BCPS 2024 – Questions With Correct Solutions
Components of CHADsVASc score ✔️Ans - C: congestive HF (+1)
H: hypertension (+1)
A: age > 75 (+2)
D: DM (+1)
S: stroke/TIA/thromboembolism (+2)
V: vascular disease (+1)
A: age 65-74 (+1)
S: sex = female (+1)
Components of HAS-BLED score ✔️Ans - H: hypertension - SBP > 160 (+1)
A: abnormal liver/renal function (+1 for either)
S: stroke hx (+1)
B: bleeding predisposition (+1)
L: labile INR (+1)
E: elderly > 65 (+1)
D: drug/alcohol use - blood thinners (+1), alc > 8 drinks/week (+1)
When to use apixaban 2.5 mg BID? ✔️Ans - 2/3 Criteria:
1. age 80 or older
2. weight 60 kg or less
3. SCr 1.5 or greater
When to dose reduce rivaroxaban and edoxaban for renal function? ✔️Ans
- CrCl < 50
Rivaroxaban to 15 mg daily and edoxaban to 30 mg daily
When to dose reduce dabigatran for renal function? ✔️Ans - CrCl < 30 to
74 mg BID
Protamine is a reversal agent for: ✔️Ans - Heparin
Off label: LMWH
Andexanet alfa is a reversal agent for: ✔️Ans - Factor Xa inhibitors
(apixaban & rivaroxaban)
,Idarucizumab (Praxbind) is the reversal agent for: ✔️Ans - Dabigatran
INR goal for mechanical mitral valve ✔️Ans - 2.5-3.5
Duration of treatment with aspirin for patients with bioprosthetic surgical
aortic or mitral valves ✔️Ans - indefinitely
Duration of treatment with DAPT for patients with bare metal stent ✔️Ans
- at least 1 month
Duration of treatment with warfarin for patients with bioprosthetic
surgical aortic or mitral valves ✔️Ans - at least 3 months
Duration of treatment with DAPT for patients with a drug-eluting stent
✔️Ans - at least 1 year
Risk factors for developing VTE ✔️Ans - Age > or = 40
Surgery
Trauma
Hypercoagulable states
Central venous catheterization
Estrogen use or selective estrogen receptor modulators
Erythropoiesis-stimulating agents
Previous VTE
Cancer & treatments
Immobility or lower-extremity paresis
Various medical conditions/disease states
Smoking
Obesity
VTE treatment strategies ✔️Ans - Bridging -- Injectable + warfarin w/ at
least 5 days overlap or until INR > 2
Switching -- Injectable x 5 days then start edoxaban or dabigatran
Monotherapy -- apixaban or rivaroxaban at high dose then lower
maintenance
Dabigatran dosing for VTE treatment ✔️Ans - 150 mg BID after 5-10 days
of injectable
, Rivaroxaban dosing for VTE treatment ✔️Ans - 15 mg BID w/ food x 21
days then 20 mg daily w/ food
after 6 months, may be reduced to 10 mg daily
Apixaban dosing for VTE treatment ✔️Ans - 10 mg BID for 7 days then 5
mg BID
after 6 months, may be reduced to 2.5 mg BID
Edoxaban dosing for VTE treatment ✔️Ans - 60 mg daily after 5-10 days
of injectable
Duration of VTE treatment ✔️Ans - 3 months
How to dose protamine ✔️Ans - 1 mg for every 100 units of UFH given in
the past 3 hours, not to exceed 50mg
Hierarchy of clinical study design ✔️Ans - 1. Systematic reviews/meta-
analysis
2. RCT
3. Cohort
4. Case-control
5. Cross-sectional
6. Case series/case reports
7. Ideas, opinions, reviews
internal validity ✔️Ans - the degree to which the outcome can be
explained by differences in assigned groups
Factors affecting internal validity ✔️Ans - poor design
inadequate randomization
lack of or inappropriate blinding
imprecise/inaccurate measurement or inappropriate stat method
incomplete or selective outcome reporting
external validity ✔️Ans - the degree to which the findings can be
generalized or extrapolated to a population beyond the study
