BCPS Questions With Accurate Answers – 100%
Asthma mild persistent Adult ✔️Ans - Sx>2 days/week
Night 3-4/month
B-agonist >2 days/week
Asthma moderate persistent ✔️Ans - Sx daily
Night>1x/wk but not nightly
B-agonist daily
Activity some
Lung fx FEV1 60-80% FEV1/FVC ⬇️ 5%
Asthma Tx ✔️Ans - Step1 SABA prn
Step2 low dose ics
Step3 low dose ics + LABA OR medium dose ics
Step4 medium dose ics + LABA
Step5 high dose ics + LABA & consider omalizumab
Step6 Step 5 + OCS
Medium dose ICS Adults ✔️Ans - Fluticasone 44 6-10 puffs
Beclomethasone 40 6-12 puffs
Assessing Asthma Control ✔️Ans - Not well controlled:
Sx>2 days/week
Night 1-3x/week
Activity some
SABA >=2 days/week
FEV1 60-80%
ACT 16-19
OCS >= 2/year
Action Step up 1
Asthma severity Age 5-11 ✔️Ans - Sx>daily
Night>once/week but not nightly
B-agonist daily
Activity some
Lung fx FEV1 60-80% FEV1/FVC 75-80%
,Asthma Tx 5-11 ✔️Ans - Step1 SABA prn
Step2 low dose ics
Step3 low dose ics + LABA LTM or theo OR medium dose ics
Step4 medium dose ics + LABA
Step5 high dose ics + LABA
Step6 Step 5 + OCS
Medium dose ICS Age 5-11 ✔️Ans - Fluticasone 44 4-8 puffs
Beclomethasone 40 4-8 puffs
Management of asthma in hospital ✔️Ans - o2 for SaO2>=90%
SABA +-ipratopium
OCS
Mg or heliox
IV corticosteroids
Gold guidelines ✔️Ans - Group A mild/mod
FEV1 50+
mMRC 0-1
CAT<10
CCQ 0-1
Group B mod FEV1 50+
mMRC>=2 CAT>=10
CCQ>1
Group C mild/mod
FEV1 30-50% or < 30%
mMRC 0-1
CAT<10
CCQ 0-1
Group D mild/mod
FEV1 <50% mMRC>=2 CAT>=10
CCQ>1
Tx for Gold ✔️Ans - Patient Group A
SA anticholinergic
OR SABA
Patient Group B
LA anticholinergic OR LABA
Patient Group C
,ICS + LABA OR LA anticholinergic
Patient Group D
ICS + LABA &/OR LA anticholinergic
Add rofumilast as alternative for groups C& D
Cardinal SX of COPD ✔️Ans - Increased dyspnea
Increased sputum volume
Increased sputum purulence*
Anticoagulant for VTE ✔️Ans - Tx at least 3 months. Extended tx for
recurrence AND low to moderate bleeding risk 0-1
HASBLED risk assessment for bleeding ✔️Ans - Htn
Abnormal renal/liver
Stroke
Bleeding hx or predisposition
Labile INR
Elderly > 65
Drugs (antiplatelet + NSAID) etoh abuse
LOW = 0
MOD = 1
HIGH = 3
Mechanical Mitral Valve ✔️Ans - INR 2.5-3.5
Warfarin adjustment ✔️Ans - Increase or decrease cumulative weekly
dose by 5-20%
Takes 5-7 days for full effect of dose change.
No vitamin k unless INR>10 or bleeding. Oral if no bleeding.
