AANP EXAM NOTES 1 Flashcards
IF A PT MISSES 7AM ORAL CONTRACEPTIVE AND IT IS NOW 1PM, WHEN SHOULD THE PT TAKE HER PILL?
A.ASAP
B. TWO PILLS TOMORROW
C. DISCONTINUE TAKING PILLS
D. OMIT TODAY’S PILL AND CONTINUE TAKING AS DIRECTED STARTING TOMORROW
ASAP
WHICH OF THE FOLLOWING WILL LIKELY LEAD TO TACHYCARDIA?
A. HYPERTENSION, ANEMIA AND PERICARDITIS
B. FEVER, HYPOTENSION, ANEMIA
C. HYPOTENSION, ANEMIA, HYPOTHROIDISM
D. FEVER, HYPERTENSION, TARDICARDITIS
B. FEVER, HYPOTENSION, ANEMIA, (ALSO: SMOKING, DRINKING, CAFFEINE, ILLEGAL DRUGS)
WHAT IS ALTERNATIVE HERBAL THERAPY MEDICATION FOR MENOPAUSAL SYMPTOMS
A. CAVA CAVA
B. NATURAL PROGESTERONE CREAM
C. YAM
D. SOY BEAN
E. ISOFLAVONES
BLACK COHOSH, RED CLOVER, FLAXSEED, SAGE, ST JOHNS WORT, GINKGO BILOBA,
WHAT ARE THE CHARACTERISTICS OF GINKGO AS IT RELATES TO BLEEDING
Increases risk of bleeding
WHAT ARE THE CHARACTERISTICS OF KAVA KAVA RELATED TO ANXIETY AND INSOMNIA
Helps to regulate stress improve sleeping
WHAT ARE THE CHARACTERISTCS OF SAW PALMETTO AS IT RELATES TO BPH
It increases Blood pressure
WHAT ARE THE CHARACTERISTICS OF CINNAMON AS IT RELATES TO BLOOD SUGAR AND CHOLESTEROL
Helps to lower blood sugar & cholesterol
WHAT ARE THE CHARACTERISTICS OF ST JOHNS WART AS IT RELATES TO DEPRESSION
Improves mood
WHAT ARE THE CHARACTERISTICS OF TURMERIC AS IT RELATES TO ALHEIZEMERS, ARTHRITIS AND CANCER
Stimulate stem cells to make new brain & decrease pain
WHAT ARE THE CHARACTERISTICS OF FISH OIL OR OMEGA 3 AS IT RELATES TO HEART DZ, HIGH CHOLESTEROL, ARTHRITIS
Help decrease lipids & reduce heart disease
ELDERLY MAN OF MEDITERRANEAN DESCENT HAS A ROUTINE CBC DONE FOR PHYSICAL WITH FOLLOWING LAB RESULTS:
HGB 12.0
HCT 39%
MCV 72
TSA RESULTS SHOW 3.2
UA NEGATIVE
WHICH OF THE FOLLOWING TESTS ARE INDICATED FOR THIS PT?
A. SERUM IRON, SERUM FERRITIN, TIBC, RDW
B . SERUM VIT B12 AND FOLATE LWITH PERIPHERAL SMEAR
C. CBC WITH DIFF AND U/A
D. URING C&S
A. SERUM IRON, SERUM FERRITIN, TIBC, RDW
BACTERIAL VAGINITIS
- SIGNS & SYMPTOMS
- Diagnostic test & results
- 1st Line tx
s/s: Vaginal pain, burning, fishy odor.
Test: Whiff test, + KOH, PH>4.5, & clue cells. 1st line Tx: Metronidazole (Flagyl) 500mg BID x 7 days.
Vaginal candidal vaginitis
*Signs & Symptoms
* Diagnostic with results
*Treatment
S/s: White cheesy/curd like discharge, pruritis, swelling, & redness. Test: Wet prep shows pseudohyphae & spores. Tx: OTC Monistat or Lotrimin. Rx: Fluconazole (Diflucan) 150mg po x1 + 1 dose terconazole (Terazol 3) cream/suppository (do not Rx diflucan to pregnant women).
