Continuing Medical Education Exam

Target: CAD

“Renal dysfunction in older age groups and mortality after acute myocardial infarction”

Learning objectives

Explore the influence of renal dysfunction on prognosis in patients with myocardial infarction (MI), taking into account risk levels at admission and quality of care.

Questions

1. Only one third of patients admitted to the hospital with acute MI have normal renal function, and _______ have severe renal impairment. a 7%

b 10%

c 17%

d 27%

2. At baseline, smoking and ________________ tended to decrease as GFR decreased in the patients enrolled in the cited study. a age

b hypercholesterolemia

c peripheral artery disease

d hypertension

3. A large segment of study participants had renal impairment, with only ____ having a GFR > 60mL/min/1.73 m² a 11.5%

b 17.6%

c 28.5%

d 29%

4. In the study patients, renal function was shown on multivariable logistic regression analysis to be an independent predictor of _______________, despite potential confounding factors, such as higher TIMI risk and quality-of-care index. a 6-month mortality

b 1-year mortality

c 15-month mortality

d recurrent MI

5. Because of left ventricle dysfunction, the patient in the case report could not receive guideline-recommended ______________ therapy. a oral antiplatelet

b ACE inhibitor

c beta blocker

d GP IIb/IIIa inhibitor

Target: Hypertension

“Hypertension in the elderly”

Learning objectives

Discuss the use of drug therapies in lowering systolic blood pressure in elderly patients with hypertension, including the issues of reduced cardiovascular end points, improved survival, and enhanced quality of life.

Questions 1. Data from the Framingham Study suggest that an individual who is 55 years of age or older and remains normotensive still has an approximately ______ lifetime risk of developing hypertension. a 25%

b 50%

c 70%

d 90%

2. Much of the morbidity associated with hypertension in elderly patients consists of ___________. a congestive heart failure

b end-stage renal disease

c stroke

d coronary artery disease

3. Large population-based studies and a meta-analysis pooling the results of 3 major international trials have found that ____________ is a better predictor of cardiovascular outcomes in older people than systolic or diastolic blood pressure. a glomerular filtration rate (GFR) < 60 mL/min

b pulse pressure

c body mass index

d family history

4. ____________________________ is largely responsible for the rise in systolic blood pressure and widened pulse pressure seen in elderly people. a increased mineralization of elastin

b vascular hypertrophy

c increased aortic collagen accumulation

d increased central arterial stiffness

5. Recent data analyses suggest that _____________ may be superior to beta blockers as first-line therapy in uncomplicated hypertension. a angiotensin-converting enzyme (ACE) inhibitors

b angiotensin receptor blockers

c diuretics

d calcium antagonists