Bcacp Exam Questions With All Correct Answers

BCACP EXAM QUESTIONS WITH ALL CORRECT ANSWERS In asthma, FeNo 20 is associated with a better or worse response to corticosteroids? - CORRECT ANSWER- better: recommended to increase ICS or add on other therapy Difference in pattern of symptoms between asthma and COPD - CORRECT ANSWERasthma has variation; COPD is persistent despite treatment Intermittent Asthma (symptom freq, nightime, SABA use, FEV1) - CORRECT ANSWER- less then/= 2 days/wk, less than/= 2 times per month, /= 2 days/wk, 80% Mild persistent Asthma (symptom freq, nightime, SABA use, FEV1) - CORRECT ANSWER- 2 days/wk, 3-4 times/mo, 2 days/wk, 80% Mod Persistent Asthma (symptom freq, nightime, SABA use, FEV1) - CORRECT ANSWER- daily, 1x weekly, daily, 60-80% Sev Persistent Asthma (symptom freq, nightime, SABA use, FEV1) - CORRECT ANSWER- throughout day, 7x/wk, several times/day, 60% Goal for frequency of needing a SABA in asthma - CORRECT ANSWER- /= 2x per week in asthma, we should not use ____ alone - CORRECT ANSWER- LABA therapy LABA with fastest onset - CORRECT ANSWER- formoterol In COPD we should not use ___ alone - CORRECT ANSWER- ICS the only ICS available nebulized - CORRECT ANSWER- budesonide LAMA that cannot be used with severe milk allergy - CORRECT ANSWERumeclidinium Theophylline goal trough - CORRECT ANSWER- 5-15; clearance decreases with age When do we consider stepping down asthma treatment? - CORRECT ANSWER- well controlled for 3 months What MDI inhalers do not need to be shaken? - CORRECT ANSWER- alvesvo, QVAR, atrovent respimat education: when to prime - CORRECT ANSWER- spray 1 puff if not used in 3 days; spray 3x if not used for 21 days GOLD grades 1-4 according to FEV1 - CORRECT ANSWER- 1: /= 80% 2: 50-79% 3: 30-49% 4: 30% COPD treatment according to pt groups A-D - CORRECT ANSWER- A: SAMA/SABA/LAMA/LABA B: LABA or LAMA C: LAMA D: LAMA or LABA+LAMA or ICS+LABA When to use steroids based on eosinophil count - CORRECT ANSWER- 100: little effect 300: likely effect COPD exacerbation steroid dose - CORRECT ANSWER- 40 mg x 5 days 3 cardinal copd symptoms - CORRECT ANSWER- 1. Increased dyspnea 2. Increased sputum 3. Increased sputum purulence When to give antibiotics in COPD - CORRECT ANSWER- If all 3 cardinal symptoms present OR Increased sputum purulence + 1 other Antibiotics choice and duration in COPD - CORRECT ANSWER- 5-10 days Uncomplicated: azith, clarith, doxy, amox Complicated: augmentin, levo, moxi Pseudomonas: high dose levo (750 mg) or cipro 5 A's of smoking cessation: ask at every visit - CORRECT ANSWER- Ask Advice Assess Assist Arrange Set a quit date within ______days/weeks - CORRECT ANSWER- 2 weeks Quit plan "STAR" - CORRECT ANSWER- Set a quit date Tell family/friends Anticipate challenges Remove tobacco Which smoking cessation agent has BBW of SI/mood changes - CORRECT ANSWERvarenicline Bupropion, varenicline, and NRT all _____ weight gain - CORRECT ANSWER- delay but do not prevent weight gain Dosing schedule for nicotine replacement patches and when to use 21 mg vs 14 mg - CORRECT ANSWER- 21 mg x6 wks, 14 mgx2 wks, 7 mg x 2 wks 21 mg = 10 cigs/day 14 mg = 10 cigs Which smoking cessation agent has contrainidication for hx of seizure, eating disorder, MAOI use? - CORRECT ANSWER- Bupropion Diagnosis for diabetes is made by: - CORRECT ANSWER- 2 abnormal results of the SAME sample (FPG and A1c) or in 2 separate samples *if pt is symptomatic, diagnosis can be made without a 2nd diagnostic test FPG cutoffs for prediab and diabetes - CORRECT ANSWER- pre-diabetes: 100-125 mg/dL Diabetes: /= 126 mg/dL OGTT cutoff for prediab and diabetes - CORRECT ANSWER- pre-diabetes: 140-199 mg/dL Diabetes: /= 200 mg/dL A1c cutoff for prediab and diab - CORRECT ANSWER- pre: 5.7% - 6.4% diabetes: /= 6.5% 2 hour OGTT level cutoffs for gestational diabetes - CORRECT ANSWER- fasting: 92 1 hr: 180 2 hr: 153 When is A1c goal less stringent (7.5-8%)? - CORRECT ANSWER- severe hypoglycemia Limited life expectancy Extensive comorbid conditions Uncontrolled DM despite appropriate management When is A1c goal more stringent (6-6.5%)? - CORRECT ANSWER- short disease duration Long life expectancy No significant CVD Managed with lifestyle changes w or w/o metformin Weight loss __% is necessary to improve glycemic control - CORRECT ANSWER- 5% At what BMI is metabolic surgery considered recommended? - CORRECT ANSWERconsidered at 30 kg/m2 Recommended at 40 kg/m2 What A1c do you use dual therapy? When should you make it an injectable dual therapy? - CORRECT ANSWER- dual therapy when A1c is 9% dual injectable when A1c is 10% or BG 300 mg/dL when do you step up therapy for diabetes treatment? - CORRECT ANSWER- if A1c targets are not met within 3 months of dual therapy What 2nd line agent (in addition to metformin) is best for: Heart failure CKD - CORRECT ANSWER- Heart failure: canagliflozin, dapagliflozin, empagliflozin CKD: canagliflozin and dapagliflozin