TRICHomoniasis
*Signs & symptoms
redness, intense itching, burning, irritation, & dysuria/frequency. Copious grey/green bubbly discharge & Strawberry cervix. Diagnostic: Mobile unicellular organism with flagella & NAAT test. RX: Metronidazole (Flagyl) 2g po x 1 dose (or 500mg BID x 7days).
WHAT BP MED CAUSES ANKLE EDEMA?
CCB
Bilateral breast bud & arolea with no separation is which TANNER stage?
Stage 2
ADOLESCENT MALE WITH C/O BREAST DEVELOPMENT. WHICH OF THE FOLLOWING IS ASSOCIATED WITH THIS CONDX? WHAT P/E? WHAT IS IMPORTANT TO DOCUMENT IN PT CHART?
A. REDUCE INTAKE OF FAT (OR SOMETHING ELSE) IN DIET
B. FREE WEIGHTS
C. MARIJUANA USE
D. COCAINE USE
Ask about marijuana use
ELDERLY MAN HAS DIFFICULTY BUTTONING SHIRT AND FORGETS THINGS. PT HAS HX OF HIGH BP AND PREVIOUS STROKE.
A. FRONTAL LOBE DEMENTIA
B. VASCULAR DEMENTIA
c. ONGOING ALHEIZEMERS
D. STEP WISE DEMENTIA
E. LEWEY BODY DEMENTIA
A. frontal lobe dimentia
CHARACTERISTICS OF MAOI CLASS OF DRUGS?
Avoid high tyramine/fermented foods (e.g., cheese, fava beans, wine). Do not combine with SSRIs.
PT HAS C/O DISCHARGE AND FOUL SMELLING DISCHARGE FROM EAR. WHAT CONDX IS THE LIKELY CAUSE?
A. CHRONIC OM
B. ACUTE OE
C. POLYPS
D.CHOLESTEOMA
Chronic OM
cholesteoma
DIABETIC PT HAS LACERATION TO FOOT . WHAT SHOULD THE NP FOCUS ON DURING EXAM?
A. ASSESS FOR DIABETIC NEUROPATHAPY
B. CHARIOTS FOOT
? ASSESS FOR DIABETIC NEUROPATHY.
BEST TOOL TO DX COGNITIVE STATUS
A. MINI COG
B. MINI MENTAL STATE EXAM
C. PAGE
D.DRAW A CLOCK
MINI COG
(CURB 65) HOSPITALIZATION CRITERIA - PT MEETS ALL CRITERIA EXCEPT?
A. New onset CONFUSION
B. 65 OR OLDER
C. BLOOD PRESSURE <90
SBP or </= 60 DBP
D. BUN > 7
E. Respiratory rate =/> 30
F. Pulse > 100
F. Pulse > 100
TX FOR UTI IN CHILDREN. WHICH ABX ? ABD ULTRA SOUND OR CT?
Bactrum 1st drug (if on test)
Cefloasporin (Keflex), amoxicillin, nitrofurantoin.
F/u in 2 days
Renal US after treating the 1st UTI [febrile, age 2 & 24 months regardless of fever)] If they 1st flunk the renal US, then a voiding cystourethrogram (VCUG) is ordered
TX FOR UTI DURING PREGNANCY
NITROFURANTOIN (MACROBID)
Examples of CYP450 INHIBITORs
Macrolides, antifungals, Lithium, & postassium sparing diuretics
QUESTION ABOUT Schizophrenia Medication
A. Haldol, clozapine, thioridazine, geodon, & seroquel may cause?
B. Other drugs used for schizophrenia include?
Haldol, clozapine, thioridazine, geodon, & seroquel may cause QT prolongation (torsade de pointes).
Latuda, Zyprexa, Risperdal & clonazipine.
Coumadin INR goal for Afib & Prosthetic heart valve?
Afib: Between 2 & 3
Prosthetic heart valve: Between 2.5 & 3.5
SYPHILIS - WHAT ARE POTENTIAL EFFECTS ON NEW BORN IF MOTHER IS SYPHILIS POSITIVE?
