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July 15, 2011
According to the 2007 ESC/ESH European Society of Cardiology/Hypertension Guidelines for the management of arterial hypertension p 1493 box 11
2007 esc hypertension
Which are true for hypertensive emergencies in pregnancy?
a) “emergency circumstances”: IV labetalol, oral methyldopa, or oral nifedipine may be used
b) IV “hydralazine should no longer be considered”
c) IV sodium nitroprusside: “treatment of choice in hypertensive crises” though “an increased risk of fetal cyanide poisoning”
d) nitroglycerin: “drug of choice” for “pre-eclampsia associated with pulmonary oedema” ; OR ANY OF ABOVE

July 14, 2011
According to the 2007 ESC/ESH European Society of Cardiology/Hypertension Guidelines for the management of arterial hypertension p 1493 box 11
2007 esc hypertension
“Preferred drugs” for pregnancy include
a) ACE i or ARBs
b) Beta blockers or ARBs but not ACE i
c) Calcium antagonists, methyldopa, or beta blockers
d) Diuretics

July 13, 2011
According to the 2007 ESC/ESH European Society of Cardiology/Hypertension Guidelines for the management of arterial hypertension p 1483 
2007 esc hypertension
“blood pressure lowering by whatever agent or agent combination can be accompanied by reduction of increased left ventricular mass,  . . . ”
Of the following, which drug class has the least efficacy in reducing LVH?
a) ACE i or ARBs
b) Beta blockers
c) Calcium blockers
d) Aldosterone antagonists

July 12, 2011
According to the 2007 ESC/ESH European Society of Cardiology/Hypertension Guidelines for the management of arterial hypertension p 1491
2007 esc hypertension
“In a meta-analysis of available studies, the mean systolic and diastolic blood pressure reductions associated with an average weight loss of 5.1 kg
were ___ and ___ mmHg, respectively”
a) 1.1 ; 0.9
b) 2.2 ; 1.8
c) 4.4 ; 3.6
d) 8.8 ; 7.2

July 11, 2011
According to the 2007 ESC/ESH European Society of Cardiology/Hypertension Guidelines for the management of arterial hypertension p 1486
2007 esc hypertension
“ . . . the association of antihypertensive agents with new diabetes is lowest for _____ ”
a) angiotensin receptor antagonists and ACE inhibitors
b) calcium antagonists
c) b-blockers
d) diuretics

July 8, 2011
According to the 2007 ESC/ESH European Society of Cardiology Guidelines for the management of arterial hypertension p. 1492
2007 esc hypertension
Which antihypertensive classes are described as having “dyslipidaemic and diabetogenic effects”
a) beta blockers (not necessarily vasodilator BBs like carvedilol) or higher dose thiazide diuretics
b) ACE inhibitors or beta blockers
c) any diuretic
d) thiazides or calcium blockers

July 7, 2011
According to the 2007 ESC/ESH European Society of Cardiology Guidelines for the management of arterial hypertensionp. 1488 box 8
“Target BP should be at least , <____ mmHg in diabetics and in high or very high risk patients, such as
those with associated clinical conditions
(stroke, myocardial infarction, renal dysfunction, proteinuria).”
a) 120/70
b) 120/80
c) 130/80
d) 140/90

July 6, 2011
According to the 2007 ESC/ESH European Society of Cardiology Guidelines for the management of arterial hypertension p. 1482
2007 esc hypertension
“Comparative randomized trials show that for similar blood pressure reductions, differences in the incidence of cardiovascular morbidity and mortality between different drug classes are _____, . . . ”
a) small
b) large, justifying ACE inhibitors as the first line in all populations
c) significant, supporting the use of beta blockers and diuretics as first line
d) well established


July 5, 2011
According to the 2007 ESC/ESH European Society of Cardiology Guidelines for the management of arterial hypertension p. 1477
2007 esc hypertension
“A slight increase in serum creatinine (up to 20%) may sometimes occur when antihypertensive therapy is initiated or potentiated, _________.”
a) if so the medication should be discontinued
b) but this should not be taken as a sign of progressive renal deterioration
c) and this signifies a serious decline in renal function
d) if this is seen, daily monitoring of serum creatinine is warranted for seven days

June 30, 2011
According to the 2007 ESC/ESH European Society of Cardiology Guidelines for the management of arterial
hypertension p. 1476
2007 esc hypertension
Electrocardiography (ECG) in patients with hypertension:
a) “optional” but has high sensitivity for left ventricular hypertrophy (LVH)
b) “routine” in all but low sensitivity for LVH
c) LVH on ECG (SV1 + RV5-6 >38 mm or Cornell QRS duration product >2440 mm*ms) “is an independent predictor of cardiovascular events”
d) (b) and (c)

June 29, 2011
According to the 2007 ESC/ESH European Society of Cardiology Guidelines for the management of arterial
hypertension p. 1474, box 6
Which tests are listed as “routine” lab tests
(several others are listed as “recommended”)
a) complete lipid profile with fasting triglycerides
b) serum uric acid, creatinine, estimated CrCl or GFR      urinalysis with dipstick microalbuminuria and micro      exam of urine
c) (a), (b), hemoglobin/hematocrit and some other tests
d) a,b,c except dipstick microalbumin is discouraged

June 28, 2011
According to the 2007 ESC/ESH European Society of Cardiology Guidelines for the management of arterial
hypertension p. 1474, box 5
The physical exam findings of “precordial or chest murmurs” or  “diminished and delayed femoral pulses” may suggest which cause(s) of secondary hypertension
a) Cushing syndrome
b) pheochromocytoma
c) polycstic kidney disease or renovascular HTN
d) aortic coarctation or aortic disease

Weekly Quiz for the Public
June 27, 2011
According to CPSC publication on fireworks
a) “in 2010, about 8,600 people were treated in hospital emergency rooms for injuries associated with fireworks”
b) more than 50% of these were persons under 20
c) small children should not use any type of fireworks except sparklers
d) all of above except (c) - young children should not use sparklers due to the risk of burns

June 27, 2011
According to the 2007 ESC/ESH European Society of Cardiology Guidelines for the management of arterial
hypertension p. 1465, table 1
2007 esc hypertension
Grade 1 hypertension is defined as
SBP  _____ and/or DBP  ____
a) 120-129; 80-84
b) 130-139; 85-89
c) 140-159; 90-99
d) 160-179; 100-109

June 22, 2011
According to the 2009 AHA
Cardiovascular Evaluation and Management of Severely Obese Patients Undergoing Surgery
(p 88)
“With regard to bariatric surgery, laparoscopic _____ clearly has the lowest risk of all of the procedures but is associated with a lower weight loss and lower resolution of comorbidities “
a) adjustable gastric banding
b) gastroplasty
c) gastric bypass
d) BPD/DS (biliopancreatic diversion)

June 21, 2011
According to the 2009 AHA
Cardiovascular Evaluation and Management of Severely Obese Patients Undergoing Surgery
(p 89)
For coronary artery bypass surgery, severe obesity (aka morbid; BMI >/= 40) is associated with
a) prolonged hospital stay and assisted ventilation
b) increased renal failure
c) increased mortality and (a) and (b)
d) just (a) and (b)

June 20, 2011
According to the 2009 AHA
Cardiovascular Evaluation and Management of Severely Obese Patients Undergoing Surgery
(p 87)
Grade I Obesity is defined as BMI (kg/m2)
a) 18.5 - 24.9
b) 25.0 - 29.9
c) 30.0 - 34.9
d) none of above; BMI was not used to define obesity

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/ index.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

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