BCPS ALL FINAL ANSWERS AND QUESTIONS SET A+
✔✔Difference btwn mild and moderate persistent asthma - ✔✔Daily vs more than 2
days/wk symptoms
Saba daily vs more than 2 d/w
Fev1 60-80 vsore than 80%
✔✔Severe persist asthma symptoms - ✔✔Night awake very day, several times per day
saba use fev1 less than 60%
✔✔Inhaled steroids - ✔✔Beclomethasone
Fluticasone
Mometasone
Bude snide
Ciclesonide
✔✔Inhaled anticholinergic - ✔✔Ipratropium
Tiotropium
Aclidinium
✔✔Labas - ✔✔Salmeterol
Formeterol
Indacaterol
✔✔Adair =? - ✔✔Fluticasone, salmeterol
✔✔Symbicort=? - ✔✔Budesonide, formorterol
✔✔Dulera=? - ✔✔Mometasone, formoterol
✔✔COPD GOLD pt group B - ✔✔fev 50-80%, mMrC >/= 2, less than 1 exacerbation/yr
✔✔COPD GOLD pt group D - ✔✔fev < 30,, mMRC >=2, 2 or more exacerbations.yr
,✔✔COPD GOLD pt groups A, C - ✔✔same as B, D but with mMRC 0-1
✔✔COPD group B treatment preference - ✔✔LABA or LA anticholingeric
✔✔three cardinal symptoms in COPD exacerbations
when should abx be used - ✔✔increase dyspnea
increased sputum volume
increased sputum purulence
abx if all three, or if two AND one is sputum purulence
✔✔Best time to.check uric acid for gout - ✔✔2 weeks after flare
✔✔Indications for urate lowering therapy - ✔✔Tophus
2 or more attacks in year
Ckd stage 2 or more
Past urolithiasis
✔✔Duration of gout ppx - ✔✔Longest of:
6 MO
3 MO after urate levels achieved (less than 5)
6mo after urate levels achieved in pt with tophi
✔✔First line xoi - ✔✔Initial: Allopurinol (max dose 800mg/dose; can use >300mg/dose
in CKD)
Added: Probenecid (1st line)
Losartan (2nd line)
Febuxostat (2nd line)
✔✔Prop treatment options for gout - ✔✔Low dose Colchicine
Low dose nsaids w/ppi if necessary
Oral corticosteroids (use if above two is CI or cant use)
Topical Ice (adjunctive therapy prn)
*Tx should start within 24 hours (Colchicine start < 36 hrs)
✔✔Prop treatment options for gout - ✔✔Low dose Colchicine
Low dose nsaids w/ppi if necessary
Oral corticosteroids (use if above two is CI or cant use)
Topical Ice (adjunctive therapy prn)
*Tx should start within 24 hours (Colchicine start < 36 hrs)
, ✔✔Meningococcal vaccine indicated for? - ✔✔College students thru age 21
No revac
✔✔Tdap indicated - ✔✔All adults
Each pregnancy
Give regardless of years since td or tdap
✔✔Zoster indicated - ✔✔Zostavax (live/attenuated) Age 60
Shingrix (recombinant) age ≥ 50
✔✔Early pneumococcal vaccine indicated - ✔✔Lung disease, smokers, other chronic
conditions
✔✔Egg free flu vaccine - ✔✔Riv 13 reserve for pts with anaphylaxis
Hives can have all but not live attenuated
✔✔Pcv indicated - ✔✔At age 65 13 then 23 in 6-12 MO
If had 23 previously after age 65 then 13 1 yr after 23
✔✔effects on lamotrigine by VPA, phenytoin - ✔✔VPA increases levels, pheny reduces
✔✔meds notorious for causing edema - ✔✔CCB
gabapentin, pregabalin
Pioglitazone (Actos), rosiglitazone (Avandia)
NSAIDS,
OC-Estrogen
(***PCN G_O***)
✔✔duration of treatmnet, preferred treatment of prostatitis - ✔✔8-12 weeks, bactrim
✔✔meds that should be avoided in pt with seizure disorder - ✔✔meperidine, tramadol,
bupriopion
✔✔detecting a difference that doesn't actually exist = type x error - ✔✔type 1
(1 = worse = 1st badness)
✔✔NOT detecting a difference that does exist = type x error - ✔✔type 2
✔✔clopidogrel metabolism pathway - ✔✔CYP2D19 - prodrug
✔✔types of clinical trials by decreasing strength of evidence - ✔✔RCT, cohort, case
controlled studies, case reports (cases at the end together)
