 cm |
|
|
What TG level is a risk factor of metabolic syndrome?
|
> 150 mg/dL
|
|
|
What BP level is a risk factor of metabolic syndrome?
|
>130 / 85 or on HTN tx
|
|
|
What HDL level in men and women is a risk factor of metabolic syndrome?
|
men <40 mg/dL
women <50 mg/dL |
|
|
What fasting glucose level is a risk factor of metabolic syndrome
|
>100 mg/dL
|
|
|
What parameters make up your framingham score>
|
age
HDL total cholestrol smoker vs non-smoker BP |
|
|
How do diuretics work? (anti-HTN)
|
reduce the blood volume
|
|
|
How do beta blockers work? (anti-HTN)
|
they slow down the work of the heart
|
|
|
how do alpha-1 receptor blockers work? (anti-HTN)
|
control norepinephrine from tightening muscles in the smaller arteries
|
|
|
How do ACE inhibitors work? (anti-HTN)
|
by inhibiting angiotensin 1 conversion to angiotensin 2
|
|
|
How do calcium antagonists work? (anti-HTN)
|
by preventing calcium from entering the heart and blood vessel walls; relaxes and widens them
|
|
|
how do direct vasodilators work? (anti-HTN)
|
dilate blood vessels
|
|
|
What is the main drug class used for treating cholestrol?
|
bile acid sequestrants
nicotenic acid HMG CoA reductase inhibitors (statins) |
|
|
Which classes of diuretics causes a loss (waste) of K+
|
loop diuretics and thiazide diuretics
|
|
|
What classes of diuretics spares K+
|
spironolactone
triamterene aldactone |
|
|
What are risk factors for CHF?
|
HTN
CHD Diabetes left ventricular hypertrophy (LVH) |
|
|
What are ways the heart compensates in CHF?
|
increase force of contraction
increase in size pump more often stimulate kidneys to conserve Na and H20 |
|
|
What stage of CHF has slight limitations to physical activity but comfort at rest?
|
stage 2
|
|
|
What stage do symptoms of cardiac insufficiency or chest pain at rest show
|
stage 4
|
|
|
What are symtoms of CHF?
|
dyspnea
nausea fullness pulmonary edema cardiac edema peripheral edema cardiac cachexia |
|
|
What are the 3 hallmarker symptoms pf CHF>
|
fatique, shortness of breath, and fluid retention
|
|
|
What condition is characteristic of cool forearms and legs and sleeping feeling
|
CHF
|
|
|
what is cardiac cachexia?
|
involuntary wt loss of atleast 6% or 6-month period characterized by loss of lean body mass
|
|
|
By how many days does the DASH diet work in at lowering BP?
|
14 days
|
|
|
What is the focus of the DASH diet?
|
lowering BP
|
|
|
How many servings of whole grains does the DASH diet recommend?
|
7-8
|
|
|
How many servings of low-fat or fat-free dairy products does the DASH diet recommend?
|
2-3
|
|
|
How many servings of legumes, nuts, or beans does the DASH diet recommend PER WEEK?
|
4-5
|
|
|
How many ounces of lean meat, poultry, or fish does the DASH diet recommend?
|
6 oz or less
|
|
|
The DASH diet recommends 4-5 servings each of what foods?
|
fruits and veggies
|
|
|
How many servings of fat and oils does the DASH diet recommend?
|
2-3
|
|
|
What % of total calories does the DASH diet recommend fat and oils be>
|
27%
|
|
|
What is the Friedwald formula used to calculate LDL?
|
LDL = TC - HDL - (TG/5)
|
|
|
What are focuses of the post MI diet?
|
promote healing
fight infection provide energy for ambulation, rehab, and PT replenish nutrient stores pay attention to protein stores when on corticosteroids |
|
|
What class of drug causes protein to be catabolized more quickly?
|
corticosteroids
|
|
|
What level of Na intake does the dietary guidelines for Americans recommend?
