AANP Family Nurse Practitioner (FNP) Certification Exam flashcards

Providing information and options for preventing unintended pregnancy, tailored to a patient's sexual activity, health status, and preferences.

• Essential for sexually active individuals.
• Addresses unintended pregnancy and sometimes STIs.
• Includes various methods: hormonal, barrier, IUDs, permanent.

Memory trick: ABC of Well-Woman Care: Address Risks, Boost Health, Choose Wisely

Rapid identification of a tear in the inner layer of the aorta, leading to blood flow between the layers of the aortic wall.

• Sudden, severe, tearing chest/back pain.
• Risk factors: hypertension, Marfan syndrome.
• Key physical finding: pulse or blood pressure differential between limbs.

Memory trick: Dissection's 'D'anger: 'D'ifferent 'D'igital Pressures.

Diagnostic approach for difficulty swallowing accompanied by red flag signs, indicating a high likelihood of serious underlying pathology.

• Alarm symptoms: weight loss, anemia, GI bleeding, progressive dysphagia.
• Always warrant prompt investigation.
• Upper endoscopy with biopsy is the first-line diagnostic tool.

Memory trick: Alarm symptoms mean you 'E'xplore 'E'sophagus 'E'arly with 'E'ndoscopy.

A chronic metabolic disorder characterized by high blood glucose levels due to insulin resistance and/or relative insulin deficiency.

• Common symptoms include polyuria, polydipsia, polyphagia, and fatigue.
• Diagnosis involves blood glucose tests (fasting plasma glucose, random plasma glucose, oral glucose tolerance test) and HbA1c.
• Early diagnosis and management are crucial to prevent complications.

Memory trick: Diabetes: A1c Confirms A Long-term Picture.

The Rome IV criteria define Irritable Bowel Syndrome (IBS) as recurrent abdominal pain, at least 1 day/week for 3 months, associated with defecation, stool frequency, or stool form changes.

• Recurrent abdominal pain: at least 1 day/week for 3 months.
• Associated with 2+ of: related to defecation, change in stool frequency, change in stool form.
• Criteria fulfilled for 3 months, with symptom onset at least 6 months prior to diagnosis.
• Absence of alarm symptoms (e.g., weight loss, GI bleeding, nocturnal symptoms).

Memory trick: Rome's Rule: Pain once a week, relieved by the poop, changes in form and frequency.

Cholestasis is a condition where bile flow from the liver is reduced or blocked, leading to accumulation of bilirubin and other bile components in the blood.

• Symptoms: pruritus, jaundice, dark urine, pale stools.
• Lab findings: elevated direct bilirubin, significantly elevated alkaline phosphatase.
• Causes include gallstones, tumors, primary biliary cholangitis.

Memory trick: Cholestasis: Itchy, Dark, Pale, High Alk Phos

Diagnosis of acute gout requires definitive identification of monosodium urate crystals in synovial fluid via joint aspiration, especially to rule out septic arthritis.

• Classic presentation: acute monoarthritis, often great toe (podagra).
• Serum uric acid can be normal in acute attack.
• Joint aspiration is gold standard for definitive diagnosis.

Memory trick: One Joint Aches: Tap It, See Crystals!

Diagnosis of a functional gastrointestinal disorder characterized by chronic abdominal pain and altered bowel habits without identifiable structural or biochemical cause.

• Diagnosed by Rome IV criteria.
• Key features: recurrent abdominal pain related to defecation or change in stool frequency/form.
• Diagnosis of exclusion after ruling out alarm symptoms.

Memory trick: IBS: 'I'f 'B'owel 'S'ymptoms are 'R'elated to 'D'efecation.

Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by chronic, recurrent abdominal pain associated with defecation or a change in bowel habits, without any identifiable organic cause.

• Diagnosis is made using the Rome IV criteria, which are symptom-based.
• Absence of 'alarm symptoms' (e.g., weight loss, nocturnal diarrhea, GI bleeding) is crucial.
• Subtypes include IBS-C (constipation-predominant), IBS-D (diarrhea-predominant), and IBS-M (mixed).

Memory trick: IBS Rome: Right On My Esophagus, My Everything!

Secondary syphilis is a systemic stage of syphilis characterized by a mucocutaneous rash, often involving palms and soles, along with other systemic symptoms like fever, malaise, lymphadenopathy, and sore throat.

