IM Connected
NYACP - MedQuest Board Review Question of the Week
As promised in the Chapter’s December 31st email correspondence, NYACP is pleased to provide you with the answer to the NYACP-MedQuest IM Question of the Week in this edition of IM Connected. For your convenience, this week we repeat the question in this newsletter in addition to the correct answer and explanation below. Did you miss our NYACP-MedQuest IM Question of the Week from January 7th? No problem, because another question is headed your way on Tuesday, January 14th!
Here is the NYACP - MedQuest IM Board Review Question of the Week from Jan 6, 2020:
A 79-year-old man is brought to the emergency department due to a loss of consciousness. He was unconscious for approximately four minutes after he fell. He had been walking home after spending the morning at the supermarket and then suddenly fell to the ground. The patient remembers regaining consciousness and woke to find himself face down on the sidewalk with abrasions on his nose and forehead. This is the patient’s first syncopal event, and he is otherwise in good health. He recalls feeling lightheaded and shaky just before the fall and currently is experiencing nausea.
His blood pressure is 78/52 mmHg, pulse is regular at 165/min, and respiratory rate is 23/min. There are no tongue abrasions, jugular venous distention, or focal neurological deficits. There are no murmurs.
What is the best treatment for this patient?
These are the responses received from members (719 total)
A. Synchronized cardioversion (39% of members selected this answer)
B. Asynchronized cardioversion (3% of members selected this answer)
C. Vagal maneuvers and administering adenosine (49% of members selected this answer)
D. Amiodarone (5% of members selected this answer)
E. Lidocaine (2% of members selected this answer)
Click here for the correct answer
New York State of the State 
Yesterday Governor Cuomo announced a number of new healthcare initiatives during his State of the State address, including plans to target rising healthcare costs, tackle the ongoing opioid epidemic, and reduce rising youth e-cigarette use. The governor unveiled a multipoint plan to reduce healthcare costs, focusing on increasing price transparency and combating prescription drug prices
- A cap on insulin co-payments at $100 per month
- Granting additional authority for the state to investigate pharmaceutical companies who raise prescription drug prices
- Creating a website for the public to compare the health care cost and quality information
- Additional limits on out-of-network billing for emergency services and disclosure of facility fees to patients
A number of new laws targeting tobacco and e-cigarettes were also announced
- A ban on the sale of all flavored nicotine products and a ban on e-cigarette ads targeting youth
- Ending the sale of tobacco and e-cigarettes at pharmacies
- Restricting online, mail, and phone purchasing of vaping products to prevent youth access
One proposal worthy of attention included in the supplemental State of the State Book is entitled “Enhancing Physician Integrity and Accountability.” It includes a number of action points, including a few listed below.
- Periodic renewal requirements for providers to maintain their NYS license with the stated goal of targeting “out-of-state bad actors who are licensed, but do not actually practice in New York”
- Strengthened disciplinary oversight of licensed providers
- Ensuring public access to up-to-date information on NYS licensed physicians, including on professional conduct
NYACP will work on there and all other healthcare issues that arise during the 2020 legislative session. Please watch for updates in IM Connected and special email alerts.
NYS Department of Health Issues a Statewide Health Advisory About the Flu
On January 3, 2020, the NYS Department of Health circulated a statewide Health Advisory to healthcare providers, clinical laboratories, hospitals, long term care facilities, healthcare facilities and local health departments.
The document contained timely and updated information on influenza prevention, surveillance and control. If you have not received or reviewed this alert, please do so at your earliest convenience. For more information about the sharp increase in the number of laboratory-confirmed flu cases and hospitalizations and/or to monitor weekly updates, visit the NYSDOH website.