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BCCP exam complete flash card set well answered to pass
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BCCP exam complete flash card set well answered to pass
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BCCP exam complete flash card setNormal BP - correct answer ✔✔<120/80 mmHg
Elevated BP - correct answer ✔✔SBP 120-129 and DBP <80 mmHg
Stage 1 hypertension - correct answer ✔✔SBP 130-139 or DBP 80-89 mmHg
Stage 2 hypertension - correct answer ✔✔SBP >140 or DBP >90 mmHg
Essential hypertension - correct answer ✔✔no identifiable cause
When do you screen for primary aldosteronism? - correct answer ✔✔patients w/ resistant HTN,
hypokalemia, incidentally discovered adrenal mass, family history of early onset HTN or stroke at a young
age
What is HBPM - correct answer ✔✔home blood pressure measurements for out of office readings
what is ABPM - correct answer ✔✔ambulatory blood pressure measurements, patients wear blood
pressure measuring device on non-dominant arm for 24 hours
What is AOBP - correct answer ✔✔automated oscillometric blood pressure measurement- device takes
many consecutive blood pressure readings in office with patient sitting and resting alone
Blood pressure goal if any comorbidities - correct answer ✔✔<130/80 mmHg
First line agents for hypertension - correct answer ✔✔Thiazide diuretics
CCB
ACEi
ARBs
,Hypertension monotherapy vs combination therapy - correct answer ✔✔monotherapy reasonable w/
stage I HTN, initiating combination therapy w/ 2 first line agents is recommended in stage 2 HTN
ACEi MOA - correct answer ✔✔prevent conversion of angiotensin I to angiotensin II by competitive
inhibition of ACE.
ARB MOA - correct answer ✔✔selective, competitive angiotensin II receptor type I receptor antagonist,
reducing end-organ responses to angiotensin II.
Thiazide MOA - correct answer ✔✔act on kidneys to reduce Na reabsorption in the distal convoluted
tubule. By impairing Na transport in the convoluted tubule, natriuresis and concomitant water loss are
induced.
DHP CCB MOA - correct answer ✔✔act by relaxing smooth muscle in the arterial wall, decreasing total
peripheral resistance, and hence reducing BP
non DHP CCB MOA - correct answer ✔✔act as potent vasodilator of coronary vessels, increasing blood
flow and decreasing the heart rate by strong depression of atrioventricular node conduction. in addition,
act as potent vasodilator of peripheral vessels, reducing peripheral resistance and afterload. Inotropic
effects.
Alpha blocker MOA - correct answer ✔✔selective a-1 antagonists reduce BP by decrease total peripheral
resistance and venous return. Selective a-1 blockade produces vasodilation and reduces preload and
afterload during rest and exercise
Loop diuretic MOA - correct answer ✔✔act by reversibly binding tot he Na, K, Cl cotransport mechanism
on the luminal side of the ascending loop of Henle, thereby inhibiting the active reabsorption of those
ions.
K-sparking MOA (amiloride, triamterene) - correct answer ✔✔block the epithelial na channel on the
lumen side of the kidney collecting tubule. na channel blockers directly inhibit na entry into the na
channels
,Aldosterone antagonists (eplerenone, spironolactone) MOA - correct answer ✔✔inhibit the effect of
aldosterone by competing for intracellular aldosterone receptors in the cortical collecting duct. This
decrease Na and water reabsorption while decreasing K secretion.
Central a agonist and other centrally acting drug (clonidine, methyldopa, guanfacine) MOA - correct
answer ✔✔stimulate a-2 recpetors in the brain, which decreases sympathetic outflow, cardiac output,
and peripheral vascular resistance, lowering BP and HR
Direct renin inhibitor (aliskiren) MOA - correct answer ✔✔direct renin inhibition, decreasing plasma
renin activity and inhbiting the conversion of Angiotensinogen to angiotensin I.
Direct vasodilators MOA (hydralazine, minoxidil) - correct answer ✔✔direct acting smooth muscle
relaxants that act as a vasodilator primarily in arteries and arterioles
KDIGO guidelines - correct answer ✔✔BP management depends on whether patients have proteinuria.
ACEi/ARBs preferentially used in CKD
pharmacologic therapy for orthostatic hypotension - correct answer ✔✔fludrocortisone- increases
intravascular volume
adrenergic hypertensives (midodrine, pyridostigmine, PSE, atomoxetine)
Droxidopa- structural analog of norepi
Which medication is metabolized by CYP2C19? - correct answer ✔✔clopidogrel
Which medication is metabolized by SLCO1B1? - correct answer ✔✔Simvastatin
Which medication is metabolized by CYP2C9? - correct answer ✔✔warfarin
Which medication is metabolized by C1 (VKORC1)? - correct answer ✔✔warfarin
Which medication is metabolized by CYP4F2? - correct answer ✔✔wafarin
, NSTE-ACS UA - correct answer ✔✔no ST elevation/ T wave inversion
ST depression may occur
negative cardiac markers
NSTEMI - correct answer ✔✔ST depression/T wave inversion
Positive cardiac markers
STEMI - correct answer ✔✔ST elevation
Positive cardiac markers
TIMI risk score - correct answer ✔✔Age>65: 1 point
3 cardiac risk factors (HTN, diabetes, hyperlipidemia, smoking, family history)= 1 point
Known CAD> 50% stenosis- 1 point
Severe angina (>2 episodes in 24 hr)= 1 point
ASA within 7 days= 1 point
Elevated markers= 1 point
ST segment deviation= 1 point
0-2 low mortality risk
3- moderate mortality risk
4- high mortality risk
Treatment for STEMI - correct answer ✔✔primary PCI within 90 min of first medical contact
fibrinolytic therapy is reserved for patients who cannot get PCI within 120min (door to needle time 30
min)
Treatment for NSTEMI - correct answer ✔✔early invasive strategy
ischemia guided therapy
surgical revascularization
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