Week 1

Question 1

adult BMI >25

Answer 1

overweight

Question 2

adult BMI >30

Answer 2

obesity

Question 3

pediatric BMI at 95th percentile for age and gender or BMI>30

Answer 3

obesity

Question 4

differential diagnosis for obesity

Answer 4

PCOS
hypothyroidism
cushing’s syndrome

Question 5

pharmacologic treatment for obesity

Answer 5

orlestat (xenical) prevents dietary fat absorption .

phentermine/ topiramate for longterm use in obese patients; appetite suppression.

Question 6

nonpharmacologic treatment for obesity

Answer 6

bariatric surgery for pts with BMI 40 or higher

Question 7

hypertension diagnosis ACC/AHA

Answer 7

2 BP measurements at different office visits (2 weeks apart). 
normal BP: 120/80
pre htn: 120-139/80-89
< 60 y/o: goal is  a BP less than 130/80
> 60 y/o: htn is 150/90 or higher.

Question 8

hypertension management

Answer 8

calculate ASCVD risk score:
if ASCVD is < 10, lifestyle management. check bp in 3-6 months.
stage 1 htn and ASCVD >10: lifestyle modifications and 1 BP med and f/u with BP in 1 month.
stage 2 htn: lifestyle modifications and 2 drugs from different classes and f/u with BP in 1 month.

prompt antiHTN meds if bp > 180/110 (don’t wait for 2nd bp. EKG and labs)

adults with well controlled HTN can be followed annually

Question 9

Stage 1 htn is classified as

Answer 9

130-139/80-89

Question 10

stage 2 htn is classified as

Answer 10

> 140/90

Question 11

ASCVD goal percentage

Answer 11

<10 %. devised of BP, LDL, age, ethnicity and sex.

Question 12

JNC guidelines 2014 role in HTN

Answer 12

does not help to diagnose. only management of HTN, less aggressive

Question 13

heart failure

Answer 13

ACE/ARB and BB and diuretic and spironolactone

Question 14

post MI

Answer 14

ACE/ ARB and BB

Question 15

CAD

Answer 15

ACE, BB, Diuretic, CCB

Question 16

diabetes

Answer 16

ACE/ARB, CCB, diuretic

Question 17

CKD

Answer 17

ACE/ARB

Question 18

pregnant women

Answer 18

labetalol (1st line), nifedipine, methyldopa

Question 19

recurrent stroke prevention

Answer 19

ACE, diuretic

Question 20

management with diuretics

Answer 20

labs for hypokalemia

Question 21

management with ACE inhibitors

Answer 21

labs for hyperkalemia

Question 22

HTN evaluation

Answer 22

H&P , UA, electrolytes, CBC, fasting glucose, hgb a1c, lipid pannel, echocardiogram, tsh, uric acid

Question 23

hydrochlorothiazide 25mg

Answer 23

if unsuccessful, add a new med. do not increase HTZ, because it will increase hypokalemia

Question 24

risk factors for hyperlipidemia

Answer 24

increased age, male, genetic disorders of lipid metabolism, family hx of CAD, smoking, obesity, htn, elevated LDL, low HDL, diabetes.

Question 25

hyperlipidemia screening guidelines

Answer 25

fasting lipids on all adults > 20 q 5 years. asymptomatic adults: age 40-79 perform 10 year ASCVD risk score. high risk patients: LDL >190 diabetics: LDL > 70-189 with or without ASCVD without DM 70-189 and ASCVD >7.5

Question 26

ACC/ AHA guidelines 2018 hyperlipidemia

Answer 26

``` clinical ASCVD ( >7.5), or LDL >190, then use high intensity statin. diabetics 40-75 with LDL < 70, moderate intensity statin ```

Question 27

high intensity statin

Answer 27

atorvastatin 40-80, rosuvastatin 20-40 mg

Question 28

low intensity statin

Answer 28

simvastatin/ pravastatin 10-20 mg

Question 29

moderate intensity statin

Answer 29

atorvastatin 10-20, simvastatin 20-40, pravastatin 40-80

Question 30

hyperlipidemia management

Answer 30

lifestyle modification, diet, exercise, and pharmacologic management, educating about side effects, take meds as prescribed, follow up for lab tests, smoking cessation

Question 31

hyperlipidemia diagnosis

Answer 31

fasting lipid panel HDL, LDL, triglycerides. check CK if on statins

Question 32

pediatrics with BMI between 85 and 95th percentile

Answer 32

considered overweight

Question 33

metabolic syndrome

Answer 33

ATP 3 criteria presence of 3 of the following traits: abdominal obesity (waist circumference > 40 inches in men and >35 inches in women), AND triglycerides >150 or on pharmacologic tx for triglycerides AND HDL <40 in males and <50 in females or on drug treatment for HDL AND BP > 130/85 or being treated for HTN AND fating glucose > 100 or on antidiabetics

Question 34

treatment of metabolic syndrome

Answer 34

statin, antihypertensive, aspirin, metformin, lifestyle changes, thiazolidinediones, glipizide, consult for surgery

Question 35

HTN management in pediatrics

Answer 35

BP measures annually on all 3+ and older