IHD

Question 1

Variables used in GRACE score to estimate mortality

Answer 1

Age, HR, SBP, renal function, cardiac failure, ST deviation, elevated cardiac markers, cardiac arrest

Question 2

Appropriate timing of elective non cardiac surgery post PCI with DES

Answer 2

12 months

Question 3

Greatest population attributable risk for MI

Answer 3

Dyslipidemia

Question 4

Role of HDL

Answer 4

Anti oxidant, anti inflammatory, anti thrombotic

Enhances endothelial cell function

Question 5

PCSK 9 inhibitor effects

Answer 5

Inhibits lysosomal degradation of LDL receptor
Increases hepatic cell surface LDL receptor
Reduces plasma LDL cholesterol
Reduces plasma triglycerides and lipoprotein a levels

Question 6

Lipid targets in IHD

Answer 6

LDL<1.8, HDL>1, TG<2, VLDL<2.5

General community- LDL<2

Question 7

Strongest indication for ceasing antiplatelets prior to Sx in patient with CA stent

Answer 7

Intracranial neuro Sx
Spinal surgery
Extraocular surgery
TURP

Question 8

Criteria for metabolic syndrome

Answer 8

Central obesity - WC>94cm M, >80cm female plus any2

• Raised TG level >1.7mmol/L
• Reduced HDL-C< 1.03mmol/L
• Raised BP >135/85
• Raised fasting glucose >5.6

Question 9

MOA ezetimibe

Answer 9

Inhibits gut absorption of cholesterol from food and bile

Reduce LDL by additional 10-15% if given with statin,TG

Question 10

MOA fibrates

Answer 10

Activate PPAR-Alpha -lipid metabolism
Reduce TG by 25-35%,LDL 10-15%
HDL increased by 10-50%