NR667/ NR 667 VISE (Latest 2023/ 2024 Update) Complete Guide with Questions and Verified Answers| 100% Correct- Chamberlain

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

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

-Consider adding non-statin if unable to achieve LDL < 70mg>

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?crease in LDL value decreases CHD risk by 2%

Q: Possible complications: Hyperlipidemia

Answer:

-CAD, cerebrovascular disease, PVD, arteriosclerosis

Q: Etiology: DM II

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> 250

-HTN

-History of CVD

-Hemochromatosis

-Impaired fasting glucose

-Physically active < 3>

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