NR667,/.CEA,/.Module,/.notes
1. Metabolic, / . syndrome:, / . >,/.Insulin-resistance,/.syndrome,/.and,/.Syndrome,/.X.
> Higher,/.need,/.for,/.type,/.II,/.DM,/.and,/.CVD
> Includes,/.three,/.of,/.the,/.following,/.traits
- Male,/.waist,/.circumference,/.>,/.40
- Female,/.waist,/.circumference,/.>,/.35
-,/.HTN,,/.BP,/.>,/.130/8-
- Triglycerides,/.>,/.150
- HDL,/.<,/.40,/.males,,/.<,/.50,/.females
- Hyperglycemia,,/.Fasting,/.glucose,/.>,/.100,/.mg/dl.
2. Cardiovascular, / . anatomy, / . and, / . flow, / . complications:, / . >,/.Location
- Central,/.anterior,/.chest
- RV,/.is,/.anteriorly,/.located
- LV,/.is,/.posteriorly,/.located
> Flow,/.of,/.blood,/.in,/.the,/.body
- Lungs,/.>,/.pulmonary,/.veins,/.>,/.left,/.atrium,/.>,/.left,/.ventricle,/.>,/.aorta,/.>,/.body,/.tissues,/.>,/.vena,/.cava,/.>,/.right,/.atrium,/.>,/.right,/.ventr
icle
> pulmonary,/.arteries,/.>,/.lungs.
> Blood,/.flow,/.complications
- Contractility:,/.EF,,/.CAD,,/.LVH,,/.Cardiomyopathy
- Preload:,/.Central,/.fluid,/.volume,/.status
- Afterload:,/.Arterial,/.backpressure,/.on,/.outflow,/.(Chronic,/.hypertension).,/.(**RAAS,/.system,/.typically,/.manages,/.this)
.
3. Hypertension:, / . >JNC8
- Defined,/.as,/.140/90
- Secondary,/.HTN:,/.Up,/.flow,/.issue,/.going,/.up,/.to,/.kidney,,/.ex:,/.renal,/.stenosis.
-,/.Age,/.>,/.60,/.or,/.<,/.60,/.years.,/.(>60,/.=,/.150/90).
- DM,/.and,/.CKD:,/.ACE/ARBs,/.(nephro,/.protective).
- Non-black,/.vs.,/.Black:,/.Calcium,/.channel,/.blocker,/.for,/.African,/.Ascent.
- General,/.starting,/.place:,/.Thiazides/ACE/ARBs.
- ACE/ARBS:,/."Prils",/.and,/."Sartans"
- Beta,/.Blockers:,/."olol",/.not,/.on,/.JNC8,/.guidelines,,/.history,/.of,/.cardiac,/.disease,,/.reduce,/.HR.,/.Carvedilol,/.is,/.a,/.dual,/
, NR667,/.CEA,/.Module,/.notes
alpha/beta,,/.great,/.for,/.Heart,/.failure.
.
, NR667,/.CEA,/.Module,/.notes
- CCB:,/.Dihydropyrines,/.and,/.Non-
Dihydropyrines.,/.Dihydropyrines,/.work,/.more,/.peripherally,/.(amlodipine,,/.etc).,/.Non-Di-
hydropyrines,/.work,/.more,/.on,/.heart,/.(Verapamil,/.and,/.diltiazem).,/.Common,/.ASE:,/.Constipation,/.and,/.peripheral,/.e
dema.
- Diuretics:,/.Thiazides,,/.Loops.,/.Thiazides,/.are,/.less,/.potent.,/.Thiazide=,/.Low,/.electrolytes,,/.Higher,/.calcium.,/.Loops
-,/.lowers,/.everything.,/.Potassium-sparing,/.diuretics,/.(Increase,/.potassium,,/.lowers,/.sodium).
4. Heart,/.failure:,/.>HFrEF,/.(Less,/.than,/.40%)
> HFpEF,/.(Higher,/.than,/.40%)
> Systolic,/.heart,/.failure:,/.inability,/.for,/.myocardium,/.to,/.ettectively,/.contract.
> Diastolic,/.heart,/.failure:,/.inability,/.to,/.myocardium,/.to,/.ettectively,/.relax.
> Typical,/.patient:,/.elderly,/.with,/.comorbidities,/.of,/.HTN,,/.DM,,/.Smoking.
- Class,/.I:,/.Mild,/.symptoms
- Class,/.II-III:,/.Symptoms,/.with,/.exertion,/.(II),,/.ADL's,/.cause,/.symptoms,/.(III)
- Class,/.IV:,/.Symptoms,/.severe,,/.likely,/.needs,/.hospitalization.
