NR667 - CEA Week 1-6 Comprehensive Review before Chicago 2025
Hypertension - correct answer Hypertension is defined as BP ≥140/90 mmHg (per JNC8).
Non-Black population treatment - correct answer Start with thiazide diuretic, ACE inhibitor,
ARB, or CCB.
Black population treatment - correct answer Start with thiazide diuretic or CCB.
DM or CKD treatment - correct answer Include ACE inhibitor or ARB for kidney protection.
Age ≥60 years treatment - correct answer Treat if BP ≥150/90 mmHg.
Age <60 years treatment - correct answer Treat if BP ≥140/90 mmHg.
Contractility - correct answer Force of cardiac muscle contraction.
Preload - correct answer Volume in ventricles at end-diastole (central venous volume).
Afterload - correct answer Resistance heart must pump against (arterial pressure).
Aortic Stenosis (AS) - correct answer Calcification narrows aortic valve → outflow obstruction.
Aortic Regurgitation (AR) - correct answer Incompetent aortic valve due to root dilation or
endocarditis.
Mitral Stenosis (MS) - correct answer Often post-rheumatic fever, calcification of mitral valve.
Mitral Regurgitation (MR) - correct answer Commonly due to MI, CHF-induced LV dilation,
papillary rupture, or endocarditis.
Direct Oral Anticoagulants (DOACs) - correct answer Do NOT require INR monitoring.
Factor Xa inhibitors - correct answer Rivaroxaban (Xarelto), Apixaban (Eliquis), Edoxaban
(Savaysa).
Direct thrombin inhibitor - correct answer Dabigatran (Pradaxa).
Warfarin (Coumadin) - correct answer Onset: Delayed — requires bridging with LMWH or
heparin.
Bridging with Warfarin - correct answer Bridging is required until INR reaches ≥2.0 for at least
24 hours.
Dopamine - correct answer Dose-dependent: low = renal perfusion, high = pressor.
Dobutamine - correct answer Inotrope (↑ contractility).
Norepinephrine (Levophed) - correct answer Vasoconstrictor + mild inotrope.
,Epinephrine - correct answer Mixed alpha & beta agonist.
Nitroglycerin - correct answer Venodilator; ↓ Preload; avoid if hypotensive.
Nitroprusside - correct answer Potent arterial/venous vasodilator; risk of cyanide toxicity with
prolonged use.
Statins - correct answer HMG-CoA reductase inhibitors used as first-line therapy for lipid
management.
High-intensity statins - correct answer Atorvastatin 40-80 mg daily and Rosuvastatin 20-40 mg
daily.
Indications for high-intensity statins - correct answer Clinical ASCVD (e.g., MI, stroke), LDL ≥190
mg/dL, Diabetes age 40-75 with ≥7.5% 10-year ASCVD risk.
Ezetimibe - correct answer A secondary therapy for mild LDL-lowering, often required before
insurance approval of PCSK9 inhibitors.
PCSK9 inhibitors - correct answer Injectable monoclonal antibodies reserved for very high-risk
patients or statin-intolerant.
ASCVD - correct answer Atherosclerotic Cardiovascular Disease, includes MI, stroke, angina,
revascularization, and peripheral artery disease.
10-year risk categories - correct answer Low risk: <5%, Moderate risk: 5%-7.4%, High risk:
≥7.5%, Very high risk: ≥20% or known ASCVD.
Aortic Stenosis (AS) - correct answer Caused by calcification of the valve leading to outflow
obstruction, with a classic triad of angina, syncope, dyspnea.
Aortic Regurgitation (AR) - correct answer Occurs when the valve fails to close, leading to wide
pulse pressure and bounding pulses.
Mitral Stenosis (MS) - correct answer Often caused by post-rheumatic fever, symptoms include
dyspnea, orthopnea, and atrial fibrillation.
Mitral Regurgitation (MR) - correct answer Caused by papillary muscle rupture, dilated LV, or
endocarditis, characterized by a holosystolic murmur.
HFrEF - correct answer Heart failure with reduced ejection fraction, defined as EF <40% and
associated with systolic dysfunction.
HFpEF - correct answer Heart failure with preserved ejection fraction, defined as EF ≥50% and
associated with diastolic dysfunction.
First-line medications for HFrEF - correct answer Include beta-blockers (Carvedilol, metoprolol
succinate, bisoprolol), ACE inhibitors or ARBs, loop diuretics, and spironolactone.
