BCACP EXAM QUESTIONS WITH
100% VERIFIED ANSWERS
What GLP-1 are dosed once weekly? - ANSWER- exanatide LAR
(bydureon)
dulaglutide (trulicity)
semaglutide (ozempic)
GLP 1 BBW for throid c-cell tumors are associated with what 3 meds? - CORRECT
ANSWER- liraglutide, dulaglutide, exenatide LAR
alpha glucosidease inhibitors (MOA, A1c reduction, fasting or post prandial, clinical
pearls, weight) - ANSWER- delay and reduce postmeal carb absorption
0.5-1%
postprandial
no hypoglycemia but poor GI side effects
dont use in GFR<30
weight neutral
acarbose (precose), miglitol (glyset)
Bile acid sequesterant (MOA, A1c reduction, fasting or post prandial, clinical pearls,
weight) - ANSWER- decreased hepatic glucose production
0.4-0.6%
FPG reduction
reduces LDL, cannot use in TG >500 or bowel obstruction, no hypoglycemia, can
increase tolerance to metformin, high pill burden
colesevelam (Welchol)
Dopamine receptor agonists (MOA, A1c reduction, fasting or post prandial, clinical
pearls, weight) - ANSWER- unknown
0.4-0.6%
FPG reduction (minimal)
cardiovascular benefit
bromocriptine (cycloset)
,Amylin analog (MOA, A1c reduction, fasting or post prandial, clinical pearls, weight)
- ANSWER- inhibits glucagon secretion and reduces gastric emptying and
increases satiety 0.5-0.7% postprandial
3x daily injection, significant hypoglycemia
weight LOSS
pramlintide (symlin)
Initial dosing of basal insulin in T2DM - ANSWER- 0.1-0.2 unit/kg/day as
basal
titrate to FPG minimum of 80 mg/dL
Initial dosing of insulin in T1DM - ANSWER- 0.5 unit/kg/day
50% as basal, 50% as bolus (split into 3 meal doses)
Correctional insulin dosing: rapid acting - ANSWER- rule of 1800:
1800 / current total daily insulin dose = mg/dL change per 1 unit of insulin
ie: 40 units per day: 1800/40 = 45 mg/dL
correctional insulin dosing: regular insulin - ANSWER- Rule of 1500:
1500/total daily insulin dose = mg/dL change per 1 unit of insulin
ie: 50 units per day: 1500/50 = 30 mg/dL
Insulin to carb ratio calulation - ANSWER- Rule of 500:
500/daily insulin dose = insulin/carb ratio
ie: 50 units per day: 500/50 = 10 g of carbs = 1 unit of insulin needed
When is insulin used 1st line in T2DM? - ANSWER- when A1c is >9% or BG
measurement in >250 mg/dL with symptoms of hyperglycemia
hypoglycemia alert value and clinically significant cut off - ANSWER- Alert =
<70 mg/dL
clinical significance = <54 mg/dL
hypoglycemia treatment - ANSWER- 15 g of rapid acting carbs asap, repeat
in 15 min if reading is still <70 mg/dL
,if unconscience, give glucagon and call 911
DKA is more common in T_DM
HHS is more common in T_DM - ANSWER- DKA --> Type 1
HHS --> Type 2
Annual diabetes monitoring needed - ANSWER- foot exams
SCr/albumin ratio
peripheral neuropathy
BP should be assessed at EVERY VISIT
How often do you measure lipids if on lipid lowering therapy?
