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Pathology | Physician Assistant (PA) School Study Aid
Primary Hypertension Risk Factors
- Excessive Alcohol Consumption
- High Sodium Diet
- Dyslipidemia
- Obesity
- People of African Descent
- Advanced Age
- Vitamin D Deficiency
- Reduced Nephron Number
- Diabetes
- Lack of Physical Activity
2 mins
Hypertension Assessment
- Mechanism
- Essential Hypertension
- Secondary Hypertension
- Assessment
- Headache
- Vision Changes
- Nosebleed (Epistaxis)
- Chest Pain
- Syncope (Fainting)
- Diagnosis
- Average 2 Sets, 2 Minutes Apart
- After 2 or More Visits (within 1-4 weeks)
- Nursing Considerations
- Take BP Both Arms
- Common in African Americans
2 mins
Blood Pressure Classification (JNC 7)
- Classifications
- Normal
- Systolic (<120)
- Diastolic (< 80)
- Prehypertension
- Systolic +20 (120-139)
- Diastolic +10 (80-89)
- Stage 1 Hypertension
- Systolic +20 (140-159)
- Diastolic +10 (90-99)
- Stage 2 Hypertension
- Systolic + > 20 (160)
- Diastolic + > 10 (100)
- Hypertensive Crisis
- Systolic > 180
- Diastolic > 110
4 mins
Blood Pressure Classification (ACC/AHA 2017)
- Classifications
- Normal
- Systolic Less than 120
- Diastolic Less than 80
- Elevated
- Systolic +10 (120-129)
- Diastolic Less than 80
- Stage 1 Hypertension
- Systolic +10 (130-139)
- Diastolic +10 (80-89)
- Stage 2 Hypertension
- Systolic +40 (140-179)
- Diastolic +30 (90-119)
- Hypertensive Crisis
- Systolic greater than or equal to 180
- Diastolic greater than or equal to 120
5 mins
Hypertension Management (JNC-8)
- Goal of Treatment
- Age Over 60 years (and Healthy)
- 150/90
- Age Under 60 years (and Healthy)
- Any Age with Diabetes or CKD
- 140/90
- Treatment
- ARB/ACE-I/Thiazide/CCB (Primary or Combo)
- CKD (w/wo Diabetes)
- ARB or ACE-I Primary
- African American
- Thiazide or CCB Primary
3 mins
Hypercholesterolemia Disease
- Risk Factors
- Diabetes
- Smoking
- Family History
- Hypertension
- HDL < 40
- Men Older than 45 Years of Age
- Women Older than 55 Years of Age
- Signs and Symptoms
- Atheromas
- Plaques in Blood Vessel Walls
- Tissue Ischemia
- Xanthomas
- Lipemia Retinalis
2 mins
Hypercholesterolemia Risk Stratification
- 0 - 1 Risk Factors
- < 160 mg/dl LDL goal
- greater or equal to 2 Risk Factors and 10-year Risk ≤ 20%
- < 130 mg/dL LDL Goal
- Coronary Heart Disease OR >/= to 2 Risk Factors AND 10-Year Risk > 20%
- < 100 mg/dL LDL Goal
2 mins
Hypercholesterolemia Treatment
- Lifestyle Modifications (Diet, Exercise, Smoking Cessation)
- Statins
- Niacin
- Ezetimibe
- Fibrates
- Bile Acid Resins
- PCSK9 Inhibitors
- Omega 3 Fatty Acids
- Screening
- Pooled Cohort Test
2 mins
Metabolic Syndrome
- Assessment
- Dyslipidemia
- Central Obesity
- Insulin Resistance
- Hypertension
- Increased C-Reactive Protein (CRP)
- Increased Fibrinogen
- Considerations
- Increased Risk Cardiovascular Disease
1 min
Peripheral Artery Disease (PAD)
- Mechanism
- Atherosclerosis
- Assessment
- Intermittent Claudication
- Pain with Exercise
- Paresthesias
- Arterial Ulcers
- Critical Limb Ischemia
- Amputation
- Consideration
- Ankle-Brachial Index (ABI)
2 mins
Abdominal Aortic Aneurysm (AAA) Assessment