, Shock categories - correct answer Include hypovolemic, cardiogenic, distributive, and
obstructive types.
Hypovolemic shock - correct answer Caused by hemorrhage or dehydration, treated with fluids
and blood products.
Cardiogenic shock - correct answer Caused by MI or CHF, treated with inotropes (dobutamine)
and vasopressors.
Distributive shock - correct answer Caused by sepsis or anaphylaxis, treated with vasopressors
(norepinephrine) and fluids.
Obstructive shock - correct answer Caused by PE, tamponade, or tension pneumothorax,
treated by relieving the obstruction.
Norepinephrine (Levophed) - correct answer First-line treatment in septic shock.
Dobutamine - correct answer Used for low-output states in cardiogenic shock to improve
contractility.
Fluid optimization - correct answer Must occur before giving vasopressors; check CVP or
physical signs.
Vasodilator agents - correct answer Used for HTN emergencies or cardiac ischemia; avoid if
volume depleted.
NOACs - correct answer Do not require INR monitoring (e.g., apixaban, rivaroxaban).
Warfarin - correct answer Requires bridging and INR goal 2.0-3.0 in most cases.
Type 1 Diabetes - correct answer Pathology: Autoimmune destruction of β-cells in the
pancreas; no insulin production; classic triad: Polyuria, polydipsia, weight loss; presents with:
Hyperglycemia and ketonuria.
Type 2 Diabetes - correct answer Pathology: Peripheral insulin resistance + decreased secretion
over time; most are asymptomatic — diagnosed via labs; associated with: Obesity, metabolic
syndrome.
Metabolic Syndrome - correct answer Must meet 3 of the 5 criteria: Waist circumference: 40 in
(men), 35 in (women); Blood pressure: >130/80 mmHg; Triglycerides: >150 mg/dL; HDL: <40
mg/dL (men), <50 mg/dL (women); Fasting glucose: >100 mg/dL; increases risk for Type 2
diabetes and cardiovascular disease.
DKA (Diabetic Ketoacidosis) - correct answer Cause: Insulin deficiency (common in Type 1); key
signs: Fruity breath, polyuria, polydipsia, N/V, abdominal pain, Kussmaul breathing; treatment:
IV fluids first, then IV insulin; potassium correction; identify and treat underlying cause.
Hypertension - correct answer Hypertension is defined as BP ≥140/90 mmHg (per JNC8).
Non-Black population treatment - correct answer Start with thiazide diuretic, ACE inhibitor,
ARB, or CCB.
Black population treatment - correct answer Start with thiazide diuretic or CCB.
DM or CKD treatment - correct answer Include ACE inhibitor or ARB for kidney protection.
Age ≥60 years treatment - correct answer Treat if BP ≥150/90 mmHg.
Age <60 years treatment - correct answer Treat if BP ≥140/90 mmHg.
Contractility - correct answer Force of cardiac muscle contraction.
Preload - correct answer Volume in ventricles at end-diastole (central venous volume).
Afterload - correct answer Resistance heart must pump against (arterial pressure).
Aortic Stenosis (AS) - correct answer Calcification narrows aortic valve → outflow obstruction.
Aortic Regurgitation (AR) - correct answer Incompetent aortic valve due to root dilation or
endocarditis.
Mitral Stenosis (MS) - correct answer Often post-rheumatic fever, calcification of mitral valve.
Mitral Regurgitation (MR) - correct answer Commonly due to MI, CHF-induced LV dilation,
papillary rupture, or endocarditis.
Direct Oral Anticoagulants (DOACs) - correct answer Do NOT require INR monitoring.
Factor Xa inhibitors - correct answer Rivaroxaban (Xarelto), Apixaban (Eliquis), Edoxaban
(Savaysa).
Direct thrombin inhibitor - correct answer Dabigatran (Pradaxa).
Warfarin (Coumadin) - correct answer Onset: Delayed — requires bridging with LMWH or
heparin.
Bridging with Warfarin - correct answer Bridging is required until INR reaches ≥2.0 for at least
24 hours.
Dopamine - correct answer Dose-dependent: low = renal perfusion, high = pressor.
Dobutamine - correct answer Inotrope (↑ contractility).
Norepinephrine (Levophed) - correct answer Vasoconstrictor + mild inotrope.
,Epinephrine - correct answer Mixed alpha & beta agonist.
Nitroglycerin - correct answer Venodilator; ↓ Preload; avoid if hypotensive.
