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4152 rehash > clw 3 > Flashcards

clw 3 Flashcards

HTN, HLD, DM, CKD

1
Q

how to calculate BMI

A

weight / height^2

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2
Q

EF of HFrEF

A

≤40%

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3
Q

what to monitor when on statins

A

Creatinine kinase, statin associated muscle symptoms

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4
Q

when to start fibrates

A

when TG >5.8

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5
Q

if CK >4xULN, can start statin?

A

no

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6
Q

if lft more than 3xULN, stop statin?

A

yes

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7
Q

high risk for future ASCVD events

A

ACS (within 12m)
MI /stroke
FH
DM
CKD

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8
Q

target LDL for ASCVD, DM more than 10 years or DM with complications (neuropathy, retinopathy, microalbuminuria), familial history

A

1.8

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9
Q

DM with no complications or less than 10 years

A

2.6

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10
Q

doubling dose of statin gives reduction of how much

A

6-7% of LDL

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11
Q

main benefit of statin

A

reduce risk of mortality, especially for those with underlying ascvd

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12
Q

statin induced AE

A

dark urine, lethargy, anorexia, stomach pain, light coloured stools, jaundice

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13
Q

monitoring statin: labs?

A

lipids: 8+-4 weeks when adjusting, else annually
ALT: 8+-4 weeks, routine repeat not recc
CK: not necessary unless got myalgia
hba1c: high dose statin only

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14
Q

sglt2i AE

A

diabetic ketoacidosis, lightheadedness, fournier gangrene (practise good personal hygiene), UTI, increased urination

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15
Q

GOT of anemia

A

correct blood loss
remove drug causes
correct iron/folate/b12 deficiency

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16
Q

MOA of ESAs in CKD

A

Stimulate differentiation of erythroid progenitor stem cells and
induce release of reticulocytes from bone marrow

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17
Q

how often to monitor hgb after esa administration

A

every 1-2 weeks, then 3 months

18
Q

AE of ESA

A

hypertension, flu-like syndrome, vascular access thrombosis (increases thickness of blood and chances of clotting)

19
Q

common side effects of ESA tx and what to co-administer

A

iron deficiency due to stimulation of erythropoiesis

iron

20
Q

oral iron administration

A

best taken without food, but can cause gastric discomfort

take apart from calcium salts, quinolones, H2RA, PPI

ADHERENCE!

21
Q

SE of PO iron intake

A

constipation, dark stools, NV

try to increase dibre intake to reduce constipation

22
Q

IV iron intake SE

A

allergy, hypotension, dizziness, dyspnea, headache, lower back pain, arthritis

23
Q

what to monitor in CKD

A

eGFR, corrected Ca, P, PTH, ALP, Vit D

24
Q

what is in the DASH diet for HTN

A

Eat this: vegetables, fruits, whole grains, fat-free or low-fat dairy, fish, poultry, beans, nuts and seeds, vegetable oils.

Limit this: fatty meats, full-fat dairy, sugar sweetened beverages, sweets, sodium intake

25
Q

when to stop metformin an why

A

egfr<30 due to lactic acidosis risk

26
Q

why SU and BB not preferred together

A

mask sx of hypofly

27
Q

when to start anemia tx and goal of hgb

A

hgb <10
goal: 10-11

28
Q

how to reduce dose of DM drugs when starting insulin

A

TZD discon
SU discon/reduce by 50%
dpp discon if got glp1

29
Q

non pharm MBD

A

avoid high phosphate foods (800-1000mg a day) such as red meat, choc, dairy

30
Q

if patient is having worsening ckd, why cannot increase dose of statin

A

may increase risk of rhabdo/SAMS

31
Q

when switching from acei to arni, washout period?

A

36h

32
Q

why do patients get tachycardia when they have HF?

A

in response to filling problem, to try and increase the filling

hence do not start BB yet until stable

33
Q

if adherence is an issue for night statin doses, what to do

A

change to morning dosing is fine

34
Q

high intensity statin

A

ator 40mg

35
Q

why is hypercalcemia dangerous

A

can lead to high risk of calcification, formation of deposits and cvs mortality

36
Q

when assessing Ca, P, PTH, can you look at the numbers one off?

A

no, review over time

37
Q

calcium salt se for phosphate binding

A

hypercalcemia, constipation, loss of appetite, NV

38
Q

phosphate binder administration

A
  • compliance!
  • take binders with meals/snacks to be effective
  • space apart from quinolones, antiepileptics, digoxin, warfarin
39
Q

vitamin d deficiency (Serum 25(OH)D) level

A

<15

40
Q

side effect of vit d drugs

A

increase GI absorption of Ca and P, causing hypercalcemia, hyperphosphatemia

41
Q

effect of calcimimetics

A
  • increase sensitivity of calcium receptor on PTH gland
  • inhibit PTH synthesis, secretion
  • decrease ca and phosphate
42
Q

side effects of calcimimetics

A

NVD, hypocalcemia

4152 rehash (9 decks)

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