I didn't quite follow your question, but if you can setup one the way you want, Right Click > Set As Default.
It sounds like you have a more complex question tho; however, between ctrl-drag to copy a Qlead and alt-drag to shift the Qlead with locked leaders, and grouping (ctrl-G) to move sets of markups (you can adjust individual grouped items while holding alt), I feel like you should be able to get a good work flow going. Bluebeam has a lot of little sub-features that can sometimes get you right where you needed, but there are a lot of them to know...