1-100 of 100
Select a term to match it with its definition
-weight-bearing exercises (walking, jogging, biking, aerobic dance)
-swimming and isometric exercises are not considered weight-bearing
Exercises for osteoporosis
,-exercise (swimming, walking, biking)
-lose weight
-stop smoking
-first line medication - acetaminophen (Tylenol)
-alternative therapies - glucosamine, SAM-e, acupuncture, Tai Chi
Degenerative joint disease treatment
-LDL >190; History of Coronary Heart Disease (CHD) or stroke
-High-intensity statins include Atorvastatin (Lipitor) and Rosuvastatin (Crestor)
-Start screening at 20 then every 5 years until 40 if no issues. At 40 every 2-3 years. IF dx
then annually etc.
When to start patient on high intensity statin
-Primary - elevated TSH; low T4; low or normal T3
-Subclinical - elevated TSH; normal T4; normal T3
-Common cause is Hashimoto's (autoimmune) - Hashimoto and Hypo both have O
-Symptoms are variable - may include fatigue
-Treatment - levothyroxine (Synthroid) daily in AM on empty stomach
-Starting dose of levothyroxine (Synthroid) is 25-50mcg
-Check TSH every 6-8 weeks to monitor treatment
, Hypothyroid
-Beta blocker - "lol"; good as add-on medication, not uncomplicated HTN; avoid abrupt
discontinuation, wean slowly to avoid rebound HTN; contraindications include asthma,
COPD, chronic bronchitis, emphysema, second and third-degree heart block (okay with
1st degree), sinus bradycardia; do not use Propranolol for HTN
-Calcium channel blocker - "pine"; first choice for ISH (isolated systolic HTN); side effects
include headaches (vasodilation), ankle edema (vasodilation, benign), heart
block/bradycardia (depresses cardiac muscle and AV node), reflex tachycardia
(nifedipine); contraindicated in 2nd and 3rd degree heart block, bradycardia, CHF
Hypertension Meds Part 2
-low dose ICS plus SABA (albuterol) PRN (preferred treatment)
-alternative treatment - cromolyn, Montelukast, nedocromil, or theophylline
-Remember all asthma patients must have SABA as rescue med (safety issue)
Adolescent with mild persistent asthma – treatment?
-caused by carotid stenosis (cholesterol plaque accumulation)
, Carotid bruit
-symptoms - intermittent claudication (leg pain when walking; no pain at rest); lower
extremities cool to touch; shiny, hyperpigmented, hairless skin on lower extremities;
decreased/absent pedal pulse; increased capillary refill; bruits over partially blocked
arteries
-higher risk for PAD with HTN, smoking, diabetes, hyperlipidemia
-treatment - smoking cessation, daily exercise, ankle and brachial BP before and after
exercise.
-Pletal/Cilostazol or phosphodiesterase inhibitor vasodilator can be taken with ASA or
Plavix.
-Grapefruit juice, Cardizem, or Prilosec can increase serum concentration if taken
together.
-Last resort percutaneous angioplasty or surgery for severe cases.
-gold standard for diagnosis - angiography
-complications - gangrene of foot or lower limb - requires amputation; increased risk of
CAD or carotid plaques
-Ankle-Brachial Index ABI </= 0.9 is ABNORMAL and Dx PAD. 0.91-1.3 is Normal. To
calculate take the SBP of each ankle and divide by the SBP of both arms.
Peripheral Artery Disease (PAD)
-HMG CoA reductase inhibitors
-Do not mix with grapefruit juice
-Drug-induced hepatitis or rhabdomyolysis higher if mixed with azole antifungals
-Also interact with fibrates (except fenofibrate), macrolides, amiodarone, and some CCBs
-High-dose Zocor has highest risk of rhabdomyolysis
-High intensity statins lower LDL by 35-63%
Select a term to match it with its definition
-weight-bearing exercises (walking, jogging, biking, aerobic dance)
-swimming and isometric exercises are not considered weight-bearing
Exercises for osteoporosis
,-exercise (swimming, walking, biking)
-lose weight
-stop smoking
-first line medication - acetaminophen (Tylenol)
-alternative therapies - glucosamine, SAM-e, acupuncture, Tai Chi
Degenerative joint disease treatment
-LDL >190; History of Coronary Heart Disease (CHD) or stroke
-High-intensity statins include Atorvastatin (Lipitor) and Rosuvastatin (Crestor)
-Start screening at 20 then every 5 years until 40 if no issues. At 40 every 2-3 years. IF dx
then annually etc.
When to start patient on high intensity statin
-Primary - elevated TSH; low T4; low or normal T3
-Subclinical - elevated TSH; normal T4; normal T3
-Common cause is Hashimoto's (autoimmune) - Hashimoto and Hypo both have O
-Symptoms are variable - may include fatigue
-Treatment - levothyroxine (Synthroid) daily in AM on empty stomach
-Starting dose of levothyroxine (Synthroid) is 25-50mcg
-Check TSH every 6-8 weeks to monitor treatment
, Hypothyroid
-Beta blocker - "lol"; good as add-on medication, not uncomplicated HTN; avoid abrupt
discontinuation, wean slowly to avoid rebound HTN; contraindications include asthma,
COPD, chronic bronchitis, emphysema, second and third-degree heart block (okay with
1st degree), sinus bradycardia; do not use Propranolol for HTN
-Calcium channel blocker - "pine"; first choice for ISH (isolated systolic HTN); side effects
include headaches (vasodilation), ankle edema (vasodilation, benign), heart
block/bradycardia (depresses cardiac muscle and AV node), reflex tachycardia
(nifedipine); contraindicated in 2nd and 3rd degree heart block, bradycardia, CHF
Hypertension Meds Part 2
-low dose ICS plus SABA (albuterol) PRN (preferred treatment)
-alternative treatment - cromolyn, Montelukast, nedocromil, or theophylline
-Remember all asthma patients must have SABA as rescue med (safety issue)
Adolescent with mild persistent asthma – treatment?
-caused by carotid stenosis (cholesterol plaque accumulation)
, Carotid bruit
-symptoms - intermittent claudication (leg pain when walking; no pain at rest); lower
extremities cool to touch; shiny, hyperpigmented, hairless skin on lower extremities;
decreased/absent pedal pulse; increased capillary refill; bruits over partially blocked
arteries
-higher risk for PAD with HTN, smoking, diabetes, hyperlipidemia
-treatment - smoking cessation, daily exercise, ankle and brachial BP before and after
exercise.
-Pletal/Cilostazol or phosphodiesterase inhibitor vasodilator can be taken with ASA or
Plavix.
-Grapefruit juice, Cardizem, or Prilosec can increase serum concentration if taken
together.
-Last resort percutaneous angioplasty or surgery for severe cases.
-gold standard for diagnosis - angiography
-complications - gangrene of foot or lower limb - requires amputation; increased risk of
CAD or carotid plaques
-Ankle-Brachial Index ABI </= 0.9 is ABNORMAL and Dx PAD. 0.91-1.3 is Normal. To
calculate take the SBP of each ankle and divide by the SBP of both arms.
Peripheral Artery Disease (PAD)
-HMG CoA reductase inhibitors
-Do not mix with grapefruit juice
-Drug-induced hepatitis or rhabdomyolysis higher if mixed with azole antifungals
-Also interact with fibrates (except fenofibrate), macrolides, amiodarone, and some CCBs
-High-dose Zocor has highest risk of rhabdomyolysis
-High intensity statins lower LDL by 35-63%
