BCPS FINAL EXAM 2026 ACTUAL QUESTIONS AND
ANSWERS GRADED A+
✔✔Outpatient CAP treatment if comorbidities or recent abx - ✔✔Respiratory FQ
(moxi/levo) monotherapy OR beta-lactam+macrolide
✔✔Integrase inhibitor NOT recommended in pregnancy - ✔✔elvitegravir
✔✔Zoledronic acid 5mg dose indication - ✔✔Osteoporosis
✔✔Zoledronic acid 4mg dose indication - ✔✔Hypercalcemia of malignancy
✔✔How long after starting levothyroxine should thyroid levels be checked? - ✔✔6
weeks
✔✔PIONEER-AF trial - ✔✔PCI for CAD, use rivaroxaban 15mg qd + clopidogrel 75 qd
x12 months
*decr rivaroxaban to 10mg qd if Crcl 30-50
✔✔DAPT treatment duration for NSTEMI, medically managed - ✔✔At least 12 months
✔✔Elevated BP - ✔✔SBP 120-129 and DBP <80 mmHg
✔✔Stage 1 HTN - ✔✔Systolic: 130-139
Diastolic: 80-89
✔✔Stage 2 HTN - ✔✔SBP >=140 and DBP >=90
✔✔Normal BP - ✔✔SBP <120 and DBP <80 mmHg
✔✔DVT ppx first 24 hrs after tPA? After 24 hrs? - ✔✔SCDs, enoxaparin
✔✔Therapeutic range carbamazepine - ✔✔4/12 mcg/mL
✔✔Antiepileptic drugs indicated after traumatic ICH (TBI) - ✔✔keppra, phenytoin, or
fosphenytoin for 7 days
✔✔Need anti-seizure ppx for non-traumatic ICH? - ✔✔No
✔✔DAPT duration after stent w/ no bleed risk - ✔✔12 months
✔✔anticoag for bioprosthetic aortic or mitral heart valve - ✔✔low bleed risk: warfarin x
3months, INR 2-3 PLUS ASA indefinitely
, mod-high bleed risk: only asa 81 indef
✔✔statins the rely on CYP 3A4 metabolism - ✔✔LAS > lova, atorva, simva
✔✔Four groups indicated for statins - ✔✔1) LDL >190
2) DM in 40-75yo w/ LDL 70-189
3) ASCVD risk >7.5%
4) Secondary ASCVD prevention
✔✔Tx duration prostatitis - ✔✔4 weeks (tx w/ FQ or bactrim)
✔✔Tx duration endocarditis - ✔✔4-6 weeks minimum for all except strep endocarditis
(which is 2 weeks)
✔✔Dolutegravir side effect - ✔✔insomnia
✔✔Cryptococcal meningitis long term prophylaxis - ✔✔Fluconazole
✔✔Best antifungal if pt is on anti-TB tx (aka rifampin) - ✔✔amphotericin B
✔✔CMV retinitis treatment + duration - ✔✔valganciclovir until CD4 count is >100 for
>=3 months
✔✔Azole antifungal with least CYP 3A4 interactions - ✔✔fluconazole
✔✔Histoplasmosis treatment: mild - ✔✔itra 200mg TID x3 days then 200 BID x12
weeks
✔✔Histoplasmosis treatment: mod-severe - ✔✔ampho B x1-2weeks, then itra x12
weeks
✔✔Coccidiodomycosis treatment - mild - ✔✔Consider not tx if immunocompetent
Fluc 400 qd or itra 400 qd x 3-6 months
✔✔Coccidiodomycosis treatment - severe - ✔✔Ampho B x1-2weeks, then fluc or itra x 1
year
✔✔Blastomycosis tx: mild - ✔✔Itra 200mg TID x3 days then 200 BID x24 weeks
✔✔Blastomycosis tx: severe - ✔✔Ampho B until improvement, then itra x 6-12 months
✔✔Aspergillosis treatment (and alternatives) - ✔✔Preferred: vori IV 6mg/kg bid x2
doses f/b 4mg/kg IV BID (or 200-300 mg PO BID)
