BCPS ACTUAL FINALS EXAM QUESTIONS AND
ANSWERS SET A+
✔✔glucose values to diagnose diabetes (non-preg)
fasting
random
OGTT
A1C - ✔✔fastin >126
random >200
OGTT - 2 hrs post 75 g test = >200
a1c 6.5% or more
✔✔glucose values to diagnose gestitational diabetes - ✔✔post OGTT (75G) test
>153 at 2 hours
> 180 at 1 hr
>92 at fasting
✔✔treatment goals for DM management
A1C
fasting bg
peak postprand glucose - ✔✔a1c <7
fasting < 70-130
peak post < 180
✔✔treatment goals for gestational diabetes
fasting
post prand - ✔✔fastin <95
post pran <140 at 1 hr
✔✔DM meds CI in poor renal function - ✔✔metformin, exanatide/liraglutide
✔✔DM meds CI in pts with heart failure - ✔✔pioglitazone, rosiglitazon (TZDs)
,✔✔regular insulin is what type of acting - ✔✔short acting
✔✔weight based estimate for starting insulin in new pts - ✔✔0.3-0.6 units/kg/day; 50%
as basal, 50% as bolus
✔✔rule for figuring out how to adjust insulin administration based on TDI
(insulin sensitivity) - ✔✔1800 rule
1800/TDI = amount of BG decreased by 1 unit insulin
ex: if TDI is 60 units
1800/60=30 so 1 unit of rapid acting insulin will decrease BG by 30
✔✔rapid acting insulins - ✔✔aspart, lispro, glulisine
✔✔When to start insulin in T2DM (vs PO at diagnosis) - ✔✔A1C >10%
fasting bg > 250
random bg >300
hyperglycemic symptoms
urine ketones present
✔✔conversion from NPH to basal insuli - ✔✔80% of NPH as glargine, detemir at NPH
dose
✔✔in DKA, when can insulin be converted from gtt to SQ - ✔✔BG < 200 AND two of the
following
pH >7.3
serum bicarb > 15
anion gap < 12
✔✔drug of choice for absence seizures - ✔✔ethosuximide
✔✔drug of choice for status epilept, for refractory - ✔✔lorazepam IV, midazolam IM
refractory - pentobarb, thoipental, midaz, propfol
✔✔anticonvulsants to avoid in pregnanct - ✔✔valproic acid (esp first tri), phenytoin,
carbamazepine, phenobar
polytherapy - use monotherapy when possible
limit dose of lamotrigine in first trimester
✔✔VPA - dose related ades - ✔✔drowsiness
cong impairment
nystagums
ataxia
✔✔ades of divalproate - ✔✔hepatotoxicity
, alopecia
n/v
wt gain
pancreatitis
interferenc w/platelet aggregation
✔✔MAO-B inhibitors used for parkinson disease - ✔✔selegiline - 5 mg PO BID
rasagiline
both have risk for serotonin syndrome
✔✔PD - med for treatment of "off" episodes in advanced disease - ✔✔apomorphine -
short acting dopamine receptor agonist - usually treat wtih trimethobenzamide b/c n/v
✔✔in PD, meds that are most helpful with tremor - ✔✔anticholinergics - trihexyphenidyl,
benztropine
✔✔in PD, med that can be used to treat dyskinesias caused by levodopa/dopamine
agonists - ✔✔amantadine; side effect = livedo reticularis (reddish blue discoloration)
✔✔prophylaxis for tension headaches - ✔✔tricyclics, botox
✔✔prophylaxis for migraine headaches - ✔✔propanolol, frovatriptan, topiramate,
✔✔prophylaxis for cluster headaches - ✔✔verapamil, melatonin, lithium
treatment with O2, triptans, intranasal lidocaine 4%
✔✔steroid dosing for MS acute relapses - ✔✔methyl pred IV 1 g/d x 3-5 d
PO pred 1250 mg/d qod x 5 doses
✔✔Difference btwn mild and moderate persistent asthma - ✔✔Daily vs more than 2
days/wk symptoms
Saba daily vs more than 2 d/w
Fev1 60-80 vsore than 80%
✔✔Severe persist asthma symptoms - ✔✔Night awake very day, several times per day
saba use fev1 less than 60%
✔✔Inhaled steroids - ✔✔Beclomethasone
Fluticasone
Mometasone
Bude snide
Ciclesonide
✔✔Inhaled anticholinergic - ✔✔Ipratropium