✔✔Difference btwn mild and moderate persistent asthma - ✔✔Daily vs more than 2
days/wk symptoms
Saba daily vs more than 2 d/w
Fev1 60-80 vsore than 80%
✔✔Severe persist asthma symptoms - ✔✔Night awake very day, several times per day
saba use fev1 less than 60%
✔✔Inhaled steroids - ✔✔Beclomethasone
Fluticasone
Mometasone
Bude snide
Ciclesonide
✔✔Inhaled anticholinergic - ✔✔Ipratropium
Tiotropium
Aclidinium
✔✔Labas - ✔✔Salmeterol
Formeterol
Indacaterol
✔✔Adair =? - ✔✔Fluticasone, salmeterol
✔✔Symbicort=? - ✔✔Budesonide, formorterol
✔✔Dulera=? - ✔✔Mometasone, formoterol
✔✔COPD GOLD pt group B - ✔✔fev 50-80%, mMrC >/= 2, less than 1 exacerbation/yr
✔✔COPD GOLD pt group D - ✔✔fev < 30,, mMRC >=2, 2 or more exacerbations.yr
,✔✔COPD GOLD pt groups A, C - ✔✔same as B, D but with mMRC 0-1
✔✔COPD group B treatment preference - ✔✔LABA or LA anticholingeric
✔✔three cardinal symptoms in COPD exacerbations
when should abx be used - ✔✔increase dyspnea
increased sputum volume
increased sputum purulence
abx if all three, or if two AND one is sputum purulence
✔✔Best time to.check uric acid for gout - ✔✔2 weeks after flare
✔✔Indications for urate lowering therapy - ✔✔Tophus
2 or more attacks in year
Ckd stage 2 or more
Past urolithiasis
✔✔Duration of gout ppx - ✔✔Longest of:
6 MO
3 MO after urate levels achieved (less than 5)
6mo after urate levels achieved in pt with tophi
✔✔First line xoi - ✔✔Initial: Allopurinol (max dose 800mg/dose; can use >300mg/dose
in CKD)
Added: Probenecid (1st line)
Losartan (2nd line)
Febuxostat (2nd line)
✔✔Prop treatment options for gout - ✔✔Low dose Colchicine
Low dose nsaids w/ppi if necessary
Oral corticosteroids (use if above two is CI or cant use)
Topical Ice (adjunctive therapy prn)
*Tx should start within 24 hours (Colchicine start < 36 hrs)
✔✔Prop treatment options for gout - ✔✔Low dose Colchicine
Low dose nsaids w/ppi if necessary
Oral corticosteroids (use if above two is CI or cant use)
Topical Ice (adjunctive therapy prn)
*Tx should start within 24 hours (Colchicine start < 36 hrs)
, ✔✔Meningococcal vaccine indicated for? - ✔✔College students thru age 21
No revac
✔✔Tdap indicated - ✔✔All adults
Each pregnancy
Give regardless of years since td or tdap
✔✔Zoster indicated - ✔✔Zostavax (live/attenuated) Age 60
Shingrix (recombinant) age ≥ 50
✔✔Early pneumococcal vaccine indicated - ✔✔Lung disease, smokers, other chronic
conditions
✔✔Egg free flu vaccine - ✔✔Riv 13 reserve for pts with anaphylaxis
Hives can have all but not live attenuated
✔✔Pcv indicated - ✔✔At age 65 13 then 23 in 6-12 MO
If had 23 previously after age 65 then 13 1 yr after 23
✔✔effects on lamotrigine by VPA, phenytoin - ✔✔VPA increases levels, pheny reduces
✔✔meds notorious for causing edema - ✔✔CCB
gabapentin, pregabalin
Pioglitazone (Actos), rosiglitazone (Avandia)
NSAIDS,
OC-Estrogen
(***PCN G_O***)
✔✔duration of treatmnet, preferred treatment of prostatitis - ✔✔8-12 weeks, bactrim
✔✔meds that should be avoided in pt with seizure disorder - ✔✔meperidine, tramadol,
bupriopion
✔✔detecting a difference that doesn't actually exist = type x error - ✔✔type 1
(1 = worse = 1st badness)
✔✔NOT detecting a difference that does exist = type x error - ✔✔type 2
✔✔clopidogrel metabolism pathway - ✔✔CYP2D19 - prodrug
✔✔types of clinical trials by decreasing strength of evidence - ✔✔RCT, cohort, case
controlled studies, case reports (cases at the end together)
