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21 Cards in this Set
- Front
- Back
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Normal lipids?
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Total cholesterol: <4
LDL: <2.5 HDL: >1.1 TC/HDL: <4 TG: <1.5 (independent RF) |
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Statins? P drug and S/E?
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HMC-CoA reductase inhibitors
Atorvastatin S/E: increase CK, myalgia, rarely rhabdo, cause abnormal LFTs |
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Fibrates? P Drug and S/E?
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Acts on PPAR-a family of nuclear receptors. Cause decreased TG and increased HDL
Fenofibrate: increased risk of gall stones and photosensitivity |
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Ezetimibe? When? Cons?
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decreases absorption cholesterole across the intestinal wall + decreases cholesterol
Used as adjunctive tx w statins or where statins are not tolerated. New and expensive |
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When to treat high cholesterol?
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Any age/sex if TC >9; TG >8
Male >35yrs if TC >7.5; TG >4 Female PMP if TC>7.5; TG>4 HT/Abo/HDL<1 if TC >5.5 Familial lipidaemia or FHX IHD if LDL >4 (above 18) or >18 yrs TC >6.5 or LDL >5 Diabetes when LDL >5.5 Treat all patient at high end of normal if high risk |
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HT classifications
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Optimal: <120; <80
Normal: 120-129; 75-84 High normal: 130-139; 85-89 Mild HT: 140-159; 90-99 Moderate: 160-179; 100-109 severe>180; >110 |
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What medication can you use for HT in athletes?
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can't use B-blockers or diuretics (b-blockers as performance enhancing, diuretics as can mask other drugs)
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What HT medications are okay to use in pregnancy?
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B-blockers, a-blockers. Not ACEi or CCB or diuretics as first line.
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Which HT medications are C/I in the following?
Gout? Asthma? heart block? HyperK+? Bilateral RAS? CCF? Dm, Metabolic syndrome ACEi NSAIDs |
- gout = diuretic
- Asthma = B-blockers -Heart block= B-blockers, CCB - Hyper K =K sparing diuretic - bilat RAS =ACEi, A2RB CCF = Alpha blockers, CCB DM = B-blockers, diuretics ACEi = A2RA NSAIDs = ACEi, A2RA and diuretics |
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Preferred HT drug in the following:
- Isolated systolic? - Pregnancy - Angina? - Headache? - PVD? -Post MI? - CCF? DM? Nephropathy? Cardiomyopathy? Lower UT sx? |
- isolated systolic = D, CCB
- Preg = Alpha, BB - angina BB, CCB -Headache = BB - PVD = CCB -Post MI = ACEi, BB CCF = ACEi, A2RA, D DM = ACEi, ARB Nephropathy = ACEi, A2RB Cardiomyopathy = ACE, A2RB LUTS = alpha Blocker |
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Common combinations of HT?
- DM or lipid - CCF or post CVA? - CCF or post AMI? - IHD? |
- DM = ACEi + CCB
- CCF = diuretic, ACEi - CCF AMI = BB, ACEi - CCB + BB |
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When to use medical tx with HT?
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Grade 1 or 2 - assess 5 yr risk
High risk - lifestyle + drug moderate - lifestyle for 3-6mths, then drug low as for moderate. Grade 3 or associated conditions or End organ disease -> lifestyle and drug and manage associated |
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Clinical conditions ass w HT?
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- DM
- CVA -CCF -CKD -Aortic disease -PVD - hypercholesterolaemia -FHx OR previous dx of premature CVD or familial hypercholesterolaemia |
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Vital signs in <6mth old?
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Pulse: 120-140
RR: 45 BP 90/60 |
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Vitals for 6mth-3yr old?
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HR: 110
RR: 30 BP: 90/60 |
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Vitals for 3-12yr old?
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HR: 80-100
RR: 20 BP: 100/70 |
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Vitals for adult?
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HR: 60-100
RR: 14 BP: <130/85 |
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7 masquerades of general practice?
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Depression
DM Drugs Anaemia Thyroid (and endocrine) Spinal dysfunction UTI |
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7 other masquerades of GP?
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malignancy
CKD HIV Rare bacterial infection Baffling viral/protozoal infection Neurological dilemmas CTDs and vasculitides |
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Causes of sick, febrile child?
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Myocarditis
meningitis meningococcal inf septicaemia viral encephalitis pneumonia bronchiolitis severe gastroenteritis Epiglotittis LTB Apendicitis/peritonitis UTI |
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Red flags of sick, febrile child?
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Neonate >38 degrees
Pulse >140 BP <90/60 RR >40 Increased work of breathing Noisy breathing Chest wall/sternal retraction Pallor Cold extremities capillary refill >2 sec Rash Sunken eyes Inactive, disinterested Drowsiness Seizure |
