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Family Med PAEA Complete Study Guide
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Family Med PAEA Complete Study Guide
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Family Med PAEA Complete Study GuideWhat causes the S4 heart sound Correct Ans - -forceful atrial
contraction during presystole from the atria trying to ejects blood into a
ventricle that cannot expand any further (diastolic failure)
What are the JNC 8 guides for the following:
pre HTN
HTN stage 1
HTN stage 2 Correct Ans - -pre HTN = 120/80 to 129/89 --> lifestyle
modifications
-HTN stage 1 = 140/90 to 159/99 --> thiazide (loop if renal pt)
-HTN stage 2 = >160/100 --> thiazide + 2nd agent
What is hypertensive urgency
how do pts present
What is the tx Correct Ans - -*stable or no end organ damage*, no
raised ICP.
-They typically present with SOB, headache, and BP *>220/110*
*-lower BP in clinic slowly* over several hours with labetalol, clonidine,
captopril
What is hypertensive emergency
How do pts present
What is the tx Correct Ans - -rapidly progressing *end organ damage*.
,-Often present with CP, AMS, weakness, MI, acute CHF, renal failure, ICH,
eclampsia, and aortic disection
-send to the ER
How can HTN be monitoring in primary care Correct Ans - -annual
urine microalbumin
-annual BMP
-annual lipids
-baseline ECG to look for LVH
Name the thiazide diuretics (2)
When should you not use thiazides in pts?
What pts are thiazides good for and why Correct Ans - -
hydrochlorothiazide, chlorthalidone
-when CrCl is <30
-osteoporosis pts because of the Ca sparing
T or F: thiazide diuretics are the drugs of choice for HTN Correct Ans -
T
Name the loop diuretic Correct Ans - furosemide
Name the K sparking diuretics (2)
Are they weak or potent drugs Correct Ans - -spironolactone,
eplerenone
-weak
Name the ACEIs
What are 2 SE to know
,Should they be used in pregnant pts? Correct Ans - -benazepril,
enalapril, lininopril
-cough, renal failure (STOP is serum Cr increases by 30%, but its ok to use if
pts have no renal function left)
-no
Name the ARBs (4)
What are the adverse effects
Should they be used in pregnancy Correct Ans - -irbesartan, losartan,
olmesartan, valsartan
-renal failure (STOP is serum Cr increases by 30%, but its ok to use if pts have
no renal function left)
-no
Name the CCBs (dihydro and non-dihydro)
What population is this class useful in
There is an FDA warning about whihc 3 CCB when using with simvastatin
What pts are CCB contridicted in Correct Ans - -dihydro = nifedipine,
amlodipine
-non-dihydro = verapamil and diltiazem
-elderly
-amlodipine, verapamil, and diltiazem
-heart failure
Name 2 direct vasodilators also used in HTN tx Correct Ans - -
hydralazine, minoxidil
, Name the alpha blockers and the use of each Correct Ans - -clonidine --
> only used for refractory HTN due to risk of falls
-*methyldopa* for HTN in pregnancy
What beta blockers are cardio selective and what pts should they be used in
What beta blockers are non selective
Beta blockers can mask signs of what?
What is a contriindication of beta blockers Correct Ans - *atenolol or
metoprolol* for asthma/COPD pts
-propranolol and labetalol
-hypogylcemia
-heart block
What is the tx of choice for HTN in pts with DM or CKD Correct Ans - -
ACEI or ARB
What is the tx of choice for HTN in pts with MI Correct Ans - Beta
blocker
-ACEI
What is the tx of choice for HTN in pts with CAD Correct Ans - -
thiazide
-b blocker
-ACEI
-CCB
What is the tx of choice for HTN in pts with CHF Correct Ans - -thiazide
-b blocker
-ACEI
What is the tx of choice for HTN in pts who are pregnant Correct Ans -
-clonidine or *methyldopa*
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