CMDManagementTM Vol. 13, No. 1, Summer 2008 Pretest

Questions marked with an * are required.

1. In contrast to previously held beliefs regarding the pathogenesis of atherosclerosis, recent research has suggested that which of the following is likely to precipitate cardiovascular (CV) events? Required Question

	High fasting plasma glucose
	Cholesterol deposition in the artery
	Rupture of nonobstructive plaque
	Positive smoking status

2. Based on results from the Measuring Effects on Intima-Media Thickness: an Evaluation of Rosuvastatin (METEOR) study, which of the following is true? Required Question

	Rosuvastatin accelerated atherosclerotic progression, as measured by carotid intima-media thickness (CIMT), compared with placebo over 2 years in subjects with low baseline risk for CV events (Framingham Risk Score [FRS] <10%) and evidence of subclinical atherosclerosis.
	Rosuvastatin had no effect on atherosclerotic progression, as measured by CIMT, compared with placebo over 2 years in subjects with low baseline risk for CV events (FRS <10%) and evidence of subclinical atherosclerosis.
	Rosuvastatin slowed atherosclerotic progression, as measured by CIMT, compared with placebo over 2 years in subjects with low baseline risk for CV events (FRS <10%) and evidence of subclinical atherosclerosis.
	None of the above

3. The Justification for the Use of statins in Primary prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER), conducted among subjects with baseline
LDL-C <130 mg/dL and C-reactive protein (CRP; a marker of inflammation) ≥2 mg/L, was recently halted earlier than expected for CV benefit. These results may suggest that statin therapy reduces the atherosclerotic process and the incidence of CV events by mechanisms that impact inflammation. Required Question

	True
	False

4. The Safety and Efficacy of A COmbination of niAcin ER and Simvastatin in paTients with Dyslipidemia (SEACOAST) trial compared the efficacy of combination therapy with niacin plus simvastatin versus simvastatin alone in decreasing non–HDL-C levels in patients with predominantly mixed dyslipidemia. Which of the following lipid parameters showed improvement with combination therapy among study participants? Required Question

5. The Framingham risk score (FRS), a risk-assessment tool for estimating the 10-year risk for developing coronary heart disease (CHD), incorporates all of the following risk factors except: Required Question

	Age
	Smoking status
	Metabolic syndrome
	Total cholesterol

6. Based on National Cholesterol Education Program (NCEP) Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel [ATP] III) guidelines, which LDL-C goal should be targeted for a patient with <2 traditional FRS factors and a <10% 10-year risk for CHD? Required Question

	<100 mg/dL
	<115 mg/dL
	<130 mg/dL
	<160 mg/dL

7. The rationale for using which of the following measures to define subclinical atherosclerosis risk is that these measures can predict CV event risk in patients that are above age-adjusted cutpoints indicated by NCEP ATP III guidelines? Required Question

	Imaging techniques (eg, coronary calcium computed tomography scans or CIMT measurement)
	Ankle-brachial indices
	CRP
	All of the above

8. Which of the following is recommended by NCEP ATP III guidelines as first-line treatment for primary prevention among patients that are not considered to be high risk? Required Question

	Therapeutic lifestyle changes
	Statins
	Cholesterol-absorption inhibitors
	Combination therapy with a statin and a cholesterol-absorption inhibitor

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	HDL-C
	TG
	Lipoprotein(a)
	Both TG and lipoprotein(a)
	All of the above