Risk of thromboembolism and interruption of warfarin for procedures
✔️Ans - HIGH risk
Bridge with LMWH (valve replacement, recent stroke or mi)
Assess coag risk
CHA2DS2VASc ✔️Ans - CHF
HTN
, Age>75 (2 points)
Diabetes
Stroke (2 points)
Vascular Dis hx
Age>65<75
Sex categ (F=1pt)
Rivaroxaban ✔️Ans - VTE Px (tkr/thr)
10mg daily
Afib
20mg qpm
DVT/PE tx
15mg bid then 20mg daily
Apixaban ✔️Ans - DVT tx
10mg bidx7days then 5mg bid
Afib
5mg bid
(>=80,wt<=60, SCr>=1.5) 2 of these then 2.5mg bid
Neonatal meningitis ✔️Ans - 0-1 month
Group b strep, listeria, ecoli
Ampicillin/gentamicin
OR
Ampicillin/cefotaxime
Meningitis 1-3 months ✔️Ans - Neonatal plus HFlu(gram-rod), N
meningitidis, strep pneumoniae
Ampicillin/ceftriaxone
Meningitis 3 mo-12 yrs ✔️Ans - 1-3 months but no neonatal pathogens
Ceftriaxone+-Vanco
Meningitis >12 yrs ✔️Ans - N meningitidis
Strep pneumoniae
Ceftriaxone+-Vanco
Asthma mild persistent Adult ✔️Ans - Sx>2 days/week
Night 3-4/month
B-agonist >2 days/week
Asthma moderate persistent ✔️Ans - Sx daily
Night>1x/wk but not nightly
B-agonist daily
Activity some
Lung fx FEV1 60-80% FEV1/FVC ⬇️ 5%
Asthma Tx ✔️Ans - Step1 SABA prn
Step2 low dose ics
Step3 low dose ics + LABA OR medium dose ics
Step4 medium dose ics + LABA
Step5 high dose ics + LABA & consider omalizumab
Step6 Step 5 + OCS
Medium dose ICS Adults ✔️Ans - Fluticasone 44 6-10 puffs
Beclomethasone 40 6-12 puffs
Assessing Asthma Control ✔️Ans - Not well controlled:
Sx>2 days/week
Night 1-3x/week
Activity some
SABA >=2 days/week
FEV1 60-80%
ACT 16-19
OCS >= 2/year
Action Step up 1
Asthma severity Age 5-11 ✔️Ans - Sx>daily
Night>once/week but not nightly
B-agonist daily
Activity some
Lung fx FEV1 60-80% FEV1/FVC 75-80%
,Asthma Tx 5-11 ✔️Ans - Step1 SABA prn
Step2 low dose ics
Step3 low dose ics + LABA LTM or theo OR medium dose ics
Step4 medium dose ics + LABA
Step5 high dose ics + LABA
Step6 Step 5 + OCS
Medium dose ICS Age 5-11 ✔️Ans - Fluticasone 44 4-8 puffs
Beclomethasone 40 4-8 puffs
Management of asthma in hospital ✔️Ans - o2 for SaO2>=90%
SABA +-ipratopium
OCS
Mg or heliox
IV corticosteroids
Gold guidelines ✔️Ans - Group A mild/mod
FEV1 50+
mMRC 0-1
CAT<10
CCQ 0-1
Group B mod FEV1 50+
mMRC>=2 CAT>=10
CCQ>1
Group C mild/mod
FEV1 30-50% or < 30%
mMRC 0-1
CAT<10
CCQ 0-1
Group D mild/mod
FEV1 <50% mMRC>=2 CAT>=10
CCQ>1
Tx for Gold ✔️Ans - Patient Group A
SA anticholinergic
OR SABA
Patient Group B
LA anticholinergic OR LABA
Patient Group C
,ICS + LABA OR LA anticholinergic
Patient Group D
ICS + LABA &/OR LA anticholinergic
Add rofumilast as alternative for groups C& D
Cardinal SX of COPD ✔️Ans - Increased dyspnea
Increased sputum volume
Increased sputum purulence*
Anticoagulant for VTE ✔️Ans - Tx at least 3 months. Extended tx for
recurrence AND low to moderate bleeding risk 0-1
HASBLED risk assessment for bleeding ✔️Ans - Htn
Abnormal renal/liver
Stroke
Bleeding hx or predisposition
Labile INR
Elderly > 65
Drugs (antiplatelet + NSAID) etoh abuse
LOW = 0
MOD = 1
HIGH = 3
Mechanical Mitral Valve ✔️Ans - INR 2.5-3.5
Warfarin adjustment ✔️Ans - Increase or decrease cumulative weekly
dose by 5-20%
Takes 5-7 days for full effect of dose change.
No vitamin k unless INR>10 or bleeding. Oral if no bleeding.
Risk of thromboembolism and interruption of warfarin for procedures
✔️Ans - HIGH risk
Bridge with LMWH (valve replacement, recent stroke or mi)
Assess coag risk
CHA2DS2VASc ✔️Ans - CHF
HTN
, Age>75 (2 points)
Diabetes
Stroke (2 points)
Vascular Dis hx
Age>65<75
Sex categ (F=1pt)
Rivaroxaban ✔️Ans - VTE Px (tkr/thr)
10mg daily
Afib
20mg qpm
DVT/PE tx
15mg bid then 20mg daily
Apixaban ✔️Ans - DVT tx
10mg bidx7days then 5mg bid
Afib
5mg bid
(>=80,wt<=60, SCr>=1.5) 2 of these then 2.5mg bid
Neonatal meningitis ✔️Ans - 0-1 month
Group b strep, listeria, ecoli
Ampicillin/gentamicin
OR
Ampicillin/cefotaxime
Meningitis 1-3 months ✔️Ans - Neonatal plus HFlu(gram-rod), N
meningitidis, strep pneumoniae
Ampicillin/ceftriaxone
Meningitis 3 mo-12 yrs ✔️Ans - 1-3 months but no neonatal pathogens
Ceftriaxone+-Vanco
Meningitis >12 yrs ✔️Ans - N meningitidis
Strep pneumoniae
Ceftriaxone+-Vanco
