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IFMCP > Cardio APM > Flashcards

Cardio APM Flashcards

1
Q

order of blood sugar/insulin labs becoming abnormal

A
  1. 2 hour PP insulin
  2. fasting insulin
  3. 2 hour PP glucose
  4. fasting glucose
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2
Q

homocysteine lowering tx effective for…

A

primary prevention of CAD

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3
Q

lab to assess vulnerable plaques

A

Lp-PLA2

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4
Q

chronically elevated insulin stimulates which enzymes

A

HMGCoA reductase

via mevalonate pathway

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5
Q

insulin’s effect on sex hormones

A

stimulates estrogen, androgens, progesterone

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6
Q

Dx criteria for metabolic syndrome

A

3/5

increased weight circum (>35 women, >40 men)
TG >150
HDL <50 women, <40 men
BP >130/85 (or on meds)
elevated FBG
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7
Q

biomarkers for dyslipidemia/atherosclerosis risk

A 
LDL-P and LDL particle size/pattern
Apo B
Apo B:Apo A-1 ratio
Lp[a]
ApoE
Lp-PLA2
CAC
myeloperoxidase assoc with rupture prone plaques
BMI, WC
CBC w diff
homocysteine, GGT
vit B12, Mag, vit D25OH
CMP (esp AST, ALT)
microalbumin: creatinine ratio
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8
Q

lifestyle and nutrition interventions for dyslipidemia/atherosclerosis

A

fiber – decrease sugar/cholesterol
no processed carbs
low fat – lowers LDL-P
MUFA

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9
Q

this lowers LDL, TG and raises HDL

A

niacin

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10
Q

this lowers LDL

A

RYR

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11
Q

this downregulates NFKB

A

turmeric

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12
Q

this lowers LDL

A

green tea (inhibits HMG CoA reductase and decreases absorption)

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13
Q

decreases cholesterol absorption

A

plant sterols

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14
Q

this decreases TC, LDL, APO-B, TG; increases HFL and APO-A1

A

pantethine

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15
Q

this decreases PCSK9, lowers cholesterol

A

berberine

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16
Q

these two supplements block PLA2

A

vitamin E and quercetin

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17
Q

which 2 areas of Matrix does visceral adiposity effect

A

Defense and Repair (inflammation) and Communication (adipokines, hyperinsulinemia)

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18
Q

TMAO assoc w

A

CVD, IR, CKD, ACS, obesity

19
Q

TG:HDL ratio >/= 3 indicative of

A

IR

20
Q

which LDL biomarker assoc with cardiometabolic risk

A

LDL-P

not LDL-C

21
Q

medical conditions outside CVD assoc with metabolic dysfunction

A 
PCOS
osteoporosis
E2 dominant CAs
NAFLD
type 3 DM
22
Q

berberine MOA cardiometabolic

A

decreases inflammatory cytokines and chemokines, increase microbial diversity, increase SCFA producing bacteria

23
Q

Direct insulin sensitizers

A

vanadium, chromium, ALA, cinnamon, magnesium

24
Q

Indirect insulin sensitizers: microbiome/anti-inflamm

A

berberine, probiotics, omega 3s

25
Q

Indirect insulin sensitizers: antiox

A

NFkB inhibitors, omega 3s

26
Q

genetic SNPs with increased CVD risk

A 
ApoE – produced in liver, macrophages, astrocytes, needed for clearance of chylomicrons and IDLs, principal cholesterol carrier in brain
MTHFR, MTRR, COMT
LDL-R (assoc with FH)
ApoB
PCSK9
27
Q

ApoE 3 and 4 assoc with

A

higher cholesterol, increase CA-IMT

increased risk MCI, Alzheimer’s, DMII, CHD

28
Q

ApoE 3 and 4 lifestyle recommendations

A

low fat
low carb
avoid alcohol, smoking

29
Q

stress and CVD

A

increases homocysteine, CRP, fibrinogen, deep ab fat
vasoconstriction + increased platelet stickiness
a fib
Takotsubo cardiomyopathy
precipitate/worsen CVD
reduce HRV and resistance to infection
MI (direct damage from norepi)

30
Q

biomarker of ox stress DNA

A

8OH deoxyguanosine

31
Q

biomarkers of ox stress - fats

A

lipid peroxides, oxidized LDL, isoprostane F2

32
Q

biomarkers of ox stress - sugars

A

A1c, AGEs

33
Q

biomarker of ox stress - protein

A

3 nitrotyrosine

34
Q

biomarker of ox stress - general

A

total antiox capacity

mincronutrient def

35
Q

risk markers for HTN

A 
plasma renin activity and aldosterone
asymmetric simethylarginine
CIMT
hsCRP
uric acid
Pb, Cd, As
TMAO
36
Q

low renin HTN tx

A

volume drugs + nutraceuticals - CCBs, diuretics, spironolactone, alpha blockers

37
Q

high renin HTN tx

A

ACE, ARB, beta blockers

38
Q

endothelial dysfunction tx

A

sildenafil, flavonoids, cocoa

39
Q

general HTN tx

A 
DASH, low sodium, lose VAT, exercise
NAC + arginine
taurine + magnesium
alpha lipoic acid + acetyl L carnitine
MBSR
40
Q

waking BP

A

controlled by sympathetic NS (so use txs that target sympathetic!)

41
Q

sleeping BP

A

controlled by RAAS (so used txs that target RAAS)

42
Q

ApoE

A

produced in liver, macrophages, CNS astrocytes
required to clear chylomicrons and IDL
principal cholesterol carrier in brain

43
Q

Low HRV indicates

A

high sympathetic and parasympathetic tone, increasing cardiac risk

44
Q

2 meds that deplete CoQ10

A

Statins and beta blockers

IFMCP (9 decks)

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