Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Cardiology > CAD: Primary & Secondary Prevention > Flashcards

CAD: Primary & Secondary Prevention Flashcards

(73 cards)

Start Studying
0
Q

What was the important point from MIRACL trial?

A

Lipitor has benefit as early as 16 weeks in pt’s w/ prior MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
1
Q

In primary prevention, do statins decrease CHD death, nonfatal MI and all-cause mortality?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do fibrates do to cholesterol? Do they decrease CV events?

A

Dec TG, Inc HDL

YES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What age (by gender) is a risk factor for CAD?

A

Men >45

Women > 55 (or early menopause)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define family hx of CAD

A

1st degree relative
Male < 55
Woman < 65

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is considered a CAD risk equivalent

A

Risk factors that confer 10 yr risk for CHD > 20%

PAD/AAA/symptomatic carotid dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Components of Framingham risk score

A 
Age
SBP
TC
HDL
smoker
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

NCEP ATP III: LDL goal and when to start Rx for high risk (>20% 10y risk)

A

Goal LDL<100

Start Rx at 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

NCEP ATP III: LDL goal and when to start Rx for moderately high risk (10-20% 10y risk)

A

LDL goal<130

Rx at 130

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What % of total calories should saturated fat be?

A

<7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Recommended intake of monounsaturated fats

A

Upto 20% of total calories

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Recommended intake of total fat

A

25-35% of total calories

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Recommended intake of fiber

A

20-30 grams per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Recommended intake of cholesterol

A

<200mg/d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When instituting TLC for lipid lowering, how often do u bring pt’s back?

A

Q6 weeks for 3 visits, then q4-6 mo’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How will statins effect cholesterol panel?

A

Dec LDL
dec TG
Inc HDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name 2 statins that are not lipophilic

A

Rosuvastatin

Pravastatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which statin is safe to use with erythromycin and ketoconazole?

A

Pravastatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which statins use Cytochrome 2C9?

A

Rosuvastatin
Fluvastatin

(“RF”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which statin does not use CYP450?

A

Pravastatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Most statins bind completely to proteins. Which one does so only 50% of the time?

A

Pravastatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which statins use CA4 cytochrome system?

A

Lovastatin
Simvastatin
Atorvastatin
Rosuvastatin (also uses 2C9)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Name the statins in order from most potent to least potent

A

Rosuvastatin>atorvastatin>simvastatin>pravastatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What to remember about statin induced myalgias

A

Dose related

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Drugs assoc w/ statin induced myopathy
``` Verapamil Amio Nicotinic acid Fibrates (Gemfibrozil>>Tricor)*** EtOH P450 3A4 inhibitors ```
25
Risk factors assoc w/ statin induced myopathy (not including drugs)
Age >75 Frail/LOL DM/CKD periop
26
Cytochrome P450 inhibitors that are associated with statin induced myopathy
Cyclosporine -conazole antifungals (ketoconazole, etc) Macrolides (erythromycin, clarithromycin, nefazodone) HIV PI's Grapefruit juice
27
What to do if statin induced myopathy?
Change statin or Dec dose by 1/2
28
Incidence and definition of statin induced myopathy
0.1% | CK> 10x ULN
29
Bile acid sequestration effect on lipid profile
Dec LDL by 15-30%* Inc HDL by 3-5% TG no effect or even increase!*
30
Do bile acid sequestration decrease mortality? Why not used?
Yes | GI sxs and expensive
31
Absolute contraindications to bile acid seq,
TG> 400 mg/dl | Familial Dysbetalipoproteinemia
32
Absolute contraindications to niacin
Severe Gout | Chronic liver dz
33
Does niacin effect all lipids favorably? Does it dec mortality? Does it reduce CHD risk?
Yes No Yes
34
AE's of niacin
Upper GI distress Flushing Hepatotoxicity Hyperuricemia
35
How much do fibrates dec TG by?
20-50%
36
Do fibrates dec CHD risk
Yes (moderately)
37
AE's if fibrates
GI sxs Gallstones Myopathy
38
Fibrates contraindications
Severe hepatic dz or severe CKD
39
MOA of fibrates
Inhibits absorption of chol at small intestine brush border--> dec chol to liver, inc clearance from blood
40
Ezetimibe (zetia) indication
High LDL (in combo with statin or fibrate)
41
Does ezetimibe reduce CHD?
Yes
42
Which med increases HDL the most?
Niacin
43
Does metabolic syndrome inc CHD mortality?
Yes
44
Metabolic syndrome criteria
``` Need 3/5: BP > 130/85 FG > 100 TG> 150 mg/dl Waist: men- 40in/women- 35in HDL: men <50 ```
45
Target for hypertriglyceridemia Rx levels?
<150
46
If TG>200 after LDL is treated, what to do?
Secondary goal for non HDL chol (total-HDL) is 30 above LDL goal
47
4 meds that can treat high TG
Niacin Fibrates Omega 3 FAs Statins
48
What did the PROVE-IT trial show for death, MI, hospitalization for angina , and revasc?
High dose Lipitor 80 better than low dose pravastatin
49
What is the LDL goal for CHD risk of high, moderately high, mod, low?
100 130 130 160
50
In secondary prevention, if TG 200-499, what is the plan?
Non-HDL should be< 130
51
What to remember about treating TG> 500?
Rx w/ fibrate or niacin too recent pancreatitis BRFORE treating LDL
52
If nor intensive at age 55, what is one's lifetime risk of developing HTN?
90%
53
When to initiate HTN therapy with TWO drugs (JNC 7)
When BP is >20/10 mmHg above goal
54
Is alcohol moderation a class I indication for BP control?
Yes
55
Punch line of ACCORD trial
Higher mortality with intensive glucose control (HbA1C<6%)
56
According to ADVANCE trial, what is the only potential benefit of intense glycemic control in DM?
Lowers incidence of nephropathy
57
What guideline class is measurement of non-standard lipid parameters (like lipoproteins)?
III
58
Class IIa indication to check CRP
Men>50, women >60 with LDL<130 and no other problems
59
Class III indication for checking CRP
- asymptomatic adults at high risk for CHD | - Low risk men<60
60
Side effects of varenicline and bupropion for smoking cessation
Suicidal ideation
61
Overweight BMI | Obese BMI
25-29.9 | 30
62
JNC 8 RCTs for age > 60
Treat at BP 150/90
63
JNC 8 recs for age <60
Treat BP of 140/90
64
JNC 8 recs for DM
Goal BP < 140/90
65
JNC 8 initial Rx for blacks
Thiazides or CCB
66
JNC 8 initial Rx for non blacks
Thiazides, ACE/ARB, CCB
67
JNC 8 recs for CKD
Rx with ACE/ARB to goal BP< 140/90
68
Which med is a class III rec for DM and SIHD?
Rosiglitazone
69
Over what age do you not start high dose statins?
75
70
If pt is age 40-75 and DM, do you start mod or high intensity statin?
Mod unless estimated 10yr ASCVD risk > 7.5%
71
At what LDL should you eval for secondary causes?
>190
72
What labs to check before starting statins?
LFTs | DM screen

Cardiology (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions