NR667 VISE Final Review
Hypertension correct- Elevated blood pressure (>140/90 mm Hg) leading to asymptomatic or
symptomatic presentation including occipital headaches, blurry vision, and microvascular or
macrovascular clinical findings.
Microvascular correct- Clinical findings related to hypertension retinopathy and kidney damage including
AV nicking, papilledema, microalbuminuria, proteinuria, elevated serum creatinine, abnormal eGFR, and
peripheral or generalized edema.
Macrovascular correct- Clinical findings related to hypertension's impact on the heart and brain including
S3 (CHF), S4 (LVH), carotid bruits, decreased or absent peripheral pulses, and TIA or hemorrhagic
stroke.
Hypertension Diagnosis correct- Diagnosis of hypertension is made when blood pressure is consistently
>140/90 mm Hg, leading to the initiation of blood pressure medication.
Hypertension Pharmacologic Management correct- Pharmacologic management includes first-line diuretic
(Hydrochlorothiazide), alternative CCB (Amlodipine besylate), ACE inhibitors (lisinopril), and
consideration of ACE/ARB in specific patient populations.
Hypertension Follow-up correct- Patients should be followed up every 2-4 weeks, and referrals should be
made to cardiology if EKG is abnormal.
Hyperlipidemia correct- Elevated levels of lipids in the blood leading to asymptomatic presentation until
the development of ASCVD, with symptoms including xanthomata, corneal arcus, angina, bruits, MI, and
stroke.
Hyperlipidemia Diagnosis correct- Diagnosis is confirmed when the optimal goal of LDL is <100 mg/dL,
and patients with LDL >= 190mg/dL are candidates for high-intensity statin therapy.
Hyperlipidemia Pharmacologic Management correct- Pharmacologic management includes first-line
atorvastatin, simvastatin, pravastatin, or rosuvastatin, and alternative Welchol for statin intolerance.
Hyperlipidemia Follow-up correct- Patients should be re-checked every 6-8 weeks until goal is achieved,
and referrals should be made to a nutritionist.
Diabetes Type 2 correct- Insulin resistance in target tissues, abnormal insulin secretion, or decrease in
insulin receptors leading to symptoms such as polydipsia, polyuria, polyphagia, agitation, nervousness,
obesity, fatigue, and chronic skin infections.
, Diabetes Type 2 Diagnosis correct- Diagnosis is confirmed with Hgb A1C >6.5%, fasting glucose
>126mg/dl, and recurrent yeast infections.
Diabetes Type 2 Pharmacologic Management correct- Pharmacologic management includes first-line
metformin, additional first-line or combination therapy, and second-line insulin or SGLT2 inhibitors.
Diabetes Type 2 Follow-up correct- Patients should be followed up every 2-4 weeks, and referrals should
be made to various specialists for comprehensive care.
Back Pain correct- Mechanical low back pain attributed to degenerative changes, classified into acute,
subacute, or chronic categories, and presenting with localized, referred, or radiating pain.
Back Pain Differential correct- Differential diagnoses include secondary hypertension, white coat
syndrome, pregnancy, and pregnancy-induced hypertension.
Anxiety correct- Complaints of apprehension, restlessness, edginess, and somatic complaints such as
fatigue, paresthesia, near syncope, dizziness, palpitation, tachycardia, chest pain, and tightness.
Anxiety Diagnosis correct- Diagnosis is assessed using tools like the Hamilton Anxiety scale and GAD-7,
with scores indicating mild, moderate, or severe anxiety.
Anxiety Pharmacological Management correct- Pharmacological management includes the use of
benzodiazepines and SSRIs, with caution and close monitoring for therapeutic response.
Anxiety Follow-up correct- Patients should be followed up every 2-4 weeks, and referrals should be made
to a psychologist or psychiatrist.
Depressive Disorder correct- Presentation includes loss of interest or pleasure, suicide ideology, early
morning awakening, hopelessness, depressed mood, fatigue, loss of energy, and feelings of
worthlessness.
Depressive Disorder Diagnosis correct- Diagnosis is made based on patient health questionnaire scores
and Becks Depression Inventory, with a score of 5 and above indicating mild depression.
Depressive Disorder Pharmacological Management correct- Pharmacological management includes the
use of SSRIs and tricyclic antidepressants, with close monitoring for therapeutic response.
Depressive Disorder Follow-up correct- Patients should be followed up every 2 weeks, and referrals
should be made to a psychologist for psychotherapy.
Obesity correct- Chronic disease due to abnormal or excessive fat accumulation, leading to increased
morbidity and mortality, and defined as 20% more than the ideal body mass index.
Obesity Pharmacological Management correct- Pharmacological management includes the use of
Adipex-P for a specified duration, with follow-up after 2-4 weeks.
GERD correct- Movement of GI contents into the esophagus due to decreased LES tone, leading to
subjective findings such as heartburn, regurgitation, chest pain, and throat symptoms.
GERD Diagnosis correct- Diagnosis is based on symptoms of heartburn and regurgitation, with empiric
PPI treatment started for 8 weeks.
GERD Pharmacological Management correct- Pharmacological management includes the use of PPIs
and H2 blockers, with follow-up after 4-8 weeks for re-evaluation.
