CME Information and Disclosures


Please note that a "1" following a contributor's name indicates that he or she has no relationships to disclose. A "2" indicates that the contributor has disclosed relationships. Please scroll down to view disclosures.

MKSAP 15 Update 1 Committee

Editor-in-Chief

Patrick C. Alguire, MD, FACP1
Acting Senior Vice President, Medical Education Division
Director, Education and Career Development
American College of Physicians
Philadelphia, Pennsylvania

Cardiovascular Medicine

Mark A. Creager, MD2
Professor of Medicine
Harvard Medical School
Cardiovascular Division
Department of Medicine
Brigham and Women's Hospital
Boston, Massachusetts

Hematology and Oncology

Stephanie L. Elkins, MD2
Program Director
Division of Hematology
Department of Medicine
University of Mississippi Medical Center
Jackson, Mississippi

Neurology

Brent P. Goodman, MD1
Assistant Professor of Neurology
Mayo College of Medicine
Consultant in Neurology
Mayo Clinic
Rochester, Minnesota

Rheumatology

Thomas P. Olenginski, MD, FACP2
Attending Staff Physician
Department of Rheumatology
Geisinger Medical Center
Danville, Pennsylvania

Gastroenterology and Hepatology

Amy S. Oxentenko, MD, FACP1
Assistant Professor of Medicine
Division of Gastroenterology and Hepatology
Mayo Clinic
Rochester, Minnesota

Associate Editors

Virginia U. Collier, MD, FACP2
Hugh R. Sharp, Jr. Chair of Medicine
Christiana Care Health System
Newark, Delaware
Professor of Medicine
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania

Richard S. Eisenstaedt, MD, FACP1
Clinical Professor of Medicine
Temple University School of Medicine
Chair, Department of Medicine
Abington Memorial Hospital
Abington, Pennsylvania

Jack Ende, MD, MACP1
Professor of Medicine
University of Pennsylvania School of Medicine
Chief, Department of Medicine
Penn Presbyterian Medical Center
Philadelphia, Pennsylvania

Thomas Fekete, MD, FACP1
Professor of Medicine
Associate Professor of Microbiology
Section of Infectious Diseases
Temple University Medical School
Philadelphia, Pennsylvania

Howard H. Weitz, MD, FACP1
Professor of Medicine
Director, Division of Cardiology
Vice-Chairman, Department of Medicine
Jefferson Medical College, Thomas Jefferson University
Philadelphia, Pennsylvania

ACP Principal Staff

D. Theresa Kanya, MBA1
Vice President, Medical Education Division

Sean McKinney1
Director
Self-Assessment Programs

Margaret Wells1
Managing Editor
Self-Assessment Programs

Valerie Dangovetsky1
Administrator
Self-Assessment Programs

Katie Idell1
Senior Staff Editor
Self-Assessment Programs

Becky Krumm1
Senior Staff Editor
Self-Assessment Programs

Ellen McDonald, PhD1
Senior Staff Editor
Self-Assessment Programs

Randy Hendrickson1
Production Administrator/Editor
Self-Assessment Programs

Megan Zborowski1
Staff Editor
Self-Assessment Programs

John Haefele1
Assistant Editor
Self-Assessment Programs

Developed by the American College of Physicians

  1. Has no relationships with any entity producing, marketing, reselling, or distributing health care goods or services consumed by, or used on, patients.
  2. Has disclosed relationship(s) with any entity producing, marketing, reselling, or distributing health care goods or services consumed by, or used on, patients.

Conflicts of Interest

The following contributors and ACP staff members have disclosed relationships with commercial companies:

Virginia U. Collier, MD, FACP
Stock Options/Holdings: Celgene, Pfizer, Merck, Schering Plough, Abbott, Johnson & Johnson, Medtronic, McKesson, Amgen

Mark A. Creager, MD
Research Grants/Contracts: Sanofi-Aventis, Merck
Consultantship: BioMarin, Genzyme, Itamar, NormOxys, Vascutek
Royalties: Elsevier, Springer
Other - Board Member: American Board of Vascular Medicine, Vascular Disease Foundation, American Heart Association

Stephanie Elkins, MD
Speakers Bureau: Cephalon Oncology, Celgene, GlaxoSmithKline

