NR667 - CEA Week 1-6 Comprehensive
Review before Chicago 2025
Hypertension ANS: Hypertension is defined as BP ≥140/90 mmHg (per JNC8).
Non-Black population treatment ANS: Start with thiazide diuretic, ACE inhibitor, ARB, or CCB.
Black population treatment ANS: Start with thiazide diuretic or CCB.
DM or CKD treatment ANS: Include ACE inhibitor or ARB for kidney protection.
Age ≥60 years treatment ANS: Treat if BP ≥150/90 mmHg.
Age <60 years treatment ANS: Treat if BP ≥140/90 mmHg.
Contractility ANS: Force of cardiac muscle contraction.
Preload ANS: Volume in ventricles at end-diastole (central venous volume).
Afterload ANS: Resistance heart must pump against (arterial pressure).
Aortic Stenosis (AS) ANS: Calcification narrows aortic valve → outflow obstruction.
Aortic Regurgitation (AR) ANS: Incompetent aortic valve due to root dilation or endocarditis.
Mitral Stenosis (MS) ANS: Often post-rheumatic fever, calcification of mitral valve.
,Mitral Regurgitation (MR) ANS: Commonly due to MI, CHF-induced LV dilation, papillary rupture, or
endocarditis.
Direct Oral Anticoagulants (DOACs) ANS: Do NOT require INR monitoring.
Factor Xa inhibitors ANS: Rivaroxaban (Xarelto), Apixaban (Eliquis), Edoxaban (Savaysa).
Direct thrombin inhibitor ANS: Dabigatran (Pradaxa).
Warfarin (Coumadin) ANS: Onset: Delayed — requires bridging with LMWH or heparin.
Bridging with Warfarin ANS: Bridging is required until INR reaches ≥2.0 for at least 24 hours.
Dopamine ANS: Dose-dependent: low = renal perfusion, high = pressor.
Dobutamine ANS: Inotrope (↑ contractility).
Norepinephrine (Levophed) ANS: Vasoconstrictor + mild inotrope.
Epinephrine ANS: Mixed alpha & beta agonist.
Nitroglycerin ANS: Venodilator; ↓ Preload; avoid if hypotensive.
Nitroprusside ANS: Potent arterial/venous vasodilator; risk of cyanide toxicity with prolonged use.
,Statins ANS: HMG-CoA reductase inhibitors used as first-line therapy for lipid management.
High-intensity statins ANS: Atorvastatin 40-80 mg daily and Rosuvastatin 20-40 mg daily.
Indications for high-intensity statins ANS: Clinical ASCVD (e.g., MI, stroke), LDL ≥190 mg/dL, Diabetes
age 40-75 with ≥7.5% 10-year ASCVD risk.
Ezetimibe ANS: A secondary therapy for mild LDL-lowering, often required before insurance approval of
PCSK9 inhibitors.
PCSK9 inhibitors ANS: Injectable monoclonal antibodies reserved for very high-risk patients or statin-
intolerant.
ASCVD ANS: Atherosclerotic Cardiovascular Disease, includes MI, stroke, angina, revascularization, and
peripheral artery disease.
10-year risk categories ANS: Low risk: <5%, Moderate risk: 5%-7.4%, High risk: ≥7.5%, Very high risk:
≥20% or known ASCVD.
Aortic Stenosis (AS) ANS: Caused by calcification of the valve leading to outflow obstruction, with a
classic triad of angina, syncope, dyspnea.
Aortic Regurgitation (AR) ANS: Occurs when the valve fails to close, leading to wide pulse pressure and
bounding pulses.
Mitral Stenosis (MS) ANS: Often caused by post-rheumatic fever, symptoms include dyspnea,
orthopnea, and atrial fibrillation.
, Mitral Regurgitation (MR) ANS: Caused by papillary muscle rupture, dilated LV, or endocarditis,
characterized by a holosystolic murmur.
HFrEF ANS: Heart failure with reduced ejection fraction, defined as EF <40% and associated with systolic
dysfunction.
HFpEF ANS: Heart failure with preserved ejection fraction, defined as EF ≥50% and associated with
diastolic dysfunction.
First-line medications for HFrEF ANS: Include beta-blockers (Carvedilol, metoprolol succinate,
bisoprolol), ACE inhibitors or ARBs, loop diuretics, and spironolactone.
Shock categories ANS: Include hypovolemic, cardiogenic, distributive, and obstructive types.
Hypovolemic shock ANS: Caused by hemorrhage or dehydration, treated with fluids and blood products.
Cardiogenic shock ANS: Caused by MI or CHF, treated with inotropes (dobutamine) and vasopressors.
Distributive shock ANS: Caused by sepsis or anaphylaxis, treated with vasopressors (norepinephrine)
and fluids.
Obstructive shock ANS: Caused by PE, tamponade, or tension pneumothorax, treated by relieving the
obstruction.
Norepinephrine (Levophed) ANS: First-line treatment in septic shock.
Dobutamine ANS: Used for low-output states in cardiogenic shock to improve contractility.