How often do you measure lipids if <40 yrs with diabetes? - ANSWER- At least anually
At diagnosis and then min of every 5 years
Pts with ASCVD and Diabetes should receive a ____ intensity statin - CORRECT
ANSWER- High intensity
Pts 40-75 yrs with diabetes and no ASCVD should receive a ____ intensity statin -
ANSWER- moderate
Pts <40 yrs with ASCVD risk should receive a ___ intensity statin - CORRECT
ANSWER- moderate
Aspirin is or is not recommended in pts with DM and at increased CV risk (ie: >50 yrs +
CVD, HTN, smoking, dyslipidemia, albumineria) - ANSWER- IS
recommended
Is regular or NPH shorter acting? - ANSWER- rapid < regular < NPH < long
acting
How do you convert intermediate insulin (NPH) to long acting? - ANSWER-
use 80% of original NPH dose
PPIs should be administered when? (related to meals) - ANSWER- 30-60
min before
Triple therapy for H. pylori and duration - ANSWER- PPI + clarithromycin +
amoxicillin (or metronidazole)
Treat for 10-14 days
preferred in pts with no macrolide exposure
, Quadruple therapy for H. pylori and duration - ANSWER- PPI+ bismuth
subsalycilate + metronidazole + tetracycline x 10-14 days
preferred in pts with previous macrolide exposure
PUD prevention (related to NSAIDS) - ANSWER- USe PPI or double dose
H2RAor misoprostol
replace NSAID with a COX-2 inhibitor (celecoxib)
Ascites treatment: first line - ANSWER- reduction in dietary sodium (2000
mg/day)
Ascites oral diuretic therapy: ratio - ANSWER- 40 mg furosemide: 100 mg
spironolactone
MAX: 160 mg furosemide: 400 mg spironolactone
can sub amiloride for spironolactone if needed
treatment for spontaneous bacterial peritonitis - ANSWER- bectrim DS daily
alternative: cipro or norfloxacin
First and second line treatment and dosing for hepatic encephalitis - ANSWER- 1.
lactulose 45 mL every 1-2 hrs until 2 loose stools. then titrate to 3 loose stools daily.
2. rifaximin 550 mg BID
Treatment for gastroesophageal varices - ANSWER- Non-selective beta
blockers
1. Propranolol 20 mg BID
2. Nadolol 40 mg QD
ALL patients receive secondary prophylaxis
AVOID long acting nitrates
Hep A treatment - ANSWER- Supportive therapy
avoid hepatotoxic insults (alcohol, meds)
Hep B treatment - compensated cirrhosis and no-cirrhosis - ANSWER-
tenofovir and entecavir preferred in cirrhosis
Interferon subQ once weekly in pt with no cirrhosis x 48 weeks
When to treat and what to use for Hep B post exposure prophylaxis - CORRECT
ANSWER- HBIG 0.06 mL/kg
100% VERIFIED ANSWERS
What GLP-1 are dosed once weekly? - ANSWER- exanatide LAR
(bydureon)
dulaglutide (trulicity)
semaglutide (ozempic)
GLP 1 BBW for throid c-cell tumors are associated with what 3 meds? - CORRECT
ANSWER- liraglutide, dulaglutide, exenatide LAR
alpha glucosidease inhibitors (MOA, A1c reduction, fasting or post prandial, clinical
pearls, weight) - ANSWER- delay and reduce postmeal carb absorption
0.5-1%
postprandial
no hypoglycemia but poor GI side effects
dont use in GFR<30
weight neutral
acarbose (precose), miglitol (glyset)
Bile acid sequesterant (MOA, A1c reduction, fasting or post prandial, clinical pearls,
weight) - ANSWER- decreased hepatic glucose production
0.4-0.6%
FPG reduction
reduces LDL, cannot use in TG >500 or bowel obstruction, no hypoglycemia, can
increase tolerance to metformin, high pill burden
colesevelam (Welchol)
Dopamine receptor agonists (MOA, A1c reduction, fasting or post prandial, clinical
pearls, weight) - ANSWER- unknown
0.4-0.6%
FPG reduction (minimal)
cardiovascular benefit
bromocriptine (cycloset)
,Amylin analog (MOA, A1c reduction, fasting or post prandial, clinical pearls, weight)
- ANSWER- inhibits glucagon secretion and reduces gastric emptying and
increases satiety 0.5-0.7% postprandial
3x daily injection, significant hypoglycemia
weight LOSS
pramlintide (symlin)
Initial dosing of basal insulin in T2DM - ANSWER- 0.1-0.2 unit/kg/day as