Nitroprusside - correct answer Potent arterial/venous vasodilator; risk of cyanide toxicity with
prolonged use.
Statins - correct answer HMG-CoA reductase inhibitors used as first-line therapy for lipid
management.
High-intensity statins - correct answer Atorvastatin 40-80 mg daily and Rosuvastatin 20-40 mg
daily.
Indications for high-intensity statins - correct answer Clinical ASCVD (e.g., MI, stroke), LDL ≥190
mg/dL, Diabetes age 40-75 with ≥7.5% 10-year ASCVD risk.
Ezetimibe - correct answer A secondary therapy for mild LDL-lowering, often required before
insurance approval of PCSK9 inhibitors.
PCSK9 inhibitors - correct answer Injectable monoclonal antibodies reserved for very high-risk
patients or statin-intolerant.
ASCVD - correct answer Atherosclerotic Cardiovascular Disease, includes MI, stroke, angina,
revascularization, and peripheral artery disease.
10-year risk categories - correct answer Low risk: <5%, Moderate risk: 5%-7.4%, High risk:
≥7.5%, Very high risk: ≥20% or known ASCVD.
Aortic Stenosis (AS) - correct answer Caused by calcification of the valve leading to outflow
obstruction, with a classic triad of angina, syncope, dyspnea.
Aortic Regurgitation (AR) - correct answer Occurs when the valve fails to close, leading to wide
pulse pressure and bounding pulses.
Mitral Stenosis (MS) - correct answer Often caused by post-rheumatic fever, symptoms include
dyspnea, orthopnea, and atrial fibrillation.
Mitral Regurgitation (MR) - correct answer Caused by papillary muscle rupture, dilated LV, or
endocarditis, characterized by a holosystolic murmur.
HFrEF - correct answer Heart failure with reduced ejection fraction, defined as EF <40% and
associated with systolic dysfunction.
HFpEF - correct answer Heart failure with preserved ejection fraction, defined as EF ≥50% and
associated with diastolic dysfunction.
First-line medications for HFrEF - correct answer Include beta-blockers (Carvedilol, metoprolol
succinate, bisoprolol), ACE inhibitors or ARBs, loop diuretics, and spironolactone.
, Shock categories - correct answer Include hypovolemic, cardiogenic, distributive, and
obstructive types.
Hypovolemic shock - correct answer Caused by hemorrhage or dehydration, treated with fluids
and blood products.
Cardiogenic shock - correct answer Caused by MI or CHF, treated with inotropes (dobutamine)
and vasopressors.
Distributive shock - correct answer Caused by sepsis or anaphylaxis, treated with vasopressors
(norepinephrine) and fluids.
Obstructive shock - correct answer Caused by PE, tamponade, or tension pneumothorax,
treated by relieving the obstruction.
Norepinephrine (Levophed) - correct answer First-line treatment in septic shock.
Dobutamine - correct answer Used for low-output states in cardiogenic shock to improve
contractility.
Fluid optimization - correct answer Must occur before giving vasopressors; check CVP or
physical signs.
Vasodilator agents - correct answer Used for HTN emergencies or cardiac ischemia; avoid if
volume depleted.
NOACs - correct answer Do not require INR monitoring (e.g., apixaban, rivaroxaban).
Warfarin - correct answer Requires bridging and INR goal 2.0-3.0 in most cases.
Type 1 Diabetes - correct answer Pathology: Autoimmune destruction of β-cells in the
pancreas; no insulin production; classic triad: Polyuria, polydipsia, weight loss; presents with:
Hyperglycemia and ketonuria.
Type 2 Diabetes - correct answer Pathology: Peripheral insulin resistance + decreased secretion
over time; most are asymptomatic — diagnosed via labs; associated with: Obesity, metabolic
syndrome.
Metabolic Syndrome - correct answer Must meet 3 of the 5 criteria: Waist circumference: 40 in
(men), 35 in (women); Blood pressure: >130/80 mmHg; Triglycerides: >150 mg/dL; HDL: <40
mg/dL (men), <50 mg/dL (women); Fasting glucose: >100 mg/dL; increases risk for Type 2
diabetes and cardiovascular disease.
DKA (Diabetic Ketoacidosis) - correct answer Cause: Insulin deficiency (common in Type 1); key
signs: Fruity breath, polyuria, polydipsia, N/V, abdominal pain, Kussmaul breathing; treatment:
IV fluids first, then IV insulin; potassium correction; identify and treat underlying cause.