- Mechanism
- Atherosclerosis
- Assessment
- Bruit
- Pulsation in Abdomen
- Abdominal or Lower Back Pain
- Tearing Pain
- Diagnosis
- Ultrasound
- Considerations
- Rupture
- Shock
- Surgical Repair
1 min
Gestational Hypertension
- New-Onset Hypertension
- > 20 Weeks Gestation
- Risk Factors
- Nulliparity
- Obesity
- African American Females
- > 35 years Old
- Multiple Gestations
- Family History of Gestational HTN (or Preeclampsia)
- Complications
- IUGR
- Prematurity
- Abruptio Placentae
- Management
- Fetal Monitoring
- Alpha-Methyldopa
- Beta-Blockers (Labetalol)
- Calcium Channel Blockers
- Hydralazine
4 mins
Subarachnoid Hemorrhage
- Bleeding into Subarachnoid Space
- Mechanisms
- Trauma
- Aneurysm Rupture
- AVM Rupture
- Vasospasm causes Ischemia
- Signs & Symptoms
- "Worst Headache Of My Life"
- Diagnosis
- Noncontrast Head CT
- Lumbar Puncture
- Angiography
- Considerations
- Surgery
- Blood Pressure Control
- Intracranial Pressure Control
- Nimodipine for Vasospasm Prophylaxis
3 mins
Abdominal Aortic Aneurysm
- Screening
- Screen Males 65-75 Who've Ever Smoked
- Diagnosis
- Ultrasound
- Treatment
- Observation
- Asymptomatic and < 5 cm in Size
- Surgical Repair
- > 5.5 cm in Abdomen
- Emergent Surgery
- Ruptured or Symptomatic
2 mins
Cardiac Tamponade
- Mechanism
- Fluid in the Pericardial Sac
- Pericarditis
- Decreased Cardiac Output
- Signs/Symptoms
- Beck's Triad
- Hypotension
- Jugular Venous Distention (JVD)
- Distant Heart Sounds
- Pulsus Paradoxus
- Electrical Alternans
- Treatment
- Pericardiocentesis
1 min
Dysbetalipoproteinemia (Type III Familial Dyslipidemia)
- INHERITANCE
- Autosomal Recessive
- PATHOGENESIS
- Defective Apolipoprotein E (Apo E)
- Lab Findings
- Increased Chylomicrons
- Increased VLDL
- Symptoms/Findings
- Premature atherosclerosis
- Tuberoeruptive xanthomas
- Palmar xanthomas
3 mins
Hypertriglyceridemia (Type IV Familial Dyslipidemia)
- INHERITANCE
- Autosomal Dominant
- pathogenesis
- Hepatic Overproduction of VLDL
- Related to Insulin Resistance
- Lab Findings
- Increased VLDL
- Increased Triglycerides (> 1000 mg/dL)
- Symptoms/Findings
- Acute Pancreatitis
- Eruptive Xanthomas
- Increased Risk for Coronary Artery Disease (CAD)
- Increased Risk of Peripheral Vascular Disease
3 mins
Hyperchylomicronemia (Type I Familial Dyslipidemia)
- INHERITANCE
- Autosomal Recessive
- PATHOGENESIS
- Lipoprotein Lipase Deficiency (LPL)
- Altered Apolipoprotein C-II (Apo C-II)
- Lab Findings
- Increased Chylomicrons
- Increased Cholesterol
- Increased Triglycerides
- Symptoms/Findings
- Pancreatitis
- Hepatosplenomegaly
- No Increased Risk for Atherosclerosis
- Eruptive/Pruritic Xanthomas
- Milky White Appearance of Blood When Drawn
3 mins
Familial Hypercholesterolemia (Type IIa Familial Dyslipidemia)
- INHERITANCE
- Autosomal Dominant
- PATHOGENESIS
- Defective or Absent LDL Receptors
- Defective Apolipoprotein B-100 (ApoB-100)
- Lab Findings
- Increased LDL
- Decreased HDL
- Type IIb also has Increased VLDL
- Symptoms/Findings
- Accelerated Atherosclerosis
- Achilles Tendon Xanthomas
- Xanthelasma
- Corneal Arcus
4 mins
Abetalipoproteinemia
- Pathophysiology
