1. Educational,./Objective:,./Hypertension,./is,./an,./important,./modifiable,./risk,./factor,
. / in,./patients,./with ,./heart,./failure,./as,./a,./result,./of,./increased,./strain,./placed,./on,./the,./l
eft,./ventricle.,./Maintaining,./a,./lower,./blood,./pressure,./improves,./cardiac,./output,./(a
long,./with, . / symptoms, . / of, . / heart, . / failure), . / and, . / slows, . / the, . / rate, . / of, . / ventricular
, . / decline:
2. if,./a,./pt,./has,./signs,./of,./angina,./pectoris,./(stable,./angina),./what,./should,./you,./do?:,./stre
ss,./test!
Stress,./testing:,./ST-segment,./or,./wall-motion,./changes,./(using,./echo),./with,./exer-
,./cise,./or,./pharmacologic,./stress,./(dobutamine,./echo,./or,./dipyridamole,./thallium),./are,./diagnostic,./of,./CAD
3. s/e,./of,./pt,./taking,./aspirin,./and,./an,./ace,./inhibitor:,./SAID,./use,./can,./precipitate,./acute,./kidney,./injury,./(
AKI),./as,./a,./result,./of,./decreased,./prostaglandin,./synthesis,,./which,./would,./otherwise,./promote,./renal,./atterent,./arter
iole,./vasodilation,./and,./renal,./blood,./flow.,./This,./can,./cause,./worsening,./of,./hypertension,,./especially,./in,./patients,./t
aking,./ACE,./inhibitors,./such,./as,./lisinopril.
4. Hyperaldosteronism, . / labs:, . / Normal,./NA:,./Inc,./Na,./retention,./but,./ANP,./inhibits,./reabsorptions,./so,./htn,./w
/out,./significant,./edema,./or,./hypernatremia
hypokalemia,,./metabolic,./acidosis(Increased,./HCO3,,./dec,./H)
5. pt,./has,./lymes,./dz;,./tx?,./first,./line,./and,./for,./preg/8yo,./and,./less:,./Doxycycline,./is,./first-
line,./for,./the,./treatment,./of,./early-stage,./Lyme,./disease.
(or,./amoxicillin,./in,./children,./<,./8,./years,./of,./age,./and,./in,./pregnant,./patients);
6. description,./of,./lymes,./disease:,./1°,./(early,./localized,./disease):,./Erythema,./migrans,./begins,./as,./a,./s
mall,./erythem-,./atous,./macule,./or,./papule,./that,./is,./found,./at,./the,./tick-
feeding,./site,./and,./expands,./slowly,./over,./days,./to,./weeks.,./The,./border,./may,./be,./macular,./or,./raised,,./often,./with,./c
entral,./clearing
7. pyelonephritis,./tx,./(severe,./+,./mild):,./severe:,./iv,./fluids,./+,./antibioti
cs,./mild:,./fluroquinolones
8. afib,./causes,./what,./with,./the,./heart:,./Atrial,./fibrillation,./can,./be,./recognized,./on,./ECG,./as,./an,./irreg
ular,,./narrow-complex,./arrhythmia,./lacking,./distinct,./P-
waves.,./Uncoordinated,./atrial,./contractions,./and,./tachycardia,./result,./in,./diminished,./left,./ventricular,./filling,./duri
ng,./diastole,,./which,./results,./in,./a,./decreased,./cardiac,./output.
9. pt, . / is, . / an, . / alcoholic;, . / wants, . / to, . / stop, . / drinking, . / but, . / isn't, . / sure, . / how, . / to..., . / wh
at, . / do, . / you,./do:,./acknowledge,./their,./discrepancy,./to,./stop
,./
,./
, For,./example,,./the,./physician,./could,./also,./ask,./what,./his,./specific,./reasons,./are,./for,./wanting,./to,./quit,./drinking,./alcoh
ol,./or,./what,./barriers,./lead,./to,./him,./not,./feeling,./ready,./to,./quit,./drinking.,./Even,./if,./the,./patient,./is,./not,./ready,./to,./stop,./
a,./behavior,,./the
,./
,./
. / in,./patients,./with ,./heart,./failure,./as,./a,./result,./of,./increased,./strain,./placed,./on,./the,./l
eft,./ventricle.,./Maintaining,./a,./lower,./blood,./pressure,./improves,./cardiac,./output,./(a
long,./with, . / symptoms, . / of, . / heart, . / failure), . / and, . / slows, . / the, . / rate, . / of, . / ventricular
, . / decline:
2. if,./a,./pt,./has,./signs,./of,./angina,./pectoris,./(stable,./angina),./what,./should,./you,./do?:,./stre
ss,./test!
