BCPS COMPREHENSIVE QUESTIONS AND
ANSWERS SET A+
✔✔type of calcium supplement to use if taking PPI - ✔✔calcium citrate
✔✔alarm symptoms with GERD - ✔✔dysphagia, odynophagia, bleeding, wegiht loss,
choking, chest pain, epigastric mass
✔✔common causes of duodenal ulcer - ✔✔h. pylori (95%), nSAIDs, low dose asa
✔✔high risk factors for NSAIDs causing duodenal ulcer - ✔✔history of ulcer, several
risk factors, use of steroids, anticoagulants (including DOACs), or antiplatelets
✔✔duration of treatment for h pylori - ✔✔7-14 days - depend on regimen, 14 preferred
✔✔triple therapy for h pylori - ✔✔antisecretory (PPI) + clarithromycin + amoxicillin or
metronidazole (Pclam)
✔✔quadruple therapy for h pylori - ✔✔bismuth subsalicylate, metronidazole,
tetracycline and PPI (bismettrap)
✔✔clinical features that distinguish
ulcerative colitis - ✔✔confined to rectum, colon; typically NOT perianal
continuous inflammation common
malabsorption/nutrition UNcommon
superficial ulcerations
✔✔clinical features that distinguish crohn disease - ✔✔can occur anywhere in GI tract,
from mouth to anus
deep ulceration possible (through submucosa)
cobblestone appearance of inflammation
malabsorption/nutrition often occurrs
,✔✔treatment of mild to moderate ulceratie colitis - ✔✔amniosalicylate (topical preferred)
mesalamine enemas or topical or suppositiories
or PO sulfasalzine, mesalamine
✔✔treatment of moderate to severe
ulcerative colitis - ✔✔corticosteroid for short term
and
TNF -inhibitor
or azathioprine
vedoliziumab for pts with out good response to above or intolerant
✔✔TNF inhibitors - ✔✔adalimumab, certolizumab, infliximab, golimumab (for UC)
✔✔treatment of severe/fulminant disease - ✔✔IV steroids 7-10 d, inflix/adalim/certoliz
✔✔best combination therapy for moderate to severe crohns disease - ✔✔infix +
azathioprine better thna agents alone
✔✔child pugh classification - how many points for each class - ✔✔A score 5-6
B score 7-9
C score 10 or more
minimum score is 5 (if everything is normal)
✔✔points given for child pugh scores
encephalopathy
ascites
bilirubin
albumin
prothrombin time - ✔✔enceph: 2 if mild/mod, 3 if severe/coma
ascites: 2 if slight, 3 if modeate
bili: 2 if 2-3, 3 if >3
albumin: 2 if 2.8-3.5, 3 if <2.8
pT: 2 if 4-6, 3 if >6
✔✔when to treat spontaneous bacterial peritonitis - ✔✔PMNs present, WBC >250 (is a
primary peritonitis)
✔✔most common infectious orgs for SBP - ✔✔50% gram neg - e coli, klebsiella
17% gram pos - strp penumo
✔✔treatment of choice for SBP - ✔✔NOT bactrim
third gen cephalo - cefotaxime or ceftriaxone
FQ considered if allergies
albumin as adjunct
, ✔✔prophylatic agent of choice for SBP - ✔✔norfloxacin or cipro
bactrim
treat indefinitely if pt had SBP - no treatment before
✔✔treatment goal of hep C - ✔✔Undetectable HCV RNA levels for 12 weeks post
treatment
✔✔preferred treatment options for hcv 1a - ✔✔LDV/SOF
SOF + SMV+ribavirin (RBV)
PVR/riton/omb/das + rbv
✔✔preferred treatment options for hcv 1b - ✔✔Harvoni [Ledipasvir/Sofosbuvir
(LDV/SOF)]
Simeprevir and Sofosbuvir (SMV-SOF)
PVR/rtion/ambi/das
✔✔preferred treatment options for hcv 2 - ✔✔Sofosbuvir [Sovaldi (SOF)] +RBV x 12 or
24 weeks
✔✔simpeprevir should NOT be used for - ✔✔poly geno1A
✔✔sofosbuvir ok for genotypes what - ✔✔1-4
✔✔harvoni = what hcv meds - ✔✔sofosb/lepripas
only ok for genotype 1
✔✔viekira pak = what hcv meds, what genotype - ✔✔partitap, ombitus, riton, dasa
genotype 1
✔✔indications for treating HCV - ✔✔positive serum HCV RNA
fibrosis with moderate inflammation
compensated liver disease
willingness
no CI to therapy
✔✔meds that may induce pancreatitis - ✔✔valproic acid
diuretics
exenatide
pentamidine
estrogens
tetracyclines
bactrim
sitagliptin