basal
titrate to FPG minimum of 80 mg/dL
Initial dosing of insulin in T1DM - ANSWER- 0.5 unit/kg/day
50% as basal, 50% as bolus (split into 3 meal doses)
Correctional insulin dosing: rapid acting - ANSWER- rule of 1800:
1800 / current total daily insulin dose = mg/dL change per 1 unit of insulin
ie: 40 units per day: 1800/40 = 45 mg/dL
correctional insulin dosing: regular insulin - ANSWER- Rule of 1500:
1500/total daily insulin dose = mg/dL change per 1 unit of insulin
ie: 50 units per day: 1500/50 = 30 mg/dL
Insulin to carb ratio calulation - ANSWER- Rule of 500:
500/daily insulin dose = insulin/carb ratio
ie: 50 units per day: 500/50 = 10 g of carbs = 1 unit of insulin needed
When is insulin used 1st line in T2DM? - ANSWER- when A1c is >9% or BG
measurement in >250 mg/dL with symptoms of hyperglycemia
hypoglycemia alert value and clinically significant cut off - ANSWER- Alert =
<70 mg/dL
clinical significance = <54 mg/dL
hypoglycemia treatment - ANSWER- 15 g of rapid acting carbs asap, repeat
in 15 min if reading is still <70 mg/dL
,if unconscience, give glucagon and call 911
DKA is more common in T_DM
HHS is more common in T_DM - ANSWER- DKA --> Type 1
HHS --> Type 2
Annual diabetes monitoring needed - ANSWER- foot exams
SCr/albumin ratio
peripheral neuropathy
BP should be assessed at EVERY VISIT
How often do you measure lipids if on lipid lowering therapy?
How often do you measure lipids if <40 yrs with diabetes? - ANSWER- At least anually
At diagnosis and then min of every 5 years
Pts with ASCVD and Diabetes should receive a ____ intensity statin - CORRECT
ANSWER- High intensity
Pts 40-75 yrs with diabetes and no ASCVD should receive a ____ intensity statin -
ANSWER- moderate
Pts <40 yrs with ASCVD risk should receive a ___ intensity statin - CORRECT
ANSWER- moderate
Aspirin is or is not recommended in pts with DM and at increased CV risk (ie: >50 yrs +
CVD, HTN, smoking, dyslipidemia, albumineria) - ANSWER- IS
recommended
Is regular or NPH shorter acting? - ANSWER- rapid < regular < NPH < long
acting
How do you convert intermediate insulin (NPH) to long acting? - ANSWER-
use 80% of original NPH dose
PPIs should be administered when? (related to meals) - ANSWER- 30-60
min before
Triple therapy for H. pylori and duration - ANSWER- PPI + clarithromycin +
amoxicillin (or metronidazole)
Treat for 10-14 days
preferred in pts with no macrolide exposure
, Quadruple therapy for H. pylori and duration - ANSWER- PPI+ bismuth
subsalycilate + metronidazole + tetracycline x 10-14 days
preferred in pts with previous macrolide exposure
PUD prevention (related to NSAIDS) - ANSWER- USe PPI or double dose
H2RAor misoprostol
replace NSAID with a COX-2 inhibitor (celecoxib)
Ascites treatment: first line - ANSWER- reduction in dietary sodium (2000
mg/day)
Ascites oral diuretic therapy: ratio - ANSWER- 40 mg furosemide: 100 mg
spironolactone
MAX: 160 mg furosemide: 400 mg spironolactone
can sub amiloride for spironolactone if needed
treatment for spontaneous bacterial peritonitis - ANSWER- bectrim DS daily
alternative: cipro or norfloxacin
First and second line treatment and dosing for hepatic encephalitis - ANSWER- 1.
lactulose 45 mL every 1-2 hrs until 2 loose stools. then titrate to 3 loose stools daily.
2. rifaximin 550 mg BID
Treatment for gastroesophageal varices - ANSWER- Non-selective beta
blockers
1. Propranolol 20 mg BID
2. Nadolol 40 mg QD
ALL patients receive secondary prophylaxis
AVOID long acting nitrates
Hep A treatment - ANSWER- Supportive therapy
avoid hepatotoxic insults (alcohol, meds)
Hep B treatment - compensated cirrhosis and no-cirrhosis - ANSWER-
tenofovir and entecavir preferred in cirrhosis
Interferon subQ once weekly in pt with no cirrhosis x 48 weeks
When to treat and what to use for Hep B post exposure prophylaxis - CORRECT
ANSWER- HBIG 0.06 mL/kg
