Continuing Medical Education Exam

Target: Lipids & CAD

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Intensive statin therapy in acute coronary syndrome

Learning objectives

Describe the effects of early, intensive statin therapy on rates of cardiovascular death and recurrent ischemia following acute coronary syndrome.

Questions

1. In the meta-analysis of 13 randomized controlled trials conducted to assess the effect of intensive statin therapy, no significant difference was noted between intensive statin therapy and the control group in the risk of any adverse cardiovascular (CV) event within 4 months of follow-up. By ______, however, a statistically significant 24% hazard reduction of adverse CV events occurred. 5 months 6 months 10 months 12 months
2. Early statin therapy was defined as medication starting within ___ of hospitalization for acute coronary syndrome. 72 hours 7 days 10 days 14 days
3. A meta-analysis recently concluded that secondary prevention of CV events with statin therapy occurs through ______ alone. the promotion of endothelial stabilization the promotion of vasculogenesis low-density lipoprotein cholesterol reduction high-density lipoprotein cholesterol elevation
4. Briel and colleagues conducted a meta-analysis similar to Hulten et al. As with the Hulten meta-analysis, they found no significant risk reduction for early, intensive statin therapy after 4 months, although a reduction in ______ was noted. recurrent ischemia nonfatal stroke nonfatal myocardial infarction (MI) revascularization procedures
5. In addition to safe, significant risk reduction of adverse CV outcomes, the authors emphasize that studies have shown the importance of beginning medications while patients are in the hospital to improve compliance. Given the high noncompliance rates of post-MI patients (up to _____ are noncompliant with medications 1 month after discharge), initiating statin therapy in the hospital is a simple, effective strategy to improve compliance and thereby reduce mortality. one fourth one third one half two thirds

To take this exam, you can

. Cardiology Review materials are posted to that site on a continuous basis (registration required).

download the CME answer form (PDF) and mail, fax, or email it to address given; or go to the University of Cincinnati's Center for Continuous Professional Development

Target: Diabetes

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Coronary artery disease in asymptomatic diabetic patients

Learning objectives

Examine the effectiveness of current American Diabetes Association guidelines for the detection of coronary artery disease in asymptomatic patients with type 2 diabetes, particularly with regard to early detection of disease.

Questions

1. Current American Diabetes Association (ADA) guidelines recommend stress screening for asymptomatic diabetic patients with at least ______ additional risk factor(s) for coronary artery disease (CAD). 1 2 3
2. Regardless of the associated risk profile, all patients in the study underwent ______ to identify asymptomatic patients with myocardial perfusion defects. transthoracic echocardiography intravascular ultrasound myocardial perfusion scintigraphy myocardial perfusion echocardiography
3. The overall prevalence of CAD was not significantly different between study group A (2 or more risk factors) and group B (1 or no risk factors), but coronary anatomy differed. The prevalence of 1-vessel disease was _____ in group A versus _____ in group B. 18.8%; 54.9% 7.6%; 33.3% 46.3%; 70.6% 3.8%; 31.2%
4. When an aggressive diagnostic approach was used in patients who would normally be excluded from screening by current ADA guidelines, the authors found a similar prevalence of CAD but a coronary vessel anatomy more likely to respond to revascularization. In group A, ____ of patients who underwent coronary artery bypass graft (CABG) surgery received complete revascularization of all myocardial areas, whereas ____ of group B patients received complete revascularization after CABG. 73.3%; 97.2% 84%; 91% 46%; 70.6% 7.6%; 33.3%
5. According to the authors, which of the following is not a cause of myocardial perfusion defects in type 2 diabetes patients? epicardial coronary stenosis asynchronous activation microvascular disease endothelial dysfunction increased platelet aggregability

To take this exam, you can

. Cardiology Review materials are posted to that site on a continuous basis (registration required).

download the CME answer form (PDF) and mail, fax, or email it to address given; or go to the University of Cincinnati's Center for Continuous Professional Development