Mksap Acp

Front 1

What antibiotics do you use for IE prophylaxis?

Back 1

Amoxicillin. If allergic can use Cephalexin, clindamycin, azithromycin or clarithromycin

Front 2

Name (6) conditions that require IE prophylaxis prior to a dental extraction?

Back 2

1) Prosthetic heart valve
2) previous IE
3) unrepaired cyanotic CHD
4) completed repaired CHD with prosthetic material during the first 6 months after
5) repaired CHD with residual effects at the site of patch/device
6) cardiac transplant recipients who develop cardiac valvulopathy

Front 3

Indications for aortic valve repair in aortic regurg (4)

Back 3

1) symptomatic
2) asymptomatic chronic severe with EF <50%
3) chronic severe AR undergoing CABG or AV surgery
4) asymptomatic, normal EF but severe LV dilation

Front 4

TIMI Risk Score for UA/NSTEMI (7)

Back 4

1) age _>65
2) _>3 CAD risk factors (high cholesterol, FHx, HTN, DM, smoker)
3) prior stenosis _> 50%
4) aspirin use in last 7 days
5) _>2 anginal events in past 24 hr
6) ST-segment deviation
7) elevated cardiac markers

Front 5

Treatment of choice for MAT

Back 5

verapamil

Front 6

electrolyte disturbance that will cause prolonged QT

Back 6

hypocalcemia

Front 7

What do you do with statins pre op?

Back 7

Do NOT hold - stopping can precipiate cardiac necrosis. Note you DO hold niacin because of rhabdo risk...

Front 8

What do you do with diuretics pre op?

Back 8

Hold unless volume overloaded.

Front 9

How long do you delay non emergent surgery when someone had a bare metal stent placed?

Back 9

30-45 days

Front 10

How long do you delay surgery after someone has had a Drug Eluting Stent placed?

Back 10

one year

Front 11

Describe the Weber exam

Back 11

place tuning fork in front of forehead.
If louder in good ear --> sensorineural
if louder in bad ear --> conducive

Front 12

Describe the Rhinne test

Back 12

place tuning fork on mastoid bone then hold out to ear
It is abnormal if hearing is better while touching and that means conductive loss.
If hearing is normal or sensorineural hearing loss is present then it is louder in the air.

Front 13

What are the two main pathogens in acute bacterial sinusitis?

Back 13

H. Flu and S. pneumo

Front 14

What is the renal value cut off for use of metformin??

Back 14

1.4 in women and 1.5 in men

Front 15

Name two insulin medications that are oral and are better for post prandial hyperglycemia?

Back 15

sulfonylurea and meglitinide

Front 16

Which class of diabetes drugs must be avoided in class III and IV heart failure?

Back 16

the insulin sensitizors pioglitazone and rosiglitazone (TZDs).

Front 17

What class of diabetic agents do not have weight gain?

Back 17

incretin memietic agents such as exenatide

Front 18

How does exenatide work?

Back 18

It is an incretin mimetic, it activates the GLP-1 receptor to allow for increase insulin secretion from beta cells and decreased glucagon secretion

Front 19

What are the most limiting side effects of exenatide?

Back 19

the GI side effects. It delays gastric emptying.

Front 20

What is a long-acting glucagon-like peptide-1 analog that is new?

Back 20

Liraglutide

Front 21

In what disease is Liraglutide contraindicated?

Back 21

Personal or family history of medullary thyroid CA or MEN2

Front 22

Name a diabetes medication other than exenatide that does not cause weight gain.

Back 22

Sitagliptin (DPP-4 inhibitor)

Front 23

Describe the mechanism of action of Pramlintide

Back 23

it is an injection to be used pre-meal with insulin, is a synthetic analog of amylin and it DECREASES GLUCAGON SECRETION

Front 24

Can amylin analog Pramlintide be used with ah HA1c > 9%?

Back 24

No