• Caused by Treponema pallidum bacterium.
• Rash can be highly variable but frequently involves palms and soles.
• Often follows a chancre (primary stage) by several weeks to months.

Memory trick: Syphilis Spreads Systemically, Showing Skin Signs, Especially Soles and Palms.

Abdominal Aortic Aneurysm (AAA) screening guidelines recommend a one-time ultrasound for specific at-risk populations to detect asymptomatic aneurysms early and prevent rupture.

• Recommended for men aged 65-75 who have ever smoked.
• Less evidence for women who have smoked, or for men/women without smoking history.
• Ultrasound is the preferred screening modality due to its safety and cost-effectiveness.

Memory trick: Old Man Smokes? Scan Once!

A common viral illness, usually caused by coxsackievirus, characterized by fever, oral lesions (vesicles/ulcers), and a rash on the hands and feet.

• Caused by coxsackievirus.
• Classic triad: fever, oral enanthem, exanthem on palms/soles.
• Self-limiting, managed with supportive care.

Memory trick: Rash with Fever: Think Viral, Treat Supportively

Dysphagia with 'alarm symptoms' (e.g., weight loss, anemia, GI bleeding, odynophagia, recurrent vomiting, onset >50 years) requires prompt and thorough investigation to rule out serious underlying conditions such as esophageal cancer or strictures.

• Upper endoscopy with biopsies is the cornerstone of investigation.
• Progressive dysphagia, especially for solids then liquids, is highly concerning.
• Unintentional weight loss is a significant alarm symptom.

Memory trick: Dysphagia Alarms: Difficulty, Down Weight, Digestion Disaster!

A rapidly progressive, life-threatening infection of the epiglottis and surrounding tissues, causing airway obstruction, most commonly in children.

• Sudden onset high fever, severe sore throat, dysphagia, drooling.
• Tripod position, stridor, muffled voice.
• Avoid direct pharyngeal examination; prioritize airway management.

Memory trick: Airway Obstruction: Recognize, Don't Provoke, Secure!

A chronic metabolic disorder characterized by insulin resistance and relative insulin deficiency, leading to hyperglycemia. It often develops in middle-aged or older adults, frequently associated with obesity.

• Symptoms include polyuria, polydipsia, fatigue, and unintentional weight loss.
• Risk factors include obesity, family history, and physical inactivity.
• Diagnosis confirmed by elevated blood glucose levels (fasting, random, or A1C).

Memory trick: Diabet-2-es: 'Too Much' sugar, 'Too Much' thirst, 'Too Much' pee.

Clinical diagnosis of acute, idiopathic unilateral facial nerve paralysis, affecting both upper and lower facial muscles.

• Sudden onset, typically maximal within 48-72 hours.
• Involves entire half of the face (forehead included).
• May be associated with altered taste, hyperacusis, or decreased lacrimation.

Memory trick: Bell's Palsy: 'B'oth 'U'pper and 'L'ower face is 'L'ame.

Bell's Palsy is an acute, idiopathic, unilateral facial paralysis resulting from inflammation or damage to the facial nerve (cranial nerve VII). It affects both the upper and lower face.

• Sudden onset, typically reaching maximum weakness within 48-72 hours.
• Affects all facial muscles on the affected side (cannot wrinkle forehead, close eye, smile).
• Often associated with viral infections (e.g., HSV-1) but is idiopathic.

Memory trick: Bell's: Both Brows and Below are Bad!

A common, self-limiting skin rash characterized by an initial 'herald patch' followed by a generalized eruption of oval, erythematous, scaly lesions in a 'Christmas tree' distribution.

• Herald patch precedes generalized rash.
• 'Christmas tree' pattern on trunk and extremities.
• Self-limiting, typically resolves in 6-8 weeks.

Memory trick: Rash Clues: Shape, Scale, and Spread

An acute febrile illness caused by coxsackieviruses, characterized by painful vesicular and ulcerative lesions primarily in the posterior oropharynx.

• Caused by Coxsackievirus.
• Lesions are vesicles/ulcers on posterior pharynx, tonsils, soft palate.
• Common in children, especially during summer/fall.

Memory trick: Herpangina Hides in the Hinterland of the Throat

A severe primary headache disorder characterized by recurrent, short-lived (15-180 minutes), unilateral headaches occurring in clusters, accompanied by prominent ipsilateral autonomic symptoms.

