CEA Exam Study Guide
Advanced Clinical Diagnosis (Chamberlain
University)
, lOMoAR cPSD| 47061011
Part 1: Cardiovascular and Respiratory Systems
Cardiovascular System
1. Hypertension in African American Patients
● Preferred Medication: Calcium channel blockers (e.g., amlodipine) are recommended as
first-line therapy, particularly dihydropyridines if lifestyle changes (e.g., DASH diet, salt
restriction) fail to control blood pressure.
● Rationale: JNC8 guidelines recommend CCBs over ACE inhibitors in African American
patients due to better outcomes.
2. Uncontrolled Hypertension Complications
● Direct Complications: Chronic hypertension can cause proteinuria, arteriovenous (AV)
nicking, and hemorrhagic stroke.
● Peripheral Neuropathy: Associated more with diabetes but may co-occur in
hypertensive patients with diabetes.
3. Diastolic Dysfunction
● Definition: The heart's inability to relax fully, leading to reduced filling during diastole.
● Significance: Common in patients with thickened myocardium; presents as heart failure
with preserved ejection fraction (HFpEF).
4. Congestive Heart Failure (CHF)
● Symptoms: Dyspnea on exertion, orthopnea, jugular venous distention (JVD), and
bilateral crackles.
● Diagnosis: JVD and pulmonary crackles indicate CHF over other conditions like
myocardial infarction (MI).
5. Heart Failure with Reduced Ejection Fraction (HFrEF) and Post-MI Care
● Management: Patients with EF <35% should use a LifeVest or implantable cardioverter-
defibrillator (AICD) for sudden cardiac death prevention.
● Rationale: Low EF increases arrhythmia risk. Re-assessment with an echocardiogram
2-3 months post-MI monitors recovery.
6. Aortic and Coronary Artery Disease
● Aortic Aneurysm Surveillance: CT angiography is preferred, offering precise aneurysm
measurements and detailed imaging for assessment.
, lOMoAR cPSD| 47061011
● Coronary Artery Disease: High-risk patients (e.g., smokers, high LDL) should be
prescribed statins to reduce ASCVD risk.
7. Orthostatic Hypotension and Severe Blood Loss
● Key Signs: Orthostatic dizziness, confusion, and clammy extremities indicate significant
blood loss, requiring urgent intervention like PRBC transfusion.
8. Peripheral Arterial Disease (PAD) Management
● First-Line Therapy: Statins and ACE inhibitors are recommended to reduce
cardiovascular events.
9. Atrial Fibrillation (AF)
● Management: Beta-blockers or non-dihydropyridine CCBs for rate control;
anticoagulation (e.g., warfarin or DOACs) for stroke prevention.
10. Heart Murmurs and Valvular Disease
● Aortic Stenosis: Presents as a systolic murmur radiating to the neck. Severe cases may
need valve replacement.
● Mitral Regurgitation: Holosystolic murmur radiating to the axilla, with severe cases
requiring surgical intervention.
Respiratory System
1. Pneumonia and Aspiration Risk
● Aspiration Pneumonia: Typically affects right middle and lower lobes due to bronchial
anatomy.
2. Chronic Obstructive Pulmonary Disease (COPD)
● Exacerbation Management: Amoxicillin-clavulanate is the preferred antibiotic, especially
for beta-lactamase-producing organisms.
● First-Line Therapy: Short-acting beta agonists (e.g., albuterol) for mild COPD.
3. Pulmonary Embolism (PE) Indicators
● Presentation: Sudden onset of dyspnea, pleuritic chest pain, tachycardia, and
hypoxemia. These symptoms suggest PE in patients without other significant history.
4. Lung Cancer Screening and Staging
● Screening: Low-dose CT is the preferred initial method for high-risk patients.
, lOMoAR cPSD| 47061011
● Stage IV Exclusion: Lack of distant metastasis indicates the patient may be staged I-III
instead of IV.
5. Heart Failure Imaging
● Kerley B Lines: Horizontal lines seen on a chest X-ray suggest interstitial edema from
CHF.
Key Review Points and Study Tips
● Understand Pathophysiology: Grasp mechanisms of each condition, such as how
chronic hypertension affects organs or the role of cardiac dysfunction in CHF
symptoms.
● Memorize Key Medications and Rationales: Know first-line treatments and rationales,
like calcium channel blockers for hypertension in African Americans or SABAs for mild
COPD.
● Differentiate Symptoms: Recognize similar presentations, like CHF vs. MI, to avoid
misdiagnosis.
● Imaging Choices: Recognize the best modality for each scenario (e.g., CT angiography
for aneurysms, low-dose CT for lung cancer screening).
● PE Red Flags: Memorize classic PE symptoms and risk factors to facilitate timely
diagnosis.
Part 2: Gastrointestinal (GI) System
Diverticulitis and Diverticulosis
1. Diverticulosis
○ Definition: Presence of diverticula (small pouches) in the colon, often
asymptomatic but can lead to bleeding or infection.
○ Risk Factors: Age > 40, low-fiber diet, obesity, and sedentary lifestyle.
○ Management: High-fiber diet to prevent progression to diverticulitis.
2. Diverticulitis
○ Presentation: Often presents with left lower quadrant (LLQ) pain, fever, and
leukocytosis.
