2.8.2013

Question 0

Adverse prognostic factors in stable ischemic heart disease

Answer 0

H/O previous MI
recent episode of unstable angina/new onset angina
EF<50%
HT,DM,dyslipidemia
Increasing age
Family h/o CAD

Question 1

FFR

Answer 1

Fractional flow reserve

Question 2

________ is a powerful predictor of short and longterm course of SIHD

Answer 2

LV function

Question 3

Intermediate and high risk groups in SIHD based on EF

Answer 3

Intermediate- 35 to 49%

High - less than 35%

Question 4

Maximum anti ischemia therapy

Answer 4

Atleast two classes were used

Question 5

Which is preferred for restenosis after CABG?

repeat CABG or PCI

Answer 5

PCI

Question 6

Hybrid coronary revascularisation

Answer 6

LIMA for LAD

PCI of other stenosed coronary arteries

Question 7

Role of dual anti platelet therapy in chronic stable angina

Answer 7

No role

Clopidogrel is given only for aspirin allergic pts

Question 8

Nicorandil is useful for

Answer 8

Microvascular angina

Question 9

BP control in SIHD

Answer 9

Less than 140/90
Less than 130/80 in diabetics and CKD pts
Aggressive control(120/80) in young pts and hypertensives of short duration

Question 10

Effect of PUFA on cholesterol

Answer 10

Decreases both LDL and HDL

MUFA doesnot reduce HDL

Question 11

Lipid therapy in SIHD

Answer 11

High risk(risk factors or CAD equivalents are present)
LDL less than 100
Non HDL C less than 130
Very high risk(ACS or established CAD)
LDL less than 70
Non HDL C less than 100

Question 12

Goal HbA1C in SIHD

Answer 12

Less than 7%

Question 13

Role of ACE inhibitors in SIHD

Answer 13

EF less than 40%
CKD
DM

Question 14

Rx of refractory angina

Answer 14

Enhanced external counterpulsation

Spinal cord stimulation

Question 15

Mechanism of enghanced external counterpulsation

Answer 15

Similar to IABP

Question 16

Conduits used in CABG

Answer 16

Saphenous vein 
Internal thoracic artery
Radial artery
Rt gastroepiploic artery
Inferior epigastric artery
Cryo preserved homograft veins

Question 17

Which is the best bypass conduit?

Answer 17

LIMA

Question 18

Why LIMA is best bypass conduit?

Answer 18

Endothelium produces EDRF and prostacyclin

Tight internal elastic lamina

Question 19

How ischemia of myocardium during bypass is prevented?

Answer 19

Infusion of k+ rich solution which arrests heart in diastole

Question 20

Complications of CABG

Answer 20

1.Neurological dysfunction
Renal dysfunction
SIRS

Question 21

Indications for CABG

Answer 21

Left main stenosis
Non LMS
TRIPLE vessel disease with more than 70% stenosis
Proximal LAD + 1 major coronary vessel

Question 22

RIMA is used in

Answer 22

Dextrocardia

Question 23

Pump head syndrome

Answer 23

Neurocognitive deficits after On pump CABG

Question 24

Role of folates in SIHD

Answer 24

No role(though they were thought to play a role by reducing homocysteine level)