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Weekly Quiz for the Public
June 20, 2011
According to the USDA (May 24, 2011) Fact Sheet
on Foodborne Illness and Disease,
http://www.fsis.usda.gov/factsheets/foodborne_illness_what_consumers_need_to_know/i ndex.asp
“Because the toxins produced by this bacterium are resistant to heat and cannot be destroyed by cooking, preventing the contamination of food before the toxin can be produced is important. Keep hot foods hot (over 140 °F) and cold foods cold (40 °F or under); . . .”

a) E Coli 0157
b) Staph aureus
c) Shigella
d) Salmonella


June 17, 2011
According to 2009 ACC/ASNC
Appropriate Use Criteria for Cardiac Radionuclide Imaging (RNI) (table 2)
When is the use of RNI 
 “appropriate” for “detection of CAD” “without ischemic equivalent” ?
a) new-onset a fib “when etiology unclear”
b) ventricular tachycardia with low, intermediate or high CHD (ATP) risk
c) new heart failure with LV systolic dysfunction
   (no prior CAD, no cath planned)
d) (b) or (c); (a) is “uncertain”

June 16, 2011
According to 2009 ACC/ASNC
Appropriate Use Criteria for Cardiac Radionuclide Imaging (RNI) (table 6)
When is the use of RNI 
 “appropriate” for “risk assessment” in “asymptomatic” indviduals “postrevascularization”
(PCI or CABG)?
a) >/= 2 years after PCI
b) revascularization “incomplete” but possible
c) >/= 5 years after CABG OR (b)
d) any of above


June 15, 2011
According to 2009 ACC/ASNC
Appropriate Use Criteria for Cardiac Radionuclide Imaging (RNI) (table 3)
When is the use of RNI 
 “appropriate” in “asymptomatic” indviduals with “prior coronary calcium Agaston score?”(table 3)
a) Agaston >/= 100
b) Agaston 100-400 AND high CHD risk
c) Agaston > 400
d) (b) or (c)

June 14, 2011
According to 2009 ACC/ASNC
Appropriate Use Criteria for Cardiac Radionuclide Imaging (RNI) (table 4)
For syncope, when is the use of RNI 
for “detection of CAD” “without ischemic equivalent” “appropriate?” (table 2)
a) low or intermediate CHD risk (ATP III)
b) intermediate or high CHD risk
c) high CHD risk
d) none of above 

Weekly Quiz for the Public
June 13, 2011
According to the USDA (May 24, 2011) Fact Sheet
on Foodborne Illness and Disease,
http://www.fsis.usda.gov/factsheets/foodborne_illness_what_consumers_need_to_know/index.asp
Ways to prevent E Coli 0157:H7 illnesses include
a) cook ground beef min internal temp= 160 degress F
b) use only pasteurized milk/juice/cider
c) rinse fruit/vegetables “running tap water”
d) wash hands “warm water and soap” after
 changing diapers, bathroom, contact with pets or
 feces
 OR ANY OF ABOVE

June 13, 2011
2009 ACC/ASNC
Appropriate Use Criteria for Cardiac Radionuclide Imaging (RNI) (table 4)
When is the use of RNI 
for “risk assessment” in the “perioperative evaluation for noncardiac surgery without active cardiac conditions” prior to “low-risk surgery” “appropriate?”
a) any person with prior MI or CABG or DM
b) anyone without stress or cath in last 1 year
c) >/= 1 “clinical risk factor”
    PLUS poor (< 4 METS) or unknown functional
    capacity
d) none of above; “inappropriate” for low-risk
     surgery
"Clinical risk factors" (Table A2, p 2221)
- history ischemic heart disease
- hx of compensated or prior heart failure
- hx cerebrovascular disease
- DM requiring insulin
- renal insuff. ( Cr > 2.0)


June 10, 2011
2009 ACC/ASNC
Appropriate Use Criteria for Cardiac Radionuclide Imaging (RNI) (table 4)
When is the use of RNI 
for “risk assessment” in the “perioperative evaluation for noncardiac surgery without active cardiac conditions” prior to “intermediate-risk surgery” “appropriate?”
a) any person with prior MI or CABG
b) all diabetics
c) anyone without stress or cath in last 1 year
d) >/= 1 “clinical risk factor”
    PLUS poor (< 4 METS) or unknown functional
    capacity
"Clinical risk factors" (Table A2, p 2221)
- history ischemic heart disease
- hx of compensated or prior heart failure
- hx cerebrovascular disease
- DM requiring insulin
- renal insuff. ( Cr > 2.0)

June 9, 2011
2009 ACC/ASNC
Appropriate Use Criteria for Cardiac Radionuclide Imaging (RNI) (table 4)
When is the use of RNI 
for “risk assessment” in the “perioperative evaluation for noncardiac surgery without active cardiac conditions” in “vascular surgery” “appropriate?”
a) anyone
b) all diabetics
c) anyone without stress or cath in last 1 year
d) >/= 1 “clinical risk factor”
    PLUS poor (< 4 METS) or unknown functional
    capacity
"Clinical risk factors" (Table A2, p 2221)
- history ischemic heart disease
- hx of compensated or prior heart failure
- hx cerebrovascular disease
- DM requiring insulin
- renal insuff. ( Cr > 2.0)

June 8, 2011
Appropriate Use Criteria for Cardiac Radionuclide Imaging (table 3)
When is the use of RNI (radionuclide imaging)
“appropriate” (others “inappropriate”) following a treadmill ECG stress?
a) “Low-risk Duke treadmill score”
b) “Intermediate-risk Duke treadmill score”
c) “High-risk Duke treadmill score”
d) (b) or (c)

June 7, 2011
Appropriate Use Criteria for Cardiac Radionuclide Imaging (table 1)
In the evaluation of “acute chest pain”
in which scenario is the use of RNI
(radionuclide imaging)
“inappropriate” (all others “appropriate”)?
a) possible ACS; non ischemic ECG,
low or high risk TIMI; peak Troponin = negative to minimally elevated
b) same as (a) except ECG = LBBB or elec v-paced
c) definite ACS
d) none of above

June 6, 2011
According to the 2009 ACC/ASNC/AHA
Appropriate Use Criteria for Cardiac Radionuclide Imaging (table 1)
In the evaluation of “ischemic equivalent
(non-acute)” in which scenario is the use of RNI
“inappropriate” (all others “appropriate”)?
a) low pretest probability; able to exercise and ECG
interpretable
b) low pretest; either unable to exercise or uninterpretable ECG
c) intermediate pretest - regardless of ECG or exercise ability
d) high pretest - regardless of ECG or exercise ability

2009 acc asnc cardiac radionuclide imaging

According to the USDA (May 24, 2011) Fact Sheet
on Foodborne Illness and Disease,
http://www.fsis.usda.gov/factsheets/foodborne_illness_what_consumers_need_to_know/index.asp
Safe cooking and heating temperatures for meat include
a) 145 degrees F for all uncooked meat
b) 145 degrees for many meats (unground beef, pork, lamb, veal)
BUT higher temperatures for GROUND meats
(beef, pork, lamb, veal) (160), uncooked poultry (165) and reheat meats to 165 degrees
c) ground meats and poultry do not need to be cooked to higher temperatures
d) none of above