Clinical Geriatrics

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Learning Objectives
Upon completion of this educational activity, participants should be able to:
1. Explain the role of BNP in the screening, diagnosis, follow-up, and prognosis of heart failure in older patients.
2. Identify and interpret the variation in BNP levels/values due to age, gender, and renal function.
3. Discuss the atypical presentations of heart failure in older persons and the diagnostic difficulties in this patient population.
4. Identify the factors related to the higher frequency of heart failure in older adults and the comorbid conditions that contribute to heart failure in this patient population.

MEDIUM USED & METHOD OF PARTICIPATION
Read the article, complete the evaluation and post-test, and return both to: NACCME via fax at (610) 560-0502 or mail (see address below). You will receive your certificate in 6-8 weeks. If you would like to print your certificate immediately, go to http://cme.naccme.com, register as a NACCME user, and access the activity test and evaluation online.

SUCCESSFUL COMPLETION
Successful completion entails participants obtaining a score of at least 70% on the post-test. A certificate of completion will be mailed to the address listed on your post-test/evaluation form within 6-8 weeks of receipt of the documents.

All post-tests/evaluations must be received by June 15, 2009.

You may fax or mail your post-test/evaluation form and receive your certificate in 6-8 weeks OR go to http://cme.naccme.com and log in to create an online account where you can access and complete the article, post-test, and evaluation and print your certificate immediately.

NACCME
83 General Warren Blvd., Suite 100
Malvern, PA  19355
Fax: (610) 560-0502

Deol BBK, Vaitkevicius PV, Cardozo LJ. The Role and Utility of BNP in Older Patients with Heart Failure. Clinical Geriatrics 2008;16(6):35-40.

June 2008

Please answer the following questions in the answer key below.

1. BNP is secreted by which of the following?
A. Brain
B. Ventricles
C. Atria
D. Arteries

2. Mr. X is a 75-year-old male with coronary artery disease, heart failure, chronic obstructive pulmonary disease, hypertension, and hyperlipidemia. He has dyspnea on exertion that has been gradually progressing for the past 3 days. Mr. X denies any chest pain. Chest x-ray shows emphysematous changes, no acute process. EKG shows no changes from baseline. Labs show a BNP of 46 pg/mL. What is the most likely cause of this patient’s dyspnea?
A. Coronary artery disease
B. Heart failure
C. Chronic obstructive pulmonary disease
D. Pulmonary embolism

3. BNP is an important tool for which of the following?
A. Screening
B. Diagnosis
C. Follow-up
D. Prognosis
E. All the above