Chronic Complications- Macrovascular

Question 1

ADA blood pressure goals

Answer 1

DM and HTN with low CV risk- <140/90
DM and HTN with high CV risk- <130/80
Pregnancy: 120-160/80-105

Question 2

ADA treatment for blood pressure

Answer 2

They have no preference (ACEi/ARB, diuretics, CCB) unless the patient has albuminuria- then use an ACEi/ARB

Question 3

AACE blood pressure goals

Answer 3

<130/80

Question 4

AACE treatment for blood pressure

Answer 4

ACEi/ARB

Question 5

ACC/AHA blood pressure goals

Answer 5

<130/80

Question 6

ACC/AHA treatment for blood pressure

Answer 6

No preference (ACEi/ARB, CCB, thiazide) unless you have CKD, HF, or are African American

Question 7

ACC/AHA BP treatment in patients with CKD

Answer 7

ACEi

Question 8

ACC/AHA BP treatment in patients with HF

Answer 8

No preference as long as it’s not a non-DHP CCB

Question 9

ACC/AHA BP treatment in African American patients

Answer 9

CCB, thiazide diuretics

Question 10

ADA guidelines for cholesterol management if <40 years old

Answer 10

Depends on ASCVD risk:

If ASCVD risk is <20%: no statin
If ASCVD risk >20%: high-intensity statin

Question 11

ADA guidelines for cholesterol management >40 years old

Answer 11

Depends on ASCVD risk:

If ASCVD risk <20%: moderate-intensity statin
If ASCVD risk >20%: high-intensity statin

Question 12

AACE guidelines for cholesterol management

Answer 12

Don’t state what intensity to use, you have to use clinical judgment

Question 13

AACE “high risk” LDL goal

Answer 13

<100

Question 14

AACE “very high risk” LDL goal

Answer 14

<70

Question 15

AACE “extreme” LDL goal

Answer 15

<55

Question 16

ACC/AHA guidelines for cholesterol management

Answer 16

All diabetes patients get a moderate-intensity statin

Question 17

ADA guidelines on ASA therapy

Answer 17

Can be considered for primary prevention if the patient has a high CVD risk (>50 years old, smoker, HTN, LDL >100, CKD)

Use in secondary prevention- 81mg

Question 18

AACE guidelines on ASA therapy

Answer 18

Use in primary prevention if ASCVD risk >10%

Use in secondary prevention- 81mg

Question 19

ADA recommendations for obesity

Answer 19

Goal is >5% weight loss

Diet, exercise, behavioral therapy

BMI ≥27: consider weight loss medications/therapy

BMI ≥35: consider bariatric surgery

Question 20

AACE recommendations for obesity

Answer 20

Essentially the same as ADA recommendations

Diet, exercise, behavioral therapy

BMI ≥27: consider weight loss medications/therapy

BMI ≥35: consider bariatric surgery

Question 21

ADA and AACE guidelines for immunizations

Answer 21

Flu shot: everyone should get it annually

Pneumococcus: PPSV23 and/or PCV13
19-64 years old: PPSV23
>65 years old: PCV13, then PPSV23 at least one year apart

Hep B: all adults should get it

Question 22

ADA guidelines on smoking

Answer 22

Avoid use of cigarettes, e-cigarettes, and other tobacco products

Counsel on smoking cessation

Question 23

AACE guidelines on smoking

Answer 23

No specific recommendations, but encourage counseling on smoking cessation