Target: Hypertension

From "Impaired coronary blood flow in prehypertension"

Learning objectives

Discuss the impact of impaired coronary flow reserve among normotensive, prehypertensive, and newly diagnosed and never-treated subjects with established hypertension.

Questions

1. The 150 subjects enrolled in the Erdogan study were divided into 3 groups according to their blood pressure: normotensive, hypertensive, and prehypertensive. Analysis of echocardiographic measurements showed that all but which of the following were similar in all 3 groups.
   
   
   1. Ejection fraction
   2. Left ventricular posterior wall thickness
   3. Left ventricular mass index
   4. End-diastolic diameter
   
   
2. Abnormal coronary flow reserve (CFR) was found in _____ of subjects with hypertension, whereas all the normotensive subjects had normal CFR.
   
   
   1. 20%
   2. 35%
   3. 40%
   4. 45%
   
   
3. _____ was slightly lower in the prehypertensive group compared with the normotensive group and significantly lower in the hypertensive group.
   
   
   1. The high-sensitivity C-reactive protein (hs-CRP) level
   2. Mitral E deceleration time
   3. Left ventricular mass index
   4. Hyperemic diastolic peak flow velocity (DPFV)
   
   
4. It has been shown that prehypertension is associated with a ____ increase in all-cause mortality and a 66% increase in cardiovascular mortality.
   
   
   1. 27%
   2. 32%
   3. 45%
   4. 56%
   
   
5. Coronary flow reserve measured by transthoracic Doppler echocardiography (TTDE) has recently been shown to have an excellent correlation with CFR measured by ________, which has been validated as the gold standard for CFR measurement.
   
   
   1. intravascular ultrasound
   2. single-photon emission computed tomography (CT)
   3. coronary CT angiography
   4. positron emission tomography
   
   

To take this exam, you can 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. Cardiology Review materials are posted to that site on a continuous basis (registration required).

Target: CAD and Diabetes

From "Pioglitazone and recurrent MI in patients with diabetes and a previous MI"

Learning objectives

Describe the effects of pioglitazone on mortality and macrovascular morbidity among subjects with diabetes, macrovascular disease, and previous myocardial infarction.

Questions

1. Pioglitazone improves glycemic control, increases high-density lipoprotein (HDL) cholesterol, and lowers low-density lipoprotein (LDL) cholesterol and triglycerides. It has also been shown to reduce ________, a marker of cardiovascular risk in patients with type 2 diabetes.
   
   
   1. high-sensitivity C-reactive protein (hs-CPR) levels
   2. elevated serum prolactin levels
   3. the progression of carotid intima media thickness
   4. body mass index
   
   
2. The use of pioglitazone in the PROactive study decreased the occurrence of acute coronary syndrome by ____.
   
   
   1. 19%
   2. 28%
   3. 37%
   4. 42%
   
   
3. The results of the multivariate analysis of 25 baseline characteristics showed that __________ was a negative predictor of a second MI.
   
   
   1. increased LDL-cholesterol level
   2. increased insulin use
   3. prior revascularization
   4. increased age
   
   
4. The American Heart Association (AHA) and the American Diabetes Association has issued guidelines for the use of thiazolidinediones in patients with type 2 diabetes and heart failure. The guidelines recommend that thiazolidinedione treatment should be initiated in patients with heart failure with the lowest possible dose, followed by slow dose escalation based on _______.
   
   
   1. fasting plasma glucose (FPG) levels
   2. glycosylated hemoglobin levels
   3. hs-CRP levels
   4. IGF-2 levels
   
   
5. The results of the subgroup analysis showed that pioglitazone was more effective in preventing MI than placebo. Treating 1000 patients with type 2 diabetes with pioglitazone in addition to their existing on-going medications would avoid ____ recurrent MIs over a 3-year follow-up period.
   
   
   1. 5
   2. 11
   3. 16
   4. 22
   
   

To take this exam, you can 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. Cardiology Review materials are posted to that site on a continuous basis (registration required).