Secondary hypercoagulable state
This is the most commonly treated cardiac arrhythmia
What is Atrial Fibrillation?
This is the immune systems compromised ability to fight infections or cancers that is caused by underlying medical conditions, medications, or treatments
What is secondary immunodeficiency?
The BMI that indicates morbid obesity
What is a BMI > or = 40 or BMI of 35-39.9 with at least one co-morbid condition
The two conditions that support the diagnosis of secondary hyperaldosteronism
What is heart failure and cirrhosis with ascites?
The type of rate and rhythm you might hear on physical exam in someone with a-fib
What is irregularly, irregular?
This is the dose of prednisone and length of treatment that supports a diagnosis of secondary immunodeficiency due to drugs
What is > or = 20mg/day of prednisone (or equivalent) for more than 14 days
The co-morbid conditions that support Morbid Obesity when BMI is 35-39.9
What are Type 2 diabetes, HTN, Hyperlipidemia, ASHD, CVD, PVD, HF, Sleep apnea, AAA, carotid artery disease
The other supportive evidence needed to diagnosis secondary hyperaldosteronism
What are member prescribed a loop diuretic or aldosterone antagonist or physical exam findings suggestive of volume expansion (lower extr. edema, pulmonary edema, ascites)?
This is used to stratify a patient's risk of thrombotic events and guide treatment decision making for patients with non-valvular atrial fibrillation or atrial flutter
What is the CHADS-VASC score?
This HgbA1C value may be considered as secondary immunodeficiency due to hyperglycemia
What is a HgbA1C > or = 8?
Case study:52 year old female with HTN, DM type 2, hyperlipidemia, morbid obesity diagnosed last year
meds: semaglutide injection, lisinopril, pravastatin, vitamin D
States she has lost 30lbs since last years exam and has had her meds cut down
exam: VS normal; ht. 5'3, wt. 175lbs BMI 31
What is obesity and remove diagnosis of morbid obesity due to excess calories?
Case study
HPI: 78 yo old female being seen for a HouseCalls visit today.PMH: MI, heart failure with reduced EF, hypertension, and hyperlipidemia MEDS: carvedilol 25mg bid, furosemide 20mg daily, lisinopril 10mg qd, and atorvastatin 10mg qhs EXAM: B/P 140/88, HR 68 reg, Lungs sound clear bilateral, LE no edema
What is secondary hyperaldosteronism evidenced by diagnosis of HF and loop diuretic?
This is NOT an atrial fibrillation classification
1. Paroxysmal
2. Persistent
3. Long-standing persistent
4. Chronic
5. Permanent
What is chronic atrial fibrillation?
Case study
72 y/o female with PMH of R mastectomy due to breast cancer 2 years ago.
Medication: Tamoxifen daily
What is Breast cancer?
not substantiated for the diagnosis secondary immunodeficiency
Case study
67 year old female with ASHD, HTN, DM type 2
meds: lisinopril 20mg daily, metformin 500mg BID, ASA 81mg daily
Exam: Ht. 5'7 wt. 229 BMI 35.86
What is morbid obesity due to excess calories?
Case study
HPI: 78 yo old female being seen for a HouseCalls visit today. PMH: Heart failure, hypertension, diabetes mellitus type II, and hyperlipidemia MEDS: carvedilol 25mg bid, spironolactone 25 mg qd, lisinopril 10mg qd, atorvastatin 10mg qhs, and metformin 1000mg bid
Exam: vitals WNL, +2 edema bilateral LE
What is a diagnosis of secondary hyperaldosteronism?
Case study
HPI: 84-year-old female with AFib x 3 years, HTN, and history of TIA, who lives at home with her daughter. Medications: carvedilol, lisinopril, atorvastatin, and apixaban. ROS: Denies palpitations or dizziness. Vitals: BP: 122/84, P:84, R:18 PE: Oriented to person and place. CV: regular rate and rhythm
What is paroxysmal a-fib and secondary hypercoagulable state?
Case study:
A 52 year old female diagnosed with rheumatoid arthritis.
medication: Humira injectable
What are secondary immunodefiency due to condition- rheumatoid arthritis and secondary immunodeficiency due to drugs- Humira?
Case study:
35 year old male with chronic low back pain and depression, uses an electric wheelchair
meds: tramadol, cymbalta
Exam: ht. 5'10 wt. 305 BMI 43.76
What is morbid obesity due to excess calories?
Case study
67 year old male with chronic liver disease-cirrhosis
meds: furosemide, receives paracentesis about once a month
exam: abdomen large, round, slightly firm
What is secondary hyperaldosteronism?