Mksap Updates

Front 1

BMS is preferred of DES in these cases

Back 1

poor adherence to therapy, HR of bleeding separate indication for long term anticoagulation, anticipated surgery

Front 2

indications for CABG in the setting of NSTEMI

Back 2

failed PCI and undergoing surgery for septal or free wall rupture. coronary anatomy not amenable to PCI and have high-risk features (ongoing or recurrent ischemia, cardiogenic shock, or severe heart failure

Front 3

Only two dihydropyridine calcium channel blockers found in to have neutral effects on mortality in heart failure

Back 3

amlodipine and felodipine

Front 4

the only oral anticoagulant indicated for the prevention of thrombosis of mechanical prosthetic valves

Back 4

warfarin

Front 5

additional indications for apixaban, rivaroxaban, dabigatran

Back 5

Apixaban and rivaroxaban for stroke and blood clot prophylaxis in atrial fibrillation; Dabigatran for treatment of atrial fibrillation

Front 6

what is imiquimod

Back 6

topical medication occasionally used to treat lentigo maligna when surgery is not an option

Front 7

when to proceed with sentinel lymph node biopsy in malignant melanoma

Back 7

histologic features such as elevated mitotic rate or presence of ulceration

Front 8

use of this drug reduces the number of squamous cell carcinomas in transplant patients on immunosuppression

Back 8

sirolimus / everolimus (whereas tacrolimus and cyclosporine increases the risk)

Front 9

moderate to severe psoriasis - need to screen for?

Back 9

dyslipidemia, hypertension, obesity, and diabetes mellitus. (these patients are at increased risk of cardiovascular disease)

Front 10

Young female patient with IBD flare and no other risk factors for DVT should still be placed on DVT prophylaxis

Back 10

owing to the high risk of VTE (3-fold without exacerbation, 15-fold with exacerbation.) Even with rectal bleeding, start VTE prophylaxis

Front 11

Hepatits C surveillance

Back 11

liver US every 6 months; AFP has no benefit

Front 12

rash is common with HCV treatment, how to manage this?

Back 12

if mild to moderate, emollients, antihistamines and topical steroids can be given; if severe, stop telapravir and continue interferon and ribavirin; if with SJS, then stop all antivirals

Front 13

Barrett's patient, endoscopy shows low grade dysplasia, what's next

Back 13

repeat EGD in 6 months with biopsies - surveillance

Front 14

Barrett's patient, endoscopy shows high grade dysplasia, what's next?

Back 14

endoscopic mucosal resection

Front 15

treatment for unprovoked DVT

Back 15

first episode - coumadin for 6 months, and based on WARFASA study, aspirin indefinitely, will reduce recurrence

Front 16

after AVR with a bioprosthetic valve, how long to given warfarin?

Back 16

6 months! not 3 months, according to a recent Danish study

Front 17

indications for Rivaroxaban

Back 17

prevention of stroke in Afib; prevention of DVT in ortho; treatment of DVT

Front 18

contraindications to Rivaroxaban

Back 18

liver or kidney injury, pregnancy, patients on HAART (lopinavir-ritonavir)

Front 19

advantages of Rivaroxaban

Back 19

oral, once daily dosing, no effect on AST/ALT, does not require monitoring

Front 20

why are aromatase inhibitors used only in postmenopausal?

Back 20

aromatase inhibitors block peripheral conversion of androgens to estrogen. there is concern that peripheral blockade may stimulate central gonadotropin production and lead to increased estrogen production by the ovaries in premenopausal patient

Front 21

how many years to give tamoxifen therapy in premenopausal patients with breast cancer?

Back 21

now it's 10 years

Front 22

Suggestive features of vasovagal syncope include any of the “3 Ps”: prodrome (lightheadedness, blurred vision, sweating, nausea), provocation (stress, micturition, dehydration), or posture (prolonged sitting or standing).

Back 22

cause

Front 23

Syncope accompanied by a neurologic prodrome (déjà vu and olfactory or visual hallucination), focal neurologic deficits (tongue biting, head or eye deviation, postevent confusion, postevent hemiparesis), or seizure risk factors (head trauma, meningitis, intracranial mass, illicit drug use) suggests seizure as the cause

Back 23

cause

Front 24

cardiogenic LOC often lacks a prodrome or can be preceded by subjective palpitations.

Back 24

cause

Front 25

Revised criteria define status epilepticus as persistent clinical or electroencephalographic seizure activity for greater than five minutes or recurrent seizure activity without interictal return to baseline

Back 25

cause

Front 26

In the out-of-hospital setting, intramuscular midazolam is effective in aborting status epilepticus, especially in persons with poor venous access.

Back 26

access

Front 27

Medical management is superior to angioplasty and stenting in treating atherosclerotic intracranial stenosis.

Back 27

Aggressive medical management consisted of lipid lowering, blood pressure management, aspirin, clopidogrel, and lifestyle modification

Front 28

FDA approved for the treatment of rheumatoid arthritis and can be administered in those with heart failure

Back 28

Abatacept