POSTTEST: Incorporating Emerging Innovation in Hemophilia A and B: Tailoring Prophylaxis and Management Strategies in the Managed Care Environment

Release date: April 15, 2016

Expiration date: April 15, 2017

Pharmacy Credit

Instructions for Receiving Continuing Pharmacy Education (CPE) Credit: Testing and Grading Information

This lesson is free online; receive instant grading and request your CE credit at www.PharmacyTimes.org.

Testing and Grading Directions

1. Each participant evaluating the activity and achieving a passing grade of 70% or higher on the online posttest is eligible to receive CE credit.

2. Participants receiving a failing grade on the exam will be notified and permitted to take 1 reexamination at no cost.

3. To receive your credit online, go to www.PharmacyTimes.org to complete the online posttest (achieving a passing grade of 70% or better) and the online activity evaluation form before the expiration date. Your CE credit will be auto-matically uploaded to CPE MonitorTM. Please ensure your Pharmacy Times account is updated with your NABP e- profile ID number and your date of birth (MMDD for-mat). Participation data will not be uploaded into CPE MonitorTM if you do not have your NABP e-profile ID number and date of birth entered into your profile on www.PharmacyTimes.org.

Sample of Online Posttest

Choose the best answer for each of the following:

1. What percent of patients with hemophilia have hemophilia A?

A. 10% to 15%

B. 20% to 25%

C. 60% to 65%

D. 80% to 85%

2. Which of the following defines severe hemophilia?

A. Clotting-factor activity less than 1% (<0.01 IU/mL)

B. Clotting-factor activity from 1% to 5% (0.01-0.05 IU/mL)

C. Clotting-factor activity from 6% to less than 40%(0.06-0.40 IU/mL)

D. Clotting-factor activity greater than 40% (>0.40 IU/mL)

3. What is the goal of prophylaxis treatment?

A. To ensure faster clotting of bleeds

B. To convert an individual with severe hemophil-ia to mild/moderate hemophilia

C. To ensure reversal of joint arthropathy and recovery of joint function

D. To maintain continuous levels of factor at

4. When was the concept of prophylaxis initiated?

A. 1940s

B. 1960s

C. 1980s

D. 1992

5. Compared with on-demand treatment, which of the following has not been demonstrated in clinical trials with prophylaxis?

A. Reduced number of bleeds per year

B. Reduced risk of life-threatening hemorrhages, including intracranial hemorrhage

C. Reversal of established joint disease

D. Decreased progression of hemophilia and potential prevention of joint damage

6. When is primary prophylaxis, the regular continuous use of treatment, initiated?

A. Before the second clinically evident large joint bleed

B. Before 3 years of age, irrespective of the number of prior bleeding episodes

C. After 2 or more bleeds into large joints but before the onset of joint disease

D. After the onset of joint disease, as documented by physical examination and plain radiographs of the affected joints

7. What percent of patients with hemophilia have severe disease?

A. Less than 15%

B. 25%

C. 50%

D. 60%

8. Which of the following accounts for more than 80% of the direct costs associated with hemophilia?

A. Clinician visits

B. Recurrent hospitalizations, including medical and surgical procedures

C. Antihemophilic medication

D. Laboratory tests

9. What is the estimated mean annual healthcare cost per patient with hemophilia in the United States?

A. $10,000 to $15,000

B. $25,000 to $50,000

C. $100,000 to $150,000

D. $500,000 to $750,000

10. BR, a full-term newborn with unremarkable prenatal and birth history and no family history of hemophilia, was circumcised 2 days after birth. Ten hours later, bleeding was observed at the site of the incision, and despite normal measures to stop the bleed, it recurred 24 hours later. Which of the following should be the next immediate step?

A. Attempt to stop the bleeding without the use of factor replacement and initiate a hematologic workup for diagnosis

B. Attempt to stop the bleeding using factor replacement and initiate genetic testing to determine the carrier status of the mother

C. Initiate factor-replacement treatment and wait for recurrence to begin prophylaxis

D. Initiate factor-replacement treatment followed by continuous primary prophylaxis

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