• Excruciating, unilateral retro-orbital pain.
• Ipsilateral autonomic symptoms: lacrimation, conjunctival injection, ptosis, nasal congestion.
• Occurs in clusters, several attacks per day.

Memory trick: Headache Types: Migraine, Tension, Cluster - Know the Clues!

Diagnostic steps for identifying a genetic heart condition characterized by abnormal thickening of the heart muscle, particularly the left ventricle.

• Often asymptomatic, but can cause sudden cardiac death.
• Key findings: systolic murmur increasing with Valsalva, family history of sudden death.
• Echocardiogram is the primary diagnostic tool.

Memory trick: HCM: 'H'ear the murmur, 'C'heck the family, 'M'easure with Echo.

Brain imaging (MRI or CT) is a critical step in the diagnostic workup for dementia to identify structural causes of cognitive decline or rule out other conditions.

• Rules out reversible causes (e.g., hydrocephalus, tumor).
• Identifies vascular lesions or atrophy patterns.
• Helps differentiate types of dementia (e.g., Alzheimer's vs. vascular).

Memory trick: Cognitive Decline: Rule Out, Look In, Then Diagnose

Bronchiectasis is a chronic lung condition characterized by permanent dilation and damage of the bronchi, leading to impaired mucociliary clearance and recurrent infections. HRCT is the gold standard for diagnosis.

• HRCT is diagnostic.
• Key findings: bronchial dilation, wall thickening.
• 'Signet ring' sign is pathognomonic.

Memory trick: Bronchiectasis: Rings, Tubes, and Thick Walls

Hypertrophic Cardiomyopathy (HCM) is a genetic condition characterized by thickening of the heart muscle (left ventricular hypertrophy) without an identifiable secondary cause, often leading to outflow tract obstruction and increased risk of sudden cardiac death.

• Family history of sudden cardiac death, especially in young individuals, is a key risk factor.
• Murmur characteristics: systolic, increases with maneuvers that decrease preload (Valsalva, standing), decreases with maneuvers that increase preload (squatting).
• Echocardiogram is the primary diagnostic tool.

Memory trick: HCM: Heart Murmur Changes, Family History Calls!

Screening for AAA involves identifying asymptomatic individuals at risk for aortic dilation, often using abdominal ultrasound.

• Risk factors: male, age >65, smoking history, family history.
• Pulsatile abdominal mass is a classic sign.
• Abdominal ultrasound is the preferred initial diagnostic and screening tool.

Memory trick: Smoker's Aorta: Ultrasound First Look

Hypothyroidism presents with a wide range of non-specific symptoms including fatigue, weight gain, constipation, muscle weakness, and edema. TSH is the primary screening test.

• Common symptoms: fatigue, cold intolerance, constipation, dry skin, weight gain.
• Physical signs: bradycardia, periorbital edema, diminished DTRs.
• Initial diagnostic test: Thyroid Stimulating Hormone (TSH).

Memory trick: When the body feels sluggish and slow, check the hormone that makes it go!

The diagnostic process for impaired bile flow, leading to accumulation of bile components in the blood and characteristic symptoms.

• Symptoms: pruritus, jaundice, dark urine, pale stools, fatigue.
• Lab findings: elevated ALP and GGT.
• Differentiate intrahepatic vs. extrahepatic causes.

Memory trick: Itching, Jaundice, and ALP High, PBC's name you must apply.

A genetic condition causing abnormal thickening of the heart muscle, leading to impaired relaxation and potentially outflow tract obstruction, a common cause of sudden cardiac death in young athletes.

• Family history of sudden cardiac death is a red flag.
• Murmur increases with standing/Valsalva.
• Echocardiogram is the diagnostic gold standard.

Memory trick: Murmur Changes? Echo is Your Answer!

A set of clinical decision rules to determine if a patient with an acute ankle injury requires radiography.

• High sensitivity for detecting ankle and midfoot fractures.
• Reduces unnecessary X-rays.
• Criteria include specific bony tenderness and inability to bear weight.

Memory trick: Ottawa RULES for 'R'adiographs when 'U'ncertain.

Bell's Palsy is an idiopathic, acute, unilateral peripheral facial nerve palsy (affecting cranial nerve VII) resulting in weakness or paralysis of the entire face on the affected side.

• Affects both upper and lower face (inability to wrinkle forehead).
• Often preceded by viral illness.
• Diagnosis of exclusion after ruling out other causes.

