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Question 1

Low Abdominal pain male pct. with severe pain in lower abd area bilaterally. On digital rectal exam there is increase tenderness. (2 differential dx)

Answer 1

prostatitis and appendicitis

Question 2

Lower abdominal pain in McBurney’s point

Answer 2

appendicitis pathognomonic

Question 3

Uninsured 53 yr old male Pt with 4 months with diarrhea, his 2 younger brothers have had Hx of Colon Cancer. His charity Medicaid is pending. What does the NP do

Answer 3

refer for colonoscopy

Question 4

27 yr old male with diarrhea 1st test

Answer 4

Occult blood test, CBC, Ova and Parasites

Question 5

At age 20?

Answer 5

Lipid screening

Question 6

Management of hyperlipidemia [obese child with family history of cardio vascular dx

Answer 6

(1st 3 assessments = BMI, lipid profile, immunizations)

Question 7

Gout and HTN-Medication of choice

Answer 7

Losartan. NEVER Thiazides

Question 8

68 yrs old male Pt who smoked for 20 yrs and stopped 5 yrs ago with clinical signs and symptoms of COPD (management):

Answer 8

spirometry

Question 9

Tx of pharyngitis due to streptococcus

Answer 9

PENICILLIN V

Question 10

Uncomplicated UTI Dx and management

Answer 10

Bactrim 3 days

Question 11

Pneumonia

Answer 11

Tactile fremitus INCREASED

Question 12

Hematology (G6PD), Sickle cell

Answer 12

(Primary prevention is counseling)

Question 13

Woman with postmenopausal vaginal bleeding (what to do)

Answer 13

Endometrial Bx

Question 14

Woman with cervical lesion (Colposcopy, cryotheraphy, excision of tissue, determination of HPV)

Answer 14

HPV, COLPOSCOPY, Leep

Question 15

Mother go with a 13 y/o girl to the NP; mother ask why she has to administer the HPV vaccine (Use of HPV vaccine)

Answer 15

Prevents cervical cancer and Genital warts. Strains 6,11,16,18

Question 16

Which primary intervention decreases risk for herpes zoster by 66%:

Answer 16

varicella vaccine in childhood

Question 17

Metronidazole (Side effect, effect with alcohol)

Answer 17

Vomiting.

Question 18

Asthma ( stages according to spirometry) Clinical presentation and FEV1 DE 80-60%

Answer 18

PERSISTENT MODERATE

Question 19

Asthma exacerbation (tx)

Answer 19

ADD INHALED CORTICOSTEROID

Question 20

Infant (2y/o) with Bronchiolitis symptoms with family Hx of asthma (differential dx:

Answer 20

Bronchiolitis, asthma, foreign object)

Question 21

3 y/o with murmur grade IV, heard in the pulmonary area, radiated all over the precordium: Dx

Answer 21

Septal Atrial Communication

Question 22

92. woman with systolic Murmur in the apex that radiated to axilla

Answer 22

MR

Question 23

Causes of anemia in a kid of 1-2 y/o:

Answer 23

Excess of whole milk

Question 24

Complications of Kawasaki (causes):

Answer 24

vasculitis

Question 25

(25 y/o man with generalized rash in the palms and soles of the hands and generalized lymphoadenopaties)

Answer 25

Secondary Syphilis

Question 26

Acne - Inflammatory lesions

Answer 26

Topical antibiotics

Question 27

Moderate papular or when topical tx has been inadequate

Answer 27

Oral antibiotics (takes 6-8 weeks to note improvement)

Question 28

Closed comedones

Answer 28

Benzoyl peroxide often in combination with topical antibiotics

Question 29

Significant inflammation

Answer 29

Tretinoin gel (Is photosensitizing, takes 6 weeks to note improvement)

Question 30

Cystic acne that does not respond to other therapies

Answer 30

Isotretinoin (Accutane) Course of 4-6 months, then 2 months off.

Question 31

COC

Answer 31

Decreased androgen and sebum production (takes 3 months to see improvement)

Question 32

Kid with gynecomastia what to tell the parents

Answer 32

It is transitory

Question 33

14 y/o Gynecomastia and sexual retardation, small testes long neck, long arms, tall

Answer 33

Klinefelter’s

Question 34

Asymmetric development of . the breast in a girl (what to tell the parents

Answer 34

NORMAL

Question 35

Woman smoker, multiple partner, did not use seat belt what is the first advice of primary prevention you should give to this lady

Answer 35

QUIT SMOKING