Advanced Clinical Diagnosis (Chamberlain
University)
, lOMoAR cPSD| 47061011
Part 1: Cardiovascular and Respiratory Systems
Cardiovascular System
1. Hypertension in African American Patients
● Preferred Medication: Calcium channel blockers (e.g., amlodipine) are recommended as
first-line therapy, particularly dihydropyridines if lifestyle changes (e.g., DASH diet, salt
restriction) fail to control blood pressure.
● Rationale: JNC8 guidelines recommend CCBs over ACE inhibitors in African American
patients due to better outcomes.
2. Uncontrolled Hypertension Complications
● Direct Complications: Chronic hypertension can cause proteinuria, arteriovenous (AV)
nicking, and hemorrhagic stroke.
● Peripheral Neuropathy: Associated more with diabetes but may co-occur in
hypertensive patients with diabetes.
3. Diastolic Dysfunction
● Definition: The heart's inability to relax fully, leading to reduced filling during diastole.
● Significance: Common in patients with thickened myocardium; presents as heart failure
with preserved ejection fraction (HFpEF).
4. Congestive Heart Failure (CHF)
● Symptoms: Dyspnea on exertion, orthopnea, jugular venous distention (JVD), and
bilateral crackles.
● Diagnosis: JVD and pulmonary crackles indicate CHF over other conditions like
myocardial infarction (MI).
5. Heart Failure with Reduced Ejection Fraction (HFrEF) and Post-MI Care
● Management: Patients with EF <35% should use a LifeVest or implantable cardioverter-
defibrillator (AICD) for sudden cardiac death prevention.
● Rationale: Low EF increases arrhythmia risk. Re-assessment with an echocardiogram
2-3 months post-MI monitors recovery.
6. Aortic and Coronary Artery Disease
● Aortic Aneurysm Surveillance: CT angiography is preferred, offering precise aneurysm
measurements and detailed imaging for assessment.
, lOMoAR cPSD| 47061011
● Coronary Artery Disease: High-risk patients (e.g., smokers, high LDL) should be
prescribed statins to reduce ASCVD risk.
7. Orthostatic Hypotension and Severe Blood Loss
● Key Signs: Orthostatic dizziness, confusion, and clammy extremities indicate significant
blood loss, requiring urgent intervention like PRBC transfusion.
8. Peripheral Arterial Disease (PAD) Management
● First-Line Therapy: Statins and ACE inhibitors are recommended to reduce
cardiovascular events.
9. Atrial Fibrillation (AF)
● Management: Beta-blockers or non-dihydropyridine CCBs for rate control;
anticoagulation (e.g., warfarin or DOACs) for stroke prevention.
10. Heart Murmurs and Valvular Disease
● Aortic Stenosis: Presents as a systolic murmur radiating to the neck. Severe cases may
need valve replacement.
● Mitral Regurgitation: Holosystolic murmur radiating to the axilla, with severe cases
requiring surgical intervention.
Respiratory System
1. Pneumonia and Aspiration Risk
● Aspiration Pneumonia: Typically affects right middle and lower lobes due to bronchial
anatomy.
2. Chronic Obstructive Pulmonary Disease (COPD)
● Exacerbation Management: Amoxicillin-clavulanate is the preferred antibiotic, especially
for beta-lactamase-producing organisms.
● First-Line Therapy: Short-acting beta agonists (e.g., albuterol) for mild COPD.
3. Pulmonary Embolism (PE) Indicators
● Presentation: Sudden onset of dyspnea, pleuritic chest pain, tachycardia, and
hypoxemia. These symptoms suggest PE in patients without other significant history.
4. Lung Cancer Screening and Staging
● Screening: Low-dose CT is the preferred initial method for high-risk patients.
, lOMoAR cPSD| 47061011
● Stage IV Exclusion: Lack of distant metastasis indicates the patient may be staged I-III
instead of IV.
5. Heart Failure Imaging
● Kerley B Lines: Horizontal lines seen on a chest X-ray suggest interstitial edema from
CHF.
Key Review Points and Study Tips
● Understand Pathophysiology: Grasp mechanisms of each condition, such as how
chronic hypertension affects organs or the role of cardiac dysfunction in CHF
symptoms.
● Memorize Key Medications and Rationales: Know first-line treatments and rationales,
like calcium channel blockers for hypertension in African Americans or SABAs for mild
COPD.
● Differentiate Symptoms: Recognize similar presentations, like CHF vs. MI, to avoid
misdiagnosis.
● Imaging Choices: Recognize the best modality for each scenario (e.g., CT angiography
for aneurysms, low-dose CT for lung cancer screening).
● PE Red Flags: Memorize classic PE symptoms and risk factors to facilitate timely
diagnosis.
Part 2: Gastrointestinal (GI) System
Diverticulitis and Diverticulosis
1. Diverticulosis
○ Definition: Presence of diverticula (small pouches) in the colon, often
asymptomatic but can lead to bleeding or infection.
○ Risk Factors: Age > 40, low-fiber diet, obesity, and sedentary lifestyle.
○ Management: High-fiber diet to prevent progression to diverticulitis.
2. Diverticulitis
○ Presentation: Often presents with left lower quadrant (LLQ) pain, fever, and
leukocytosis.
