Cardiac disease prevention

Question 1

what is the cut off point for drug therapy in cardiac disease?

Answer 1

10% risk of a cardiac event over 5 years

Question 2

what is the usefulness of CT calcium score?

Answer 2

if a patient has a zero score it reduces the cardiac risk to less than 1% over 10 years!

Question 3

what is the mechanism of statins?

Answer 3

it increases the LDL-R in the liver, leading to increased removal

Question 4

what is the indication of CABG?

Answer 4

severe multi-vessel disease (MUST BE >70% of ALL 3 vessels)

severe left main disease (>50% narrowing of LM)

Question 5

what is the most effective method of smoking cessation?

Answer 5

champix is the stronger (varenicline)

bupropion (zyban) is quite good, but not as good

Question 6

what are the targets of risk factors for secondary prevention of IHD?

asking about:
BP
LDL-C
TriG
HbA1c

Answer 6

BP < 140, less than 130 in diabetics

LDL < 7%

Question 7

is there any evidence for hydralazine in heart failure?

Answer 7

the study that showed prognostic benefit was based on dual administration of hydralazine and nitrates

Question 8

what is the only lipid lowering agent to increase TGs?

Answer 8

Cholestyramine does this.

Question 9

what is the treatment for TG > 4?

Answer 9

statins have not been shown to decrease TG levels when they are above 4.

the correct treatment is a fibrate

Question 10

what three drugs cause gingival hyperplasia?

Answer 10

Phenytoin
Ciclosporin
Nifedipine.