BCACP Exam Questions With Correct Answers

BCACP Exam Questions With Correct Answers In asthma, FeNo 20 is associated with a better or worse response to corticosteroids? - answerbetter: recommended to increase ICS or add on other therapy difference in pattern of symptoms between asthma and COPD - answerasthma has variation; COPD is persistent despite treatment Intermittent Asthma (symptom freq, nightime, SABA use, FEV1) - answerless then/= 2 days/wk, less than/= 2 times per month, /= 2 days/wk, 80% Mild persistent Asthma (symptom freq, nightime, SABA use, FEV1) - answer2 days/wk, 3- 4 times/mo, 2 days/wk, 80% Mod Persistent Asthma (symptom freq, nightime, SABA use, FEV1) - answerdaily, 1x weekly, daily, 60-80% Sev Persistent Asthma (symptom freq, nightime, SABA use, FEV1) - answerthroughout day, 7x/wk, several times/day, 60% goal for frequency of needing a SABA in asthma - answer/= 2x per week in asthma, we should not use ____ alone - answerLABA therapy LABA with fastest onset - answerformoterol In COPD we should not use ___ alone - answerICS the only ICS available nebulized - answerbudesonide LAMA that cannot be used with severe milk allergy - answerumeclidinium theophylline goal trough - answer5-15; clearance decreases with age when do we consider stepping down asthma treatment? - answerwell controlled for 3 months What MDI inhalers do not need to be shaken? - answeralvesvo, QVAR, atrovent respimat education: when to prime - answerspray 1 puff if not used in 3 days; spray 3x if not used for 21 days GOLD grades 1-4 according to FEV1 - answer1: /= 80% EXAM STUDY MATERIALS July 30, 2024 11:26 AM 2: 50-79% 3: 30-49% 4: 30% COPD treatment according to pt groups A-D - answerA: 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 - answer100: little effect 300: likely effect COPD exaccerbation steroid dose - answer40 mg x 5 days 3 cardinal copd symptoms - answer1. increased dyspnea 2. increased sputum 3. increased sputum purulence when to give antibiotics in COPD - answerIf all 3 cardinal symptoms present OR increased sputum purulence + 1 other antibiotics choice and duration in COPD - answer5-10 days uncomplicated: azith, clarith, doxy, amox complicated: augmentin, levo, moxi psedomonus: high dose levo (750 mg) or cipro 5 A's of smoking cessation: ask at every visit - answerAsk Advise Assess Assist Arrange set a quit date within ______days/weeks - answer2 weeeks quit plan "STAR" - answerSet a quit date tell family/friends EXAM STUDY MATERIALS July 30, 2024 11:26 AM anticipate challenges remove tobacco Which smoking cessation agent has BBW of SI/mood changes - answervarenicline bupropion, varenicline, and NRT all _____ weight gain - answerdelay but do not prevent weight gain dosing schedule for nicotine replacement patches and when to use 21 mg vs 14 mg - answer21 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? - answerBupropion diagnosis for diabetes is made by: - answer2 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 - answerpre-diabetes: 100-125 mg/dL diabetes: /= 126 mg/dL OGTT cutoff for prediab and diabetes - answerpre-diabetes: 140-199 mg/dL diabetes: /= 200 mg/dL A1c cutoff for prediab and diab - answerpre: 5.7% - 6.4% diabetes: /= 6.5% 2 hour OGTT level cutoffs for gestational diabetes - answerfasting: 92 1 hr: 180 2 hr: 153 When is A1c goal less stringent (7.5-8%)? - answersevere hypoglycemia limited life expectancy extensive comorbid conditions uncontrolled DM despite appropriate management When is A1c goal more stringent (6-6.5%)? - answershort disease duration EXAM STUDY MATERIALS July 30, 2024 11:26 AM long life expectancy no significant CVD managed with lifestyle changes w or w/o metformin Weight loss __% is necessary to improve glycemic control - answer5% at what BMI is metabolic surgery considered? recommended? - 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? - answerdual 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? - answerif 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 - answerHeart failure: canagliflozin, dapagliflozin, empagliflozin CKD: canagliflozin and dapagliflozin Med classes used in T1DM - answerinsulin, metformin, pramlintide Med classes used in gestational diabetes - answerinsulin (usually NPH and regular) glyburide metformin Metformin (MOA, A1c reduction, fasting or post prandial, clinical pearls, weight) - answerinhibits hepatic glucose production A1c reduction 1-2% fasting plasma reduction dont use in CrCl 30 weight loss or neutral Sulfonylureas (MOA, A1c reduction, fasting or post prandial, clinical pearls, weight) - answerstimulates insulin secretion fr