HDL And HTN Flashcards

1
Q

CAC score

A

Amount of calcium build up on inner lining of the heart

Over 400 = severe

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2
Q

Hyperlipidemia

A

Increased lipids in the blood

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3
Q

Dyslipidemia

A

Abnormal amount, higher or lower of cholesterol in the blood

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4
Q

Normal Lipid panals

A

T : <200
LDL < 120
HDL >55
Tri : 30-150

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5
Q

Secondary causes of HLD

A

Diuretics, glucocorticoid steriods, nephrotic syndrome, hypothyroidism , pregnancy

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6
Q

Statin administeration guide

A

When indication is high statin — start with moderate and then increase after 4-6 weeks

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7
Q

When to recheck LDL

A

Measure 6 weeks after initiation of therapy and every 6-12 months there after

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8
Q

Muscle symptoms - what do you do

A

Stop and assess for Rhabdomyolsis

Muscle weakness, muscle pain and dark urine

Rechallenge with lower or same dose of statin
Re- challenge with a statin that uses a different pathway

If can tolerate moderate statin - refer

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9
Q

High intensity statin

A

Lower LDL by > 50 %

  • Atorvastatin (Lipitor) 40-80mg
  • Rosuvastin (Crestor) 20-40 mg

Age 21 - 75 years with clinically evident ASCVD – MI, unstable angina, stroke, TIA, PAD

Age 21 or older with LDL of ≥190 mg but without evidence of ASCVD (consider genetic or secondary causes)

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10
Q

Moderate intensity statin

A

Lower LDL by 30-50 %
Atorvastatin 10-20mg
Rosuvastin 5-10
Simvistatin 20-40

Age 40 – 75 with Diabetes and LDL ≥ 70

Age 40 – 75 w/LDL – C 70 – 189 mg and estimated 10 year risk ASCVD ≥ 7.5%

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11
Q

Low intensity Statin

A

lower LDL by < 30 %
Simvistatin - 10 mg
Pravasatin -10-20 mg

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12
Q

Chronic liver disease

A

Use statins very caiutiously
All statins are metabolized in liver
Use Pravastatin and Rosuvastatin

Monitor ALT 4- 12 weeks

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13
Q

Chronic Kidney Disease

A

Atorvastin and Fluvastatin

Cause they do not require dose adjustments

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14
Q

Nictonic Acid

A

Used to lower TRI and increase HDL

SE; Itching, flushing, tingling, hepatoxicity

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15
Q

Fibrates

A

Lower tri and increase HDL

SE; gallstones and dyspepsia

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16
Q

Bile Acid Sequestrants

A

Interfere with fat absorption, lower LDL , for people who can not tolerate statins

Bloating, flatulence, abdominal pain

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17
Q

PCSK9 Inhibitors

A

Targets and inactivates protein in the liver that helps to decrease LDL

Subcutaneous injection ( biweekly)

18
Q

Cholesterol absorption inhibitors

A

Reducing absorption of cholesterol from the intestine, does not reduce tri

Diarrhea, abdominal pain, joint pain

19
Q

Treatment for triglycerides

A

Lifestyle, determine if familiaral, address other diseases ( hypothyroidism )

Observe for pancreatitis

Fibrates and Nictininic Acid

20
Q

Organ damage of HTN

A

Brain - CVA, encephalopathy

Blood : elevated BS

EYE; rentinopathy

Heart : MI, HF

Kidneys: Nephopathy CKD

21
Q

BP

A

CO X systemic vascular resistance

  • sympathies nervous system
  • Renin - angiotensin- aldosterone
  • plasma volume largely mediated by kidneys
22
Q

Normal BP

A

120/80

23
Q

Elevated BP

A

120-129 / 80

24
Q

Stage 1 HTN

A

130-139 / 80-89

25
Q

Stage 2 HTN

A

> 140 / >90

26
Q

DX of HTN

A

3 or more elevated BP readings obtained from three or more office visits

27
Q

Eye exam with HTN

A

Looking for hemorrhage, papilledema, cotton wool spots, AV narrowing or nicking

28
Q

Lifestyle modification

A
Weight reduction
DASH 
Sodium restriction 
30min/day exercise 
Moderate alcohol consumption 
W < 1 drink 
M < 2 drink
29
Q

Thiazide diuretics

A

Inhibit reabsorption of sodium and chloride ions - increasing urine output and decreasing preload

SE: hypokalemia, hyponaturmia, hyperglycemia, gout, hypertricylerdemia, hypercholesteremai

MEDS: Cholrthalidone , HCTZ

30
Q

ACE/ARB

A

Blocks conversion of angiotensin 1 to II

SE; cough, may raise K

Meds : PRIL, ARTAN

31
Q

CCB

A

Dilates aterioles and decreases vascular resistance, resulting in systemic vasodilation

SE: headache, ankle edem, heart block or bradycardia

Contraindicated : 2nd and 3 rd degree block

DIhydropyridines - amilopidine PINE
Can combine with BB

NONDI - diltiaszem, rescue HR and proteinuria

32
Q

Diabetes

A

Lifestyle , treat DM

ACE or ARB ( BP 130-80) when second agent nesssary CCB

33
Q

CKD

A

Lifestyle + ACE or ARB ( 130-80) when second or third agent needed consider thiazide diuretic or CCB

34
Q

Black with DM

A

Lifestyle + CC or Thiazide Diuetic ( 130/80)

35
Q

Refractory HTN causes

A

BP uncontrolled despite being complaint with 3 antihypertensive drugs

36
Q

Heart Failure HTN

A

ACE/ ARB + BB + Diuretic + spiraloctone

37
Q

Post MI / Clinical CAD

A

ACE/ARB + BB

38
Q

CAD

A

ACE, ARB, diuretics ,CCB

39
Q

Recurrent stroke prevention

A

ACE and diuretic

40
Q

Preg

A

Labetolol, nifedipine, mehtyldopa

41
Q

BB

A

Safer in patients with COPD, asthma, diabetes and PhD

Lol ‘s