BCPP Exam(2024 LATEST
UPDATE 2024)CORRECT
What is the GAD7? - ANSWER Patient self rated screener for anxiety (doesn't
measure tx response)
What are GAD7 cutoffs? - ANSWER 5= mild
10= moderate
15= severe
What is the HAM A? - ANSWER Clinician rated anxiety scale
Measures tx response
What are HAM A cutoffs? - ANSWER Mild: 0-17
Mod: 18-24
Severe: 25-30
Remission: 70% imp
Improved: 50% imp
Partial: 25-49%
Starting dose of sertraline in elderly and children? - ANSWER 12.5-25 mg
Starting dose of venlafaxine in children and elderly? - ANSWER 37.5 mg
,How should BZDs be discontinued? - ANSWER 25% reduction per week until 50%
of dose is reached, then reduce by 1/8 every 4-7 days
Therapy > 8 weeks: 2-3 weeks
Therapy > 6 months: 4-8 weeks
Therapy > 1 year: slow taper over 2-4 months
What is the DI between omeprazole and diazepam? - ANSWER Omeprazole
increases half life and concentration of diazepam
Which SGAs can be used as augmenting agents in GAD? - ANSWER Olanzapine,
quetiapine, risperidone. Quetiapine XR can be used as early as 2nd line
What are first line treatments for panic disorder - ANSWER CBT: evidence does
NOT show superiority of pharm over non-pharm
SSRI
Venlafaxine
BZD
Clomipramine, imipramine
2nd line: mirtazepine
Can consider sga augmentation or MAOI after failure of ssri, Snri, and tca
What are first line treatments for ptsd - ANSWER Trauma focused psychotherapy:
exposure based, emdr, anxiety management or cbt. Emphasized in recent
guidelines.
SSRI: paroxetine, sertraline and fluoxetine have strong evidence
, Venlafaxine
Consider alternative agents or augmentation after 3 failed trials: Tcas,
mirtazepine, phenelzine, AEDs
NO BZDs or SGAs
What is the YBOCS? - ANSWER Yale-Brown Obsessive-Compulsive scale
Clinician rated
Used for diagnosis and to assess response
How is the YBOCS interpreted? - ANSWER 0-7 sub clinical
8-15 mild
16-23 moderate
24-31 severe
32-40 very severe
Response: 25%
Remission: score <8
What is the difference between cohort and case-control studies? - ANSWER
Cohort sorts based on exposure and looks forward in time for outcomes.
Case-control classifies based on outcome and looks back in time for exposure.
Blocked random allocation - ANSWER Used to ensure that at any given point in
time, the groups will be similar or equal in size. I.e. ABBA, BAAB, ABAB
cluster randomization - ANSWER groups of patients are randomized rather than
the individual patients, I.e. entire hospitals or clinics are randomized to an
intervention
, Stratified randomization - ANSWER individuals are grouped into strata (I.e.
gender) and then randomized to one treatment group
What is the kappa statistic and what score is satisfactory.? - ANSWER quantitative
measure of inter-rater reliability (inter-rater concordance). -1 is perfect
disagreement, +1 is perfect disagreement.
Kappa >.7 is satisfactory.