ANSWERS GRADED A+
✔✔Outpatient CAP treatment if comorbidities or recent abx - ✔✔Respiratory FQ
(moxi/levo) monotherapy OR beta-lactam+macrolide
✔✔Integrase inhibitor NOT recommended in pregnancy - ✔✔elvitegravir
✔✔Zoledronic acid 5mg dose indication - ✔✔Osteoporosis
✔✔Zoledronic acid 4mg dose indication - ✔✔Hypercalcemia of malignancy
✔✔How long after starting levothyroxine should thyroid levels be checked? - ✔✔6
weeks
✔✔PIONEER-AF trial - ✔✔PCI for CAD, use rivaroxaban 15mg qd + clopidogrel 75 qd
x12 months
*decr rivaroxaban to 10mg qd if Crcl 30-50
✔✔DAPT treatment duration for NSTEMI, medically managed - ✔✔At least 12 months
✔✔Elevated BP - ✔✔SBP 120-129 and DBP <80 mmHg
✔✔Stage 1 HTN - ✔✔Systolic: 130-139
Diastolic: 80-89
✔✔Stage 2 HTN - ✔✔SBP >=140 and DBP >=90
✔✔Normal BP - ✔✔SBP <120 and DBP <80 mmHg
✔✔DVT ppx first 24 hrs after tPA? After 24 hrs? - ✔✔SCDs, enoxaparin
✔✔Therapeutic range carbamazepine - ✔✔4/12 mcg/mL
✔✔Antiepileptic drugs indicated after traumatic ICH (TBI) - ✔✔keppra, phenytoin, or
fosphenytoin for 7 days
✔✔Need anti-seizure ppx for non-traumatic ICH? - ✔✔No
✔✔DAPT duration after stent w/ no bleed risk - ✔✔12 months
✔✔anticoag for bioprosthetic aortic or mitral heart valve - ✔✔low bleed risk: warfarin x
3months, INR 2-3 PLUS ASA indefinitely
, mod-high bleed risk: only asa 81 indef
✔✔statins the rely on CYP 3A4 metabolism - ✔✔LAS > lova, atorva, simva
✔✔Four groups indicated for statins - ✔✔1) LDL >190
2) DM in 40-75yo w/ LDL 70-189
3) ASCVD risk >7.5%
4) Secondary ASCVD prevention
✔✔Tx duration prostatitis - ✔✔4 weeks (tx w/ FQ or bactrim)
✔✔Tx duration endocarditis - ✔✔4-6 weeks minimum for all except strep endocarditis
(which is 2 weeks)
✔✔Dolutegravir side effect - ✔✔insomnia
✔✔Cryptococcal meningitis long term prophylaxis - ✔✔Fluconazole
✔✔Best antifungal if pt is on anti-TB tx (aka rifampin) - ✔✔amphotericin B
✔✔CMV retinitis treatment + duration - ✔✔valganciclovir until CD4 count is >100 for
>=3 months
✔✔Azole antifungal with least CYP 3A4 interactions - ✔✔fluconazole
✔✔Histoplasmosis treatment: mild - ✔✔itra 200mg TID x3 days then 200 BID x12
weeks
✔✔Histoplasmosis treatment: mod-severe - ✔✔ampho B x1-2weeks, then itra x12
weeks
✔✔Coccidiodomycosis treatment - mild - ✔✔Consider not tx if immunocompetent
Fluc 400 qd or itra 400 qd x 3-6 months
✔✔Coccidiodomycosis treatment - severe - ✔✔Ampho B x1-2weeks, then fluc or itra x 1
year
✔✔Blastomycosis tx: mild - ✔✔Itra 200mg TID x3 days then 200 BID x24 weeks
✔✔Blastomycosis tx: severe - ✔✔Ampho B until improvement, then itra x 6-12 months
✔✔Aspergillosis treatment (and alternatives) - ✔✔Preferred: vori IV 6mg/kg bid x2
doses f/b 4mg/kg IV BID (or 200-300 mg PO BID)