Components of CHADsVASc score ✔️Ans - C: congestive HF (+1)
H: hypertension (+1)
A: age > 75 (+2)
D: DM (+1)
S: stroke/TIA/thromboembolism (+2)
V: vascular disease (+1)
A: age 65-74 (+1)
S: sex = female (+1)
Components of HAS-BLED score ✔️Ans - H: hypertension - SBP > 160 (+1)
A: abnormal liver/renal function (+1 for either)
S: stroke hx (+1)
B: bleeding predisposition (+1)
L: labile INR (+1)
E: elderly > 65 (+1)
D: drug/alcohol use - blood thinners (+1), alc > 8 drinks/week (+1)
When to use apixaban 2.5 mg BID? ✔️Ans - 2/3 Criteria:
1. age 80 or older
2. weight 60 kg or less
3. SCr 1.5 or greater
When to dose reduce rivaroxaban and edoxaban for renal function? ✔️Ans
- CrCl < 50
Rivaroxaban to 15 mg daily and edoxaban to 30 mg daily
When to dose reduce dabigatran for renal function? ✔️Ans - CrCl < 30 to
74 mg BID
Protamine is a reversal agent for: ✔️Ans - Heparin
Off label: LMWH
Andexanet alfa is a reversal agent for: ✔️Ans - Factor Xa inhibitors
(apixaban & rivaroxaban)
,Idarucizumab (Praxbind) is the reversal agent for: ✔️Ans - Dabigatran
INR goal for mechanical mitral valve ✔️Ans - 2.5-3.5
Duration of treatment with aspirin for patients with bioprosthetic surgical
aortic or mitral valves ✔️Ans - indefinitely
Duration of treatment with DAPT for patients with bare metal stent ✔️Ans
- at least 1 month
Duration of treatment with warfarin for patients with bioprosthetic
surgical aortic or mitral valves ✔️Ans - at least 3 months
Duration of treatment with DAPT for patients with a drug-eluting stent
✔️Ans - at least 1 year
Risk factors for developing VTE ✔️Ans - Age > or = 40
Surgery
Trauma
Hypercoagulable states
Central venous catheterization
Estrogen use or selective estrogen receptor modulators
Erythropoiesis-stimulating agents
Previous VTE
Cancer & treatments
Immobility or lower-extremity paresis
Various medical conditions/disease states
Smoking
Obesity
VTE treatment strategies ✔️Ans - Bridging -- Injectable + warfarin w/ at
least 5 days overlap or until INR > 2
Switching -- Injectable x 5 days then start edoxaban or dabigatran
Monotherapy -- apixaban or rivaroxaban at high dose then lower
maintenance
Dabigatran dosing for VTE treatment ✔️Ans - 150 mg BID after 5-10 days
of injectable
, Rivaroxaban dosing for VTE treatment ✔️Ans - 15 mg BID w/ food x 21
days then 20 mg daily w/ food
after 6 months, may be reduced to 10 mg daily
Apixaban dosing for VTE treatment ✔️Ans - 10 mg BID for 7 days then 5
mg BID
after 6 months, may be reduced to 2.5 mg BID
Edoxaban dosing for VTE treatment ✔️Ans - 60 mg daily after 5-10 days
of injectable
Duration of VTE treatment ✔️Ans - 3 months
How to dose protamine ✔️Ans - 1 mg for every 100 units of UFH given in
the past 3 hours, not to exceed 50mg
Hierarchy of clinical study design ✔️Ans - 1. Systematic reviews/meta-
analysis
2. RCT
3. Cohort
4. Case-control
5. Cross-sectional
6. Case series/case reports
7. Ideas, opinions, reviews
internal validity ✔️Ans - the degree to which the outcome can be
explained by differences in assigned groups
Factors affecting internal validity ✔️Ans - poor design
inadequate randomization
lack of or inappropriate blinding
imprecise/inaccurate measurement or inappropriate stat method
incomplete or selective outcome reporting
external validity ✔️Ans - the degree to which the findings can be
generalized or extrapolated to a population beyond the study
