Tools of the Trade / Lab Findings

Question 1

Stress Test:

Answer 1

Indications:

• Screen for CAD
• Eval CP
• Exercise capacity
• Prognosis
• Eval post revascularization

CONTRAindications:

• UA
• Untreated life-threatening arrhythmia
• Uncompensated HF
• Advanced AV block
• ACUTE myocarditis/pericarditis
• Critical aortic stenosis
• Significant HOCM
• Uncontrolled HTN
• Acute systemic illness

Good for seeing 3-vessel CAD, not so much 1-vessel: LAD > RCA > CIRC

Make sure HR > 85%, systolic BP inc 20mmHg

Question 2

Naturietic peptides

Answer 2

BNP: From ventricles, released from stretching

- Correlate with EDVP, low = exclude HF, high = could be

Question 3

1. Understand the primary goals in CVD prevention.
2. Review the public health benefits of BP control.
3. Understand the barriers to CVD risk reduction including adherence.
4. Debunk the myths in CVD prevention.
5. Understand public and community health approaches to CVD prevention.

Answer 3

JNC-8 BP goals:

• Age > 60: 150/90
• Diabetes: 140/90
• Kidney Dis: 140/90

LDL > 190 = high intensity statin
LDL = 70-189 & DM = moderate intensity statin
Known CVD = high intensity, regardless of #

Fish oil doesn’t do squat
Glycemic control doesn’t impact CVD
ASA works for CAD & Stroke, others…?

Question 4

Every student should be able to:

1. Describe the steps in the pathogenesis of the atherosclerotic plaque the role of lipids and lipoproteins in this process.
2. List the main classes of lipids and describe their relative polarities.
3. Describe the Chylomicron, VLDL and HDL pathways.
4. List the functions of apo-lipoproteins and give examples of each.
5. List the relationship between each lipid class and cardiovascular risk.

Answer 4

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