HTN, HLD And Cardiac RF Flashcards
Which labs should be ordered for obesity?
CMP, liver enzymes, fasting glucose, A1c, TSH and fasting lipid prolife
What are findings in the eyes for dyslipidemia?
Corneal arcus, xanthelasma, lipemia retinalis (rare)
What skin findings will be found in someone with dyslipidemia?
Xanthomas and orange palmar creases type III
Which labs should be ordered for dyslipidemia?
Fasting serum lipid prolife, fasting glucose, thyroid test, LFT, serum creatinine, UA
Which labs should be ordered for DM?
Glucose log, A1c, lipid profile, CMP, TSH, vitamin B12, serum creatinine, eGFR, albumin to creatinine ratio in urine
When should echocardiography be done?
Only if clinical evidence of HF or LVH
More sensitive to detect LVH than EKG
Stress echo if you suspect CAD or valvular dz
When should you ultrasound the kidneys?
Onset labile, elevated serum creatinine, abnormal urinalysis and bruit heard on PE
What is normal BP?
<120/80
What is considered elevated BP?
<120-129/<80
What is stage I HTN?
BP<130-139/80-89
What is stage II HTN?
BP >140/90
What are the best non-pharmacological interventions to decrease BP?
Weight loss, healthy diet, reduced intake of dietary Na, enhanced intake of dietary K+, physical activity, moderation in alcohol intake
What is the first line tx for HTN?
RAAS inhibitors, CCBs, thiazide diuretics
What is the MOA for Biguanides?
Decreases hepatic glucose production and intestinal glucose absorption; increases insulin sensitivity
What are the indications for Biguanides?
T2DM
Ex. Metformin (glucophage)
What are the SE of Biguanides?
Anorexia, N/V and diarrhea
What are the contraindications for Biguanides?
Creatinine above 1.4, liver failure, excessive EtOH intake
What is the MOA for sulfonylureas?
Stimulates pancreatic islet beta cell inuslin release
What are the indications for sulfonylureas?
T2DM
Ex. Glyburide (dia beta), glipizide (glucatrol)
What are the SE of sulfonylureas?
Hypoglycemia, weight gain, nausea
What is the MOA for thiazolidinediones?
Sensitize peripheral tissues to insulin, PPAR-gamma, decrease hepatic glucose output
What are the indications for thiazolidinediones?
T2DM
Ex. Rosiglitazone (Avandia), pioglitazone (actos)
What are the SE for thiazolidinediones?
MI, angina, edema, macular edema, weight gain
What is the MOA for GLP-1 receptor agonists?
Activates glucagon like peptide 1 receptor, increases insulin secretion, decreases glucagon secretion, delays gastric emptying
What are the indications for GLP-1 receptor agonists?
T2DM
Ex. Dulaglutide (trulicity), Liraglutide (Victoza)
What are the side effects for GLP-1 receptor agonists?
N/V/D, pancreatitis (1/1000)
What is the MOA for DPP-4 inhibitors?
Inhibits the enzyme DPP-4 and prolongs action of GLP-1, increases insulin release, decreases glucagon levels
What is the indication for DPP-4 inhibitors?
T2DM
Ex. Sitagliptin (Januvia), Linagliptin (Tradjenta)
What are the SE for DPP-4 inhibitors?
URI, HA, diarrhea, abdominal pain, arthralgias
What is the MOA for SGLT2 inhibitors?
Inhibits glucose reabsorption in proximal tubules in kidney, cause glucosuria, and thereby lowers glucose levels
What are the indications for SGLT2 inhibitors?
T2DM
Ex. Dapaglifozin (farxiga) and empagliflozin (Jardiance)
What are the SE for SGLT2 inhibitors?
Yeast infections, UTI, orthostatic hypotension, nausea, fatigue
