BCPP Exam || 100% Correct.
What is the GAD7? correct answers Patient self rated screener for anxiety (doesn't measure tx
response)
What are GAD7 cutoffs? correct answers 5= mild
10= moderate
15= severe
What is the HAM A? correct answers Clinician rated anxiety scale
Measures tx response
What are HAM A cutoffs? correct answers Mild: 0-17
Mod: 18-24
Severe: 25-30
Remission: 70% imp
Improved: 50% imp
Partial: 25-49%
Starting dose of sertraline in elderly and children? correct answers 12.5-25 mg
Starting dose of venlafaxine in children and elderly? correct answers 37.5 mg
How should BZDs be discontinued? correct answers 25% reduction per week until 50% of dose
is reached, then reduce by 1/8 every 4-7 days
Therapy > 8 weeks: 2-3 weeks
Therapy > 6 months: 4-8 weeks
Therapy > 1 year: slow taper over 2-4 months
What is the DI between omeprazole and diazepam? correct answers Omeprazole increases half
life and concentration of diazepam
Which SGAs can be used as augmenting agents in GAD? correct answers Olanzapine,
quetiapine, risperidone. Quetiapine XR can be used as early as 2nd line
What are first line treatments for panic disorder correct answers CBT: evidence does NOT show
superiority of pharm over non-pharm
SSRI
Venlafaxine
BZD
Clomipramine, imipramine
2nd line: mirtazepine
Can consider sga augmentation or MAOI after failure of ssri, Snri, and tca
What are first line treatments for ptsd correct answers Trauma focused psychotherapy: exposure
based, emdr, anxiety management or cbt. Emphasized in recent guidelines.
,SSRI: paroxetine, sertraline and fluoxetine have strong evidence
Venlafaxine
Consider alternative agents or augmentation after 3 failed trials: Tcas, mirtazepine, phenelzine,
AEDs
NO BZDs or SGAs
What is the YBOCS? correct answers Yale-Brown Obsessive-Compulsive scale
Clinician rated
Used for diagnosis and to assess response
How is the YBOCS interpreted? correct answers 0-7 sub clinical
8-15 mild
16-23 moderate
24-31 severe
32-40 very severe
Response: 25%
Remission: score <8
What are first line treatments for OCD? correct answers CBT or SSRI. CBT + pharmacotherapy
not better than CBT alone, but is better than pharmacotherapy alone.
2nd line: venlafaxine XR, clomipramine, mirtazepine. Clomipramine may be more effective, but
less tolerated.
Adjunctive: aripiprazole, risperidone *esp in pts with tics!
How should SSRIs be dosed in OCD? correct answers Dose higher than usual
At least 12 weeks needed for response
How long to continue pharmacotherapy in OCD? correct answers 1-2 years. Life long after 2-4
relapses.
How are SGAs used in OCD? correct answers Augmentation, hapiperidol or aripiprazole or
risperidone, after failing 2 antidepressants.
Clomipramine monitoring parameters and AES? correct answers Cardiotoxic in overdose
Epilepsy- inc risk of seizures
Caution in hepatic and rental impairment
Which natural product may benefit OCD? correct answers D- cycloserine
What is the difference between interval and ratio data? correct answers Ratio has absolute 0
(values make a true ratio when divided)
What are the 2 types of continuous data? correct answers Interval and ratio
How is SD calculated? correct answers Square root of variance
, SD percents? correct answers 68% lie within 1 SD
95% lie within 2 SD
99.7% lie within 3 SD
How is SEM calculated? correct answers SD/SQRTn
What is the difference between cohort and case-control studies? correct answers Cohort sorts
based on exposure and looks forward in time for outcomes.
Case-control classifies based on outcome and looks back in time for exposure.
Blocked random allocation correct answers Used to ensure that at any given point in time, the
groups will be similar or equal in size. I.e. ABBA, BAAB, ABAB
cluster randomization correct answers groups of patients are randomized rather than the
individual patients, I.e. entire hospitals or clinics are randomized to an intervention
Stratified randomization correct answers individuals are grouped into strata (I.e. gender) and then
randomized to one treatment group
What is the kappa statistic and what score is satisfactory.? correct answers quantitative measure
of inter-rater reliability (inter-rater concordance). -1 is perfect disagreement, +1 is perfect
disagreement.
Kappa >.7 is satisfactory.
Allocation bias correct answers Occurs when subjects or investigators can choose which
treatment group they would like. Results in groups with different characteristics
Attrition bias correct answers Certain participants are more likely to drop out of the study than
others, leading to a final sample that differs from the initial
channeling bias correct answers Occurs in observational studies. Occurs when clinicians choose
treatment according to pts diagnosis, I.e, pt at highest risk gets treatment
Classification bias correct answers Bias due to a misclassification (ex. measurement error, errors
in diagnosing AD in clinical trials without a PET scan)
Confounding bias correct answers occurs with 2 closely associated factors; the effect of 1 factor
distorts or confuses the effect of the other
interviewer bias correct answers effects of interviewers on respondents that lead to biased
answers- I.e. placebo response
observer bias correct answers when observations may be skewed to align with observer
expectations. Control by blinding raters.