May cause baby to be born stillborn or die from infection as a newborn.
May have health problems (e.g., skin rashes, jaundice, enlarged liver/spleen, severe anemia, developmental delay, or seizures)
FETAL ALCOHOL SYNDROME CHARACTERISTICS.
- Small head facies (microcephaly)
- Shortened papheral fissures (narrow eyes)
- epicanthal folds & flat nasal bridge
*Thin upper lip (smooth philtrum) - Small jaw
*Underdeveloped ears
What will eye exam reveal in pt. with HTN?
AV Nicking
Narrow QRS preceded by rapid regular P waves in rapid uncoordinated atrial contraction (Sawtooth)?
Atrial Flutter
PAD - ENCOURAGE AMBULATION - THROMBOEMBOLIC HOSE - WHICH ONE DO YOU NOT USE?
KNOW QUESTIONS WITH TOTAL CHLORESTEROL/LIPID VALUES
SILDENAFIL (Viagra) - BP MEDICATION that SHOULD NOT BE USED?
A. TRANSDERMAL CATAPRESS (nitrate)
B. PROPRANLOL (BB)
No nitrates (isosorbide), alpha blockers (tamsulosin/flomax or doxazosin/cardura), ARBs, CCB, & diuretics. Avoid grapefruit juice & alcohol.
QUESTIONS ON STROKE AND/OR TIA
PT WITH RIGHT SIDE WEAKNESS AND FACIAL DROOPING, SLURRED SPEECH. HOW DO YOU TREAT PT?
A. GIVE ASPRIN AND RECEHCK BP
B. CALL 911
C. SEND TO ER
PT EXPERIENCING RIGHT SIDE WEAKNESS, FACIAL DROOPING, SLURRED SPEECH FOR 24 HOURS. WHAT CONDX IS MOST LIKELY?
A. TRIGEMINAL NEURALGIA
B. TIA
C. STROKE
QUESTION ABOUT METABOLIC SYNDROME. WHAT HTN MEDS DO YOU AVOID?
Avoid thiazide diuretics (e.g., HCTZ)
ACE or CCB are best
DERMITITIS PT WITH SKIN LESION ON NECK - Pink, DARK BLUE, BLACK, WHAT KIND OF WOUND IS IT?
A. MELANOMA
B. PSYROSIS
C. Brown recluse spider bite
Brown recluse spider bite
DERMO QUESTION - RASH X FEW DAYS AGO, NOW HAS CRUSTED EXTERIOR WITH CENTRAL CLEARING. WHAT IS CAUSE?
Early Lyme Dz: Erythema Migrans
QUESTION ABOUT WHAT RASH AND WEB FINGERS …
Scabies
QUESTION ABOUT LEISION ON A SINGLE FINGER … HERPATIC WHITLOW?
CHILD HAS C/O NODULE ON LIP AND SOMETHING ELSE … WHITE …
A. HAND, FOOT, AND MOUTH DZ
WHAT CONDX IS DESCRIBED BY A PT FACE WITH WARM RED RASH?
A. ERYFITELAS -
HIDRADENITIS SUPPURAPIVA
- TX
- SIGNS/SYMPTOMS
ADOLESCENT PT WITH ACNE WHO IS TAKING ADELAIC ACID WITHOUT IMPROVEMENT AFTER 2 WEEKS. WHAT SHOULD THE NP DO?
A. INCREASE MEDICATION
B. REFER TO DERMOTOLOGIST
C. DECREASE MILK/CHANGE DIET
D. STOP MEDICATION
ROCKY MTN SPOTTED FEVER
- SIGNS/SYMPTOMS
- TX
PT EXPOSED TO ANIMAL HIDES CONTRACTS CUTANIOUS ANTHRAX . WHAT IS TX?
A. DOXYCYCLONE, CIPRO, LEVOFLOXIN
Ciprofloxacin 500mg bid x 60 days
4 PTS WITH BMI OF 25. WHO IS MOST AT RISK FOR DM?
A. FEMALE WHO JUST HAD 9 LB BABY
B. ELDERLY WHITE MAN SEDENTARY LIFESTYLE
C. AA WHO EXERCISES EVERYDAY
D.
