JAAPA CME Post-Test August 2023

Colorectal Cancer Screening: The Role of MT-sDNA Testing

Because an estimated 10.5% of new colorectal cancer (CRC) cases occur in patients under age 50 years, the U.S. Preventive Services Task Force in 2021 recommended CRC screening for adults ages 45 to 49 years. The prevalence of up-to-date CRC screening with any recommended test among patients age 45 years and older in the United States is only 59% in 2023, indicating that existing screening practices are ineffective. Screening options now include invasive and noninvasive measures. Multi-target stool DNA (MT-sDNA) testing is a simple, low-risk, noninvasive test that provides excellent sensitivity and specificity, is cost-effective, and may increase patient screening rates. CRC screening guideline recommendations and alternative screening methods may help improve patient outcomes and reduce morbidity and mortality. This activity describes MT-sDNA testing, its effectiveness, recommended use, and potential expanding role as a screening option.

Learning Objectives

  • Describe CRC pathophysiology
  • Describe how MT-sDNA screening works and its expected efficacy
  • Discuss the expanding evidence for MT-sDNA’s role in new screening guidelines, different population subsets, and high-risk patients
  • Compare and contrast MT-sDNA cost-effectiveness with FIT and colonoscopy

Strategies for Rate and Rhythm Control of Atrial Fibrillation in the ED

Atrial fibrillation (AF) is one of the most common dysrhythmias managed in the ED and accounts for more than half a million visits a year in the United States. More than 6 out of 10 of these visits result in admissions. As the prevalence of AF has continued to increase in recent years, so has the presentation of patients with AF to the ED. For these reasons, clinicians in emergency settings must be knowledgeable of evidence-based rate and rhythm control strategies for stabilizing patients and preventing complications. This activity discusses options, indications, contraindications, and safe implementation of rate and rhythm control strategies for ED clinicians. Recent studies have suggested that early rhythm control may benefit newly diagnosed patients, reducing stroke risk, cardiovascular deaths, and disease progression.

Learning Objectives

  • Discuss rate control strategies for stabilization of patients with AF in the ED
  • Discuss rhythm control strategies for stabilization of patients with AF in the ED
  • Compare and contrast the potential benefits of rhythm and rate control strategies

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