Azathioprine
ANSWERS SET A+
✔✔type of calcium supplement to use if taking PPI - ✔✔calcium citrate
✔✔alarm symptoms with GERD - ✔✔dysphagia, odynophagia, bleeding, wegiht loss,
choking, chest pain, epigastric mass
✔✔common causes of duodenal ulcer - ✔✔h. pylori (95%), nSAIDs, low dose asa
✔✔high risk factors for NSAIDs causing duodenal ulcer - ✔✔history of ulcer, several
risk factors, use of steroids, anticoagulants (including DOACs), or antiplatelets
✔✔duration of treatment for h pylori - ✔✔7-14 days - depend on regimen, 14 preferred
✔✔triple therapy for h pylori - ✔✔antisecretory (PPI) + clarithromycin + amoxicillin or
metronidazole (Pclam)
✔✔quadruple therapy for h pylori - ✔✔bismuth subsalicylate, metronidazole,
tetracycline and PPI (bismettrap)
✔✔clinical features that distinguish
ulcerative colitis - ✔✔confined to rectum, colon; typically NOT perianal
continuous inflammation common
malabsorption/nutrition UNcommon
superficial ulcerations
✔✔clinical features that distinguish crohn disease - ✔✔can occur anywhere in GI tract,
from mouth to anus
deep ulceration possible (through submucosa)
cobblestone appearance of inflammation
malabsorption/nutrition often occurrs
,✔✔treatment of mild to moderate ulceratie colitis - ✔✔amniosalicylate (topical preferred)
mesalamine enemas or topical or suppositiories
or PO sulfasalzine, mesalamine
✔✔treatment of moderate to severe
ulcerative colitis - ✔✔corticosteroid for short term
and
TNF -inhibitor
or azathioprine
vedoliziumab for pts with out good response to above or intolerant
✔✔TNF inhibitors - ✔✔adalimumab, certolizumab, infliximab, golimumab (for UC)
✔✔treatment of severe/fulminant disease - ✔✔IV steroids 7-10 d, inflix/adalim/certoliz
✔✔best combination therapy for moderate to severe crohns disease - ✔✔infix +
azathioprine better thna agents alone
✔✔child pugh classification - how many points for each class - ✔✔A score 5-6
B score 7-9
C score 10 or more
minimum score is 5 (if everything is normal)
✔✔points given for child pugh scores
encephalopathy
ascites
bilirubin
albumin
prothrombin time - ✔✔enceph: 2 if mild/mod, 3 if severe/coma
ascites: 2 if slight, 3 if modeate
bili: 2 if 2-3, 3 if >3
albumin: 2 if 2.8-3.5, 3 if <2.8
pT: 2 if 4-6, 3 if >6
✔✔when to treat spontaneous bacterial peritonitis - ✔✔PMNs present, WBC >250 (is a
primary peritonitis)
✔✔most common infectious orgs for SBP - ✔✔50% gram neg - e coli, klebsiella
17% gram pos - strp penumo
✔✔treatment of choice for SBP - ✔✔NOT bactrim
third gen cephalo - cefotaxime or ceftriaxone
FQ considered if allergies
albumin as adjunct
, ✔✔prophylatic agent of choice for SBP - ✔✔norfloxacin or cipro
bactrim
treat indefinitely if pt had SBP - no treatment before
✔✔treatment goal of hep C - ✔✔Undetectable HCV RNA levels for 12 weeks post
treatment
✔✔preferred treatment options for hcv 1a - ✔✔LDV/SOF
SOF + SMV+ribavirin (RBV)
PVR/riton/omb/das + rbv
✔✔preferred treatment options for hcv 1b - ✔✔Harvoni [Ledipasvir/Sofosbuvir
(LDV/SOF)]
Simeprevir and Sofosbuvir (SMV-SOF)
PVR/rtion/ambi/das
✔✔preferred treatment options for hcv 2 - ✔✔Sofosbuvir [Sovaldi (SOF)] +RBV x 12 or
24 weeks
✔✔simpeprevir should NOT be used for - ✔✔poly geno1A
✔✔sofosbuvir ok for genotypes what - ✔✔1-4
✔✔harvoni = what hcv meds - ✔✔sofosb/lepripas
only ok for genotype 1
✔✔viekira pak = what hcv meds, what genotype - ✔✔partitap, ombitus, riton, dasa
genotype 1
✔✔indications for treating HCV - ✔✔positive serum HCV RNA
fibrosis with moderate inflammation
compensated liver disease
willingness
no CI to therapy
✔✔meds that may induce pancreatitis - ✔✔valproic acid
diuretics
exenatide
pentamidine
estrogens
tetracyclines
bactrim
sitagliptin
Azathioprine
