AAPA members should complete and submit posttests on the AAPA Web site by going to www.aapa.org and searching for keyword JAAPA post-tests. All others may complete and submit posttests online at no charge at www.mycme.com. To obtain 1 hour of AAPA Category I CME credit, PAs must receive a score of 70% or better on each test taken.

HEPATORENAL SYNDROME 


1. Twenty percent of patients develop hepatorenal 
syndrome (HRS) within 1 year after the onset of


a. Splenomegaly

b. Ascites 

c. Esophageal varices 

d. Asterixis


2. What level of creatinine is considered the threshold for early detection of HRS, regardless of type?


a. 0.5 mg/dL

b. 1.0 mg/dL

c. 1.5 mg/dL

d. 2.0 mg/dL


3. In contrast to type 1 HRS, type 2 HRS


a. Manifests more insidiously, typically over weeks 
to months

b. Has a higher mortality rate

c. Is associated with precipitating factors

d. Carries a much greater need for prompt 
treatment


4. Adequate coverage of aerobic gram-negative 
organisms in spontaneous bacterial peritonitis is 
traditionally provided by


a. Macrolides

b. Quinolones

c. Third-generation cephalosporins

d. Sulfonamides


5. What has a limited role in the treatment of HRS?


a. Albumin infusion

b. Normal saline infusion

c. Noradrenaline

d. Octreotide


6. A side effect associated with terlipressin is


a. Tremor

b. Photosensitivity

c. Skeletal pain

d. Bronchospasm



ORAL ANTICOAGULATION

7. A current indication for dabigatran (Pradaxa) is 
prophylaxis of


a. Stroke in patients with a history of transient ischemic attack

b. Deep vein thrombosis in patients undergoing hip 
fracture surgery

c. Stroke and systemic embolism in patients with 
nonvalvular atrial fibrillation

d. Ischemic complications in unstable angina


8. Concurrent parenteral anticoagulation should be given to patients just starting warfarin who have


a. Valvular heart disease

b. Pulmonary embolism

c. Recurrent myocardial infarction

d. A history of atrial flutter


9. Patients receiving warfarin should have their international normalized ratio (INR) checked at least every


a. Week

b. 2 weeks

c. 4 weeks

d. 6 weeks


10. The most powerful predictor of intracranial 
hemorrhage has been found to be


a. Intensity of treatment

b. Comorbid conditions

c. Number of agents with drug interactions

d. History of unstable INR response


11. Patients taking dabigatran should be advised to


a. Take the medication 1 hour before meals

b. Not mix the medication with grapefruit juice

c. Take a double dose if they miss a dose

d. Take the medication whole (do not crush or break the capsules)


12. Which P-glycoprotein inducer may interact with dabigatran?


a. Ciprofloxacin

b. Carbamazepine

c. Fluoxetine

d. Simvastatin