Thomas P. Olenginski, MD, FACP
Speakers Bureau: Wyeth-Pfizer, Amgen, Roche, Abbott, Novartis, Sanofi-Aventis, Procter & Gamble, Eli Lilly, Forest, Genzyme
Research Grants/Contracts: Roche, Eli Lilly, Veterans Administration

MKSAP 15 Update 2 Committee

Editor-in-Chief

Patrick C. Alguire, MD, FACP1
Acting Senior Vice President, Medical Education Division
Director, Education and Career Development
American College of Physicians
Philadelphia, Pennsylvania

Dermatology

Barbara M. Mathes, MD, FACP2
Clinical Associate, Department of Dermatology
University of Pennsylvania
Philadelphia, Pennsylvania

Endocrinology and Metabolism

Silvio E. Inzucchi, MD2
Professor of Medicine
Clinical Director, Section of Endocrinology
Director, Yale Diabetes Center
Yale University School of Medicine
New Haven, Connecticut

General Internal Medicine

David C. Demoise, MD1
Clinical Assistant Professor of Medicine
Division of General Internal Medicine
University of Pittsburgh Medical Center
Shadyside Hospital
Pittsburgh, Pennsylvania

Infectious Disease

Michael Melia, MD2
Associate Fellowship Program Director
Assistant Professor
Division of Infectious Diseases
Baltimore, Maryland

Nephrology

Michelle Whittier Krause, MD, MPH1
Associate Professor of Medicine
Division of Nephrology
Department of Medicine
University of Arkansas for Medical Sciences
Little Rock, Arkansas

Pulmonary and Critical Care Medicine

Robert A. Balk, MD, FACP1
J. Baily Carter, MD Professor of Medicine
Rush Medical College
Director, Pulmonary and Critical Care Medicine
Rush University Medical Center
Chicago, Illinois

Associate Editors

Virginia U. Collier, MD, FACP2
Hugh R. Sharp, Jr. Chair of Medicine
Christiana Care Health System
Newark, Delaware
Professor of Medicine
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania

Richard S. Eisenstaedt, MD, FACP1
Clinical Professor of Medicine
Temple University School of Medicine
Chair, Department of Medicine
Abington Memorial Hospital
Abington, Pennsylvania

Jack Ende, MD, MACP1
Professor of Medicine
University of Pennsylvania School of Medicine
Chief, Department of Medicine
Penn Presbyterian Medical Center
Philadelphia, Pennsylvania

Thomas Fekete, MD, FACP1
Professor of Medicine
Associate Professor of Microbiology
Section of Infectious Diseases
Temple University Medical School
Philadelphia, Pennsylvania

Howard H. Weitz, MD, FACP1
Professor of Medicine
Director, Division of Cardiology
Vice-Chairman, Department of Medicine
Jefferson Medical College, Thomas Jefferson University
Philadelphia, Pennsylvania

ACP Principal Staff

D. Theresa Kanya, MBA1
Vice President, Medical Education Division

Sean McKinney1
Director
Self-Assessment Programs

Margaret Wells1
Managing Editor
Self-Assessment Programs

Valerie Dangovetsky1
Administrator
Self-Assessment Programs

Katie Idell1
Senior Staff Editor
Self-Assessment Programs

Becky Krumm1
Senior Staff Editor
Self-Assessment Programs

Ellen McDonald, PhD1
Senior Staff Editor
Self-Assessment Programs

Randy Hendrickson1
Production Administrator/Editor
Self-Assessment Programs

Megan Zborowski1
Staff Editor
Self-Assessment Programs

John Haefele1
Assistant Editor
Self-Assessment Programs

Linnea Donnarumma1
Assistant Editor
Self-Assessment Programs

Developed by the American College of Physicians

  1. Has no relationships with any entity producing, marketing, reselling, or distributing health care goods or services consumed by, or used on, patients.
  2. Has disclosed relationship(s) with any entity producing, marketing, reselling, or distributing health care goods or services consumed by, or used on, patients.

