CVD 2

Question 1

traditional ASCVD risk factors

Answer 1

Diabetes
Smoking
Obesity and overweight
Physical inactivity
Hypertension
Dyslipidemia

Question 2

non-traditional ASCVD risk factors (no good validation)

Answer 2

Preterm delivery
Hypertensive disorders of pregnancy
Gestational diabetes
Autoimmune disease
Breast cancer treatment
Depression

Question 3

ASCVD risk in women
__ 10 year risk, but __ lifetime risk
higher rates of __

Answer 3

ASCVD risk in women
lower 10 year risk, but higher lifetime risk
higher rates of subclinical coronary artery disease (CAD)

Question 4

signs of stable angina

Answer 4

pain with exertion only

Question 5

unstable angina signa

Answer 5

pain at rest
symptoms new or escalated from baseline

Question 6

non-ST segement elevation MI (NSTEMI) signs

Answer 6

same as unstable angina + troponin and CKMB

Question 7

ST segment elevation MI (STEMI)

Answer 7

same as NSTEMI but with ST segment elevation

Question 8

hyperlipidemia is

Answer 8

an excess of lipids or fats in blood

Question 9

symptoms of high cholesterol

Answer 9

often no symptoms

Question 10

strongest risk factor for CAD/CHD

Answer 10

hypercholesterolemia

Question 11

people with high cholesterol have about __x the risk of heart disease

Answer 11

people with high cholesterol have about 2x the risk of heart disease

Question 12

__% of American adults have high LDL cholesterol

Answer 12

33.5% of American adults have high LDL cholesterol

Question 13

__% of adults with high LDL get treatment

Answer 13

< 50% of adults with high LDL get treatment

Question 14

consequence of hyperlipidemia

Answer 14

atherosclerosis

Question 15

5 types of people to screen for hyperlipidemia

Answer 15

• Men at higher risk at 25 y.o.
• Men at lower risk at 35 y.o.
• Women at higher risk at 35 y.o.
• Women at lower risk at 45 y.o.
• People with diabetes

Question 16

risk enhancers for hyperlipidemia

Answer 16

• Family Hx
• Persistently elevated LDL >= 160 mg/dL
• Persistently elevated TGs >= 175 mg/mL
• Chronic kidney disease
• Preeclampsia, gestational HTN, early menopause
• Metabolic syndrome
• Inflammatory disease: RA, SLE, psoriasis, HIV
• Ethnicity: South Asian ancestry

Question 17

elevated LDL as a risk enhancer is

Answer 17

> = 160 mg/dL

Question 18

elevated TGs as a risk enhancer is

Answer 18

> = 175 mg/dL

Question 19

what ethnicity is a risk enhancer for hyperlipidemia

Answer 19

South Asian

Question 20

if measured in select individuals, these values are risk enhancers

Answer 20

Hs-CRP > = 2.0 mg/L
Lp(a) > 50 mg/dL or > 125 nmol/L
apoB > = 130 mg/dL
ABI < 0.9

Question 21

Lp(a) should be checked in adults and youth with (primary prevention)

Answer 21

1. first-degree relatives with premature ASCVD or elevated Lp(a)
2. personal history of premature ASCVD or ischemic stroke
3. primary of familial high cholesterol

Question 22

Lp(a) should be checked in adults with (secondary prevention)

Answer 22

1. premature ASCVD
2. recurrent or progressive ASCVD (despite lipid-lowering)
3. aortic stenosis
4. less LDL-C lowering than expected with statins

Question 23

total cholesterol goal

Answer 23

< 200: normal*
200-239: Borderline
> 240: High

Question 24

bad LDL cholesterol goals

Answer 24

< 140: normal*
< 70 for CHD or DM (Diabetes Mellitus)
> 160: probably too high

Question 25

good HDL cholesterol goals

Answer 25

> 60 for women > 40 for men

Question 26

triglycerides goals

Answer 26

< 150: normal 150-199: borderline 200-499: high > 500: very high

Question 27

statins are used for

Answer 27

primary and secondary prevention of CVD

Question 28

statins in primary prevention of CVD

Answer 28

prevent or delay ONSET of CVD

Question 29

statins in secondary prevention of CVD

Answer 29

treat CVD and prevent or delay disease manifestations

Question 30

statins effects

Answer 30

reduce LDL by 30-60% mild increase in HDL decrease TGs by 14-33%

Question 31

side effects of statins

Answer 31

rare hepatotoxicity proteinuria renal failure cognitive impairment diabetes

Question 32

statins decrease __ no other lipid lowering drug besides __ does this

Answer 32

statins decrease **mortality** no other lipid lowering drug besides **PCSK9** does this

Question 33

PCSK9 is a serine protease made in the liver that degrades __ and increases __ levels

Answer 33

PCSK9 is a serine protease made in the liver that degrades **LDL receptors** and increases **LDL** levels

Question 34

PCSK9 inhibitors mechanism

Answer 34

monoclonal antibody inhibits PCSK9, prevents endocytosis of LDL-receptor

Question 35

PCSK9 inhibitors decrease

Answer 35

mortality

Question 36

2 lipid lowering drugs that decrease mortality

Answer 36

statins and PCSK9 inhibitors

Question 37

PCSK9 inhibitor side effects

Answer 37

flu-like symptoms back and joint pain muscle pain

Question 38

Statin + __ had greater LDL reduction that statin alone

Answer 38

Statin + **Evolocumab** had greater LDL reduction that statin alone

Question 39

Statin + Evolocumab also reduced __, __, and __ BUT, not __

Answer 39

Statin + Evolocumab also reduced **cardiovascular death**, **stroke**, and **hospitalization** BUT, not **mortality**

Question 40

statin + alirocumab showed reduced __ and __

Answer 40

statin + alirocumab showed reduced **MI** and **all cause mortality**

Question 41

Vascepa helps fix blood __ levels but doesn't prevent __

Answer 41

Vascepa helps fix blood **TG** levels but doesn't prevent **CVD**

Question 42

3 lifestyle modifications for CVD and hypertension

Answer 42

exercise diet smoking cessation

Question 43

exercise recommendations

Answer 43

150 mins MVPA per week decreased sedentary time

Question 44

diet recommendations: reduce

Answer 44

reduce sodium, potassium, alcohol

Question 45

how should we reduce sodium

Answer 45

increase urine hydrate!

Question 46

ideal diet

Answer 46

fruits, veggies, whole grains, lean protein

Question 47

ideal diet: avoid

Answer 47

tropical oils SSB