NR667 CEA MODULE NOTES QUESTIONS &
ELABORATED ANSWERS PASSED 100%
1. Metabolic
> Insulin-resistance syndrome and Syndrome X.
syn- drome
> 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. Cardiovascul
> Location
ar anatomy
-Central anterior chest
and flow
-RV is anteriorly located
complication
-LV is posteriorly located
s
> Flow of blood in the body
-Lungs > pulmonary veins > left atrium > left ventricle > aorta >
body tissues > vena cava > right atrium > right ventricle >
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).
,NR667 CEA MODULE NOTES QUESTIONS &
ELABORATED ANSWERS PASSED 100%
-Non-black vs. Black: Calcium channel blocker for African Ascent.
-General starting place: Thiazides/ACE/ARBs.
,NR667 CEA MODULE NOTES QUESTIONS &
ELABORATED ANSWERS PASSED 100%
-ACE/ARBS: "Prils" and "Sartans"
-Beta Blockers: "olol" not on JNC8 guidelines, history of cardiac
disease, reduce HR. Carvedilol is a dual alpha/beta, great for Heart
failure.
-CCB: Dihydropyrines and Non-Dihydropyrines. Dihydropyrines work
more pe- ripherally (amlodipine, etc). Non-Dihydropyrines work more on
heart (Verapamil and diltiazem). Common ASE: Constipation and
peripheral edema.
-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 tolerance, 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 >AVSCD
manage- -Statins
ment -Hight-intensity statins: Atorvastatin 40-80mg and Rovusatan 20-
40mg (Don't require being taken at bedtime). LDL < 190
,NR667 CEA MODULE NOTES QUESTIONS &
ELABORATED ANSWERS PASSED 100%
-Common ASE: Myalgia.
Rhabdomyolysis worse
case scenario.
-Statins, Ezetimibe in
conjunction. PC9-
Inhibitors (injectable
Q2 weeks). (Cardi-
ology at consult
prior to PC9-
Inhibitors).
-Familial homozygous
hyperlipidemia= PC9-
Inhibitors.
ELABORATED ANSWERS PASSED 100%
1. Metabolic
> Insulin-resistance syndrome and Syndrome X.
syn- drome
> 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. Cardiovascul
> Location
ar anatomy
-Central anterior chest
and flow
-RV is anteriorly located
complication
-LV is posteriorly located
s
> Flow of blood in the body
-Lungs > pulmonary veins > left atrium > left ventricle > aorta >
body tissues > vena cava > right atrium > right ventricle >
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).
,NR667 CEA MODULE NOTES QUESTIONS &
ELABORATED ANSWERS PASSED 100%
-Non-black vs. Black: Calcium channel blocker for African Ascent.
-General starting place: Thiazides/ACE/ARBs.
,NR667 CEA MODULE NOTES QUESTIONS &
ELABORATED ANSWERS PASSED 100%
-ACE/ARBS: "Prils" and "Sartans"
-Beta Blockers: "olol" not on JNC8 guidelines, history of cardiac
disease, reduce HR. Carvedilol is a dual alpha/beta, great for Heart
failure.
-CCB: Dihydropyrines and Non-Dihydropyrines. Dihydropyrines work
more pe- ripherally (amlodipine, etc). Non-Dihydropyrines work more on
heart (Verapamil and diltiazem). Common ASE: Constipation and
peripheral edema.
-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 tolerance, 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 >AVSCD
manage- -Statins
ment -Hight-intensity statins: Atorvastatin 40-80mg and Rovusatan 20-
40mg (Don't require being taken at bedtime). LDL < 190
,NR667 CEA MODULE NOTES QUESTIONS &
ELABORATED ANSWERS PASSED 100%
-Common ASE: Myalgia.
Rhabdomyolysis worse
case scenario.
-Statins, Ezetimibe in
conjunction. PC9-
Inhibitors (injectable
Q2 weeks). (Cardi-
ology at consult
prior to PC9-
Inhibitors).
-Familial homozygous
hyperlipidemia= PC9-
Inhibitors.