Review before Chicago 2025
Hypertension ANS: Hypertension is defined as BP ≥140/90 mmHg (per JNC8).
Non-Black population treatment ANS: Start with thiazide diuretic, ACE inhibitor, ARB, or CCB.
Black population treatment ANS: Start with thiazide diuretic or CCB.
DM or CKD treatment ANS: Include ACE inhibitor or ARB for kidney protection.
Age ≥60 years treatment ANS: Treat if BP ≥150/90 mmHg.
Age <60 years treatment ANS: Treat if BP ≥140/90 mmHg.
Contractility ANS: Force of cardiac muscle contraction.
Preload ANS: Volume in ventricles at end-diastole (central venous volume).
Afterload ANS: Resistance heart must pump against (arterial pressure).
Aortic Stenosis (AS) ANS: Calcification narrows aortic valve → outflow obstruction.
Aortic Regurgitation (AR) ANS: Incompetent aortic valve due to root dilation or endocarditis.
Mitral Stenosis (MS) ANS: Often post-rheumatic fever, calcification of mitral valve.
,Mitral Regurgitation (MR) ANS: Commonly due to MI, CHF-induced LV dilation, papillary rupture, or
endocarditis.
Direct Oral Anticoagulants (DOACs) ANS: Do NOT require INR monitoring.
Factor Xa inhibitors ANS: Rivaroxaban (Xarelto), Apixaban (Eliquis), Edoxaban (Savaysa).
Direct thrombin inhibitor ANS: Dabigatran (Pradaxa).
Warfarin (Coumadin) ANS: Onset: Delayed — requires bridging with LMWH or heparin.
Bridging with Warfarin ANS: Bridging is required until INR reaches ≥2.0 for at least 24 hours.
Dopamine ANS: Dose-dependent: low = renal perfusion, high = pressor.
Dobutamine ANS: Inotrope (↑ contractility).
Norepinephrine (Levophed) ANS: Vasoconstrictor + mild inotrope.
Epinephrine ANS: Mixed alpha & beta agonist.
Nitroglycerin ANS: Venodilator; ↓ Preload; avoid if hypotensive.
Nitroprusside ANS: Potent arterial/venous vasodilator; risk of cyanide toxicity with prolonged use.
,Statins ANS: HMG-CoA reductase inhibitors used as first-line therapy for lipid management.
High-intensity statins ANS: Atorvastatin 40-80 mg daily and Rosuvastatin 20-40 mg daily.
Indications for high-intensity statins ANS: Clinical ASCVD (e.g., MI, stroke), LDL ≥190 mg/dL, Diabetes
age 40-75 with ≥7.5% 10-year ASCVD risk.
Ezetimibe ANS: A secondary therapy for mild LDL-lowering, often required before insurance approval of
PCSK9 inhibitors.
PCSK9 inhibitors ANS: Injectable monoclonal antibodies reserved for very high-risk patients or statin-
intolerant.
ASCVD ANS: Atherosclerotic Cardiovascular Disease, includes MI, stroke, angina, revascularization, and
peripheral artery disease.
10-year risk categories ANS: Low risk: <5%, Moderate risk: 5%-7.4%, High risk: ≥7.5%, Very high risk:
≥20% or known ASCVD.
Aortic Stenosis (AS) ANS: Caused by calcification of the valve leading to outflow obstruction, with a
classic triad of angina, syncope, dyspnea.
Aortic Regurgitation (AR) ANS: Occurs when the valve fails to close, leading to wide pulse pressure and
bounding pulses.
Mitral Stenosis (MS) ANS: Often caused by post-rheumatic fever, symptoms include dyspnea,
orthopnea, and atrial fibrillation.
, Mitral Regurgitation (MR) ANS: Caused by papillary muscle rupture, dilated LV, or endocarditis,
characterized by a holosystolic murmur.
HFrEF ANS: Heart failure with reduced ejection fraction, defined as EF <40% and associated with systolic
dysfunction.
HFpEF ANS: Heart failure with preserved ejection fraction, defined as EF ≥50% and associated with
diastolic dysfunction.
First-line medications for HFrEF ANS: Include beta-blockers (Carvedilol, metoprolol succinate,
bisoprolol), ACE inhibitors or ARBs, loop diuretics, and spironolactone.
Shock categories ANS: Include hypovolemic, cardiogenic, distributive, and obstructive types.
Hypovolemic shock ANS: Caused by hemorrhage or dehydration, treated with fluids and blood products.
Cardiogenic shock ANS: Caused by MI or CHF, treated with inotropes (dobutamine) and vasopressors.
Distributive shock ANS: Caused by sepsis or anaphylaxis, treated with vasopressors (norepinephrine)
and fluids.
Obstructive shock ANS: Caused by PE, tamponade, or tension pneumothorax, treated by relieving the
obstruction.
Norepinephrine (Levophed) ANS: First-line treatment in septic shock.
Dobutamine ANS: Used for low-output states in cardiogenic shock to improve contractility.
