Board Basics 3

Patrick Alguire, MD, FACP, Editor-in-Chief1
Senior Vice President, Medical Education
American College of Physicians
Philadelphia, Pennsylvania

Douglas S. Paauw, MD, MACP, Editor1
Professor of Medicine
Division of General Internal Medicine
Director, Medicine Student Programs
Rathmann Family Foundation Endowed Chair for Patient-Centered Clinical Education
University of Washington
Seattle, Washington

Edward R. Bollard, MD, DDS, FACP, Associate Editor1
Vice Chair for Educational Affairs
Director, Internal Medicine
Residency Training Program
Department of Medicine
Penn State College of Medicine
Milton S. Hershey Medical Center
Hershey, Pennsylvania

Joyce E. Wipf, MD, FACP, Associate Editor2
Professor of Medicine
University of Washington
Section Head of General Internal Medicine
VA Puget Sound Health Care System
Seattle, Washington

Committee

David J. Aizenberg, MD, FACP1
Assistant Professor of Clinical Medicine
University of Pennsylvania
Philadelphia, Pennsylvania

Douglas B. Berger, MD1
Staff Physician
VA Puget Sound Health Care System
Acting Instructor
University of Washington
Seattle, Washington

Sarah Jolley, MD1
Fellow, Division of Pulmonary/Critical Care Medicine
University of Washington
Seattle, Washington

Michael F. Krug, MD1
Chief Resident
Internal Medicine
University of Washington
Seattle, Washington

Sarah E. Mayson, MD1
Fellow, Division of Endocrinology, Diabetes and Metabolism
University of Pennsylvania
Philadelphia, Pennsylvania

Erin M. Ney, MD, FACP1
Clinical Assistant Professor
Assistant Residency Program Director
Department of Internal Medicine
Thomas Jefferson University
Philadelphia, Pennsylvania

Maryann K. Overland, MD1
Clinician Teacher Fellow
Ambulatory Chief Resident
VA Puget Sound Health Care System
University of Washington
Seattle, Washington

Brian S. Porter, MD2
Acting Instructor
Department of Medicine
University of Washington
Seattle, Washington

Carl R. Reynolds, MD1
Assistant Clinical Professor of Medicine
Division of Cardiology
Penn Presbyterian Medical Center
Philadelphia, Pennsylvania

Nakhle Saba, MD1
Fellow, Division of Hematology and Medical Oncology
Tulane University
New Orleans, Louisiana

L. Renata Thronson, MD1
Clinical Instructor
University of Washington
Seattle, Washington

Jennifer Wright, MD1
Acting Instructor
Department of Medicine
University of Washington
Seattle, Washington

Nathan J. Yeasted, MD1
Fellow, Division of Gastroenterology and Hepatology
Penn State College of Medicine
Milton S. Hershey Medical Center
Hershey, Pennsylvania

Board Basics ACP Editorial Staff

Linnea Donnarumma1, Assistant Editor
Sean McKinney1, Director, Self-Assessment Programs
Margaret Wells1, Managing Editor
Becky Krumm1, Senior Staff Editor
Ellen McDonald, PhD1, Senior Staff Editor
Katie Idell1, Senior Staff Editor
Randy Hendrickson1, Production Administrator/Editor
Megan Zborowski1, Staff Editor
John Haefele1, Assistant Editor

ACP Principal Staff

Patrick C. Alguire, MD, FACP1
Senior Vice President, Medical Education

D. Theresa Kanya, MBA1
Vice President, Medical Education

Sean McKinney1
Director, Self-Assessment Programs

Margaret Wells1
Managing Editor

Valerie Dangovetsky1
Program Administrator

Becky Krumm1
Senior Staff Editor

Ellen McDonald, PhD1
Senior Staff Editor

Katie Idell1
Senior Staff Editor

Randy Hendrickson1
Production Administrator/Editor

Megan Zborowski1
Staff Editor

Linnea Donnarumma1
Assistant Editor

John Haefele1
Assistant Editor

Developed by the American College of Physicians

  1. Has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
  2. Has disclosed relationships with entities producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. See below.

