Three new risk categories: Folic acid for pregnant patients

One of the great things about teaching at The Review Course is having sharp residents and practice-eligible physicians who are up to date and ask us several questions about the latest guidelines - thank you! Case in point: did you know that within the last year, the SOGC released a new guideline on pre-conception folic acid supplementation? Until recently, I, like the rest of my practice group, had still been recommending 5mg of folic acid to people I considered to be in high risk groups: patients with diabetes or obesity, patients on anti-folate medications, and those with a family history of neural tube defects. There is now new official guidance on this and I have changed the way I manage

A. Fib: Do you know how to choose the right anticoagulant?

As it is estimated that up to 20% of strokes are the result of atrial fibrillation, it is important to consider the need for anticoagulation for your patients. That said, in the last few years a number of novel oral anticoagulants (NOACs) have emerged onto the market providing therapeutic alternatives to that of warfarin in nonvalvular atrial fibrillation. Valvular? Use Warfarin Warfarin remains the only approved therapy in cases of valvular atrial fibrillation. The principal advantages of these agents lies in their lack of regular therapeutic monitoring and fewer interactions with diet or other medications. Relative downsides of these newer agents include increased cost, lack of long-term
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Disclosures: The Review Course founders have no conflicting commercial interests. As is the case with any private events hosted on a university campus or hospital, this event is not affiliated with nor endorsed by the host venues. Our materials are peer-reviewed and prepared by Canadian physicians; we do not guarantee that our preparation materials are representative of any Canadian examination and we do not provide questions from any other examination nor are they intended as medical advice. The College of Family Physicians of Canada does not affiliate with nor endorse any exam preparation course.

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