Continuing Medical Education Exam

Target: CAD

“Healthy lifestyle factors and prevention of coronary heart disease”

Learning objectives

Examine the effects of modifiable lifestyle factors on the prevalence of coronary heart disease (CHD) among educated, middle-aged, and older men; the benefits of a healthy lifestyle on men already receiving drug therapy for increased lipid levels and hypertension; and the relationship between lifestyle modifications later in life and the risk of CHD.

Questions

1. In the Chiuve study, “low risk” was defined as including all but which of the following lifestyle factors? a absence of smoking

b body mass index < 25 kg/m²

c stress management

d moderate-to-vigorous daily exercise

e moderate alcohol consumption

2. In this study, _____________ of moderate-to-vigorous exercise was considered to be low risk. a ≥ 20 minutes per day

b ≥ 30 minutes per day

c ≥ 45 minutes per day d ≥ 60 minutes per day

3. The population-attributable risk for subjects who were at low risk for all 5 lifestyle factors and who used antihypertensives and lipid-lowering medication was _____.

a 66%

b 62%

c 57% d 49%

4. Compared with study subjects who did not implement healthy lifestyle changes, those who adopted at least ___ new healthy change(s) decreased their risk of developing CHD by 27%. a 1

b 2

c 3 d 4

5. Of the 42,847 male health professionals in this study, only ____ adopted all 5 low-risk lifestyle practices. a 4% b 14%

c 28% d 32%

Target: Diabetes & Hypertension

“Relationship between insulin use and development of hypertension”

Learning objectives

Evaluate the relationship between hypertension development and the use of exogenous insulin for blood glucose control among patients with type 2 diabetes.

Questions

1. The comparison of the baseline characteristics between users and nonusers of insulin in the Tseng study showed that all variables differed significantly except for: ______. a body mass index

b smoking

c parental hypertension d age

e duration of diabetes

2. Insulin users in the Tseng study ____________. a had a higher prevalence of hypertension, higher systolic and diastolic blood pressures, were more often smokers, and more likely to be men.

b had a higher prevalence of hypertension, higher systolic and diastolic blood pressures, a higher body mass index (BMI), and were more likely to be women.

c had a higher prevalence of hypertension, higher systolic and diastolic blood pressures, had a shorter duration of diabetes, and were more likely to be women

d had a higher prevalence of hypertension, higher systolic and diastolic blood pressures, less often smokers, had a slightly lower BMI, and were more likely to be women.

3. The high concentration of blood insulin caused by repetitive use of exogenous insulin may produce negative effects on the vascular system, resulting in increased blood pressure. The potential mechanisms could be explained based on all but which of the following? a effects of insulin on sodium retention

b decrease in plasma norepinephrine levels

c ion transport

d stimulation of sympathetic nerves

e induction of oxidative stress

4. The risk of hypertension increased approximately ______ in the Tseng study subjects using insulin for > 10 years compared with nonusers. a 1.5 fold b 2.0 fold

c 2.2 fold d 3.0 fold

5. The risk of hypertension increased approximately ______ when comparing subjects using insulin 10 years or more with those using insulin less than 5 years but without hypertension at the start of insulin use. a 1.5 fold b 2.0 fold

c 2.2 fold d 3.0 fold