- Autosomal Recessive
- Deficiency of Apolipoproteins B-48 and B-100
- MTTP Gene Mutation
- Clinical Features
- Malabsorption
- Steatorrhea
- Failure to Thrive
- Ataxia
- Retinitis Pigmentosa
- Spinocerebellar Degeneration
- Diagnosis
- Lipid-Laden Enterocytes
- Acanthocytes
- Decreased Cholesterol and LDL
- Treatment
- Vitamin E (Alpha-Tocopherol)
4 mins
Arteriolosclerosis
- Characteristics
- Small Arteries and Arterioles
- Thickening of Arteriole Wall
- Hyperplastic Arteriolosclerosis
- Hyperplastic
- Smooth Muscle Cell Hyperplasia
- "Onion Skin" Appearance
- Malignant Hypertension
- Hyaline Arteriolosclerosis
- Hyaline
- Subendothelial Protein Deposits
- Chronic Hypertension
- Diabetes Mellitus
- Aging
2 mins
Central Retinal Artery Occlusion
- Etiology
- Atherosclerosis
- Atrial Fibrillation
- Giant Cell (Temporal) Arteritis
- Clinical Features
- Sudden Painless Monocular Vision Loss
- Descending Curtain
- Fundoscopic Findings
- Retinal Plaques
- Grayish Retinal Discoloration
- Cherry Red Spot on Macula
- Diagnosis
- Ultrasound
- Interventions
- Ocular Massage
- Reduce Intraocular Pressure
3 mins
Thoracic Aortic Aneurysm
- Characteristics
- Elderly Men
- Above the Diaphragm
- Usually Asymptomatic
- Risk Factors
- Hypertension
- Smoking
- Connective Tissue Disorders
- Vasculitis
- Diagnosis
- Chest X-Ray
- Chest CT Angiography
- Management
- Manage Risk Factors
- Surgery if Rupture or Dissection
- Observation if Asymptomatic
4 mins
Hypertensive Retinopathy
- Etiology
- Chronic Hypertension
- Fundoscopic Findings
- Flame Hemorrhages
- Arteriovenous Nicking
- Retinal Microaneurysms
- Cotton Wool Spots
- Macular Star
- Papilledema
- Treatment
- Lower Blood Pressure
2 mins
Abdominal Aortic Aneurysm Rupture
- Clinical Features
- Acute Tearing Pain
- Pulsatile Abdominal Mass
- Grey Turner Sign
- Cullen Sign
- Hypovolemic Shock
- Diagnosis
- Diagnosis by Clinical Impression
- Treatment
- Emergent Surgical Intervention
- Considerations
- Poor Prognosis
3 mins
Aortic Dissection
- Characteristics
- Tear in Aortic Intima
- Stanford Classification
- Type A: Tear of Ascending Aorta
- Type B: Tear of Descending Aorta
- Risk Factors
- Hypertension
- Aortic Aneurysm
- Marfan Syndrome
- Signs/Symptoms
- Chest Pain
- Blood Pressure Difference Between Arms
- Mediastinal Widening
- Treatment
- Surgery for Type A
- Beta Blockers for Type B
2 mins
Central Retinal Vein Occlusion
- Etiologies
- Hypercoagulability
- Hypertension
- Diabetes Mellitus
- Clinical Features
- Non-Ischemic
- Mild to Moderate Vision Loss
- Sparse Dot-blot and Flame Hemorrhages
- Ischemic
- Sudden, Painless Vision Loss
- "Blood and Thunder" Appearance
- Cotton Wool Spots
- Papilledema
- Interventions
- Observation if Non-Ischemic
- Laser Photocoagulation
- VEGF Inhibitors
3 mins
Hyperlipoproteinemia (Type V Dyslipidemia)
- Pathophysiology
- Increased Cholesterol
- Increased VLDL
- Increased Chylomicrons
- Increased Triglycerides
- Increased Risk of Cardiovascular Disease
- Clinical Features
- Xanthomas
- Acute Pancreatitis
- Diagnosis
- Lipid Panel
- Management
- Lifestyle Changes
- Statins
- Fibrates
2 mins
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