Quiz on statins
Short quiz on statins Quiz on statins Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Congratulations - you have completed Quiz on statins. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%% Your answers are highlighted below. Question 1 Which of the following should not be combined with statin? AFenofibrateBEz...
Source: Cardiophile MD - December 26, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Combination with statin – Cardiology MCQ
Which of the following should not be combined with statin? a) Fenofibrate b) Ezetimibe c) Gemfibrozil d) Aspirin Correct answer: c) Gemfibrozil   If Gemfibrozil is combined with statin, there is increased risk of muscle symptoms and rhabdomyolysis. (Source: Cardiophile MD)
Source: Cardiophile MD - December 12, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Blow your HDL through the roof
The HDL cholesterol value is one of the four values on any conventional lipid/cholesterol panel, along with total cholesterol, triglycerides, and calculated LDL cholesterol (what I call “fictitious” LDL because of its incredible inaccuracy when compared to superior measures). The HDL cholesterol value has some unique characteristics not shared by the others, however, and can serve as an index of overall health. Very high HDL values, for instance, are associated with extreme longevity. Centenarians typically have values of 90 mg/dl or higher. Higher HDLs are also associated with less risk for diabetes, hypertens...
Source: Wheat Belly Blog - June 29, 2015 Category: Cardiology Authors: Dr. Davis Tags: Wheat Belly Lifestyle fish oil HDL longevity omega-3 saturated fat vitamin D Source Type: blogs

Healthier and Happier
By: Alexandra Norcott, MD, second-year internal medicine resident at Yale-New Haven Hospital and member of the West Haven Veterans Affairs Center of Excellence in Primary Care Education (CoEPCE). She plans to pursue a career in general internal medicine with subpecialization in patient safety and quality improvement. “On average, how much alcohol do you drink?” I questioned the sixty-three year-old veteran. “About fifty beers a week,” Nate nonchalantly retorted. I noticed his cherry cheeks, accented by the red sailboats on his Hawaiian shirt. “OK. For about how long?” “About as long as I’ve been married—...
Source: Academic Medicine Blog - January 22, 2015 Category: Universities & Medical Training Authors: Guest Author Tags: Featured Trainee Perspective Center of Excellence in Primary Care Education health care teams interprofessionalism patient centered care Source Type: blogs

Why I don't Always Follow Guidelines, My Response To Barron Lerner
Barron Lerner thinks he understands doctor's motives.  In his recent article in the Atlantic he laments that physicians act on tradition and emotion over adopting new science.  In defense of his position, he sites the example of how cardiologists use angioplasty and coronary artery bypass to treat coronary disease.  He states:cardiologists have been remarkably slow to abandon the old hypothesis, continuing to perform hundreds of thousands of bypass operations and angioplasties annually not only in the setting of heart attacks (when they are appropriate) but also to try to prevent them.He, of course, makes th...
Source: In My Humble Opinion - April 6, 2014 Category: Primary Care Authors: Jordan Grumet Source Type: blogs

Drug which blocks intestinal absorption of cholesterol
: a) Atorvastatin b) Gemfibrozil c) Ezetimibe d) Rosuvastatin Correct answer: c) Ezetimibe Ezetimibe acts by selectively blocking the uptake of  cholesterol and other sterols by intestinal epithelial cells. The action is on Niemann-Pick C1-like 1 (NPC1L1) cholesterol uptake receptors. Interestingly, it has been recently shown that NPC1L1 expression is necessary for HCV (hepatitis C virus) infection. Ezetimibe can block the entry of HCV into the cell, in experimental situations. Clinical effect on this aspect has to be further studied [Sainz B Jr et al. Identification of the Niemann-Pick C1-like 1 cholesterol absorption...
Source: Cardiophile MD - October 31, 2013 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Niemann-Pick C1-like 1 receptor NPC1L1 Source Type: blogs

High triglycerides: Wheat elimination or gemfibrozil?
April posted this question about high triglycerides. High triglycerides are very confusing to many people, often even ignored by many of my colleagues. Because she got such lousy advice from her doctor and because the solutions are really SO simple, I thought I’d relate her story with the advice that really works. I had blood work done last week after experiencing some edema in my feet and legs. My non-fasting triglycerides were 600 mg/dl and the doctor wants to put me on gemfibrozil and do a HbA1c to rule out diabetes. I want to try Wheat Belly first before taking the meds. Is that reasonable? He told me I need to ...
Source: Wheat Belly Blog - October 14, 2013 Category: Cardiology Authors: Dr. Davis Tags: Lipids Triglycerides Source Type: blogs

Self-Managing Cholesterol
By David Spero As a recent study indicates, reducing LDL (“bad" cholesterol) can help prevent complications in most people with diabetes. Why is LDL cholesterol a bad thing, and how do you get to a healthy level? First, what is cholesterol? Discovered in 1769 by analyzing gallstones, cholesterol is a fat-like organic chemical that is an essential part of animal cell membranes. Without it, cells won't function properly. Cholesterol is made into bile, which is needed for digesting fats. It is also helps produce the body's natural steroids, including our sex hormones and the vital stress hormone cortisol. Cholesterol ...
Source: Diabetes Self-Management - May 15, 2013 Category: Diabetes Authors: David Spero Source Type: blogs

Should Niacin Still Be Prescribed? William Boden Versus Harlan Krumholz
In the wake of HPS2-THRIVE many have argued that there is no longer any reason to prescribe niacin. William Boden, the lead investigator of AIM-HIGH and COURAGE, thinks there were enough flaws in the design of the niacin trials to justify the cautious use of niacin in certain circumstances. Says Boden: “There is evidence of clinical outcome improvement (i.e., CHD death/MI reduction) from VA-HIT for gemfibrozil; there is similar clinical outcome improvement for niacin from the Coronary Drug Project. Numerous studies show niacin’s benefit on surrogate outcome measures (i.e., quantitative coronary angiography, IVUS, c...
Source: CardioBrief - January 9, 2013 Category: Cardiology Authors: Larry Husten Tags: Policy & Ethics Prevention, Epidemiology & Outcomes AIM-HIGH Boden cholesterol HDL Heart Protection Study High-density lipoprotein HPS2-THRIVE LDL niacin Source Type: blogs