BCPS Exam 2024/2025 Questions and Answers (Graded
A)
Drugs that can cause hyponatremia - ANSWER thiazide diuretics,
carbamazepine/oxcarbazepine, SSRI's, TCAs
hypokalemia/hyperkalemia effect on ECG - ANSWER Hypokalemia: flattened T
waves, elevated U wave
Hyperkalemia: Narrowed T waves, widened QRS
Overfeeding complications - ANSWER hepatic steatosis, hypercapnia (resp
acidosis), hyperglycemia, azotemia
Calorie goals - ANSWER 25-35 kcal /kg for normal weight
11-14 kcal/kg for obese
*intentional underfeeding (60-70% kcal goal) of critically ill patients while keeping
protein 90-100% showed a mortality benefit
Protein goals - ANSWER 0.8-1 g/kg/da for maintenance
1.5 g/kg/day for stressed patients
2.5 g/kg/day for CRRT
2-2.5 g/kg IBW/day for obese patients
3 g/kg/day in burn patients
MAP formula - ANSWER [SBP+(2DBP)]/3
Effects of TTM (therapeutic hypothermia) - ANSWER reduced drug clearance,
bleeding, increased water excretion, bradycardia, hyperglycemia, hyokalemia,
hypomagnesemia, hypophosphatemia
Starting rate and max rate of propofol - ANSWER Starting rate: 5 mcg/kg/minute
Max rate: 80 mcg/kg/minute
*above this can cause PRIS
Starting rate and max rate of Precedex - ANSWER Starting rate: 0.2 mcg/kg/hour
Max rate: 1.5 mcg/kg/hour
BP goal in ICH - ANSWER <140
Drugs used in ICH - ANSWER aminocaproic acid 4-5 g load followed by 1g/hour
nimodipine 60 mg q4h x 21 days in SAH for vasospasm
Normal NADIR after chemo - ANSWER 10-14 days recovering at 3-4 weeks
*mitomycin, decitabine, azacitidine, bleomycin, vincristine, carmustine have delayed
NADIR 28-42 days recovering at 6-8 weeks
, Chemos that should be adjusted for renal function - ANSWER methotrexate, carbo,
cisplatin, etoposide, bleomycin, topotecan, capecitabine, lenalidomide
Chemos that should be adjusted for hepatic function - ANSWER anthracyclines,
vinca alkaloids, taxanes, methotrexate
CURB-65 - ANSWER 1) Confusion
2) BUN>19
3) RR>30
4) BP<90/60
5) 65yo
One or less indicates patient can be treated outpatient, >1 =hospitalization
MRSA risk factors - ANSWER prior respiratory MRSA
hospitalization/parenteral abx given in last 90 days
When are 2 antipseudomonals indicated in pneumonia - ANSWER VAP: risk factors
for MDR organisms= IV abx in past 90 days, hospitalization of 5 days or more, septic
shock, ARDS, acute renal replacement therapy before VAP
HAP: IV abx in the past 90 days, high risk of mortality including being on a ventilator.
pseudomonas risk factors - ANSWER IV abx within last 90 days??
