Cardio Iii Test 1

Front 1

Calculate BMI

Back 1

(lbs * 703) / (ht")^2
or
kg / m^2

Front 2

calculate CrCl

Back 2

((140-age)*IBW) / (72*SrCr)
or
if BW is 120% of IBW
((140-age)*AdjBW) / (72*SrCr)
and
if female, multiply answer by 0.85

Front 3

Calculate IBW

Back 3

male: 50kg + 2.3(ht" above 60")
female: 45.5kg + 2.3(ht" above 60")

Front 4

Calculate AdjBW

Back 4

IBW + 0.4(BW - IBW)

Front 5

Calculate mean arterial pressure

Back 5

MAP = 1/3systolic + 2/3diastolic
or
= diastolic + 1/3pulse-pressure

Front 6

calculate pulse pressure

Back 6

systolic pressure - diastolic pressure

Front 7

Adverse events for loop diuretics

Back 7

hyperkalemia (always)
hyponatremia
hyperglycemia
hyperuricemia
ototoxicity (at very high doses)

Front 8

Chem 7 values
(from left, down and over, ending at the fishtail)

Back 8

Na+ = 135-145mEq/L
K+ = 3.5-5.0mEq/L
Cl- = 96-106mEq/L
CO2 = 24-30mEq/L
BUN = 7-20mg/dL
SrCr = 0.7-1.5mg/dL
glucose = 70-110mg/dL

Front 9

contraindications for ACE inhibitors

Back 9

bilateral renal arterial stenosis
history of angioedema
pregnancy

Front 10

Thiazides
give lab values needed and why

Back 10

BP -- duh
Uric acid -- uricemia, but only a problem for gout pts
glucose -- may incr blood glucose, so watch in diabetics
SrCr--> CrCl, because cannot use thiazides in CrCl <25ml/min
K+, b/c they can cause hypokalemia
[Na+ -- though not required regularly]

Front 11

blood pressure agents proven to be safe in pregnant patients

Back 11

labetolol
methyldopa

Front 12

For low-sodium diet:
recommended daily sodium intake
and
maximum daily sodium intake

Back 12

1.6g recommended
and
2.4g max

Front 13

Risk of hyperkalemia increases with loop diuretics and which other drugs?

Back 13

ACE-Is, ARBs
Aldosterone antagonists
K+ supplements (duh)
trimethoprim
pentamidine

Front 14

do not use loop diuretics if K+ level is over what value?

Back 14

5.5mEq/L

Front 15

adverse events for eplerenone

Back 15

hyperkalemia (always)
hypertriglyceridemia (in some pts)

Front 16

K+ monitoring schedule for aldosterone antagonist therapy

Back 16

prior to therapy
@ 1wk after initiation
@ 1mo after initiation or dose adjustment
then periodically

Front 17

concurrent use of eplerenone and which drugs is contraindicated?

Back 17

major CYP3A4 inhibitors ketoconazole, itraconazole
(increases [eplerenone] 5-fold)

Front 18

aldosterone antagonists cannot be used if CrCl is below what value?

Back 18

spironolactone - <30ml/min
eplerenone - <50ml/min

Front 19

symptoms of visceral angioedema

Back 19

emesis
watery diarrhea
abdominal pain

Front 20

angioedema Tx

Back 20

epinephrine, antihistamine, or steroids for swelling
d/c ACE-I

Front 21

adverse events for DHP CCBs

Back 21

Peripheral edema
reflex tachycardia
dizziness
headache and flushing
constipation

Front 22

name four CYP3A4 inducers (to avoid giving w/ 3A4 substrates e.g. NDHPs, Zocor, etc)

Back 22

rifampin
phenytoin
barbiturates
carbamazepine

Front 23

VTE prevention recommendations for total hip/knee replacement or hip fracture surgery

Back 23

thromboprophylaxis x10days
(aspirin alone doesn't cut it)

Front 24

heparin antidote

Back 24

protamine sulfate IV over 10 mins
dosing: 1mg/100 units UFH given in the past 6 hrs
max dose: 50mg

Front 25

HIT presentation

Back 25

after day 5 of therapy
rapid onset
50% decrease in baseline platelet count (or <100,000/mm^3)
systemic thrombosis
IgG mediated

Front 26

HIT management

Back 26

discontinue heparin
discontinue warfarin, give vit K 5-10mg PO or IV
give alternate antigoagulant: lepirudin, argatroban
reintroduce warfarin after platelet count >100,000

Front 27

enoxaparin dosing for DVT treatment

Back 27

--outpt--
1mg/kg SC Q12H
--inpt--
same as outpt OR 1.5mg/kg SC Q24H
--CrCl <30ml/min--
1mg/kg SC Q24H

Front 28

enoxaparin dosing for DVT prevention

Back 28

--illness--
40mg SC Q24H
--trauma--
30mg SC Q12H starting 12-36H after injury
--CrCl<30ml/min--
30mg SC Q24H

Front 29

monitoring direct thrombin inhibitors for DVT therapy

Back 29

lepirudn, desirudin, argatroban: aPTT

bivalrudin: activated clotting time (ACT)

Front 30

cilostazol

Back 30

Pletal
for intermittent claudication (in PAD)
100mg PO BID
CYP2c19, 3a
empty stomach
black box: contraindicated for any heart failure
may take 12 weeks to see benefit

Front 31

pentoxifylline

Back 31

Trental
intermittent claudication (in PAD) - 2nd line
400mg PO TID

Front 32

positive dyslipidemia risk factors

Back 32

age (>45 males, >55 females)
premature CHD in 1st degree relative
cigarette smoking (current)
HTN)
Low HDL

Front 33

established CHD, per NCEP ATPIII

Back 33

myocardial ischemia
MI
coronary angioplasty/ stent placement
CABG
unstable angina history

Front 34

CHD risk equivalents, per NCEP ATPIII

Back 34

cerebroarterial disease (TIA, stroke, carotid stenosis)
PAD
abdominal aortic aneurism
DM