BCPS Exam August 2024
LATEST UPDATE
Unpaired T-test - ANSWER Continuous data
2 independent samples
Paired T-test - ANSWER Continuous data
2 paired samples
ANOVA - ANSWER Continuous outcome data
Categorical exposure data
3+ independent variables
ANCOVA - ANSWER Continuous outcome data
Categorical exposure data
3+ independent variables
Controls for covariates
Wilcoxon Rank Sum Test (Mann-Whitney U Test) - ANSWER Ordinal data
2 independent samples
Wilcoxon Signed Rank Test - ANSWER Ordinal data
2 paired samples
, Chi Squared Test - ANSWER Categorical data
2 independent samples
Values >5
Fisher's Exact Test - ANSWER Categorical data
2 independent samples
Values <5
When to cardiovert AF - ANSWER AF >48h, anticoagulate for at least 3 weeks
before cardioversion and at least 4 weeks after cardioversion regardless of
CHADS2VASc score
May utilize a TEE to visualize the atria to skip the anticoagulation prior to
cardioversion
HASBLED - ANSWER HTN (>160)
Abnormal renal (SCr >2.26, dialysis)
Abnormal liver (3x ULN)
Stroke (hx)
Bleed (hx or tendency)
Labile INR
Elder (>65)
Antiplatelets/NSAIDs
, EtOH >8drink/wk
≥3 high risk
Warfarin - ANSWER MOA: Inhibits vitamin K epoxide reductase, preventing
production of clotting factors 2 (72h), 7 (6h), 9 (24h), 10 (36h) and inhibits
activation of protein C and S
S-warfarin is 5x more potent than R-warfarin
Antibiotics reduce vitamin K synthesis by the intestinal flora
Warfarin clearance affected by amiodarone, propafenone, cimetidine
Enzyme inducers - ANSWER phenytoin
phenobarbital
carbamazepine
rifampin
St. John's Wort
Enzyme inhibitors - ANSWER fluconazole
azithromycin
Bactrim
Flagyl
amiodarone
, Dabigatran for AF - ANSWER 150mg twice daily
75mg twice daily for CrCl 15-30 or CrCl 30-50 with ketoconazole or dronedarone
Avoid with CrCl <15, dialysis, rifampin, CrCl 15-30 with amiodarone, verapamil,
ketoconazole, dronedarone, diltiazem, clarithromycin
Bleeding, dyspepsia, cannot use pillbox
To warfarin: Overlap by 3 days (CrCl >50), 2 days (CrCl 31-50), or 1 day (CrCl 15-30)
From warfarin: INR <2
Rivaroxaban for AF - ANSWER 20mg daily with meals
15mg daily with meals for CrCl 15-50 or dialysis
Avoid with rifampin, phenytoin, carbamazepine, St. John's Wort, protease
inhibitors, azoles, conivaptan
To warfarin: Bridge with parenteral anticoagulant
From warfarin: INR <3
Apixaban for AF - ANSWER 5mg twice daily
LATEST UPDATE
Unpaired T-test - ANSWER Continuous data
2 independent samples
Paired T-test - ANSWER Continuous data
2 paired samples
ANOVA - ANSWER Continuous outcome data
Categorical exposure data
3+ independent variables
ANCOVA - ANSWER Continuous outcome data
Categorical exposure data
3+ independent variables
Controls for covariates
Wilcoxon Rank Sum Test (Mann-Whitney U Test) - ANSWER Ordinal data
2 independent samples
Wilcoxon Signed Rank Test - ANSWER Ordinal data
2 paired samples
, Chi Squared Test - ANSWER Categorical data
2 independent samples
Values >5
Fisher's Exact Test - ANSWER Categorical data
2 independent samples
Values <5
When to cardiovert AF - ANSWER AF >48h, anticoagulate for at least 3 weeks
before cardioversion and at least 4 weeks after cardioversion regardless of
CHADS2VASc score
May utilize a TEE to visualize the atria to skip the anticoagulation prior to
cardioversion
HASBLED - ANSWER HTN (>160)
Abnormal renal (SCr >2.26, dialysis)
Abnormal liver (3x ULN)
Stroke (hx)
Bleed (hx or tendency)
Labile INR
Elder (>65)
Antiplatelets/NSAIDs
, EtOH >8drink/wk
≥3 high risk
Warfarin - ANSWER MOA: Inhibits vitamin K epoxide reductase, preventing
production of clotting factors 2 (72h), 7 (6h), 9 (24h), 10 (36h) and inhibits
activation of protein C and S
S-warfarin is 5x more potent than R-warfarin
Antibiotics reduce vitamin K synthesis by the intestinal flora
Warfarin clearance affected by amiodarone, propafenone, cimetidine
Enzyme inducers - ANSWER phenytoin
phenobarbital
carbamazepine
rifampin
St. John's Wort
Enzyme inhibitors - ANSWER fluconazole
azithromycin
Bactrim
Flagyl
amiodarone
, Dabigatran for AF - ANSWER 150mg twice daily
75mg twice daily for CrCl 15-30 or CrCl 30-50 with ketoconazole or dronedarone
Avoid with CrCl <15, dialysis, rifampin, CrCl 15-30 with amiodarone, verapamil,
ketoconazole, dronedarone, diltiazem, clarithromycin
Bleeding, dyspepsia, cannot use pillbox
To warfarin: Overlap by 3 days (CrCl >50), 2 days (CrCl 31-50), or 1 day (CrCl 15-30)
From warfarin: INR <2
Rivaroxaban for AF - ANSWER 20mg daily with meals
15mg daily with meals for CrCl 15-50 or dialysis
Avoid with rifampin, phenytoin, carbamazepine, St. John's Wort, protease
inhibitors, azoles, conivaptan
To warfarin: Bridge with parenteral anticoagulant
From warfarin: INR <3
Apixaban for AF - ANSWER 5mg twice daily
