NR667\/ NR 667 VISE (Latest 2023\/ 2024 Update) Complete Guide with Questions and Verified Answers| 100% Correct- Chamberlain<\/p>\n\n\n\n
NR667\/ NR 667 VISE (Latest 2023\/ 2024
Update) Complete Guide with Questions and
Verified Answers| 100% CorrectChamberlain
Q: Etiology: Hyperlipidemia
Answer:
-Inherited disorder, high dietary intake, obesity, sedentary lifestyle, DM, hypothyroidism,
anabolic steroid use, hepatitis, cirrhosis, uremia, nephrotic syndrome, stress, drug-induced
(thiazide diuretics, beta blockers, cyclosporine), alcohol, caffeine, metabolic syndrome
Q: Risk factors: Hyperlipidemia
Answer:
-Family history, physical inactivity, smoking, age (men > 45, women > 55 or premature
menopause without estrogen replacement), obesity, diet high in sat. fat, DM
Q: Assessment findings: Hyperlipidemia
Answer:
-Few physical findings; xanthomata (fat deposits in the skin), xanthelasma (yellow plaques on
the eyelid), corneal arcus prior to age 50 (arc of cholesterol around the iris), bruits, angina
pectoris, MI, stroke
Q: Differential diagnosis: Hyperlipidemia
Answer:
-Secondary causes: hypothyroidism, pregnancy, DM, non-fasting state<\/p>\n\n\n\n
Q: Final diagnosis: Hyperlipidemia
Answer:
-Fasting lipid profile: 9-12 hours
-Glucose level
-Urinalysis, creatinine (for detection of nephrotic syndrome which can induce dyslipidemia)
-Baseline transaminases
-TSH for detection of hypothyroidism (which can cause secondary dyslipidemia)
-Calculate ASCVD 10-year risk
Q: Prevention: Hyperlipidemia
Answer:
-Healthy lifestyle reduces ASCVD in all age groups
-Dietary interventions: encourage mediterranean and DASH diet; limit saturated and trans fats;
limit sodium intake; increase fiber, vegetables, fruits, and other whole grains; eat lean meats
(poultry, fish); eggs, beans, nuts, low-fat dairy, avoid red meat, limit sugary drinks and sweets
-Mod to vigorous exercise of at least 40 mins 3-4x\/week (sustained aerobic activity increases
HDL, decreases total cholesterol)
-Avoid tobacco
-Appropriately manage systemic diseases (DM, hypothyroidism, HTN)
Q: Non-pharm management: Hyperlipidemia
Answer:
-Nutrition, weight reduction, increased physical activity, patient education about risk factors
Q: Pharmacological management: Hyperlipidemia
Answer:
-Assign to a statin treatment group using ASCVD 10-year risk calculator
-Primary lipid target it LDL
-Statins are 1st-line therapy
-Combo of statin and non-statin in some patients<\/p>\n\n\n\n
-Consider adding non-statin if unable to achieve LDL < 70mg\/dl, but VERIFY adherence to
statins and lifestyle changes
-Non-statins: ezetimibe (1st), bile acid sequestrant, vibrate, PCSK9 inhibitor
Q: Pregnancy\/lactation consideration: Hyperlipidemia
Answer:
-Cholesterol is usually elevated during pregnancy; measurement is not recommended and
treatment is contraindicated
Q: Follow-up: Hyperlipidemia
Answer:
-Check fasting lipid panel 4-12 weeks after starting or adjusting a statin or non-statin
-Monitor for medication compliance and lifestyle modification, especially if LDL drop is less
than expected
Q: Expected course: Hyperlipidemia
Answer:
-Depends on etiology and severity of disease
-1% decrease in LDL value decreases CHD risk by 2%
Q: Possible complications: Hyperlipidemia
Answer:
-CAD, cerebrovascular disease, PVD, arteriosclerosis
Q: Etiology: DM II<\/p>\n\n\n\n
Answer:
-Influences by genetics and environmental factors
-High body mass and central obesity
-Drug or chemical-induced: glucocorticoids, highly active antiretroviral therapy
Q: Risk factors: DM II
Answer:
-BMI > 25
-History of gestational DM and\/or macrocosmic infant
-Family history of T2DM
-Conditions associated with insulin resistance: PCOS, acanthosis nigricans)
-HDL-C < 35 and\/or TG > 250
-HTN
-History of CVD
-Hemochromatosis
-Impaired fasting glucose
-Physically active < 3 days\/week Q: Assessment findings: DM II Answer: -Usually discovered on routine exam -CMP and urinalysis: glycosuria, proteinuria, hyperglycemia -Obesity -Acanthosis nigricans -Polydipsia, polyuria, polyphagia -Fatigue -Blurred vision -Chronic skin infections -Balanitis in men > 65 years
-Chronic candidiasis vulvovaginitis
-Hyperosmolar state or coma
Q: Differential diagnosis: DM II
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