Continuing Medical Education Exam

Target: Lipids

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Statins and cancer in the elderly

Learning objectives

Discuss the results of a cohort study assessing the possible positive effect of statins on colorectal, lung, and breast cancer in a large elderly population.

1. In the Setoguchi study, statin use was not associated with a clinically important decrease or increase in the risk of common cancers (colorectal, lung and breast) during an average follow-up period of ____ year(s).

1. 1.0
2. 1.5
3. 2.9
4. 5.0

2. All but which one of the following applies to the statin users (vs the glaucoma drug control subjects) in this study?

1. They were more likely to take aspirin.
2. They were less likely to be smokers.
3. They had a slightly higher body mass index.
4. They were more educated.

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3. Results of the proportional hazards test were significant for _____ ( = .003), suggesting that the effect of statin use might be different over time. The short-term effect of statin use tended to be protective when short-term use (3 years) was compared to long-term (> 3 years) use.

1. breast cancer
2. colorectal cancer
3. lung cancer

4. Another population-based case-control study showed that patients aged 60 years or older who had used statins for more than 5 years had a 47% decrease in ______.

1. breast cancer
2. colorectal cancer
3. lung cancer

5. The strengths of this study include all but which of the following?

1. It was based on a very large group of elderly patients with a high risk of cancer.
2. Analyses were limited to new statin users, removing the possibilities of biases that can occur when including prevalent statin users.
3. The investigators used a comparison group that had adherence rates for screening procedures and health-seeking behaviors that were similar to statin users.
4. Possible confounders, such as obesity and smoking, were completely measured.

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: Arrhythmias

From the article:

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Antithrombotic treatment of high-risk patients hospitalized with atrial fibrillation

Learning Objectives

Describe the use of antithrombotic treatment among high-risk elderly patients hospitalized for atrial fibrillation and the attributable effectiveness of this treatment during a nearly 1-year follow-up period.

1. In this study of 1920 patients with a diagnosis of atrial fibrillation, the cardiovascular comorbidity with the highest prevalence was _____________.

1. congestive heart failure
2. coronary heart disease
3. hypertension
4. diabetes

2. Death rates among study subjects were significantly lower among patients who had taken antithrombotic therapy. Antithrombotic therapy was associated with a _____ reduction in all-cause mortality overall.

1. 85%
2. 77%
3. 72%
4. 64%

3. The most recommended antithrombotic agents are _________.

1. anticoagulants
2. antiplatelet drugs
3. thrombolytics

4. Patients are usually hesitant to take anticoagulant therapy. In one study, only ____ of patients said they would prefer anticoagulant therapy to no treatment.

1. 11%
2. 31%
3. 61%
4. 69%

5. The chief finding of this study analysis is that antithrombotic therapy is significantly underused among unselected high-risk elderly patients. There may be several reasons for this result. In this study, the average age of patients was 79 years. Furthermore, the high rate of noncardiovascular comorbidity could explain this low exposure to antithrombotic therapy. This study showed that patients with malignancy and ________ received antithrombotic therapy less often.

1. gastrointestinal ulcerations
2. chronic obstructive pulmonary disease
3. kidney or liver disease
4. a history of alcoholism

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