American College of Physicians: Internal Medicine — Doctors for Adults ®

Advertisement

The MKSAP Challenge

From the May ACP Observer, copyright 2006 by the American College of Physicians.

Clinical Scenario

A 58-year-old man with a history of congestive heart failure develops psoriatic arthritis. He has chronic stable exertional dyspnea but no chest pain or orthopnea. Medications are warfarin, aspirin, a statin, an angiotensin-converting enzyme inhibitor and a beta-blocker.

On physical examination, pulse rate is 66/min and irregular, respiration rate is 12/min, and blood pressure is 130/60 mm Hg. There is no jugular venous distention, and the lungs are clear to auscultation. An electrocardiogram reveals atrial fibrillation, a previous anterior myocardial infarction and an incomplete left bundle-branch block. An echocardiogram shows a left ventricular ejection fraction of 38%.

Which of the following is a contraindication for initiating infliximab therapy in this patient?

A. Atrial fibrillation
B. Cardiac conduction abnormality
C. Decreased ejection fraction
D. Ischemic heart disease

Answer

Top

This is a printer-friendly version of this page

Print this page  |  Close the preview

Advertisement

Share

 
 

Internist Archives Quick Links

Annals Virtual Patients Series 1-4 Available

Annals Virtual Patient series 1-4 available

Annals Virtual Patients is a unique online patient simulator that helps you learn while you earn CME Credit and MOC Points.
Start your journey now.

 

ACP keeps you on target to earn MOC Points

ACP keeps you on target to earn MOC Points

December 2015 is the deadline for most internists participating in ABIM MOC to earn some MOC points. Review our stimulating and rewarding options.