[05.30.2024] Updated content, AnKing Overhaul for Step 1 & 2/AnKingMed, ID 1631960

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Point of card is to test Tx for all patients with high risk of stroke, would prefer finding of way of clarifying >2 in males, >3 in females

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@AnKing-Maintainers What if instead we did:

What is the recommended treatment for patients with a high-risk CHA2DS2-VASc score (≥ 2 in males or ≥ 3 in females)?

Does this work?

Just to confirm, AMBOSS says long-term anticoagulation for any patient with high risk “^” score

https://next.amboss.com/us/article/GS0Baf?q=chads₂%20score#Xp19L30

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It’s a tricky one
Even if it says woman or female the answer should be “consider anticoagulation” so it wont make much difference

I would personally recommend adding the distinction in the extra section and move DOACs in front of warfarin since it’s the first line

I honestly added a few cards of my own with different examples to master this topic so i am not sure that the current cards cover it perfectly!

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Think to preserve original purpose of the card we shouldn’t worry about the indications for intermediate risk. And we can convert extra to:

Use DOACs or warfarin at INR 2-3 to prevent thromboembolism

More concise this way, think we cover what DOACs are more directly on more relevant cards so examples aren’t needed here

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Think change to the text is unnecessary. Clarification in the extra would be better.

I would be in favor of @Cameron’s change to the text because it emphasizes high risk patients need AC while acknowledging the different scores between sexes.

I would also prefer leaving the examples of DOACs in the extra but that’s personal preference. I add example drugs to my lecture notes on a lot of cards that reference a class without specifics

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@AnKing-Maintainers Made some changes to the suggestion; personally really think Text needs to change because as is the original card is trying to test treatment in high-risk patients but is unclear. Want some more opinions though!

Clarifying in extra while leaving text the same as suggested above would have us testing treatment for high risk males vs intermediate risk females which is still unclear imo

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Would use “or” instead of semi-colon but otherwise support. This is a tough grey area since UW QID education objectives stratify males vs. females but questions are usually men to avoid any confusion.

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@Ahmed7 Tie breaker? Been open for a bit and we’ve got a split on the need to change text vs just clarifying meaning in the extra

I like the way you approached it with high risk. If we don’t change the text now we will continue to get suggestions for it since it does differ by sex.

Unless “high risk” gives it away, we can remove and just say ≥ 2 in males or ≥ 3 in females

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Would def remove high-risk, agree that it is sorta a giveaway

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Didn’t think about that! Being able to interprate a high risk score should def still be on this card

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Updated + added note

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