exam

• • Known or suspected pregnancy
• • History of breast cancer
• • History of hormone-sensitive cancer
• • Unexplained uterine bleeding
• • Liver disease (this especially applies to oral ET)
• • History of blood clots
• • Confirmed cardiovascular disease
• Danger Signs of HRT: abn. Vag bleeding, calf pain, chest pain, SOB, hemoptysis, severe headache, vision probs, breast changes abd. Pain, and jaundice

• The CDC's recommendations found in Morbidity and Mortality Weekly Report (MMWR)
• The management of TB depends on the classification of the disease based on the pathogenesis and diagnostic results.
• Class 0 and 1 no tx. Class 1 should have a repeat test several months after exposure.

Class 2 Main purpose of preventive therapy is decrease the risk that LTBI will progress to active TB. Isoniazid (INH) 300mg/day 6-12 months.

Class 3 requires multidrug therapy. Initial tx regimen: isoniazid, rifampin, pyrazinamide (PZA) and ethambutol is used to prevent MDR TB. Once drug susceptibility to isoniazid and rifampin is demonstrated, administration of these two drugs is continued after the initital 2 months of multidrug therapy.

Monthly follow up evals at the least

TB skin tests

Chest x-ray or sputum smears may be recommended in high risk populations

Dx of active disease:


3 sputum specimens for BOTH smear exam and culture


presumptive dx can be made with detection of acid fast bacilli (AFB)

a positive sputum culture for M. tuberculosis is essential to confirm but can take weeks

TB skin test is helpful: absence does not exclude Dx

PA CXR

• National Cholesterol Education Program ATP III Guidelines
• ATP III counts diabetes as a CHD risk equivalent., age and smoker also increases risk. According to the guidelines The LDL cholesterol goal is <100 mg/dL.

• Reduced intakes of saturated fats and cholesterol
• ● Therapeutic dietary options for enhancing LDL lowering (plant stanols/sterols and increased soluble fiber)
• ● Weight reduction
• ● Increased regular physical activity