Memory trick: Bell's: Forehead Folds, No Other Faults

A systemic stage of syphilis characterized by mucocutaneous lesions, lymphadenopathy, and constitutional symptoms, occurring weeks to months after the primary infection.

• Widespread maculopapular rash, often involving palms and soles.
• Associated with systemic symptoms like fever, malaise, lymphadenopathy.
• Caused by the spirochete Treponema pallidum.

Memory trick: Syphilis Spreads Systemically: Palms, Soles, and Systemic Signs.

Initial evaluation of a testicular mass primarily involves imaging to differentiate between benign and malignant etiologies.

• Painless, firm mass is highly suspicious for malignancy.
• Scrotal ultrasound is the first-line diagnostic imaging.
• Doppler helps assess blood flow and viability.

Memory trick: Painless Swelling? Ultrasound is the first call!

Meningitis in infants presents with non-specific symptoms but can rapidly progress. A bulging fontanelle is a key sign, and lumbar puncture is crucial for diagnosis.

• Non-specific symptoms: irritability, poor feeding, fever.
• Key physical finding: bulging anterior fontanelle.
• Definitive diagnosis: lumbar puncture with CSF analysis.

Memory trick: Fever, fuss, and a bulging brain fountain, get that spinal fluid flowing!

Intramuscular injections, such as vaccines, can be safely administered to patients on anticoagulant therapy with specific technique modifications.

• Use a fine-gauge needle (23-gauge or smaller).
• Apply firm pressure to the injection site for at least 2 minutes.
• Do not rub the injection site after administration.
• Do not hold anticoagulant therapy for routine vaccinations.

Memory trick: Fine Needle, Firm Press, No Rub, No Pause for Warfarin!

When managing anxiety/depression in patients planning pregnancy, a careful risk-benefit analysis is crucial. Paroxetine carries higher risks of congenital cardiac malformations; therefore, tapering and exploring non-pharmacological options, or switching to a safer SSRI (e.g., sertraline, escitalopram), is often recommended pre-conception.

• Paroxetine has a higher risk of fetal cardiac malformations.
• Abrupt discontinuation of SSRIs is not recommended.
• Non-pharmacological therapies (CBT) are preferred if effective.
• Sertraline and escitalopram are generally preferred SSRIs during pregnancy.

Memory trick: Baby on the way? Paroxetine, no way!

Active surveillance involves close monitoring of low-risk localized prostate cancer with the intent to intervene only if there is evidence of disease progression.

• Suitable for low-risk, localized prostate cancer.
• Involves regular PSA, DRE, and repeat biopsies.
• Aims to avoid or delay treatment-related side effects, preserving quality of life.

Memory trick: Prostate Choices: Risk, Benefits, and Your Voice.

Diabetes Self-Management Education and Support (DSMES) provided by RDs and CDEs is an essential component of comprehensive diabetes care.

• Improves glycemic control and reduces complication risk.
• Covers nutrition, physical activity, medication management, monitoring, and problem-solving.
• Recommended for all individuals with diabetes at diagnosis and annually.

Memory trick: New Diabetes needs Diet, Drugs, and Dedicated Educators.

For persistent sciatica from a herniated disc, non-pharmacological interventions beyond initial conservative care include targeted injections.

• Lumbar Epidural Steroid Injections (ESIs) are indicated for radicular pain.
• ESIs provide temporary relief by reducing nerve root inflammation.
• ESIs are a bridge to continued physical therapy or surgical consideration.

Memory trick: For Herniated Sciatica, ESI is the targeted solution!

SSRIs and SNRIs are the recommended first-line pharmacological treatments for generalized anxiety disorder.

• Require 4-6 weeks for full therapeutic effect.
• Dosage adjustments may be needed.
• Benzodiazepines are typically reserved for short-term or acute symptom management.

Memory trick: Anxiety's First Line: SSRIs and Talk.

Acute symptom relief for stable angina is primarily achieved with sublingual nitroglycerin, which rapidly dilates coronary arteries and reduces myocardial oxygen demand.

• Sublingual nitroglycerin is the first-line for acute angina attacks.
• It provides rapid relief (within minutes).
• Patients should be educated on proper use and when to seek emergency care.

Memory trick: For Angina's Sting, Nitroglycerin Brings Quick Relief!

Cognitive Behavioral Therapy for Insomnia (CBT-I) is a multi-component therapy focusing on cognitive restructuring and behavioral changes to improve sleep.

