Continuing Medical Education Exam

Target: Diabetes • CAD/Angina

“Undiagnosed diabetes mellitus in coronary artery bypass graft surgery”

Profile the prevalence and risks of undiagnosed diabetes mellitus in a population of coronary bypass patients and its impact on the perioperative and postoperative outcomes.

Learning objectives

Questions

1. In the Lauruschkat study, resuscitation after coronary artery bypass graft (CABG) surgery was required for _____of patients with undiagnosed diabetes versus 1.5% of patients with diabetes and 1.7% of patients without diabetes.

a 2.2%

b 4.2%

c 6.2%

d 8.2%

2. The perioperative mortality rate was _____for patients with undiagnosed diabetes, compared with patients with and without diabetes.

a higher

b lower

c similar

d statistically identical

3. Coronary artery bypass graft surgery patients without diabetes in the Lauruschkat study had ________than patients with diabetes.

a lower high-density lipoprotein

b higher low-density lipoprotein

c higher ejection fractions

d lower stress hyperglycemia

4. Levetan and colleagues found that____ of 1034 patients hospitalized in an urban, tertiary-care teaching hospital were found to have undiagnosed diabetes on admission.

a 25%

b 33%

c 50%

d 66%

5. In Lauruschkat’s study, the percentage of CABG surgery patients with known diabetes was_____, while the prevalence of patients with undiagnosed diabetes mellitus was_____.

a 39.3%; 2.1%

b 35.6%; 3.2%

c 32.3%; 4.1%

d 29.6%; 5.2%

Target: Lipid Disorders • Stroke

“Elevated high-density lipoprotein cholesterol and carotid atherosclerosis”

Examine the relationship between high-density lipoprotein (HDL) cholesterol and carotid plaque progression and the mechanisms by which HDL cholesterol counteracts plaque growth.

Learning objectives

1. High-density lipoprotein (HDL) cholesterol may exert its protective effects by

Questions

a indirectly buffering vessel injuries.

b improving the oxidation of lipoprotein.

c returning low-density lipoprotein (LDL) back to the liver from the atheroma.

d promoting the development of echogenic plaques.

Plaques that contain fewer cellular components, more connective tissue (collagen), and varying degrees of calcification are noted by

a high absorption of ultrasound energy

b high gray-scale mediam (GSM)

c low GSM

d a gray appearance on the ultrasound monitor.

2.

3. Plaque growth was inversely associated with

a age

b systolic blood pressure

c current smoking

d HDL cholesterol level

4. The plaques with a lower growth rate tended to become

a less echogenic

b less echolucent.

c more echogenic

d more echolucent.

5. ______ particles may transform plaques into more fibrotic lesions and thereby thwart their growth by removing ________ from the vessel wall.

a HDL cholesterol; LDL cholesterol

b LDL cholesterol; HDL cholesterol

c HDL cholesterol; cholesteryl ester

d HDL cholesterol; lecithin-cholesterol acyltransferase

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