|
< 2,300 mg/day
|
|
|
What level of Na intake does the dietary guidelines for Americans recommend for ppl 51+, aa, or has a diagnosis of HTN, CM, or CKD?
|
1,500 mg/day
|
|
|
What Na+ levels correlated with a no added salt diet order?
|
4,000 mg/day (4g)
|
|
|
What Na+ levels correlated with a mild-moderate Na+ restriction diet order?
|
2,000-3,000 mg/day (2-3g)
|
|
|
What Na+ levels correlated with a strict Na+ restriction diet order?
|
1,000 mg (1g)
|
|
|
What Na+ levels correlated with a severe Na+ restriction diet order?
|
500 mg (.5g)
|
|
|
What does a "very low sodium" term on a food label mean?
|
<35 mg/serving
|
|
|
What does a "low sodium" term on a food label mean?
|
<140 mg/ serving
|
|
|
What does a "reduced sodium" term on a food label mean?
|
50% less than comparison food
|
|
|
What does a "sodium free, no sodium" term on a food label mean?
|
<5mg/serving
|
|
|
What are the parameters for saturated fat under the TLC diet?
|
<7% total cals
|
|
|
What are the parameters for polyunsaturated fat under the TLC diet?
|
up to 10% total cals
|
|
|
What are the parameters for monounsaturated fat under the TLC diet?
|
up to 20% total cals
|
|
|
What are the parameters for total fat under the TLC diet?
|
25-35% total cals
|
|
|
What are the parameters for carbs under the TLC diet?
|
50-60% total cals
|
|
|
What are the parameters for protein under the TLC diet?
|
about 15% total cals
|
|
|
What are the parameters for fiber under the TLC diet?
|
25-30 g/day
|
|
|
What are the parameters for cholesterol under the TLC diet?
|
<200 mg/day
|
|
|
At what point would you use a fluid restriction in CHF>
|
if serum Na+ is <130 mEq/L
|
|
|
If the pt is severely decompensated in CHF what is the fluid restriction?
|
1000-1500 mL daily
|
|
|
What vitamins and minerals may need to be supplemented in CHF?
|
Calcium
vit d magnesium thiamin |
|
|
Why might a HF pt need a calcium supplement?
|
at risk for osteoporosis
|
|
|
Why might a HF pt need a vit d supplement?
|
it helps reduce inflammation
|
|
|
Why might a HF pt need a magnesium supplement?
|
because def is common because of poor diet and the use of diuretics
|
|
|
Why might a HF pt need a thiamin supplement?
|
because theres a risk of def because of poor diet, loop diuretics use (increases excretion), and advanced age
|
|
|
What happens as a result of an occlusion or hemorrhage of a cerebral artery resulting in impaired function, tissue damage, or death
|
stroke
|
|
|
what are the two type of stroke?
|
ischemic and hemorrhagic
|
|
|
which type of stroke accounts for 87% of all strokes?
|
ischemic
|
|
|
Which type of stroke involves a clot as a result of an obstruction within blood vessel supplying the brain?
|
ischemic
|
|
|
what is the most common cause of an ischemic stroke?
|
plaque build up due to high cholesterol
|
|
|
What type of stroke involves bleeding and occurs when weakened blood vessels rupture?
|
hemorrhagic
|
|
|
what is the most common cause of a hemorrhagic stroke?
|
uncontrolled HTN
|
|
|
What are two types of weakened blood vessels that cause a stroke?
|
aneurysms
arteriovenous malformations |
|
|
What is a significant risk factor for a stroke?
|
old age
|
|
|
what is the function of rtPA
* recombinant tissue plasminogen activator |
a protein that is made by the body to dissolve blood clots
|
|
|
What type of foods are easier to chew and swallow?
|
low viscosity foods
|
|
|
To reduce fat the chance of drug nutrient interactions, what diet modification may be recommended to a stroke pt?
|
reduce fat intake to reduce cholesterol by increasing intake of fruits and veggies
|