> Classic,/.symptoms:,/.SOB,,/.Fatigue,,/.exertional,/.dyspnea,,/.dependent,/.and,/.pulmonary,/.edema,,/.low,/.activity,/.t
olerance,,/.abdominal,/.bloating,,/.orthopnea.
> Causes:,/.ischemic,/.heart,/.disease,,/.valve,/.disease,,/.MI,,/.cardiomyopathy.
> Treatment:,/.ACE/ARB,,/.ARB/ARNI,,/.BB,,/.Diuretics,,/.nitrates,/.plus,/.hydralazine,,/.Fluid,/.and,/.salt,/.restriction,,/.daily,/.weights.
5. Lipid, / . management:, / . >AVSCD
- Statins
- Hight-intensity,/.statins:,/. Atorvastatin,/. 40-80mg,/. and,/.Rovusatan,/. 20-
40mg,/. (Don't,/. require,/.being,/. taken,/. at,/. bedtime).,/.LDL
<,/.190
- Common,/.ASE:,/.Myalgia.,/.Rhabdomyolysis,/.worse,/.case,/.scenario.
- Statins,,/.Ezetimibe,/.in,/.conjunction.,/.PC9-
Inhibitors,/.(injectable,/.Q2,/.weeks).,/.(Cardiology,/.at,/.consult,/.prior,/.to,/.PC9-In-hibitors).
- Familial,/.homozygous,/.hyperlipidemia=,/.PC9-Inhibitors.
- HDL:,/."Cleaning,/.agent."
- LDL-,/."Scrum,/.between,/.glass,/.window,/.in,/.shower"
6. Valve,/.disease,/.and,/.aneurysms:,/.>,/.Aortic,/.stenosis:,/.Narrowing,/.of,/.outflow,/.to,/.aortic,/.root,/.through,/.aor
tic,/.valve,/.due,/.to,/.calcification.,/.Symptoms,/.tend,/.to,/.mirror,/.CAD,/.with,/.addition,/.of,/.syncope/near,/.syncope.
, NR667,/.CEA,/.Module,/.notes
> Aortic,/.Regurgitation/Insuflciency:,/.instability,/.for,/.aortic,/.valve,/.to,/.appropriately,/.close.,/.Commonly,/.due,/.to,/.a
ortic,/.root,/.dilation,/.or,/.endocarditis/infection.,/.A,/.direct,/.contraindication,/.for,/.IABP,/.use,/.(common,/.board,/.exam,/.
question).
1. Metabolic, / . syndrome:, / . >,/.Insulin-resistance,/.syndrome,/.and,/.Syndrome,/.X.
> Higher,/.need,/.for,/.type,/.II,/.DM,/.and,/.CVD
> Includes,/.three,/.of,/.the,/.following,/.traits
- Male,/.waist,/.circumference,/.>,/.40
- Female,/.waist,/.circumference,/.>,/.35
-,/.HTN,,/.BP,/.>,/.130/8-
- Triglycerides,/.>,/.150
- HDL,/.<,/.40,/.males,,/.<,/.50,/.females
- Hyperglycemia,,/.Fasting,/.glucose,/.>,/.100,/.mg/dl.
2. Cardiovascular, / . anatomy, / . and, / . flow, / . complications:, / . >,/.Location
- Central,/.anterior,/.chest
- RV,/.is,/.anteriorly,/.located
- LV,/.is,/.posteriorly,/.located
> Flow,/.of,/.blood,/.in,/.the,/.body
- Lungs,/.>,/.pulmonary,/.veins,/.>,/.left,/.atrium,/.>,/.left,/.ventricle,/.>,/.aorta,/.>,/.body,/.tissues,/.>,/.vena,/.cava,/.>,/.right,/.atrium,/.>,/.right,/.ventr
icle
> pulmonary,/.arteries,/.>,/.lungs.
> Blood,/.flow,/.complications
- Contractility:,/.EF,,/.CAD,,/.LVH,,/.Cardiomyopathy
- Preload:,/.Central,/.fluid,/.volume,/.status
- Afterload:,/.Arterial,/.backpressure,/.on,/.outflow,/.(Chronic,/.hypertension).,/.(**RAAS,/.system,/.typically,/.manages,/.this)
.
3. Hypertension:, / . >JNC8
- Defined,/.as,/.140/90
- Secondary,/.HTN:,/.Up,/.flow,/.issue,/.going,/.up,/.to,/.kidney,,/.ex:,/.renal,/.stenosis.
-,/.Age,/.>,/.60,/.or,/.<,/.60,/.years.,/.(>60,/.=,/.150/90).
- DM,/.and,/.CKD:,/.ACE/ARBs,/.(nephro,/.protective).
- Non-black,/.vs.,/.Black:,/.Calcium,/.channel,/.blocker,/.for,/.African,/.Ascent.
