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Flashcards in Cardiac Risk Factors Deck (19):
1

Which patients should have their cholesterol checked?`

men >/= 40
women >/= 50 or postmenopausal
or all patients with the following conditions, regardless of age:
- smoking
- diabetes
- arterial htn
- family hx of premature CVD
- family hx of hyperlipidemia
- ED
- CKD
- inflammatory disease
- HIV
- COPE
- clinical evidence of atherosclerosis or abdominal aneurysm
- clinical manifestations of hyperlipidemia
- obesity

2

If Framingham risk score

5%, repeat every year

3

Using the Framingham risk stratification tool, patients receive points for what risk factors? How does this total score relate to risk?

age, HDL-C level, total cholesterol level, SBP, smoker, diabetes
as score increases, risk of CVD increases
if family Hx, current guidelines suggest multiplying risk x 2

4

When is statin therapy indicated?

intermediate risk (FRS 10-15%) if LDL > 3.5
high risk (FRS >20%), clinical vascular disease, AAA, diabetes
CKD
high risk Htn

5

What is target LDL for patients with high risk FRS (>20%) or intermediate risk FRS (10-19%)?

6

What is target LDL in patients with low risk FRS (<10%) ?

>50% reduction

7

When can you Dx htn in the first visit?

Only if there is hypertensive urgency/emergency

8

When can you Dx htn in the second visit?

if target organ damage, diabetes or BP >180/110

9

If you do not Dx htn in the first two visits, what is your next step?

Office BPM
ABPM
Home BPM

10

For home measurement of blood pressure, average BP of equal to or over ____mmHg should be considered elevated

135/85

11

What should daily sodium target be?

<2000mg/day

12

What are side effects of statins? *** EXAM

muscle cramping
liver failure
rhabdomyolysis

13

What are usual blood pressure threshold values for initiation of pharmacological treatment for pts with diabetes, high risk (TOD or CV RFs), low risk (no TOD or CV RFs), very elderly?

diabetes - 130/80
high risk - 140/90
low risk - 160/100
very elderly - 160

14

When should you suspect secondary hypertension?

younger pts
pts with extremely high bp
pts with difficult to control bp
concerning sx (of palpitations, pallor, htn)
certain blood work abnormalities

15

True or False: Beta blockers are not indicated as first line therapy for htn for pts >60

True

16

When may a combination of two first-line drugs be considered as initial therapy for htn?

if blood pressure is >/= 20mmHg systolic or >/=10mmHg diastolic above target

17

Is the combination of an ACE inhibitor with an ARB recommended?

No - except in htn with HF refractory to ACE-i.

18

What are good Rx for Htn in pts with CKD or diabetes?

ACE-Is or ARBs

19

What needs to be monitored following administration of an ACE-I?

renal function & electrolytes (especially K)