Risk factors:
Gestational diabetes
Sedentary lifestyle
Sibling with DM
GRAVES DZ. WHAT MEDICATIONS ARE CONTRAINDICATED.
Anti thyroid meds (propylthiouracil & methimazole/tapazole); Beta blockers
HASHIMOTO DZ AS IT RELATES TO THYROID
ADDISON’S DISEASE QUESTION
SUBCONJUNCTIVAL HEMMORAGE QUESTION.
A. ANTERIOR UVEITIS
- S/S
- TX
CORNEAL ABRASION QUESTION. PT FELT FOREIGN BODY SENSATION.
WHAT IS FIRST THING NP SHOULD DO?
A. VISUAL EXAM
B. FLUORESCEIN EXAM
C. REFER TO OPTHAMOLOGIST
QUESTION ABOUT NEW BORN WITH DISCHARGE ON EYE AND CONTINUED.
A. DACROSTENOSIS
TEENAGE PT HAD NYSTAGNAS AND SOMETHING ABOUT GAZE
A. LEISION ON CN 3 AND CN 5
B . BENIGN VERTIGO
C.
VERTIGO QUESTION
A. DIX HALLPIPE MANEUVER
LISTENING TO TESTICLE YOU HEAR BOWEL SOUNDS. WHAT IS THE MOST LIKELY CONDX?
A. HERNIA
B. VAROTEL
C. HYDROCELE
CHILD FELL OFF BIKE WITH OUTSTRETCHED ARM TO BREAK THE FALL. WHAT IS MOST LIKELY CONDX?
A. NAVICULAR (SCATHOID) FRACTURE
B. NAVICULAR FRACTURE
CHOOSE THALASSEMIA OR ANEMIA OF CHRONIC DZ FOR VARIOUS VALUES OF
FERROTIN, TIBC, RDW VALUES -AND ELECTROPHORESIS
QUESTION ABOUT TX FOR PROSTATITIS
A.
QUESTION ABOUT TX FOR MASTATITIS
THE FINKLESTEIN TEST IS USED TO DIAGNOSE WHAT CONDITION?
A. DE QUEVAINS TENDONITIS
QUESTION ABOUT NODULE FELT BETWEEN 3RD AND 4TH METATARFALS
A. MORTON NEUROMA
QUESTION ABOUT TORN MCL AND ACL ?
S/S
DX TEST
TX
QUESTIONS ABOUT BURSITIS. ELBOW AND PETELLAR (KNEE)
QUESTION ABOUT ASSESSING PT BACK PAIN WITH TAP ON HEAD, WHAT IS INDICATED?
QUESTION ABOUT CHADWICK SIGN
QUESTION ABOUT MILESTONE FOR 6 MONTH OLD INFANT
A. INFANT MORO REFLEX AND RAISING HEAD WHILE ON TUMMY
ENCOPREFIS QUESTION. DEGRESSION IN BOWEL MOVEMENT IN TODDLERS.
KAWASAKI DZ. KNOW S/S. 1ST LINE TX.
MEDICATIONS TO TREAT TREMORS.
A. PROPANOLOL
WHAT TEST IS USED TO ASSESS RISK FOR FALLS?
A. GET UP AND GO TEST FOR FALLS
USING SPIROMETER TESTING FOR OBSTRUCTIVE LUNG DZ IN RELATION TO FEV 95, BEFORE AND AFTER BRONCHO DIALATOR …
QUESTIONS ABOUT RHINITIS.
HIV QUESTION.
PT WITH C/O EXTERNAL LEISIONS TO VAGINAL AREA THAT ARE PAINLESS.
A. CONDYLOMA ACUMINATA.
ELDERLY FEMALE TAKING ANTIPSYCHOTIC MED (XANEX)
A. TAPER MEDICATION
B. STOP MED ABRUPTLY
C.
A. LATEX ALERGY