• Sleep restriction and stimulus control.
• Cognitive restructuring of maladaptive sleep thoughts.
• Sleep hygiene education and relaxation techniques.

Memory trick: SLEEP SMART: Stimulus, Light, Exercise, Environment, Pacing, Schedule, Mindset, Avoid.

Behavioral interventions, such as time-outs and consistent discipline, are the first-line non-pharmacological strategies for managing aggressive behaviors in young children, aiming to teach self-regulation and appropriate coping mechanisms.

• Consistency is key for behavioral interventions.
• Time-outs provide a brief period of isolation from positive reinforcement.
• Pharmacology is typically a last resort.

Memory trick: Aggression in tots? Time-out blocks the plots!

Acute cluster headache attacks require rapid-acting treatments due to their severe, sudden onset and short duration.

• High-flow oxygen (100%) is a first-line acute treatment.
• Subcutaneous sumatriptan is another highly effective first-line acute treatment.
• Oral medications are generally too slow for acute attacks.

Memory trick: Cluster Attacks Need Quick Shots (Sumatriptan) or Oxygen!

Colorectal cancer screening decisions for individuals aged 70-75 should be individualized, considering patient preferences, health status, and prior screening results.

• Screening generally recommended until age 75 for average risk.
• Options include colonoscopy (every 10 years if negative) or annual stool-based tests.
• Decision based on life expectancy, comorbidity, and patient values.

Memory trick: AGE, RISK, CHOICE: Age 70-75, Assess Risk, Offer Choices.

Routine screening for depression in adults is a recommended preventative service to identify and address mental health concerns early.

• Recommended for all adults, including pregnant and postpartum women.
• Utilize validated screening tools (e.g., PHQ-2, PHQ-9).
• Follow up positive screens with a comprehensive assessment.

Memory trick: Elderly patients NEED Mental Health Checks.

For patients with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD), specific glucose-lowering medications with proven cardiovascular benefits are recommended.

• GLP-1 receptor agonists or SGLT2 inhibitors are preferred add-on therapies.
• These agents reduce the risk of major adverse cardiovascular events.
• This recommendation applies regardless of the patient's A1C value.

Memory trick: For Diabetic Hearts, SGLT2s or GLP-1s are Smart!

Non-pharmacological strategies for atopic dermatitis focus on skin barrier repair and reducing irritants to alleviate symptoms and prevent flares.

• Regular lukewarm baths followed by immediate emollient application.
• Avoidance of harsh soaps, hot water, and irritants.
• Keeping skin hydrated and protected.

Memory trick: BATH and MOISTURIZE to Keep the Rash Away!

GDMT for HFrEF includes ACE inhibitors/ARBs, beta-blockers, and mineralocorticoid receptor antagonists (MRAs) to reduce morbidity and mortality.

• MRAs (e.g., spironolactone, eplerenone) are recommended for all HFrEF patients with NYHA class II-IV symptoms.
• Monitor potassium and renal function closely after initiating MRAs.
• MRAs provide significant mortality benefits beyond ACEIs/ARBs and beta-blockers.

Memory trick: ACE, Beta, MRA: The Core Heart Failure Trio.

Effective strategies for picky eaters include repeated, non-pressured exposure to a variety of foods, involving children in meal prep, and modeling healthy eating.

• Children often need 10-15 exposures to a new food before acceptance.
• Avoid power struggles and making food a reward/punishment.
• Focus on the division of responsibility: parents offer, children decide how much to eat.

Memory trick: Picky Eaters need Patient, Persistent, Positive Exposure.

For postmenopausal women with recurrent UTIs, low-dose topical vaginal estrogen is a highly effective non-antibiotic strategy that addresses the underlying cause of vaginal atrophy and altered flora, significantly reducing UTI recurrence.

• Estrogen deficiency causes vaginal atrophy and altered pH.
• Topical estrogen restores normal flora and reduces bacterial colonization.
• It is a preferred non-antibiotic approach.
• Oral estrogen is not as effective and has more systemic risks.

Memory trick: Post-menopause UTI? Estrogen's the key!

For type 2 diabetes patients, critical health maintenance strategies for preventing microvascular complications (retinopathy, nephropathy, neuropathy) include strict glycemic control, blood pressure management, and regular screening exams (e.g., dilated eye exams for retinopathy, urine albumin-creatinine ratio for nephropathy).