Conflicts of Interest

The following contributors and ACP staff members have disclosed relationships with commercial companies:

Virginia U. Collier, MD, FACP
Stock Options/Holdings: Celgene, Pfizer, Merck, Schering Plough, Abbott, Johnson & Johnson, Medtronic, McKesson, Amgen

Silvio E. Inzucchi, MD
Consultantship: Takeda, Merck, Amylin, Medtronic
Honoraria: NovoNordisk
Research Grants/Contracts: Boehringer-Ingelheim, Eli Lilly

Barbara Mathes, MD
Consultantship: Astellas, Johnson & Johnson

Michael Melia, MD
Other: Tibotec

MKSAP 15 Update 3 Committee

Editor-in-Chief

Patrick C. Alguire, MD, FACP1
Senior Vice President, Medical Education Division
American College of Physicians
Philadelphia, Pennsylvania

Cardiovascular Medicine

Mark A. Creager, MD2
Professor of Medicine
Harvard Medical School
Cardiovascular Division
Department of Medicine
Brigham and Women's Hospital
Boston, Massachusetts

Gastroenterology and Hepatology

Brian P. Bosworth, MD2
Assistant Professor of Medicine
Anne and Ken Estabrook Clinical Scholar in Gastroenterology
Director, Gastroenterology and Hepatology Fellowship Program
Weill Medical College of Cornell University
New York, New York

Hematology and Oncology

Stephanie Elkins, MD2
Professor, School of Medicine
Division of Hematology
Department of Medicine
University of Mississippi Medical Center
Jackson, Mississippi

Neurology

Brent P. Goodman, MD1
Assistant Professor of Neurology
Mayo College of Medicine
Consultant in Neurology
Mayo Clinic
Scottsdale, Arizona

Rheumatology

Thomas P. Olenginski, MD, FACP2
Attending Staff Physician
Department of Rheumatology
Geisinger Medical Center
Danville, Pennsylvania

Associate Editors

Virginia U. Collier, MD, FACP2
Hugh R. Sharp, Jr. Chair of Medicine
Christiana Care Health System
Newark, Delaware
Professor of Medicine
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania

Richard S. Eisenstaedt, MD, FACP1
Clinical Professor of Medicine
Temple University School of Medicine
Chair, Department of Medicine
Abington Memorial Hospital
Abington, Pennsylvania

Jack Ende, MD, MACP1
Professor of Medicine
University of Pennsylvania School of Medicine
Chief, Department of Medicine
Penn Presbyterian Medical Center
Philadelphia, Pennsylvania

Thomas Fekete, MD, FACP1
Professor of Medicine
Associate Professor of Microbiology
Section of Infectious Diseases
Temple University Medical School
Philadelphia, Pennsylvania

Howard H. Weitz, MD, FACP1
Professor of Medicine
Director, Division of Cardiology
Vice-Chairman, Department of Medicine
Jefferson Medical College, Thomas Jefferson University
Philadelphia, Pennsylvania

ACP Principal Staff

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

D. Theresa Kanya, MBA1
Vice President, Medical Education Division

Sean McKinney1
Director
Self-Assessment Programs

Margaret Wells1
Managing Editor
Self-Assessment Programs

Katie Idell1
Senior Staff Editor
Self-Assessment Programs

Becky Krumm1
Senior Staff Editor
Self-Assessment Programs

Ellen McDonald, PhD1
Senior Staff Editor
Self-Assessment Programs

Randy Hendrickson1
Production Administrator/Editor
Self-Assessment Programs

Megan Zborowski1
Staff Editor
Self-Assessment Programs

Valerie Dangovetsky1
Administrator
Self-Assessment Programs

Linnea Donnarumma1
Assistant Editor
Self-Assessment Programs

John Haefele1
Assistant Editor
Self-Assessment Programs

Developed by the American College of Physicians

  1. Has no relationships with any entity producing, marketing, reselling, or distributing health care goods or services consumed by, or used on, patients.
  2. Has disclosed relationship(s) with any entity producing, marketing, reselling, or distributing health care goods or services consumed by, or used on, patients.

Conflicts of Interest

The following contributors and ACP staff members have disclosed relationships with commercial companies:

Brian Bosworth, MD
Stock Options/Holdings: Merck
Consultantship: Salix, Centocor Ortho Biotech Inc.

