1. Contraindications to stress testing: 
- Dobutamine - hypertension
- Exercise EKG - beta blocker (need to be able to get to 80% of max HR - max HR = 220 - age), not able to exercise ie claudication
- Dipyridimole/adenosine - bronchospasm
2. Secondary prevention of stroke - antiplatelet > anticoagulation. Best evidence aspirin alone, also good evidence for aspirin + dipyridamole, OK evidence for plavix, do not give aspirin+plavix (MATCH trial - increased risk of bleed)
3. For people with a-fib on anticoagulation with a high risk of stroke (stroke/TIA within 3 mos or CHADS2 4-5) who need to temporarily stop anticoagulation (ie for surgery), should bridge with coumadin
4. Tod's paralysis - post ictal, typically focal peripheral weakness (paresis in limbs), but can also present with aphasia, ophthalmoplegia.
5. Never do exercise stress test in asymptomatic patient. 
6. Goal INR
- Aortic mechanical valve - 2 to 3, +Afib - 2.5 to 3.5
- Mitral mechanical valve - 2.5 to 3.5,
- If systemic emoboli at therapeutic INR, then add aspirin
7. Causes of pulmonary HTN
- Heart (valve, intrinsic heart)
- Lungs - chronic hypoxia
- Weight loss drugs (phen fen, serotonin)
- HIV
- Chronic liver disease (hepato-pulm)
- Collagen vascular disease
- Idiopathic/Primary
8. Maternal mortality in severe pulmonary hypertension - 30-50%, even if she is asymptomatic. Pt should be counseled to avoid pregnancy, and if it happens, counseled to terminate.
9. Pulmonary artery pressures: 
- Exercise-induced rise in pulmonary systolic pressure abnormal if > 25 change or it total systolic pressure > 60
- Pulm artery HTN defined as mean pulm artery pressure > 25 or systolic > 40
10. CVVH vs hemodialysis: 
- CVVH uses convection while hemodialysis uses diffusion - both use semipermeable membrane
- CVVH can take off larger molecules like cytokines, thus theoretically works better in sepsis but has not been shown to pan out in clinical trials