Family Medicine EOR - Cardiology Blueprint || A+ Guaranteed.

Family Medicine EOR - Cardiology Blueprint || A+ Guaranteed.
What are 95% of HTN cases? correct answers essential HTN

What are secondary causes of HTN? correct answers - renal disease
- renal stenosis
- aortic coarctation
- hyperaldosteronism from tumor or hyperplasia
- Cushing's
- pheochromocytoma
- OSA

What are the JNC-7 classifications and initial treatment of HTN? correct answers pre-HTN:
120/80-139/89 --> lifestyle changes
HTN Stage I: 140/90-159/99 --> thiazide (or loop if renal patient)
HTN Stage II: >160/100 --> thiazide + 2nd agent

What is the 2nd MCC of ESRD? correct answers HTN

What signifies an advanced stage of malignant HTN? correct answers papilledema

What is hypertensive urgency correct answers - stable or no end organ damage
- no raised ICP

What are symptoms and signs of hypertensive urgency correct answers - SOB
- HA
- BP >220/110

How is hypertensive urgency managed? correct answers - lower BP slowly over 24-48h with
labetaolol, clonidine, captopril, furosemide, or nicardipine
- reduce to/below 160/100
- MAP should not be lowered by >25% in first several hours

What happens in a hypertensive emergency? correct answers - rapidly progressing end organ
damage
- 180/120+
- papilledema if malignant

What are signs and symptoms of a hypertensive emergency correct answers - chest pain
- AMS
- weakness
- MI
- acute CHF
- renal failure
- ICH
- eclampsia

,- aortic dissection
- retinal damage

How is a hypertensive emergency managed? correct answers decrease MAP by no more than
25% in 1st hour and then another 5-15% over next 23h with *IV agents* unless:
- acute phase of ischemic stroke (don't lower BP unless patient with 185/110+ who can have
thrombolytics or patient with 220/120+ who cannot have thrombolytics)
- acute aortic dissection (BP reduced to SBP 100-120 in 20min)

How is HTN monitored in primary care correct answers - annual urine microalbumin
- annual BMP
- annual lipids
- baseline EKG (look for LVH)

How much does a single pharmacologic agent lower BP in HTN? correct answers by 10-20
mmHg (may need 2nd agent)

What thiazides are used to treat HTN? correct answers - HCTZ
- chlorthalidone

When is a thiazide preferred for treating HTN? correct answers good for osteoporosis because it
is calcium sparing

When can't a thiazide be used? correct answers CrCl<30

What loop diuretic is used to treat HTN? correct answers furosemide

What are some K-sparing agents for HTN? correct answers - spironolactone
- eplerenone

What is the problem with K-sparing agents? correct answers not very potent

What ACEIs are used to treat HTN? correct answers - benazepril
- enalapril
- lisinopril

What is a common side effect of ACEIs? correct answers cough

What precautions should be taken with ACEIs? correct answers - can cause renal failure
- *stop if serum Cr increases by 30%*
- pregnancy D

What ARBs are used to treat HTN? correct answers - irbesartan
- losartan
- olmesartan
- valsartan

,What is a common side effect of ARBs? correct answers cough

What precautions should be taken with ARBs? correct answers - can cause renal failure
- *stop if serum Cr increases by 30%*
- pregnancy D

What CCBs are used to treat HTN? correct answers - nifedipine (dihydropyridine)
- amlodipine (dihydropyridine)
- verapamil (non-dihydropyridine)
- diltiazem (non-dihydropyridine)

What warning was issued by the FDA regarding CCBs? correct answers caution with using
simvastatin with amlodipine, verapamil, and diltiazem

What is a contraindication to CCBs? correct answers heart failure

When can clonidine be used to treat HTN? correct answers refractory HTN (due to risk of falls)

What is a contraindication to B-blockers? correct answers - heart block
- decompensated heart failure

What can B-blockers mask? correct answers signs of hypoglycemia

What are the preferred HTN drug class if a patient also has a history of diabetes? correct answers
- thiazide
- B-blocker
- ACEI/ARB
- CCB

What are the preferred HTN drug class if a patient also has a history of MI? correct answers - B-
blocker
- ACEI
- AA

What are the preferred HTN drug class if a patient also has a history of CAD? correct answers -
thiazide
- B-blocker
- ACEI
- CCB

What are the preferred HTN drug class if a patient also has a history of CHF? correct answers -
thiazide
- B_blocker
- ACEI/ARB
- AA

, What are the preferred HTN drug class if a patient also is pregnant? correct answers - clonidine
- methyldopa

What are the preferred HTN drug class for older patients? correct answers CCB

What are the preferred HTN drug class if a patient also has a history of CKD? correct answers
ACEI/ARB

What are the preferred HTN drug class if a patient also has a history of stroke? correct answers -
thiazide
- ACEI

What are the risk factors for coronary artery disease? correct answers - age
- males
- FHx
- sedentary lifestyle
- tobacco
- HTN
- DM
- increased lipids

What is the underlying pathology of acute MIs? correct answers burst plaque --> activation of
clotting system --> infarction

How long does it typically take for stable angina to resolve? correct answers 2-30min

How many classes are there for coronary artery disease? correct answers 4

For coronary artery disease, what does Class 1 look like? correct answers no limitations or
symptoms with normal activity

For coronary artery disease, what does Class 2 look like? correct answers slight limitations and
normal activity result in symptoms

For coronary artery disease, what does Class 3 look like? correct answers marked limitation and
minimal activity results in symptoms

For coronary artery disease, what does Class 4 look like? correct answers symptoms persist with
minimal activity and rest

What is the differential for cardiac chest pain? correct answers - atherosclerosis
- vasospasm (from cocaine or stimulants
- Prinzmetal's angina (women <50yo)
- coronary artery or aortic dissection
- congenital abnormality