Virginia U. Collier, MD, FACP
Stock Options/Holdings: Celgene, Pfizer, Merck, Schering-Plough, Abbott, Johnson & Johnson, Medtronic, McKesson, Amgen

Mark A. Creager, MD
Research Grants/Contracts: Sanofi-Aventis, Merck
Consultantship: AstraZeneca, BioMarin, Genzyme, Itamar, Merck, NormOxys, Vascutek
Royalties: Elsevier, Springer
Board Member: American Board of Vascular Medicine, Vascular Disease Foundation, American Heart Association

Stephanie Elkins, MD
Speakers Bureau: Cephalon Oncology, Celgene, GlaxoSmithKline, Bristol-Myers Squibb

Thomas P. Olenginski, MD, FACP
Speakers Bureau: Wyeth-Pfizer, Amgen, Roche, Abbott, Novartis, Sanofi-Aventis, Procter & Gamble, Eli Lilly, Forest, Genzyme
Research Grants/Contracts: Roche, Eli Lilly, Veterans Administration
Consultantship: Eli Lilly, Amgen

MKSAP 15 Update 4 Committee

Editor-in-Chief

Patrick C. Alguire, MD, FACP1
Senior Vice President, Medical Education
American College of Physicians
Philadelphia, Pennsylvania

Dermatology

Misha Rosenbach, MD2
Assistant Professor of Dermatology and Internal Medicine
Department of Dermatology and Internal Medicine
Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania

Endocrinology and Metabolism

Henry B. Burch, MD1
Chair, Endocrine Division and Professor of Medicine
Uniformed Services University of the Health Sciences
Endocrinology, Diabetes, and Metabolism Service
Walter Reed National Military Medical Center
Bethesda, Maryland

General Internal Medicine

David C. Demoise, MD1
Clinical Assistant Professor of Medicine
Division of General Internal Medicine
University of Pittsburgh Medical Center
Shadyside Hospital
Pittsburgh, Pennsylvania

Infectious Disease

Henry S. Fraimow, MD2
Associate Professor of Medicine
UMDNJ Robert Wood Johnson Medical School
Division of Infectious Diseases
Cooper University Hospital
Camden, New Jersey

Nephrology

Michelle Whittier Krause, MD, MPH1
Associate Professor of Medicine
Division of Nephrology
Department of Medicine
University of Arkansas for Medical Sciences
Little Rock, Arkansas

Pulmonary and Critical Care Medicine

John G. Park, MD2
Assistant Professor of Medicine
Division of Pulmonary and Critical Care and Sleep Medicine
Mayo Clinic College of Medicine
Rochester, Minnesota

Associate Editors

Virginia U. Collier, MD, FACP2
Hugh R. Sharp, Jr. Chair of Medicine
Christiana Care Health System
Newark, Delaware
Professor of Medicine
Jefferson Medical College of Thomas Jefferson University
Philadelphia, Pennsylvania

Richard S. Eisenstaedt, MD, FACP1
Professor of Medicine
Temple University School of Medicine
Chair, Department of Medicine
Abington Memorial Hospital
Abington, Pennsylvania

Jack Ende, MD, MACP1
Professor of Medicine
University of Pennsylvania School of Medicine
Chief, Department of Medicine
Penn Presbyterian Medical Center
Philadelphia, Pennsylvania

Thomas Fekete, MD, FACP1
Professor of Medicine
Associate Professor of Microbiology
Section of Infectious Diseases
Temple University Medical School
Philadelphia, Pennsylvania

Howard H. Weitz, MD, FACP1
Professor of Medicine
Director, Division of Cardiology
Vice-Chairman, Department of Medicine
Jefferson Medical College, Thomas Jefferson University
Philadelphia, Pennsylvania

ACP Principal Staff

D. Theresa Kanya, MBA1
Vice President, Medical Education Division

Sean McKinney1
Director
Self-Assessment Programs

Margaret Wells1
Managing Editor
Self-Assessment Programs

Katie Idell1
Senior Staff Editor
Self-Assessment Programs

Becky Krumm1
Senior Staff Editor
Self-Assessment Programs

Ellen McDonald, PhD1
Senior Staff Editor
Self-Assessment Programs

Randy Hendrickson1
Production Administrator/Editor
Self-Assessment Programs

Megan Zborowski1
Staff Editor
Self-Assessment Programs

Valerie Dangovetsky1
Administrator
Self-Assessment Programs

Linnea Donnarumma1
Assistant Editor
Self-Assessment Programs

John Haefele1
Assistant Editor
Self-Assessment Programs

Developed by the American College of Physicians

  1. Has no relationships with any entity producing, marketing, reselling, or distributing health care goods or services consumed by, or used on, patients.
  2. Has disclosed relationship(s) with any entity producing, marketing, reselling, or distributing health care goods or services consumed by, or used on, patients.

