Cardiovascular Risk Factors and Immunizations in Diabetes

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Author:
giddyupp
ID:
70573
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Cardiovascular Risk Factors and Immunizations in Diabetes
Updated:
2011-03-03 22:03:44
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Cardiovascular Risk Factors Immunizations Diabetes PHPR523 Test4
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Cardiovascular Risk Factors and Immunizations in Diabetes
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  1. What are the characteristics associated with metabolic syndrome?
    • Waist > 40in in men; > 35in in women
    • TG > 150
    • HDL < 40 for men; < 50 for women
    • HTN
    • Insulin resistance (with or w/o glucose intolerance)
  2. What are the 5 risks for cardiovascular complications in diabetes?
    • Smoking
    • HTN
    • Dyslipidemia
    • Hyperglycemia
    • Immunizations (give them)
    • (Thrombus formation)
  3. What is the BP goal for diabetes?
    • < 130/80
    • 110-129/65-79 in pregnant diabetics
    • if under 140/90 = lifestyle modification x 3mo
    • if 140/90 or higher = lifestyle mod + pharmacotherapy
  4. What is lifestyle modification for HTN in diabetes?
    • DASH diet
    • Wt loss
    • Alcohol moderation
    • Exercise
  5. What is the recommended pharmacotherapy for HTN in diabetes?
    • ACE inhibitor
    • ARB
    • Monitor K, renal fx, BP
    • (Methyldopa, Labetolol, Diltiazem, Clonidine, Prazosin in Pregnancy)
  6. What are the goals for lipids in diabetes?
    • LDL < 100 (70 if possible)
    • HDL > 40 in men; > 50 in women
    • TG < 150
    • Use statins (except in pregnancy)
    • If LDL goal cannot be reached, decrease it by 30-40% of baseline
  7. When should ASA be recommended for thrombus prevention?
    • Primary prevention:
    • if 10yr risk > 10% (male > 50yo, female > 60yo, + HTN, family hx of CVD, smoking, dyslipidemia, OR albuminuria)
    • Secondary prevention:
    • if personal hx of CVD
  8. What are the 5 As of smoking cessation?
    • Ask
    • Advise
    • Assess
    • Assist
    • Arrange
  9. What therapies should be initiated in diabetics with established CVD?
    • ACEI
    • Statin
    • ASA
    • Post-MI: beta-blockers for at least 2yrs
    • Metformin okay if stable CHF and normal renal fx
    • NO TZDs
  10. What is the schedule for immunizations in diabetes?
    • Influenza:
    • every year
    • Pneumoccocal:
    • > 64yo if orignal vaccine < 65 and at least 5 yo ago

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