ANSWERS SET A+
✔✔glucose values to diagnose diabetes (non-preg)
fasting
random
OGTT
A1C - ✔✔fastin >126
random >200
OGTT - 2 hrs post 75 g test = >200
a1c 6.5% or more
✔✔glucose values to diagnose gestitational diabetes - ✔✔post OGTT (75G) test
>153 at 2 hours
> 180 at 1 hr
>92 at fasting
✔✔treatment goals for DM management
A1C
fasting bg
peak postprand glucose - ✔✔a1c <7
fasting < 70-130
peak post < 180
✔✔treatment goals for gestational diabetes
fasting
post prand - ✔✔fastin <95
post pran <140 at 1 hr
✔✔DM meds CI in poor renal function - ✔✔metformin, exanatide/liraglutide
✔✔DM meds CI in pts with heart failure - ✔✔pioglitazone, rosiglitazon (TZDs)
,✔✔regular insulin is what type of acting - ✔✔short acting
✔✔weight based estimate for starting insulin in new pts - ✔✔0.3-0.6 units/kg/day; 50%
as basal, 50% as bolus
✔✔rule for figuring out how to adjust insulin administration based on TDI
(insulin sensitivity) - ✔✔1800 rule
1800/TDI = amount of BG decreased by 1 unit insulin
ex: if TDI is 60 units
1800/60=30 so 1 unit of rapid acting insulin will decrease BG by 30
✔✔rapid acting insulins - ✔✔aspart, lispro, glulisine
✔✔When to start insulin in T2DM (vs PO at diagnosis) - ✔✔A1C >10%
fasting bg > 250
random bg >300
hyperglycemic symptoms
urine ketones present
✔✔conversion from NPH to basal insuli - ✔✔80% of NPH as glargine, detemir at NPH
dose
✔✔in DKA, when can insulin be converted from gtt to SQ - ✔✔BG < 200 AND two of the
following
pH >7.3
serum bicarb > 15
anion gap < 12
✔✔drug of choice for absence seizures - ✔✔ethosuximide
✔✔drug of choice for status epilept, for refractory - ✔✔lorazepam IV, midazolam IM
refractory - pentobarb, thoipental, midaz, propfol
✔✔anticonvulsants to avoid in pregnanct - ✔✔valproic acid (esp first tri), phenytoin,
carbamazepine, phenobar
polytherapy - use monotherapy when possible
limit dose of lamotrigine in first trimester
✔✔VPA - dose related ades - ✔✔drowsiness
cong impairment
nystagums
ataxia
✔✔ades of divalproate - ✔✔hepatotoxicity
, alopecia
n/v
wt gain
pancreatitis
interferenc w/platelet aggregation
✔✔MAO-B inhibitors used for parkinson disease - ✔✔selegiline - 5 mg PO BID
rasagiline
both have risk for serotonin syndrome
✔✔PD - med for treatment of "off" episodes in advanced disease - ✔✔apomorphine -
short acting dopamine receptor agonist - usually treat wtih trimethobenzamide b/c n/v
✔✔in PD, meds that are most helpful with tremor - ✔✔anticholinergics - trihexyphenidyl,
benztropine
✔✔in PD, med that can be used to treat dyskinesias caused by levodopa/dopamine
agonists - ✔✔amantadine; side effect = livedo reticularis (reddish blue discoloration)
✔✔prophylaxis for tension headaches - ✔✔tricyclics, botox
✔✔prophylaxis for migraine headaches - ✔✔propanolol, frovatriptan, topiramate,
✔✔prophylaxis for cluster headaches - ✔✔verapamil, melatonin, lithium
treatment with O2, triptans, intranasal lidocaine 4%
✔✔steroid dosing for MS acute relapses - ✔✔methyl pred IV 1 g/d x 3-5 d
PO pred 1250 mg/d qod x 5 doses
✔✔Difference btwn mild and moderate persistent asthma - ✔✔Daily vs more than 2
days/wk symptoms
Saba daily vs more than 2 d/w
Fev1 60-80 vsore than 80%
✔✔Severe persist asthma symptoms - ✔✔Night awake very day, several times per day
saba use fev1 less than 60%
✔✔Inhaled steroids - ✔✔Beclomethasone
Fluticasone
Mometasone
Bude snide
Ciclesonide
✔✔Inhaled anticholinergic - ✔✔Ipratropium
