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EvidenceMedicine.com / GuidelineMedicine.com
BOARD REVIEW QUESTIONS FOR CARDIOLOGY, INTERNAL MEDICINE, EMERGENCY MEDICINE AND FAMILY PRACTICE
BOARD REVIEW HOT TOPICS:
NIH Summary of Foodborne Diseases (E Coli, Botulism, Salmonella, Campylobacter) http://www.niaid.nih.gov/factsheets/foodbornedis.htm - must read for Internal Medicine Boards
Choose quizzes from list on left
NEW Aug 2, 2004 Cardiology/Medicine Drug Interactions
NEW Aug 14, 2004 Cholesterol Guidelines 2004 Quiz (Lipids)
2004 Cholesterol Guidelines Quiz
(1) MONDAY’S QUIZ QUESTION:
ACCORDING TO THE NCEP/ATP 3 (2001) AND THE JULY 2004 UPDATE WHICH ARE TRUE?
A) “In high-risk persons, the recommended LDL-C is <100 mg/dL . . . <70 mg/dL is a therapeutic option . . .
especially for patients at very high risk”
B) “For moderately-high risk persons (2+ risk factors and 10-year risk of 10 to 20%), the recommended goal is
<130 mg/dL . . . <100 mg/dL is a therapeutic option . . .”
C) “Moderate risk: 2+ risk factors (10 year risk <10%)” LDL Goal: “ < 130 mg/dL”)
D) “Lower risk: 0-1 risk factors” LDL Goal: “<160 mg/dL)
E) All of above correct
F) Only A & B correct
G) None of above correct
(2)TUESDAY’S QUESTIONS:
ACCORDING TO NECEP/ATP 3 AND 2004 UPDATE: WHEN USING STATIN THERAPY, A “30% - 40% REDUCTION OF LDL-C” IS A GOAL. WHICH ARE CORRECT LIKELY DOSES REQUIRED TO OBTAIN THIS REDUCTION BASED ON CURRENT DATA?
A) ATORVASTATIN (LIPITOR) 10 MG
B) LOVASTATIN (MEVACOR) 40 MG
C) PRAVASTATIN (PRAVACHOL) 40 MG
D) SIMVISTATIN (ZOCOR) 20-40 MG
E) FLUVASTATIN (LESCOL) 40-80 MG
F) ROSUVASTATIN (CRESTOR) 5-10 MG
G) A-E ARE CORRECT
H) ALL ARE CORRECT”
I) NONE ARE CORRECT
WEDNESDAY’S QUESTION:
(3) ACCORDING TO NCEP/ATP 3 2001/2004 THE “HIGH RISK” CATEGORY CONSISTS OF “CHD OR CHD RISK EQUIVALENTS.” WHICH QUALIFY?
A) “MYOCARDIAL INFARCTION, UNSTABLE ANGINA, CORONARY ARTERY PROCEDURES . . . OR . . . CLINICALLY SIGNIFICANT ISCHEMIA”
B) “PERIPHERAL ARTERIAL DISEASE”
C) “ ABDOMINAL AORTIC ANEURYSM”
D) “CAROTID ARTERY DISEASE” (WITH TIA, CVA OR >50%)
E) “DIABETES”
F) “2+ RISK FACTORS WITH 10-YEAR RISK FOR HARD CHD >20%”
G) ALL OF ABOVE ARE CORRECT
H) A, B AND E ONLY
I) NONE OF ABOVE
THURSDAY’S QUESTION”
(4) ACCORDING TO NCEP/ATP 3 2001/2004, WHICH COUNT AS “RISK FACTORS”
A) “CIGARETTE SMOKING”
B) “HYPERTENSION”
C) “LOW HDL CHOLESTEROL (<40 MG/DL)
D) “FAMILY HISTORY OF PREMATURE CHD”
E) “DIABETES”
F) A-D ONLY, DIABETES SHOULD BE BE CONSIDERED A CHD EQUIVALENT NOT JUST A RISK FACTOR FOR NCEP/ATP PURPOSES
G) A-E
(note, age based on gender another risk factor; women >/= 55, men >/=45 years)
FRIDAY’S QUESTIONS:
A 54 YO WOMAN (NO KNOWN CHD OR EQUIVALENT) HAS
QUIT USING TOBACCO 10 YEARS AGO,
SHE HAS BEEN DIAGNOSED WITH HYPERTENSION AND TAKES HYDROCHLOROTHIAZIDE DAILY. HER LAST BP WAS 140/70.
HER FATHER WAS DIAGNOSED WITH CAD AFTER MYOCARDIAL INFARCTION AT AGE 56.
HER MOTHER WAS DIAGNOSED WITH CAD 5 DAYS BEFORE CORONARY ARTEY BYPASS GRAFTING AT AGE 66.
HER GRANDFATHER DIED OF MYOCARDIAL INFARCTION AT AGE 30.
SHE HAS NO DIABETES.
HER HDL = 40. (TOTAL CHOL = 200, TRIGLYCERIDES = 100).
CALCULATE HER LDL TO ANSWER QUESTION 6 BELOW (TOT CHOL = LDL + HDL + (TRIG/5)
LDL=140
(5) WHAT RISK CATEGORY IS SHE IN (LDL GOALS IN PARENTHESES)
A) HIGH RISK - CHD OR EQUIV (<100 OR <70 AN OPTION)
B) MODERATELY-HIGH RISK : 2+ RISK AND 10-20% RISK (<130 OR < 100 AN OPTION)
C) MODERATE RISK : 2+ RISK AND <10% RISK (<130)
D) LOWER RISK (0-1 risk) (<160)
IF YOU THINK SHE HAS 2+ RISK FACTORS USE THE ONLINE CALCLATOR http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=prof TO DISTINGUISH B FROM C
- YOU CAN ALSO JUST USE THE PAPER TABLES TO DETERMINE AVAIL AT
http://www.nhlbi.nih.gov/guidelines/cholesterol/dskref.htm
(6) SHE IS AT GOAL FOR LDL
A) TRUE
B) FALSE
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