Order Hyperlipidemia And Obesity Discussion

Order Hyperlipidemia And Obesity Discussion
Order 5899332
Order Hyperlipidemia And Obesity Discussion
1 A 60-year-old woman presents to the emergency
department with chest discomfort and is diagnosed
with unstable angina. She undergoes coronary
angiography that reveals a right-dominant system
with a hazy ulcerated lesion in the RPDA. In the
area of the lesion, the most severe percent diameter
stenosis is 40% and the blood flow is TIMI grade 3
flow. The left coronary artery has mild diffuse disease
and does not supply any collaterals to the RPDA.
What is the optimal strategy?
(A) PCI with stenting to the RPDA given the hazy
culprit appearance
(B) Medical therapy of carotid artery disease (CAD)
given that no stenosis is at least 50%
(C) Catheter-based thrombectomy procedure without balloon or stent implantation
(D) Intravascular ultrasound (IVUS) examination of
the lesion
(E) Determination of fractional flow reserve (FFR)
of the lesion
12 A 42-year-old woman with familial hypercholesterolemia and a previous history of anterior MI (at
age 25) and lateral MI (at age 37) presents to your
office for follow-up. She has been doing well and denies chest pain or shortness of breath. She states that
she wishes to get pregnant. She is currently on clopidogrel due to her severe aspirin allergy, lipitor 80 mg,
zetia 10 mg, metoprolol 50 mg b.i.d., and ramipril
5 mg a day. Which of the following medications
should she be on during pregnancy?
(A) Desensitize her aspirin allergy because aspirin is
the only safe drug during pregnancy
(B) Clopidogrel and metoprolol
(C) Clopidogrel, metoprolol, and zetia
(D) Clopidogrel, metoprolol, and lipitor
(E) Clopidogrel, ramipril, and zetia
13 A 69-year-old man with a prior CABG surgery 8 years
ago (LIMA-LAD, SVG-OM2, SVG-RPDA) presents
with unstable angina and a troponin T of 0.07 ng per
mL. His EKG reveals 2 mm ST-segment depressions
in leads I and aVL during chest discomfort. Coronary
and graft angiography reveals severe left main
trunk disease, occluded mid-LAD, severe proximal
circumflex stenosis, and occluded dominant RCA.
Order Hyperlipidemia And Obesity Discussion
The grafts to LAD and RCA are patent. The vein graft
to obtuse marginal branch has a severe ulcerated
stenosis in its midportion with TIMI grade 2 flow.
There appears to be an adequate landing zone for a
distal emboli protection device. What is the optimum
treatment strategy for this patient?
(A) PCI to SVG with distal emboli protection
(B) PCI to SVG with adjunctive glycoprotein (GP)
IIb/IIIa
(C) PCI to left main trunk and proximal circumflex
(D) Redo-CABG to OM2
(E) Medical therapy given that LAD and RCA grafts
are patent
14 A 55-year-old man with hyperlipidemia and obesity
undergoes PCI with sirolimus-eluting stenting to
LAD to treat his NSTEMI. The PCI is successful.
His BP is not elevated. Post-PCI echocardiogram
reveals normal ventricular function and mild mitral
regurgitation. His discharge medications should
include:
(A) Aspirin 325 mg daily, clopidogrel 75 mg daily, a
statin, and a β-adrenergic blocker
(B) Aspirin 81 mg daily, clopidogrel 75 mg daily, a
statin, and an ACE inhibitor
(C) Aspirin 325 mg daily, clopidogrel 75 mg daily,
and a statin
(D) Aspirin 81 mg daily, clopidogrel 75 mg daily, a
statin, and a β-adrenergic blocker
(E) Aspirin 325 mg daily, clopidogrel 75 mg daily,
a statin, a β-adrenergic blocker, and an ACE
inhibitor
15 A 52-year-old woman is transferred after presenting
to an outside hospital with chest discomfort and being diagnosed with an NSTEMI. She then undergoes
Practice Guidelines in Non–ST-Elevation Acute Coronary Syndromes 291
PCI with implantation of three sirolimus-eluting
stents to the RCA. She is not at an increased risk
of bleeding. Her EKG demonstrates sinus rhythm.
In addition to low-dose aspirin, how should she be
prescribed clopidogrel?
(A) 75 mg daily indefinitely
(B) 75 mg daily for 1 month
(C) 75 mg daily for 9 to 12 months
(D) 150 mg daily for 2 years
(E) 150 mg daily for 9 to 12 months
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