Continuing Medical Education Exam

Target: Lipid Disorders

“Low cholesterol level in midlife and quality of life in old age”

Learning objectives Describe the compression-of-morbidity hypothesis and the effect of baseline cholesterol levels on mortality rates and quality of life in old age.

Questions 1. In the Strandberg study, multivariate analyses showed that the relative hazard of death rose by 11% for every increase of:

a 1 mmol/L of cholesterol.

b 3 mmol/L of cholesterol.

c 5 mmol/L of cholesterol.

d 10 mmol/L of cholesterol.

2. Strandberg found that total mortality was _____ in the low-cholesterol group compared with the higher-cholesterol groups combined.

a 10% lower

b 10% higher

c 25% lower

d 25% higher

3. The reported prevalence of _____ was significantly lower in the lowest baseline cholesterol group than in the combined higher-cholesterol groups.

a diabetes

b coronary artery disease and cerebrovascular disease

c cancer

d mental illness

4. There was no difference in the _______ of quality of life between the low-cholesterol and combined higher-cholesterol groups.

a social component score

b spiritual component score

c physical component score

d mental component score

5. The Honolulu Heart Program showed that low blood cholesterol levels predicted:

a greater quality of life in the elderly.

b lower total mortality risk in the elderly.

c greater total mortality risk in the elderly.

d lower quality of life in the elderly.

Target: Diabetes • CAD/Angina

“Revascularization in patients 75 years or older with diabetes mellitus and angina pectoris”

Learning objectives

Discuss the results of the TIME study that compared invasive treatment with optimized medical treatment in patients over 75 years of age with chronic angina. Discuss the rates of ad­verse clinical events in patients who underwent revascularization versus those who did not undergo revascularization.

Questions

1. In the TIME study, there was no difference in:

a risk factors for atherosclerosis.

b left ventricular ejection fraction.

c peripheral vascular disease.

d the number of angiographically diseased vessels.

2. At inclusion, patients with diabetes were treated less often with: a angiotensin-converting enzyme inhibitors.

b beta blocking agents.

c diuretics.

d statins.

3. In terms of the revascularization rate for diabetic and nondiabetic patients, PCI rates in patients with diabetes were ____ and CABG rates were _____. a significantly lower; significantly lower

b significantly higher; significantly lower

c significantly higher; significantly higher

d statistically the same; statistically the same

4. In the first year of follow-up, the highest rate of freedom from major adverse clinical events was in: a nondiabetic patients who underwent revascularization procedures.

b patients with diabetes who underwent revascularization procedures.

c nondiabetic patients who did not undergo revascularization.

d patients with diabetes who did not undergo revascularization.

5. After 4 years of follow-up, _____ of 10 diabetic 80-year-old patients who underwent revascularization were free of major adverse clinical events; only______ of 10 diabetic 80-year-old patients who did not undergo revascularization were free of any major adverse clinical events. a 6; 4

b 5; 3

c 4; 1

d 3; 1