Conflicts of Interest

The following contributors and ACP staff members have disclosed relationships with commercial companies:

Virginia U. Collier, MD, FACP
Stock Options/Holdings: Celgene, Pfizer, Merck, Schering Plough, Abbott, Johnson & Johnson, Medtronic, McKesson, Amgen

Henry S. Fraimow, MD Research Grants/Contracts: JMI Laboratories, NIAID HIV/AIDS Clinical Trials Network, NIH, Epilepsy Research Foundation
Employment: Cooper University Hospital
Other: Epilepsy Study Consortium

John G. Park, MD
Research Grants/Contracts: Dymedix Corporation

Misha Rosenbach, MD
Research Grants/Contracts: Centocor, Johnson & Johnson

Disclosure Policy

It is the policy of the American College of Physicians (ACP) to ensure balance, independence, objectivity, and scientific rigor in all 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 MKSAP 15 Editor-in-Chief and Associate Editors. 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 so that future decisions about content and contributors can be made in light of this information.

Contributors' disclosure information can be found in Contributors and Conflict of Interest Disclosures.

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.

Continuing Medical Education

Each of the four Updates allows you to earn up to 5 AMA PRA Category 1 Credits.

The American Medical Association has determined that physicians not licensed in the United States who participate in this CME activity are eligible for AMA PRA Category 1 Credit.

Credit for the July 2010 Update is available from July 31, 2010 to July 31, 2013.

Credit for the January 2011 Update is available from January 15, 2011 to January 15, 2014.

Credit for the July 2011 Update is available from July 31, 2011 to July 31, 2014.

Credit for the January 2012 Update is available from January 15, 2012 to January 15, 2015.

To earn CME credits, you must answer all of the provided questions, answering at least 33% of them correctly. When you have done so, go to the Answer Sheet, complete the identification form, and follow the instructions to complete your submission. You will receive confirmation of your submission on-screen and via email.

The American College of Physicians is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American College of Physicians designates this enduring material, MKSAP 15 Updates, for a maximum of 20 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Learning Objectives

The learning objectives of MKSAP 15 Updates are to:

  • Close gaps between actual care in your practice and preferred standards of care, based on best evidence
  • Diagnose disease states that are less common and sometimes overlooked and confusing
  • Improve management of comorbidities that can complicate patient care
  • Determine when to refer patients for surgery or care by subspecialists
  • Pass the ABIM Certification Examination
  • Pass the ABIM Maintenance of Certification Examination

Target Audience

  • General internists and primary care physicians
  • Subspecialists who need to remain up-to-date in internal medicine
  • Residents preparing for the certifying examination in internal medicine
  • Physicians preparing for maintenance of certification in internal medicine (recertification)

Educational Disclaimer

The editors and publisher of Medical Knowledge Self-Assessment Program 15 Update recognize that the development of new material offers many opportunities for error. Despite our best efforts, some errors may persist. Drug dosage schedules are, we believe, accurate and in accordance with current standards. Readers are advised, however, to ensure that the recommended dosages in the MKSAP 15 Updates concur with the information provided in the product information material. This is especially important in cases of new, infrequently used, or highly toxic drugs.

The primary purpose of the MKSAP 15 Updates is educational. Information presented, as well as publications, technologies, products, and/or services discussed, are 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. The ACP disclaims any and all liability for damages and claims, which may result from the use of information, publications, technologies, products, and/or services discussed in the MKSAP 15 Updates.

Publisher's Information

Copyright © 2011 American College of Physicians. All rights reserved.

This publication is protected by copyright. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic or mechanical, including photocopy, without the express consent of the ACP.

Important copyright information from the ACP

Unauthorized reproduction of this publication is unlawful. The ACP prohibits reproduction of this publication in its entirety in any form either for individual use or for distribution. The ACP will consider granting an individual permission to reproduce only limited portions of this publication for his or her own exclusive use. Send requests in writing to MKSAP Permissions, American College of Physicians, 190 North Independence Mall West, Philadelphia, PA 19106-1572.

Published in the United States of America.