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CV Unit II > Secondary Prevention (complete) > Flashcards

Secondary Prevention (complete) Flashcards

1
Q

What is used for the pharmacologic guidelines?

A
  • Anti-platelets
  • Beta-blockers
  • RAAS inhibitors
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2
Q

What is used for pharmacologic and lifestyle guidelines?

A
  • BP control
  • Lipid mgmt
  • Diabetes mgmt
  • Depression screening and mgmt
  • Smoking cessation
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3
Q

What is used for lifestyle guidelines?

A
  • Weight mgmt

- Physical activity

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4
Q

What is used in the ‘other’ category?

A

Cardiac rehab

Flu vx

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5
Q

What does Class I mean?

A

Therapy should be reformed

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6
Q

What does Class IIa and IIb mean?

A

assigned when there is debate over benefit of the therapy

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7
Q

What does Class III mean?

A

Therapy should not be performed

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8
Q

What are the Class I antiplatelet guidelines for all CAD pts?

A

Aspirin 75-162mg

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9
Q

What are the Class I antiplatelet guidelines for all pts w/ ACS or PCI?

A

For 1 year following event:

  • Thienopyridines
  • Aspirin 81-325mg
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10
Q

What are the Class I antiplatelet guidelines for post-bypass surgery pts?

A

Asprin 100-325mg

for 1 year

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11
Q

What are the Class I antiplatelet guidelines for post-stroke pts?

A
  • Aspirin alone
  • Clopidogrel alone
  • Combined aspirin/dipyridamole daily
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12
Q

What are the Class I antiplatelet guidelines for pts w/ symptomatic PAD?

A
  • Aspirin alone

OR

  • Clopidogrel alone
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13
Q

What are the Class I antiplatelet guidelines for a pt who requires warfarin for another indication (e.g. AF)?

A

Low-dose aspirin and monitor closely for bleeding

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14
Q

What are the Class I beta-blocker guidlines?

A

BBs in all w/ LVSD (EF <40%) and HF symptoms or MI/ACS in past 3 years

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15
Q

What are the Class IIa beta-blocker guidelines?

A
  • BBs in all w/ LVSD (EF <40%) even in absence of HF symptoms
  • BBs in all w/ any history of MI/ACS
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16
Q

What are the Class I RAAS inhibition guidelines for ACEIs?

A 
Give to those w/:
- LVSD
- DM
- HTN
OR
- chronic kidney disease
17
Q

What are the Class I RAAS inhibition guidelines for ARBs?

A
  • w/ LVSD

AND

  • either prior MI or HF symptoms

Must be intolerant to ACEIs

18
Q

What are the Class I RAAS inhibition guidelines for aldosterone inhibition?

A
  • Post-MI w/ LVSD
  • Are receiving therapeutic doses of BB & ACEI/ARB
    AND
  • Have HF or diabetes

Avoid in those w/ renal dysfunction or significant hyperkalemia

19
Q

Which interventions can control BP?

A
  • Lifestyle
  • Low sat fat/Na diet
  • RAAS inhibitors
  • BBs
  • Diuretics
  • CCBs
  • Direct vasodilators
20
Q

What are the Class I BP control guidelines? (think #s)

A

Age <150/90

21
Q

Which types of statins are more efficacious in reducing cardiac events?

A

High dose statins

22
Q

What are some non-statin lipid tx?

A
  • Bile acid binding agents
  • Niacin
  • Fibrates

No evidence of efficacy

23
Q

What are the Class I lipid guidelines for all CAD pts?

A
  • High dose (atorvastatin 80mg or rosuvastitin 20-40mg) in pts ≤75yo
24
Q

What are some negating factors (don’t know what else to call it) in the 2013 Class I lipid guidelines?

A
  • No need to titrate med to LDL
  • No indication for non-statin lipid lowering therapies
  • Not proven in HF NYHA Class III-IV
  • Not proven in hemodialysis pts
25
Q

What are some unclear relationships (lol) with Class I lipids guidelines?

A
  • Myopathy/myalgies (~5-15%)
  • New-onset DM (0.1-0.3%)
  • Rhabdo in 0.01%
  • Hemorrhagic CVA in 0.01%
26
Q

Diabetes confers the same mortality risk as what?

A

Prior MI

27
Q

What are the Class I diabetes guidelines?

A
  • Life modifications

- Coordination w/ PCP

28
Q

What are the IIa diabetes guidelines?

A
  • Metformin

First-line pharmacologic therapy

29
Q

What are the IIb diabetes guidelines?

A
  • HbA1c <7% can be considered
30
Q

Depression is associated with _____ cardiac outcomes

A

Worse

31
Q

What are the Class IIa depression guidelines?

A
  • Assessment of depression
32
Q

What are the Class IIb depression guidelines?

A
  • Tx for depression does not appear to improve cardiac outcomes
  • Is beneficial for overall mental health
33
Q

How does smoking promote atherosclerosis?

A
  • Oxidizes LDL
  • Inflammatory
  • Decreases HDL
  • Causes endothelial dysfunctions
  • Causes reductions in NO
34
Q

What are the Class I smoking guidelines?

A

Just stop fucking smoking

easier said than done though…

35
Q

What are the Class I weight control guidelines?

A
  • Goal BMI = 18.5 - 24.9
  • Goal waist circumference (men) = <35 in
  • Initial goals of weight loss should be 5-10% of body weight
36
Q

What are the Class I physical activity guidelines?

A
  • Moderate to high-intensity exercise for 30-60 min/day

- At least 5, ideally 7, days/week

CV Unit II (12 decks)

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