HTN, HLD And Cardiac RF

Question 1

Which labs should be ordered for obesity?

Answer 1

CMP, liver enzymes, fasting glucose, A1c, TSH and fasting lipid prolife

Question 2

What are findings in the eyes for dyslipidemia?

Answer 2

Corneal arcus, xanthelasma, lipemia retinalis (rare)

Question 3

What skin findings will be found in someone with dyslipidemia?

Answer 3

Xanthomas and orange palmar creases type III

Question 4

Which labs should be ordered for dyslipidemia?

Answer 4

Fasting serum lipid prolife, fasting glucose, thyroid test, LFT, serum creatinine, UA

Question 5

Which labs should be ordered for DM?

Answer 5

Glucose log, A1c, lipid profile, CMP, TSH, vitamin B12, serum creatinine, eGFR, albumin to creatinine ratio in urine

Question 6

When should echocardiography be done?

Answer 6

Only if clinical evidence of HF or LVH
More sensitive to detect LVH than EKG
Stress echo if you suspect CAD or valvular dz

Question 7

When should you ultrasound the kidneys?

Answer 7

Onset labile, elevated serum creatinine, abnormal urinalysis and bruit heard on PE

Question 8

What is normal BP?

Answer 8

<120/80

Question 9

What is considered elevated BP?

Answer 9

<120-129/<80

Question 10

What is stage I HTN?

Answer 10

BP<130-139/80-89

Question 11

What is stage II HTN?

Answer 11

BP >140/90

Question 12

What are the best non-pharmacological interventions to decrease BP?

Answer 12

Weight loss, healthy diet, reduced intake of dietary Na, enhanced intake of dietary K+, physical activity, moderation in alcohol intake

Question 13

What is the first line tx for HTN?

Answer 13

RAAS inhibitors, CCBs, thiazide diuretics

Question 14

What is the MOA for Biguanides?

Answer 14

Decreases hepatic glucose production and intestinal glucose absorption; increases insulin sensitivity

Question 15

What are the indications for Biguanides?

Answer 15

T2DM

Ex. Metformin (glucophage)

Question 16

What are the SE of Biguanides?

Answer 16

Anorexia, N/V and diarrhea

Question 17

What are the contraindications for Biguanides?

Answer 17

Creatinine above 1.4, liver failure, excessive EtOH intake

Question 18

What is the MOA for sulfonylureas?

Answer 18

Stimulates pancreatic islet beta cell inuslin release

Question 19

What are the indications for sulfonylureas?

Answer 19

T2DM

Ex. Glyburide (dia beta), glipizide (glucatrol)

Question 20

What are the SE of sulfonylureas?

Answer 20

Hypoglycemia, weight gain, nausea

Question 21

What is the MOA for thiazolidinediones?

Answer 21

Sensitize peripheral tissues to insulin, PPAR-gamma, decrease hepatic glucose output

Question 22

What are the indications for thiazolidinediones?

Answer 22

T2DM

Ex. Rosiglitazone (Avandia), pioglitazone (actos)

Question 23

What are the SE for thiazolidinediones?

Answer 23

MI, angina, edema, macular edema, weight gain

Question 24

What is the MOA for GLP-1 receptor agonists?

Answer 24

Activates glucagon like peptide 1 receptor, increases insulin secretion, decreases glucagon secretion, delays gastric emptying

Question 25

What are the indications for GLP-1 receptor agonists?

Answer 25

T2DM | Ex. Dulaglutide (trulicity), Liraglutide (Victoza)

Question 26

What are the side effects for GLP-1 receptor agonists?

Answer 26

N/V/D, pancreatitis (1/1000)

Question 27

What is the MOA for DPP-4 inhibitors?

Answer 27

Inhibits the enzyme DPP-4 and prolongs action of GLP-1, increases insulin release, decreases glucagon levels

Question 28

What is the indication for DPP-4 inhibitors?

Answer 28

T2DM | Ex. Sitagliptin (Januvia), Linagliptin (Tradjenta)

Question 29

What are the SE for DPP-4 inhibitors?

Answer 29

URI, HA, diarrhea, abdominal pain, arthralgias

Question 30

What is the MOA for SGLT2 inhibitors?

Answer 30

Inhibits glucose reabsorption in proximal tubules in kidney, cause glucosuria, and thereby lowers glucose levels

Question 31

What are the indications for SGLT2 inhibitors?

Answer 31

T2DM | Ex. Dapaglifozin (farxiga) and empagliflozin (Jardiance)

Question 32

What are the SE for SGLT2 inhibitors?

Answer 32

Yeast infections, UTI, orthostatic hypotension, nausea, fatigue