PVD
Guideline for screening for AAA?
MEN 65-75, who have EVER smoked w/AAA US
3 Medications/classes that are indicated for Lipid lowering therapy (LLT)
statin, zetia, PCSK9 inhibitors
Name the medications for HFrEF GDMT?
ARNI in NYHA II-III
ACEi or ARB in NYHA II-IV,
Beta-blocker,
MRA (mineralocorticoid receptor antagonist),
SGLT2i
Diuretics not GDMT but always helpful for maintaining volume status
What drug is effective for short term improvement of gambling disorder?
Naltrexone or OLANZAPINE/ZYPREXA
This famous song by Sean Paul is one of the core vital signs we interpret daily?
Temperature
Method for diagnosing PAD and normal value range?
ABI (0.9-1.4)
4 Medication classes that improve survival post MI?
1. ACE-inhibitors
2. ß-blockers
3. statins
4. ASA
ICD placement criteria?
Implantable cardioverter defibrillator (ICD) to reduce risk of sudden death due to ventricular tachyarrhythmias For patients with
EF ≤35%
NYHA class II – III symptoms on GDMT
Life expectancy >1 year
Which common med used to treat UTIs should be avoided in patients taking an ACE-i?
Bactrim/TMP/SMX (combo increases the risk of severe hyperkalemia and sudden cardiac death)
What song from 1999, ties in the standard medical uniform and rejection of a partner with low effort, low ambition and broke traits?
No Scrubs
AAA US screening comes back with a aortic diameter of 4.0 – 4.9cm, When do we want to obtain follow up screening?
12 months
3.0 – 3.9cm→ 36 months 5.0 – 5.4cm-> 6 months
the bigger the aneurysms the faster it expands
Name the 3 types of ACS (acute coronary syndromes) and differentiate between them?
Unstable Angina: symptoms + no trop elevation with EKG changes
NSTEMI: symptoms + trop elevation with EKG changes,
STEMI: symptoms+ specifically trop elevation with ST Elevations
For Renal Artery Stenosis what is the main cause in patients less than 30 and main cause in patients greater than 30?
Fibromsuclar dysplasia and atherlosclerotic disease
Dx MRA (CTA angio)
ACE/ARB may significantly increase renal function when started which can be an indicator of RAS
Revascularization does not typically improve outcomes
3 first line oral antibiotics for treatment of UTI?
nitrofurantoin , TMP/SMX, Fosfomycin
What drug ultimately lead to Michael Jackson's death?
Propofol intoxication (but also had ativan, versed, valium in his system)
Name 3 Interventions for PAD/claudication?
Supervised exercise training
LLT
Cilostazol (Pletal) →Inhibits phosphodiesterase type 3, ? Vasodilatory/antiplatelet
In addition to risk factor modification: smoking cessation, aspirin OR Clopidogrel,
what are 4 groups of patients that would benefit from statin?
Individuals with clinical ASCVD
With primary elevations of LDL-C > 190 mg/dL
40-75 yrs with diabetes and LDL-C 70-189
Without clinical ASCVD or diabetes, age 40-75, LDL-C 70-189, and estimated 10-year ASCVD risk >7.5% [Note: USPSTF uses threshold of 10% 10-year risk]
Guidelines for following up on Mild aortic Stenosis in asymptomatic patients? (testing and time frame)
Per the AHA Repeat echocardiography every 3-5 years in asymptomatic patients with mild aortic stenosis ACA/AHA 2008 guidelines on valvular heart disease
What is the most cost effective and validated screening tool for advanced liver fibrosis in primary care?
FIB-4 index
What mood stabilizer happens to also be the title of one of nirvana's most popular songs?
Lithium
Reynauds phenomena most commonly associated with what disease?
!!!! Progressive systemic sclerosis/scleroderma !!!!
Mixed/Undifferentiated connective tissue disease
SLE
Dermatomyositis
Sjogren’s
Your patient cant tolerate a statin or zetia for LLT, what other oral therapy option can you offer them?
bempedoic acid
reduces non-high-density lipoprotein cholesterol, apolipoprotein B, and total cholesterol
Name 3 Meds associated with worse outcomes in heart failure?
Verapamil and diltiazem, due to their negative inotropic effect
Most antiarrhythmic drugs
NSAIDs
Thiazolidinediones (increase fluid reabsorption at DCT) Pioglitazone (Actos) Rosiglitazone (Avandia)
Nesiritide (B-type natriuretic peptide) Vasodilatory properties can trigger hypotension
Medications available for treatment of MASLD (Metabolic dysfunction-associated steatotic liver disease)?
GLP, GLP/GiP medication
Resmetirom is a thyroid hormone receptor-beta agonist, was approved for MASH/moderate to severe fibrosis with diet and exercise
MASLD→ MASH (liver cell damage) → Cirrhosis
1-800-273-8255, was a popular song by what three artists, that brought the suicide hotline number into mainstream music?
Logic, Alessia Cara & Khalid