Hopkins Flashcards
(27 cards)
DM meds that can worsen heart failure
TZDs (Pioglitazone) –> black box warning
DPP4 inhibitors also may
DM meds that improve CKD. have added benefit of wt loss
SGLT2 (empagliflozin). Also good for HF
GLP-1 agonists (liraglutide)
DM meds with risk of hypoglycemia
Insulin
Sulfonylureas (glyburide, glipizide, glimepiride)
Tips for starting basal insulin
start at 10 units/day or 0.1-0.2 units/kg. Titrate to am fasting glucose. increase by 2 units q3 days til at goal <130.
when to get screening mammograms?
every 2 years for ages 50-74. age 40-49 is individual conversations
who gets breast MRI?
annual for age 25-30 for high risk group:
- known BRCA carrier
- untested pt with 1st deg with BRCA
- chest radiation when age 10-30 (i.e. Hodgkin lymphoma)
- lifetime risk >25%
Results of Pap leading to colposcopy
LSIL with +HPV
HSIL
T/F: HPV testing should be performed with pap smears in women <30
False, up to 30% can have transient infection <30 yo. Do HPV testing when >30 and also when there is ASCUS
most common cause of PSA between 4-10
BPH. Still is recommended to get Prostate Biopsy if PSA >4. 15% of men with prostate cancer have normal PSA.
when can you stop cervical cancer screening?
65
lung cancer screen recommendations
annual LDCT for ages 55-80 if 30 pack year hx and current smoker/quit within the past 15 years
when would you screen for prostate cancer?
based on individual convo and risk for ages 55-69 only
what rise of PSA would make you refer for biopsy?
if PSA <4: rate of 0.35/year
>4: rate of 0.75/year
most important risk factor for breast cancer
AGE
not personal hx of cancer or fhx of brca
how much do statins reduce LDL?
Low: <30%
Medium: 30-50%
High: >50% (Atorva 40-80; Rosuva 20-40)
Goal LDL while on Statin
LDL<70. Next step is to add ezetimibe. Then you add a PCSK9 inhibitor (evolocumab and alirocumab).
Statin guidance for Diabetics
Age 20-39: If any complications (proteinuria, retinopathy, neuropathy) then moderate intensity statin
Age 40-75: ASCVD >20 = high intensity statin, <20 = moderate intensity statin
when should all diabetics be started on a statin?
age 40
define severe hypercholesterolemia
LDL > 190. Indication for high intensity statin if age > 20. Goal is >50% reduction and LDL < 100
Live attenuated vaccine list
MMR
Varicella
Zoster
Intranasal influenza
what are the only real contraindications to vaccine?
anaphylaxis to vaccine or component; relative CI if moderate to severe illness
who gets pneumococcal vaccine
all adults >65, don’t need revaccination after. if got it at younger age revaccinate at 65.
Do PCV 13, then PPSV 23 8 weeks later
T/F: If it has been more than 5 years since tetanus booster and you have puncture injury, give Tetanus immunoglobulin
False, revaccinate with tetanus booster
when do antibodies form from vaccine?
IgM detectable in 7-10 days, peaks in 2-6 weeks