What is the GAD7? correct answers Patient self rated screener for anxiety (doesn't measure tx
response)
What are GAD7 cutoffs? correct answers 5= mild
10= moderate
15= severe
What is the HAM A? correct answers Clinician rated anxiety scale
Measures tx response
What are HAM A cutoffs? correct answers Mild: 0-17
Mod: 18-24
Severe: 25-30
Remission: 70% imp
Improved: 50% imp
Partial: 25-49%
Starting dose of sertraline in elderly and children? correct answers 12.5-25 mg
Starting dose of venlafaxine in children and elderly? correct answers 37.5 mg
How should BZDs be discontinued? correct answers 25% reduction per week until 50% of dose
is reached, then reduce by 1/8 every 4-7 days
Therapy > 8 weeks: 2-3 weeks
Therapy > 6 months: 4-8 weeks
Therapy > 1 year: slow taper over 2-4 months
What is the DI between omeprazole and diazepam? correct answers Omeprazole increases half
life and concentration of diazepam
Which SGAs can be used as augmenting agents in GAD? correct answers Olanzapine,
quetiapine, risperidone. Quetiapine XR can be used as early as 2nd line
What are first line treatments for panic disorder correct answers CBT: evidence does NOT show
superiority of pharm over non-pharm
SSRI
Venlafaxine
BZD
Clomipramine, imipramine
2nd line: mirtazepine
Can consider sga augmentation or MAOI after failure of ssri, Snri, and tca
What are first line treatments for ptsd correct answers Trauma focused psychotherapy: exposure
based, emdr, anxiety management or cbt. Emphasized in recent guidelines.
,SSRI: paroxetine, sertraline and fluoxetine have strong evidence
Venlafaxine
Consider alternative agents or augmentation after 3 failed trials: Tcas, mirtazepine, phenelzine,
AEDs
NO BZDs or SGAs
What is the YBOCS? correct answers Yale-Brown Obsessive-Compulsive scale
Clinician rated
Used for diagnosis and to assess response
How is the YBOCS interpreted? correct answers 0-7 sub clinical
8-15 mild
16-23 moderate
24-31 severe
32-40 very severe
Response: 25%
Remission: score <8
What are first line treatments for OCD? correct answers CBT or SSRI. CBT + pharmacotherapy
not better than CBT alone, but is better than pharmacotherapy alone.
2nd line: venlafaxine XR, clomipramine, mirtazepine. Clomipramine may be more effective, but
less tolerated.
Adjunctive: aripiprazole, risperidone *esp in pts with tics!
How should SSRIs be dosed in OCD? correct answers Dose higher than usual
At least 12 weeks needed for response
How long to continue pharmacotherapy in OCD? correct answers 1-2 years. Life long after 2-4
relapses.
How are SGAs used in OCD? correct answers Augmentation, hapiperidol or aripiprazole or
risperidone, after failing 2 antidepressants.
Clomipramine monitoring parameters and AES? correct answers Cardiotoxic in overdose
Epilepsy- inc risk of seizures
Caution in hepatic and rental impairment
Which natural product may benefit OCD? correct answers D- cycloserine
What is the difference between interval and ratio data? correct answers Ratio has absolute 0
(values make a true ratio when divided)
What are the 2 types of continuous data? correct answers Interval and ratio
How is SD calculated? correct answers Square root of variance
, SD percents? correct answers 68% lie within 1 SD
95% lie within 2 SD
99.7% lie within 3 SD
How is SEM calculated? correct answers SD/SQRTn
What is the difference between cohort and case-control studies? correct answers Cohort sorts
based on exposure and looks forward in time for outcomes.
Case-control classifies based on outcome and looks back in time for exposure.
Blocked random allocation correct answers Used to ensure that at any given point in time, the
groups will be similar or equal in size. I.e. ABBA, BAAB, ABAB
cluster randomization correct answers groups of patients are randomized rather than the
individual patients, I.e. entire hospitals or clinics are randomized to an intervention
Stratified randomization correct answers individuals are grouped into strata (I.e. gender) and then
randomized to one treatment group
What is the kappa statistic and what score is satisfactory.? correct answers quantitative measure
of inter-rater reliability (inter-rater concordance). -1 is perfect disagreement, +1 is perfect
disagreement.
Kappa >.7 is satisfactory.
Allocation bias correct answers Occurs when subjects or investigators can choose which
treatment group they would like. Results in groups with different characteristics
Attrition bias correct answers Certain participants are more likely to drop out of the study than
others, leading to a final sample that differs from the initial
channeling bias correct answers Occurs in observational studies. Occurs when clinicians choose
treatment according to pts diagnosis, I.e, pt at highest risk gets treatment
Classification bias correct answers Bias due to a misclassification (ex. measurement error, errors
in diagnosing AD in clinical trials without a PET scan)
Confounding bias correct answers occurs with 2 closely associated factors; the effect of 1 factor
distorts or confuses the effect of the other
interviewer bias correct answers effects of interviewers on respondents that lead to biased
answers- I.e. placebo response
observer bias correct answers when observations may be skewed to align with observer
expectations. Control by blinding raters.
