Cardiology CE 1

Question 1

stage 1 HTN range

Answer 1

130-139 or 80-89

Question 2

stage 2 HTN range

Answer 2

140 or more OR 90 or more

Question 3

start pharm if BP exceeds what - < 60 or 60 or older

Answer 3

<60 - start 140/90, DM, CKD
60 or older - start 150/90

Question 4

4 first line meds for HTN

Answer 4

thiazide diuretics
ACE
ARB
CCB

Question 5

obese BMI

Answer 5

30 or more

Question 6

which first line BP med is also good for DM

Answer 6

ACE

Question 7

sulfa allergy - consider what

Answer 7

thiazide diuretics like chlorthalidone may be contraindicated due to similar chemical structures

Question 8

what to check in two weeks if started on amlodipine

Answer 8

none

Question 9

what should be checked in 2 weeks if lisinopril is started

Answer 9

K
BUN, Cr

Question 10

you started them on an ACE or ARB - what to check and when

Answer 10

check K, BUN, and Cr in two weeks

Question 11

what to check in 2 weeks if started on chlorthalidone and why

Answer 11

K - as 7% of patients end up with treatable hypokalemia

Question 12

why can’t you be on an ACE and ARB together

Answer 12

increases risk of stroke

Question 13

can you add thiazide diuretics with ACE?

Answer 13

yes!

Question 14

best statins for high risk patients are
2

Answer 14

atorvastatin
rosuvastatin

Question 15

dyslipidemia guidelines - hx of CHD or stroke

Answer 15

recommend LDL reduction with statin - 50% reduction of LDL with atorvastatin 40, 80 mg or rosuvastatin 20, 40 mg

Question 16

dyslipidemia guidelines - LDL >190 (familial hyperlipidemia)

Answer 16

recommend LDL reduction with statin, 50% reduction

Question 17

dyslipidemia guidelines - DM, aged 40-75, LDL 70-189

Answer 17

recommend LDL reduction with statin - 30-49% reduction with atorvastatin 10, 20 mg; rosuvastatin 5, 10 mg;
simvastatin 10, 20 mg;
pravastatin 20, 40 mg

Question 18

dyslipidemia guidelines - global 10 year risk score 7.5 or more (primary prevention)

Answer 18

rec statin for LDL reduction by 30-49%

Question 19

starting dose of rosuvastatin

Answer 19

5 mg

Question 20

can you start statins at higher than lowest dose

Answer 20

yes - we are not much concerned about this as we are with BP medications

Question 21

fibrates do what

Answer 21

lower trig levels

Question 22

when to start fibrates

Answer 22

trigs >500; trigs <500 we recommend lifestyle modifications

Question 23

statins can reduce trigs by what percent

Answer 23

5-15%

Question 24

NSAIDs and BP

Answer 24

NSAIDs can cause you to hold onto water and thus can increase BP

Question 25

common NSAIDs
4

Answer 25

ibuprofen (short acting, OTC)
naproxen (long acting, script)
celecoxib/Celebrex (long acting, script)
meloxicam (long acting (qd), script)

Question 26

triamterene/HCTZ - what are they and what are some things to watch out for

Answer 26

Triamterene is a K sparing diuretic - can cause K to rise and Na to drop as kidneys filter out excess water with sodium

Question 27

difference between dihydropyridine and non-dihydropyridine CCBs

Answer 27

• dihydropyridines are more vascular selective
• non-dihydropyridines are more myocardial selective and tend to reduce the heart rate

Question 28

which CCB tend to reduce HR

Answer 28

non-dihydropyridines

Question 29

vascular selective is to which CCB

Answer 29

dihydropyridines

Question 30

non-dihydropyridine CCBs examples

Answer 30

diltiazem
verapamil

Question 31

dihydropyridine CCBs examples

Answer 31

-pines: amlodipine, nifedipine, nimodipine

Question 32

-pine CCB are to

Answer 32

dihydropyridine CCB - less effect of HR