BCACP flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

A1C goal, most adults with diabetes

ADA recommends A1C below 7% for most nonpregnant adults; targets may be relaxed to below 8% with limited life expectancy, severe hypoglycemia history, or extensive comorbidity.

CHA2DS2-VASc anticoagulation threshold

Anticoagulation is recommended in atrial fibrillation when the score is at least 2 in men or at least 3 in women; a score of 1 in men or 2 in women warrants individualized consideration.

Cockcroft-Gault creatinine clearance

CrCl = [(140 - age) x weight in kg] / (72 x serum creatinine); multiply by 0.85 for females. Weight choice (actual, ideal, adjusted) depends on body size.

HFrEF quadruple therapy

Guideline-directed therapy combines an ARNI, ACE inhibitor, or ARB with an evidence-based beta-blocker, a mineralocorticoid receptor antagonist, and an SGLT2 inhibitor to reduce mortality.

High-intensity statin criteria

Atorvastatin 40-80 mg or rosuvastatin 20-40 mg daily is indicated for clinical ASCVD and for adults with estimated 10-year ASCVD risk of 20% or greater.

Warfarin INR, mechanical mitral valve

Target INR 2.5 to 3.5 for a mechanical mitral valve or caged-ball prosthesis; most other indications, including atrial fibrillation, target 2.0 to 3.0.

Beers Criteria drugs to avoid

In adults 65 and older, avoid benzodiazepines, long-acting sulfonylureas, strong anticholinergics, and chronic NSAID use because of falls, hypoglycemia, and gastrointestinal bleeding risk.

GINA preferred asthma reliever

As-needed low-dose inhaled corticosteroid-formoterol is the preferred reliever for adolescents and adults; short-acting beta-agonist-only treatment is no longer recommended.

Metformin renal cutoffs

Do not initiate at eGFR below 45; reduce the dose at eGFR 30-44; contraindicated below 30. Hold before iodinated contrast when eGFR is 30-60.

Levothyroxine administration timing

Take on an empty stomach 30 to 60 minutes before breakfast; separate calcium, iron, and antacids by at least four hours to avoid reduced absorption.

CPT 99605

Medication therapy management initial consultation, face-to-face with the patient, covering the first 15 minutes; add 99607 for each additional 15 minutes.

Collaborative practice agreement

A written protocol between a pharmacist and prescriber defining which drugs may be initiated or adjusted, monitoring parameters, documentation, and communication requirements under state law.

340B duplicate discount prohibition

A covered entity may not obtain a 340B discount and also bill Medicaid for the same drug; it must use the Medicaid exclusion file to prevent duplicate discounts.

Break-even point formula

Break-even volume equals total fixed costs divided by the difference between unit price and variable cost per unit; revenue equals total cost at that volume.

SOAP note components

Subjective (patient-reported history), Objective (exam, labs, vitals), Assessment (problem list and clinical reasoning), and Plan (therapy, monitoring, education, follow-up).

Charge capture

The process of documenting every service and product delivered so it can be converted into a coded, billable claim; missed charges directly reduce practice revenue.

Prior authorization appeal

Review the denial reason, submit clinical notes and a letter of medical necessity, and meet the payer deadline; external review may follow a second-level denial.

Sensitivity formula

Sensitivity equals true positives divided by true positives plus false negatives; it is the proportion of people with disease correctly identified by the test.

Number needed to treat

NNT equals 1 divided by the absolute risk reduction, where ARR is the control event rate minus the treatment event rate; a lower NNT indicates greater benefit.

Prevalence versus incidence

Prevalence is the proportion of a population with a condition at a given time; incidence is the number of new cases arising in a population over a specified period.

Herd immunity threshold

The proportion of a population that must be immune to interrupt transmission, approximated as 1 minus 1 divided by the basic reproduction number (R0).

USPSTF grade B

The service is recommended with high certainty of moderate net benefit, or moderate certainty of moderate-to-substantial benefit; ACA plans must cover it without cost sharing.

Positive predictive value

PPV equals true positives divided by true positives plus false positives; it is the probability that a positive result is correct and rises as disease prevalence increases.

Reportable disease

A condition that state law or regulation requires clinicians and laboratories to report to the public health authority, enabling surveillance, case investigation, and outbreak control.

Hunger Vital Sign

A two-item food insecurity screen asking whether the household worried food would run out and whether food did not last before there was money to buy more.

PDSA cycle

Plan-Do-Study-Act: a rapid-cycle quality improvement method using small tests of change, then adopting, adapting, or abandoning the change based on results.

Kotter's first step

Creating a sense of urgency by showing why the status quo is unsustainable; it precedes building a guiding coalition and forming a strategic vision.

SMART goal

A goal that is Specific, Measurable, Achievable, Relevant, and Time-bound, allowing clear tracking of progress and objective evaluation of completion.

Situational leadership styles

Directing, coaching, supporting, and delegating, matched to a follower's competence and commitment; the leader shifts style as readiness changes.

One-minute preceptor model

Five microskills: get a commitment, probe for supporting evidence, teach a general rule, reinforce what was done well, and correct errors.

SWOT analysis

A planning framework that sorts internal strengths and weaknesses from external opportunities and threats to guide strategy for a service or organization.

Thomas-Kilmann conflict modes

Five conflict-handling styles based on assertiveness and cooperativeness: competing, collaborating, compromising, avoiding, and accommodating; collaborating fits high-stakes issues affecting both parties.