Stress,./testing:,./ST-segment,./or,./wall-motion,./changes,./(using,./echo),./with,./exer-
,./cise,./or,./pharmacologic,./stress,./(dobutamine,./echo,./or,./dipyridamole,./thallium),./are,./diagnostic,./of,./CAD
3. s/e,./of,./pt,./taking,./aspirin,./and,./an,./ace,./inhibitor:,./SAID,./use,./can,./precipitate,./acute,./kidney,./injury,./(
AKI),./as,./a,./result,./of,./decreased,./prostaglandin,./synthesis,,./which,./would,./otherwise,./promote,./renal,./atterent,./arter
iole,./vasodilation,./and,./renal,./blood,./flow.,./This,./can,./cause,./worsening,./of,./hypertension,,./especially,./in,./patients,./t
aking,./ACE,./inhibitors,./such,./as,./lisinopril.
4. Hyperaldosteronism, . / labs:, . / Normal,./NA:,./Inc,./Na,./retention,./but,./ANP,./inhibits,./reabsorptions,./so,./htn,./w
/out,./significant,./edema,./or,./hypernatremia
hypokalemia,,./metabolic,./acidosis(Increased,./HCO3,,./dec,./H)
5. pt,./has,./lymes,./dz;,./tx?,./first,./line,./and,./for,./preg/8yo,./and,./less:,./Doxycycline,./is,./first-
line,./for,./the,./treatment,./of,./early-stage,./Lyme,./disease.
(or,./amoxicillin,./in,./children,./<,./8,./years,./of,./age,./and,./in,./pregnant,./patients);
6. description,./of,./lymes,./disease:,./1°,./(early,./localized,./disease):,./Erythema,./migrans,./begins,./as,./a,./s
mall,./erythem-,./atous,./macule,./or,./papule,./that,./is,./found,./at,./the,./tick-
feeding,./site,./and,./expands,./slowly,./over,./days,./to,./weeks.,./The,./border,./may,./be,./macular,./or,./raised,,./often,./with,./c
entral,./clearing
7. pyelonephritis,./tx,./(severe,./+,./mild):,./severe:,./iv,./fluids,./+,./antibioti
cs,./mild:,./fluroquinolones
8. afib,./causes,./what,./with,./the,./heart:,./Atrial,./fibrillation,./can,./be,./recognized,./on,./ECG,./as,./an,./irreg
ular,,./narrow-complex,./arrhythmia,./lacking,./distinct,./P-
waves.,./Uncoordinated,./atrial,./contractions,./and,./tachycardia,./result,./in,./diminished,./left,./ventricular,./filling,./duri
ng,./diastole,,./which,./results,./in,./a,./decreased,./cardiac,./output.
9. pt, . / is, . / an, . / alcoholic;, . / wants, . / to, . / stop, . / drinking, . / but, . / isn't, . / sure, . / how, . / to..., . / wh
at, . / do, . / you,./do:,./acknowledge,./their,./discrepancy,./to,./stop
,./
,./
, For,./example,,./the,./physician,./could,./also,./ask,./what,./his,./specific,./reasons,./are,./for,./wanting,./to,./quit,./drinking,./alcoh
ol,./or,./what,./barriers,./lead,./to,./him,./not,./feeling,./ready,./to,./quit,./drinking.,./Even,./if,./the,./patient,./is,./not,./ready,./to,./stop,./
a,./behavior,,./the
,./
,./