Brand: Seropehen
Generic: clomiphene - ANSWER first line for infertility, used in PCOS for fertility
improvement
Risks/adverse effects of estrogen - ANSWER endometrial cancer (when unopposed
estrogen)
embolic complications (stroke, DVT)
breast tenderness
*deficiency in regimen=breakthrough bleeding early in cycle
**high dose higher than 35 mcg, very low dose less than 10 mcg
FRAX score when to treat - ANSWER Z score -1 to -2.5 with:
-10 year hip FRAX OF 3%
-10 year major fracture FRAX 20%
Risks/adverse effects of progestins - ANSWER androgenic adverse effects ,
depression, weight gain
*deficiency in regimen=breakthrough bleeding late in cycle
drospirenone - ANSWER progestin best for antiandrogenic effects, but acts like
spironolactone so watch for K
mirabegron MOA - ANSWER beta-3 agonists-relaxes detrusor and helps uring
storing (contracting detrusor muscle causes urination)
alpha antagonists for urinary incontinence - ANSWER non-specific: terazosin,
doxazosin, prazosin
A)
Drugs that can cause hyponatremia - ANSWER thiazide diuretics,
carbamazepine/oxcarbazepine, SSRI's, TCAs
hypokalemia/hyperkalemia effect on ECG - ANSWER Hypokalemia: flattened T
waves, elevated U wave
Hyperkalemia: Narrowed T waves, widened QRS
Overfeeding complications - ANSWER hepatic steatosis, hypercapnia (resp
acidosis), hyperglycemia, azotemia
Calorie goals - ANSWER 25-35 kcal /kg for normal weight
11-14 kcal/kg for obese
*intentional underfeeding (60-70% kcal goal) of critically ill patients while keeping
protein 90-100% showed a mortality benefit
Protein goals - ANSWER 0.8-1 g/kg/da for maintenance
1.5 g/kg/day for stressed patients
2.5 g/kg/day for CRRT
2-2.5 g/kg IBW/day for obese patients
3 g/kg/day in burn patients
MAP formula - ANSWER [SBP+(2DBP)]/3
Effects of TTM (therapeutic hypothermia) - ANSWER reduced drug clearance,
bleeding, increased water excretion, bradycardia, hyperglycemia, hyokalemia,
hypomagnesemia, hypophosphatemia
Starting rate and max rate of propofol - ANSWER Starting rate: 5 mcg/kg/minute
Max rate: 80 mcg/kg/minute
*above this can cause PRIS
Starting rate and max rate of Precedex - ANSWER Starting rate: 0.2 mcg/kg/hour
Max rate: 1.5 mcg/kg/hour
BP goal in ICH - ANSWER <140
Drugs used in ICH - ANSWER aminocaproic acid 4-5 g load followed by 1g/hour
nimodipine 60 mg q4h x 21 days in SAH for vasospasm
Normal NADIR after chemo - ANSWER 10-14 days recovering at 3-4 weeks
*mitomycin, decitabine, azacitidine, bleomycin, vincristine, carmustine have delayed
NADIR 28-42 days recovering at 6-8 weeks
, Chemos that should be adjusted for renal function - ANSWER methotrexate, carbo,
cisplatin, etoposide, bleomycin, topotecan, capecitabine, lenalidomide
Chemos that should be adjusted for hepatic function - ANSWER anthracyclines,
vinca alkaloids, taxanes, methotrexate
CURB-65 - ANSWER 1) Confusion
2) BUN>19
3) RR>30
4) BP<90/60
5) 65yo
One or less indicates patient can be treated outpatient, >1 =hospitalization
MRSA risk factors - ANSWER prior respiratory MRSA
hospitalization/parenteral abx given in last 90 days
When are 2 antipseudomonals indicated in pneumonia - ANSWER VAP: risk factors
for MDR organisms= IV abx in past 90 days, hospitalization of 5 days or more, septic
shock, ARDS, acute renal replacement therapy before VAP
HAP: IV abx in the past 90 days, high risk of mortality including being on a ventilator.
pseudomonas risk factors - ANSWER IV abx within last 90 days??
Brand: Seropehen
Generic: clomiphene - ANSWER first line for infertility, used in PCOS for fertility
improvement
Risks/adverse effects of estrogen - ANSWER endometrial cancer (when unopposed
estrogen)
embolic complications (stroke, DVT)
breast tenderness
*deficiency in regimen=breakthrough bleeding early in cycle
**high dose higher than 35 mcg, very low dose less than 10 mcg
FRAX score when to treat - ANSWER Z score -1 to -2.5 with:
-10 year hip FRAX OF 3%
-10 year major fracture FRAX 20%
Risks/adverse effects of progestins - ANSWER androgenic adverse effects ,
depression, weight gain
*deficiency in regimen=breakthrough bleeding late in cycle
drospirenone - ANSWER progestin best for antiandrogenic effects, but acts like
spironolactone so watch for K
mirabegron MOA - ANSWER beta-3 agonists-relaxes detrusor and helps uring
storing (contracting detrusor muscle causes urination)
alpha antagonists for urinary incontinence - ANSWER non-specific: terazosin,
doxazosin, prazosin
