Order Elective Coronary Intervention Discussion

Order Elective Coronary Intervention Discussion
Order 5890394
Order Elective Coronary Intervention Discussion
1 What clinical and anatomic features weigh against a
reoperation (repeat CABG) in this patient?
(A) Patent internal mammary graft to the LAD artery
(B) Three patent grafts
(C) Bilateral severe carotid vascular disease
(D) Chronic renal insufficiency
(E) Risk of second CABG is approximately 3X higher
than first CABG
(F) All of the above
2 What clinical and anatomic features weigh against
PCI for this patient?
(A) Noncompliance causes concern for the use of
dual antiplatelet therapy, if patient were to
receive DES
(B) Noncompliance with statins and antihypertensive agents increases likelihood of adverse outcomes after PCI
(C) Chronic renal insufficiency increases risk of
bleeding and restenosis
(D) Multivessel disease increases likely dye load (and
attendant contrast-associated nephropathy) and
restenosis likelihood
(E) SVG disease is associated with decreased likelihood of procedural success and increased
likelihood of distal embolization with attendant
morbidity and/or mortality
(F) All of the above
3 How soon is the creatinine likely to peak from the
development of contrast-associated nephropathy?
(A) 1 day
(B) 2 days
(C) 3 days
(D) 5 days
(E) 1 week
4 Which of the following are established means
(supported by one or more randomized trials)
of reducing the likelihood of contrast-associated
nephropathy?
(A) Hydration with normal saline
(B) Keeping contrast dose to a minimum (<125 mL)
(C) Fenoldopam
(D) N-acetyl cysteine
(E) Dopamine infusion in ‘‘renal perfusion’’ dose
(<5 mics/kg/min)
(F) A and B
(G) A and D
5 With regard to PCI of the native LAD lesion in this
patient, which of the following concepts is usually
correct?
(A) PCI through the native LAD (were it possible)
would be less likely to injure the internal
mammary
(B) PCI of the distal LIMA-LAD anastomosis is one
of the few anatomic settings where stents have
not been shown to reduce restenosis
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