• Glycemic control is primary for microvascular prevention.
• Hypertension exacerbates microvascular damage.
• Regular screening allows for early intervention.
• Retinopathy and nephropathy are leading microvascular complications.

Memory trick: Diabetes eyes, kidneys, feet: Check them all, can't be beat!

Effective counseling for vaccine hesitancy involves empathetic communication, addressing specific concerns, and providing accurate, evidence-based information.

• Listen to and acknowledge parental concerns.
• Provide tailored, evidence-based information.
• Use motivational interviewing to explore values and overcome barriers.

Memory trick: LISTEN, EDUCATE, MOTIVATE: L.E.M. for Vaccine Hesitation!

For suspected significant ligamentous injuries after trauma, especially with instability or functional impairment, prompt referral to an orthopedic specialist is indicated for definitive diagnosis and management.

• Orthopedic specialists manage acute musculoskeletal trauma.
• Ligamentous injuries may require advanced imaging (MRI) or surgery.
• Early specialist evaluation can prevent chronic issues.

Memory trick: Twisted and Torn? See Ortho, Don't Mourn!

Lifestyle modifications like consistent sleep, stress reduction, and trigger avoidance are key non-pharmacological strategies for migraine prevention.

• Identify and avoid individual triggers (foods, smells, stress).
• Maintain regular sleep patterns and meal times.
• Practice stress reduction techniques (e.g., mindfulness, biofeedback).

Memory trick: Migraines need a calm, consistent life.

Erectile dysfunction, particularly in patients with cardiovascular risk factors, is often a strong predictor of underlying cardiovascular disease and microvascular complications.

• ED shares common risk factors with CVD (diabetes, hypertension, dyslipidemia).
• ED can precede symptomatic CVD by several years.
• Evaluation for ED should include a comprehensive cardiovascular risk assessment.
• Optimization of chronic disease management is crucial for both ED and CVD prevention.

Memory trick: ED = EARLY WARNING: Evaluate Disease, Address Risks, Optimize Management.

For osteoarthritis pain, acetaminophen is the preferred first-line oral analgesic in patients with comorbidities like hypertension, gastric reflux, or cardiovascular disease, due to its safer GI and cardiovascular profile compared to NSAIDs.

• Acetaminophen is first-line for OA pain.
• NSAIDs carry risks for GI bleeding, renal dysfunction, and hypertension.
• COX-2 inhibitors have lower GI risk but still have cardiovascular risks.

Memory trick: Old lady aches? Acetaminophen makes sense!

A common side effect of ACE inhibitors is a persistent dry cough; management involves switching to an Angiotensin Receptor Blocker (ARB).

• Cough is due to bradykinin accumulation.
• ARBs do not affect bradykinin, thus do not cause the cough.
• ARBs have similar cardiovascular and renal protective benefits as ACEIs.

Memory trick: When ACEI makes you cough, ARB is the smooth switch.

Management of acute gout flares in patients with chronic kidney disease requires careful selection of medications to avoid exacerbating renal dysfunction.

• NSAIDs are generally contraindicated in CKD due to nephrotoxicity.
• Colchicine requires significant dose reduction or avoidance in moderate to severe CKD.
• Systemic corticosteroids (e.g., prednisone) are preferred for acute flares in CKD patients.

Memory trick: Kidney-Friendly Gout Relief: Steroids are the Safe Bet!

For uncomplicated urinary tract infections, certain antibiotics are preferred as first-line due to efficacy, safety, and resistance patterns.

• TMP-SMX is a common first-line agent for uncomplicated UTIs.
• Nitrofurantoin is another first-line option for uncomplicated UTIs.
• Fluoroquinolones are generally reserved for second-line treatment due to resistance concerns.

Memory trick: Treat Uncomplicated UTIs with TNT: Trimethoprim, Nitrofurantoin, or Cephalexin!

For patients with type 2 diabetes and established atherosclerotic cardiovascular disease (ASCVD) or high cardiovascular risk, SGLT2 inhibitors (like empagliflozin) or GLP-1 receptor agonists are preferred agents due to their proven cardiovascular and renal protective benefits, independent of glycemic control.

• SGLT2 inhibitors and GLP-1 RAs have ASCVD benefits.
• Consider patient-specific comorbidities and medication side effects.
• Avoid medications that worsen CV risk (e.g., fluid retention with TZDs).

Memory trick: Diabetes Heart Smart? SGLT2 is the start!