- General,/.starting,/.place:,/.Thiazides/ACE/ARBs.
- ACE/ARBS:,/."Prils",/.and,/."Sartans"
- Beta,/.Blockers:,/."olol",/.not,/.on,/.JNC8,/.guidelines,,/.history,/.of,/.cardiac,/.disease,,/.reduce,/.HR.,/.Carvedilol,/.is,/.a,/.dual,/
, NR667,/.CEA,/.Module,/.notes
alpha/beta,,/.great,/.for,/.Heart,/.failure.
.
, NR667,/.CEA,/.Module,/.notes
- CCB:,/.Dihydropyrines,/.and,/.Non-
Dihydropyrines.,/.Dihydropyrines,/.work,/.more,/.peripherally,/.(amlodipine,,/.etc).,/.Non-Di-
hydropyrines,/.work,/.more,/.on,/.heart,/.(Verapamil,/.and,/.diltiazem).,/.Common,/.ASE:,/.Constipation,/.and,/.peripheral,/.e
dema.
- Diuretics:,/.Thiazides,,/.Loops.,/.Thiazides,/.are,/.less,/.potent.,/.Thiazide=,/.Low,/.electrolytes,,/.Higher,/.calcium.,/.Loops
-,/.lowers,/.everything.,/.Potassium-sparing,/.diuretics,/.(Increase,/.potassium,,/.lowers,/.sodium).
4. Heart,/.failure:,/.>HFrEF,/.(Less,/.than,/.40%)
> HFpEF,/.(Higher,/.than,/.40%)
> Systolic,/.heart,/.failure:,/.inability,/.for,/.myocardium,/.to,/.ettectively,/.contract.
> Diastolic,/.heart,/.failure:,/.inability,/.to,/.myocardium,/.to,/.ettectively,/.relax.
> Typical,/.patient:,/.elderly,/.with,/.comorbidities,/.of,/.HTN,,/.DM,,/.Smoking.
- Class,/.I:,/.Mild,/.symptoms
- Class,/.II-III:,/.Symptoms,/.with,/.exertion,/.(II),,/.ADL's,/.cause,/.symptoms,/.(III)
- Class,/.IV:,/.Symptoms,/.severe,,/.likely,/.needs,/.hospitalization.
> Classic,/.symptoms:,/.SOB,,/.Fatigue,,/.exertional,/.dyspnea,,/.dependent,/.and,/.pulmonary,/.edema,,/.low,/.activity,/.t
olerance,,/.abdominal,/.bloating,,/.orthopnea.
> Causes:,/.ischemic,/.heart,/.disease,,/.valve,/.disease,,/.MI,,/.cardiomyopathy.
> Treatment:,/.ACE/ARB,,/.ARB/ARNI,,/.BB,,/.Diuretics,,/.nitrates,/.plus,/.hydralazine,,/.Fluid,/.and,/.salt,/.restriction,,/.daily,/.weights.
5. Lipid, / . management:, / . >AVSCD
- Statins
- Hight-intensity,/.statins:,/. Atorvastatin,/. 40-80mg,/. and,/.Rovusatan,/. 20-
40mg,/. (Don't,/. require,/.being,/. taken,/. at,/. bedtime).,/.LDL
<,/.190
- Common,/.ASE:,/.Myalgia.,/.Rhabdomyolysis,/.worse,/.case,/.scenario.
- Statins,,/.Ezetimibe,/.in,/.conjunction.,/.PC9-
Inhibitors,/.(injectable,/.Q2,/.weeks).,/.(Cardiology,/.at,/.consult,/.prior,/.to,/.PC9-In-hibitors).
- Familial,/.homozygous,/.hyperlipidemia=,/.PC9-Inhibitors.
- HDL:,/."Cleaning,/.agent."
- LDL-,/."Scrum,/.between,/.glass,/.window,/.in,/.shower"
6. Valve,/.disease,/.and,/.aneurysms:,/.>,/.Aortic,/.stenosis:,/.Narrowing,/.of,/.outflow,/.to,/.aortic,/.root,/.through,/.aor
tic,/.valve,/.due,/.to,/.calcification.,/.Symptoms,/.tend,/.to,/.mirror,/.CAD,/.with,/.addition,/.of,/.syncope/near,/.syncope.
, NR667,/.CEA,/.Module,/.notes
> Aortic,/.Regurgitation/Insuflciency:,/.instability,/.for,/.aortic,/.valve,/.to,/.appropriately,/.close.,/.Commonly,/.due,/.to,/.a
ortic,/.root,/.dilation,/.or,/.endocarditis/infection.,/.A,/.direct,/.contraindication,/.for,/.IABP,/.use,/.(common,/.board,/.exam,/.
question).
