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BCPS 2024 LATEST UPDATE!!
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components of CHADsVASc score - ANSWER C: congestive HF (+1) H: hypertension (+1) A: age > 75 (+2) D: DM (+1) S: stroke/TIA/thromboembolism (+2) V: vascular disease (+1) A: age 65-74 (+1) S: sex = female (+1) components of HAS-BLED score - ANSWER H: hypertension - SBP > 160 (+1) A:...

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  • September 26, 2024
  • 32
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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BCPS 2024 LATEST UPDATE!!
components of CHADsVASc score - ANSWER C: congestive HF (+1)
H: hypertension (+1)
A: age > 75 (+2)
D: DM (+1)
S: stroke/TIA/thromboembolism (+2)
V: vascular disease (+1)
A: age 65-74 (+1)
S: sex = female (+1)


components of HAS-BLED score - ANSWER H: hypertension - SBP > 160 (+1)
A: abnormal liver/renal function (+1 for either)
S: stroke hx (+1)
B: bleeding predisposition (+1)
L: labile INR (+1)
E: elderly > 65 (+1)
D: drug/alcohol use - blood thinners (+1), alc > 8 drinks/week (+1)


When to use apixaban 2.5 mg BID? - ANSWER 2/3 Criteria:
1. age 80 or older
2. weight 60 kg or less
3. SCr 1.5 or greater

, When to dose reduce rivaroxaban and edoxaban for renal function? - ANSWER
CrCl < 50
Rivaroxaban to 15 mg daily and edoxaban to 30 mg daily


When to dose reduce dabigatran for renal function? - ANSWER CrCl < 30 to 74 mg
BID


Protamine is a reversal agent for: - ANSWER Heparin


Off label: LMWH


Andexanet alfa is a reversal agent for: - ANSWER Factor Xa inhibitors (apixaban &
rivaroxaban)


Idarucizumab (Praxbind) is the reversal agent for: - ANSWER Dabigatran


INR goal for mechanical mitral valve - ANSWER 2.5-3.5


Duration of treatment with aspirin for patients with bioprosthetic surgical aortic
or mitral valves - ANSWER indefinitely


Duration of treatment with DAPT for patients with bare metal stent - ANSWER at
least 1 month

,Duration of treatment with warfarin for patients with bioprosthetic surgical aortic
or mitral valves - ANSWER at least 3 months


Duration of treatment with DAPT for patients with a drug-eluting stent - ANSWER
at least 1 year


Risk factors for developing VTE - ANSWER Age > or = 40
Surgery
Trauma
Hypercoagulable states
Central venous catheterization
Estrogen use or selective estrogen receptor modulators
Erythropoiesis-stimulating agents
Previous VTE
Cancer & treatments
Immobility or lower-extremity paresis
Various medical conditions/disease states
Smoking
Obesity


VTE treatment strategies - ANSWER Bridging -- Injectable + warfarin w/ at least 5
days overlap or until INR > 2
Switching -- Injectable x 5 days then start edoxaban or dabigatran
Monotherapy -- apixaban or rivaroxaban at high dose then lower maintenance

, Dabigatran dosing for VTE treatment - ANSWER 150 mg BID after 5-10 days of
injectable


Rivaroxaban dosing for VTE treatment - ANSWER 15 mg BID w/ food x 21 days
then 20 mg daily w/ food


after 6 months, may be reduced to 10 mg daily


Apixaban dosing for VTE treatment - ANSWER 10 mg BID for 7 days then 5 mg BID


after 6 months, may be reduced to 2.5 mg BID


Edoxaban dosing for VTE treatment - ANSWER 60 mg daily after 5-10 days of
injectable


Duration of VTE treatment - ANSWER 3 months


How to dose protamine - ANSWER 1 mg for every 100 units of UFH given in the
past 3 hours, not to exceed 50mg


Hierarchy of clinical study design - ANSWER 1. Systematic reviews/meta-analysis
2. RCT
3. Cohort
4. Case-control
5. Cross-sectional
6. Case series/case reports

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