BCACP REVIEW UPDATED EXAM QUESTIONS WITH 10% VERIFIED ANSWERS

BCACP REVIEW UPDATED EXAM QUESTIONS WITH 10% VERIFIED ANSWERS Who is included in per protocol analysis? - ANSWER- Only those who followed the protocol Who is included in as-treated analysis? - ANSWER- All patients randomized according to the therapy they actually received What is the formula for power? - ANSWER- 1-B(eta) What is a Type 1 error? AKA alpha error - ANSWER- Really no difference, but study shows difference What is a Type II error? AKA beta error - ANSWER- Really is a difference, but study shows no difference What type of data is the mean preferred? - ANSWER- continuous data What type of data is the median preferred? - ANSWER- Ordinal data What is nominal data? - ANSWER- Named categories with no rank/order What is oridinal data? - ANSWER- Categories with rank/order What type of statistical tests are preferred for nominal data? - ANSWER- Chi squared, fishers exact, McNemar (paired samples) What is minimum number of subjects for Chi Squared test? - ANSWER- 40 What type of statistical tests are preferred for ordinal data? - ANSWER- Mann Whitney U, Wilcoxon rank sum, Wilcoxon signed rank (paired samples) What type of statistical tests are preferred for continuous data? - ANSWER- Mann Whitney U (median), Student t-test (2 groups mean), paired t-test (paired data), ANOVA (if 3+ groups), Cox proportional hazard Should you stop beta-blockers when patient presents to inpatient for HF exacerbation? - ANSWER- NO (exceptions: cardiogenic shock, refractory volume overload, and symptomatic bradycardia) What is minimum intervals between beta blocker titration in HF? - ANSWER- 2 weeks What is the goal digoxin dose in HF? (in units of ng/mL) - ANSWER- 0.5-0.8 or 0.9 What is IV:PO equivalents for loop diretics? - ANSWER- bumetanide 1:1, torsemide 1:1, furosemide 1:2 What are equivalent dose of PO loop diuretics? - ANSWER- bumetanide 1 mg = torsemide 20 mg = furosemide 40 mg What are typical doses of digoxin used in HF? - ANSWER- 125-250 mcg/day What acronym should be explained to patients on s/s of heart failure? - ANSWER- FACES= fatigue, activities limited, congestion, edema, shortness of breath Which medications commonly used in HF have mortality data? - ANSWER- ACE-I (or ARB if not taking ACE-I), beta blocker, aldosterone antagonist (hydralazine + isosorbide dinitrate in African Americans) What was the name of the study that showed mortality benefits with aldosterone antagonists? - ANSWER- EMPHASIS-HF What are prerequisites for using aldosterone antagonists in HF? - ANSWER- NYHA class II-IV, LVEF 35%, SCr 2.5 (men) or 2 (women) or eGFR 30, and K 5 What are the goal doses of beta blockers used in HF? - ANSWER- bisoprolol 10 mg daily, carvedilol 25 mg BID if 85 kg or 50 mg BID if 85 kg, metoprolol succinate 200 mg daily In heart failure, when should you stop an aldosterone antagonist? Based on K - ANSWER- Once K is 6, (but can just) decrease dose by 50% if K 5-5.5 What is the target dose of ace-inhibitors in HF for captopril? - ANSWER- 50 mg TID What is the target dose of ace-inhibitors in HF for enalapril? - ANSWER- 10 mg BID What is the target dose of ace-inhibitors in HF for fosinopril? - ANSWER- 40 mg daily What is the target dose of ace-inhibitors in HF for lisinopril? - ANSWER- 20 mg daily What is the target dose of ace-inhibitors in HF for quinapril? - ANSWER- 20 mg BID What is the target dose of ace-inhibitors in HF for ramipril? - ANSWER- 10 mg daily For HFrEF, Class I-IV, what meds should be added first? - ANSWER- ACE-I (or ARB) and Beta Blocker When should Loop diuretics be added to 1st line therapies of HFrEF? - ANSWER- NYHA Class II - IV if volume overload When should aldosterone antagonists be added to 1st line therapies of HFrEF? - ANSWER- NHYA class II - IV (given they meet minumum requirements for K, SCr, etc) When sohuld hydralazine + isosorbide dinitrated by added to 1st line therapies of HFrEF? - ANSWER- If African american, persistently symptomatic, and NYHA Class IIIIV (or if they cannot tolerate ACE-I aldosterone antagonist) What is goal HR for ivabradine? - ANSWER- 50-60 bpm What is minumum HR to start ivabradine in HF? - ANSWER- 70 bpm Which second generation antipsychotics have the highest metabolic risks? - ANSWER- clozapine and olanzapine What is the drug of choice for treatment refractory schizophrenia? - ANSWER- clozapine For patients on atypical antipsychotics, what should be monitored at baseline? - ANSWER- PMH/FH, weight (BMI), waist circumference, BP, fasting BG (or A1C), lipids For patients on atypical antipsychotics, what should be monitored at 4 weeks? - ANSWER- weight For patients on atypical antipsychotics, what should be monitored at 8 weeks? - ANSWER- weight