Family Practice Recertification | June 2015

Family Practice Recertification

Martin Quan, MD
With much fanfare earlier this month, the Endocrinologic and Metabolic Drugs Advisory Committee of the Food and Drug Administration endorsed approval of 2 new highly-anticipated, injectable agents for lowering cholesterol, alirocumab and evolocumab. Although the FDA is not obliged to follow these recommendations, it is a only a matter of time before these two proprotein convertase subtilisin kexin 9 inhibitors will be available by prescription in the United States.
This study evaluated the association between alcohol consumption and all-cause mortality, as well as the relevance of age-specific limits for alcohol consumption. Alcohol use, particularly consumption of excessive amounts, is negatively associated with many acute and chronic diseases. The direct and indirect economic burden due to alcohol use is substantial.
Frank J. Domino, MD
There is consistent observational data that identifies concomitant use of proton pump inhibitors for gastroesophageal reflux disease and clopidogrel following acute coronary syndrome increases the risk of recurrent cardiovascular events. While a variety of theories exist (lower pH alters absorption, etc.), no clear factor has been identified.
This study was a meta-analysis that examined the association between sedentary behavior and hospitalizations, all-cause mortality, cardiovascular disease, diabetes and cancer in adults.
Frank J. Domino, MD
This Meta analysis verified that there is no relationship between MMR vaccinations and the development of autism, and found no evidence of publication bias, implying that the medical literature was not altered to hide an association.
This prospective epidemiological study compares the capabilities of the new 2013 American Heart Association and American College of Cardiology ASCVD risk calculator against several alternative cardiovascular risk calculators and explores the potential effect of preventive therapy on risk overestimation in the AHA-ACC-ASCVD model.
Francisco A. Durazo, MD
You see a 48-year-old white man for his annual examination. He is in good health with no major medical problems and an unremarkable medical history. He states he regularly drinks one or two beers a day on the weekend but not usually on weekdays. He denies blood transfusions, tattoos or intravenous drugs. His father had diabetes. Physical examination is notable for the patient being mildly obese with a body mass index of 32.
James D. Collins, MD
This is a 12-year-old male water polo player who presented with intermittent headaches associated with black floaters in his visual fields and loss of vision
Daniel Stulberg, MD
This 69-year-old woman requested evaluation of scaling behind her left ear, which has been present for 8 months after she started a new shampoo.
While treating our patients' depression is a crucial aspect of sound pain management practice in primary care, the analgesic effects of certain antidepressants, particularly for select types of chronic pain, should also not be underestimated.
Daniel Schimmel, MD, MS
A 36-year-old man presents to his primary care physician's office for follow-up after being told he had an abnormal ECG at a health fair he attended. He has no complaints. He is sedentary and does not participate in any exercise or athletic activity.

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Dermatology Quiz

Older Woman With Scaling Behind Her Ears
This 69-year-old woman requested evaluation of scaling behind her left ear, which has been present for 8 months after she started a new shampoo.
Older Woman With Scaling Behind Her Ears
What Is Your Diagnosis?

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