Conflicts of Interest

The following committee members, reviewers, and ACP staff members have disclosed relationships with commercial companies:

Brian S. Porter, MD
Employment
University of Washington

Joyce E. Wipf, MD, FACP
Royalties
UpToDate

Acknowledgments

The American College of Physicians (ACP) gratefully acknowledges the special contributions to the development and production of the 16th edition of the Medical Knowledge Self-Assessment Program® (MKSAP® 16) made by the following people:

Graphic Services: Michael Ripca (Technical Administrator/Graphics Designer) and Willie-Fetchko Graphic Design (Graphic Designer).

Production/Systems: Dan Hoffmann (Director, Web Services & Systems Development), Neil Kohl (Senior Architect), and Scott Hurd (Senior Systems Analyst/Developer).

MKSAP 16 Digital: Under the direction of Steven Spadt, Vice President, ACP Digital Products & Services, the digital version of MKSAP 16 was developed within the ACP’s Digital Product Development Department, led by Brian Sweigard (Director). Other members of the team include Dan Barron (Senior Systems Analyst/Developer), Chris Forrest (Senior Software Developer/Design Lead), Kara Kronenwetter (Senior Web Developer), Brad Lord (Senior Web Application Developer), John McKnight (Senior Web Developer), Chris Patterson (Senior Architect), and Nate Pershall (Senior Web Developer).

The College also wishes to acknowledge that many other persons, too numerous to mention, have contributed to the production of this program. Without their dedicated efforts, this program would not have been possible.

Introducing the MKSAP Resource Site (mksap.acponline.org)

The MKSAP Resource Site (mksap.acponline.org) is a continually updated site that provides links to MKSAP 16 online answer sheets for print subscribers; access to MKSAP 16 Digital, Board Basics® 3, and MKSAP 16 Updates; the latest details on Continuing Medical Education (CME) and Maintenance of Certification (MOC) in the United States, Canada, and Australia; errata; and other new information.

Disclosure Policy

It is the policy of the American College of Physicians (ACP) to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. To this end, and consistent with the policies of the ACP and the Accreditation Council for Continuing Medical Education (ACCME), contributors to all ACP continuing medical education activities are required to disclose all relevant financial relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Contributors are required to use generic names in the discussion of therapeutic options and are required to identify any unapproved, off-label, or investigative use of commercial products or devices. Where a trade name is used, all available trade names for the same product type are also included. If trade-name products manufactured by companies with whom contributors have relationships are discussed, contributors are asked to provide evidence-based citations in support of the discussion. The information is reviewed by the committee responsible for producing this text. If necessary, adjustments to topics or contributors’ roles in content development are made to balance the discussion. Further, all readers of this text are asked to evaluate the content for evidence of commercial bias and send any relevant comments to mksap_editors@acponline.org so that future decisions about content and contributors can be made in light of this information.

Resolution of Conflicts

To resolve all conflicts of interest and influences of vested interests, the ACP precluded members of the content-creation committee from deciding on any content issues that involved generic or trade-name products associated with proprietary entities with which these committee members had relationships. In addition, content was based on best evidence and updated clinical care guidelines, when such evidence and guidelines were available. Contributors’ disclosure information can be found with the list of contributors’ names and those of ACP principal staff listed in the beginning of this book.

Educational Disclaimer

The editors and publisher of MKSAP 16 recognize that the development of new material offers many opportunities for error. Despite our best efforts, some errors may persist in print. Drug dosage schedules are, we believe, accurate and in accordance with current standards. Readers are advised, however, to ensure that the recommended dosages in MKSAP 16 concur with the information provided in the product information material. This is especially important in cases of new, infrequently used, or highly toxic drugs. Application of the information in MKSAP 16 remains the professional responsibility of the practitioner.

The primary purpose of MKSAP 16 is educational. Information presented, as well as publications, technologies, products, and/or services discussed, is intended to inform subscribers about the knowledge, techniques, and experiences of the contributors. A diversity of professional opinion exists, and the views of the contributors are their own and not those of the ACP. Inclusion of any material in the program does not constitute endorsement or recommendation by the ACP. The ACP does not warrant the safety, reliability, accuracy, completeness, or usefulness of and disclaims any and all liability for damages and claims that may result from the use of information, publications, technologies, products, and/or services discussed in this program.