Allocation bias - ANSWER Occurs when subjects or investigators can choose which
treatment group they would like. Results in groups with different characteristics
Attrition bias - ANSWER Certain participants are more likely to drop out of the
study than others, leading to a final sample that differs from the initial
channeling bias - ANSWER Occurs in observational studies. Occurs when clinicians
choose treatment according to pts diagnosis, I.e, pt at highest risk gets treatment
Classification bias - ANSWER Bias due to a misclassification (ex. measurement
error, errors in diagnosing AD in clinical trials without a PET scan)
Confounding bias - ANSWER occurs with 2 closely associated factors; the effect of
1 factor distorts or confuses the effect of the other
interviewer bias - ANSWER effects of interviewers on respondents that lead to
biased answers- I.e. placebo response
UPDATE 2024)CORRECT
What is the GAD7? - ANSWER Patient self rated screener for anxiety (doesn't
measure tx response)
What are GAD7 cutoffs? - ANSWER 5= mild
10= moderate
15= severe
What is the HAM A? - ANSWER Clinician rated anxiety scale
Measures tx response
What are HAM A cutoffs? - ANSWER Mild: 0-17
Mod: 18-24
Severe: 25-30
Remission: 70% imp
Improved: 50% imp
Partial: 25-49%
Starting dose of sertraline in elderly and children? - ANSWER 12.5-25 mg
Starting dose of venlafaxine in children and elderly? - ANSWER 37.5 mg
,How should BZDs be discontinued? - ANSWER 25% reduction per week until 50%
of dose is reached, then reduce by 1/8 every 4-7 days
Therapy > 8 weeks: 2-3 weeks
Therapy > 6 months: 4-8 weeks
Therapy > 1 year: slow taper over 2-4 months
What is the DI between omeprazole and diazepam? - ANSWER Omeprazole
increases half life and concentration of diazepam
Which SGAs can be used as augmenting agents in GAD? - ANSWER Olanzapine,
quetiapine, risperidone. Quetiapine XR can be used as early as 2nd line
What are first line treatments for panic disorder - ANSWER CBT: evidence does
NOT show superiority of pharm over non-pharm
SSRI
Venlafaxine
BZD
Clomipramine, imipramine
2nd line: mirtazepine
Can consider sga augmentation or MAOI after failure of ssri, Snri, and tca
What are first line treatments for ptsd - ANSWER Trauma focused psychotherapy:
exposure based, emdr, anxiety management or cbt. Emphasized in recent
guidelines.
SSRI: paroxetine, sertraline and fluoxetine have strong evidence
, Venlafaxine
Consider alternative agents or augmentation after 3 failed trials: Tcas,
mirtazepine, phenelzine, AEDs
NO BZDs or SGAs
What is the YBOCS? - ANSWER Yale-Brown Obsessive-Compulsive scale
Clinician rated
Used for diagnosis and to assess response
How is the YBOCS interpreted? - ANSWER 0-7 sub clinical
8-15 mild
16-23 moderate
24-31 severe
32-40 very severe
Response: 25%
Remission: score <8
What is the difference between cohort and case-control studies? - ANSWER
Cohort sorts based on exposure and looks forward in time for outcomes.
Case-control classifies based on outcome and looks back in time for exposure.
Blocked random allocation - ANSWER Used to ensure that at any given point in
time, the groups will be similar or equal in size. I.e. ABBA, BAAB, ABAB
cluster randomization - ANSWER groups of patients are randomized rather than
the individual patients, I.e. entire hospitals or clinics are randomized to an
intervention
, Stratified randomization - ANSWER individuals are grouped into strata (I.e.
gender) and then randomized to one treatment group
What is the kappa statistic and what score is satisfactory.? - ANSWER quantitative
measure of inter-rater reliability (inter-rater concordance). -1 is perfect
disagreement, +1 is perfect disagreement.
Kappa >.7 is satisfactory.
Allocation bias - ANSWER Occurs when subjects or investigators can choose which
treatment group they would like. Results in groups with different characteristics
Attrition bias - ANSWER Certain participants are more likely to drop out of the
study than others, leading to a final sample that differs from the initial
channeling bias - ANSWER Occurs in observational studies. Occurs when clinicians
choose treatment according to pts diagnosis, I.e, pt at highest risk gets treatment
Classification bias - ANSWER Bias due to a misclassification (ex. measurement
error, errors in diagnosing AD in clinical trials without a PET scan)
Confounding bias - ANSWER occurs with 2 closely associated factors; the effect of
1 factor distorts or confuses the effect of the other
interviewer bias - ANSWER effects of interviewers on respondents that lead to
biased answers- I.e. placebo response