Hypertension correct- Elevated blood pressure (>140/90 mm Hg) leading to asymptomatic or
symptomatic presentation including occipital headaches, blurry vision, and microvascular or
macrovascular clinical findings.
Microvascular correct- Clinical findings related to hypertension retinopathy and kidney damage including
AV nicking, papilledema, microalbuminuria, proteinuria, elevated serum creatinine, abnormal eGFR, and
peripheral or generalized edema.
Macrovascular correct- Clinical findings related to hypertension's impact on the heart and brain including
S3 (CHF), S4 (LVH), carotid bruits, decreased or absent peripheral pulses, and TIA or hemorrhagic
stroke.
Hypertension Diagnosis correct- Diagnosis of hypertension is made when blood pressure is consistently
>140/90 mm Hg, leading to the initiation of blood pressure medication.
Hypertension Pharmacologic Management correct- Pharmacologic management includes first-line diuretic
(Hydrochlorothiazide), alternative CCB (Amlodipine besylate), ACE inhibitors (lisinopril), and
consideration of ACE/ARB in specific patient populations.
Hypertension Follow-up correct- Patients should be followed up every 2-4 weeks, and referrals should be
made to cardiology if EKG is abnormal.
Hyperlipidemia correct- Elevated levels of lipids in the blood leading to asymptomatic presentation until
the development of ASCVD, with symptoms including xanthomata, corneal arcus, angina, bruits, MI, and
stroke.
Hyperlipidemia Diagnosis correct- Diagnosis is confirmed when the optimal goal of LDL is <100 mg/dL,
and patients with LDL >= 190mg/dL are candidates for high-intensity statin therapy.
Hyperlipidemia Pharmacologic Management correct- Pharmacologic management includes first-line
atorvastatin, simvastatin, pravastatin, or rosuvastatin, and alternative Welchol for statin intolerance.
Hyperlipidemia Follow-up correct- Patients should be re-checked every 6-8 weeks until goal is achieved,
and referrals should be made to a nutritionist.
Diabetes Type 2 correct- Insulin resistance in target tissues, abnormal insulin secretion, or decrease in
insulin receptors leading to symptoms such as polydipsia, polyuria, polyphagia, agitation, nervousness,
obesity, fatigue, and chronic skin infections.
, Diabetes Type 2 Diagnosis correct- Diagnosis is confirmed with Hgb A1C >6.5%, fasting glucose
>126mg/dl, and recurrent yeast infections.
Diabetes Type 2 Pharmacologic Management correct- Pharmacologic management includes first-line
metformin, additional first-line or combination therapy, and second-line insulin or SGLT2 inhibitors.
Diabetes Type 2 Follow-up correct- Patients should be followed up every 2-4 weeks, and referrals should
be made to various specialists for comprehensive care.
Back Pain correct- Mechanical low back pain attributed to degenerative changes, classified into acute,
subacute, or chronic categories, and presenting with localized, referred, or radiating pain.
Back Pain Differential correct- Differential diagnoses include secondary hypertension, white coat
syndrome, pregnancy, and pregnancy-induced hypertension.
Anxiety correct- Complaints of apprehension, restlessness, edginess, and somatic complaints such as
fatigue, paresthesia, near syncope, dizziness, palpitation, tachycardia, chest pain, and tightness.
Anxiety Diagnosis correct- Diagnosis is assessed using tools like the Hamilton Anxiety scale and GAD-7,
with scores indicating mild, moderate, or severe anxiety.
Anxiety Pharmacological Management correct- Pharmacological management includes the use of
benzodiazepines and SSRIs, with caution and close monitoring for therapeutic response.
Anxiety Follow-up correct- Patients should be followed up every 2-4 weeks, and referrals should be made
to a psychologist or psychiatrist.
Depressive Disorder correct- Presentation includes loss of interest or pleasure, suicide ideology, early
morning awakening, hopelessness, depressed mood, fatigue, loss of energy, and feelings of
worthlessness.
Depressive Disorder Diagnosis correct- Diagnosis is made based on patient health questionnaire scores
and Becks Depression Inventory, with a score of 5 and above indicating mild depression.
Depressive Disorder Pharmacological Management correct- Pharmacological management includes the
use of SSRIs and tricyclic antidepressants, with close monitoring for therapeutic response.
Depressive Disorder Follow-up correct- Patients should be followed up every 2 weeks, and referrals
should be made to a psychologist for psychotherapy.
Obesity correct- Chronic disease due to abnormal or excessive fat accumulation, leading to increased
morbidity and mortality, and defined as 20% more than the ideal body mass index.
Obesity Pharmacological Management correct- Pharmacological management includes the use of
Adipex-P for a specified duration, with follow-up after 2-4 weeks.
GERD correct- Movement of GI contents into the esophagus due to decreased LES tone, leading to
subjective findings such as heartburn, regurgitation, chest pain, and throat symptoms.
GERD Diagnosis correct- Diagnosis is based on symptoms of heartburn and regurgitation, with empiric
PPI treatment started for 8 weeks.
GERD Pharmacological Management correct- Pharmacological management includes the use of PPIs
and H2 blockers, with follow-up after 4-8 weeks for re-evaluation.
