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AANP EXAM > AANP EXAM NOTES 6 > Flashcards

AANP EXAM NOTES 6 Flashcards

1
Q

Transient ischemic attack (TIA) is an episode of dysfuntion of what system?

A

Neurologic

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2
Q

A PT who had a TIA is at high/low risk for severe stroke in the future

A

HIGH

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3
Q

TX for TIA?

A

Refer to ED, Schedule CT/MRI within 24 hrs

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4
Q

TIA ABCD2 Score is a tool to help predict who is at high risk for subsequent stroke after a TIA within next 7 days. What is next step if PT has ABCD2 score of 3 or greater?

A

Refer to ED for hospitalization

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5
Q

What does ABCD represent for a PT with a possible TIA?

A

Age (greater than 65)
BP (140/90 or higher)
Clinical features of TIA (unilateral weakness)
Duration (> 60 mins)
Diabetes

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6
Q

72-year-old patient with a hx of coronary artery disease and hypertension reports an episode of slurred speech and right sided facial droop that started yesterday while at home. It lasted for about an hour. She denies pain or headache. What is likely cause?

A

TIA

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7
Q

An 80-year-old pt. comes with c/o ataxic gait, new onset headache & slurred speech that began 2 hours ago. What is likely Etiology?

A

Stroke/TIA

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8
Q

Name 2 risk factors of CVA (stroke)

A

A fib, prolonged immobilization.

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9
Q

Name 1 risk factor for Homorrhagic CVA

A
  1. Poorly controlled HTN
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10
Q

Name 3 s/s the describes how hemorrhagic CVA presents

A
  1. abrupt onset severe HA
  2. N&V
  3. Photophobia
  4. Nuchal rigidity
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11
Q

Intracerebral/ Sub arachnoid hemorrhage presents with sudden onset of severe “thunderclap”/ “the worst HA of my life” or “sentinel HA. T/F

A

TRUE

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12
Q

CVA has high prevalence in blacks, hispanics, american indians, and women of what age?

A

25-34

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13
Q

PTs preparing to undergo heart catheterization should/should not stop Losartan

A

Should not stop Losartan

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14
Q

Naproxen should be stopped for 24 hours prior to heart cath due to the impact on renal prostaglandin production. T/F

A

TRUE

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15
Q

The TIMI score evaluates patients for what 2 condx?

A

angina & possible MI

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16
Q

Splinter hemorrhages on nail, new onset murmur fever, chills, tender violet-colored (red to purple) nodules on fingers & toes are some symptoms presented by what bacterial condition?

A

bacterial endocarditis

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17
Q

Osler Nodes are what color?

A

purple/pink

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18
Q

What part of body do you find Osler Nodes?

A

These nodules are found on distal fingers/ toes

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19
Q

Lesions that are irregular, non-tender, erythematous macules/papules on the hands and soles are called?

A

Janeway lesions

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20
Q

What condx includes a color change in hands from white, blue, and red in a symmetric pattern.

A

Raynaud’s Phenomenon

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21
Q

What is TX for Raynaud’s Phenomenon

A

CCB (nifedipine, amlodipine)

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22
Q

Insulin resistance syndrome is AKA

A

Metabolic Syndrome, Syndrome X

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23
Q

What labs would you order for Metabolic Syndrome?

A

Labs: Fasting (9 to 12 hrs) lipid profile (esp. triglycerides & HDL), Fasting blood glucose

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24
Q

What type of HTN Medication should be avoided when treating a PT with Metabolic syndrome?

A
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25
Q

A butterfly rash is associated with what dz?

A

lupus

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26
Q

When may children with chickenpox return to school?

A

After lesions have crusted.

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27
Q

What OTC medication should be avoided in children with chickenpox? why?

A

ASPRIN - May cause Reye’s syndrome

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28
Q

What condx presents with Lip/ oral cavity symptoms that may present as painful vesicles on the soft palate & mouth

A

Herpangina

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29
Q

What condx presents with honey colored crusts, fragile bullae (that easily ruptures), pruritic.

A

Impetigo

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30
Q

What labs are drawn for PT with Impetigo?

A

C&S of crusts/wound

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31
Q

What is the TX for PT with severe case of Impetigo but NKDA?

A

Cephalexin (Keflex) QID, dicloxacillin QID x 10 days.

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32
Q

What is the TX for PT with severe case of Impetigo who has penicillin allergy?

A

Azithromycin 250mg x 5 days (Macrolide), Clindamycin x 10 days.

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33
Q

What is the TX for PT with Impetigo with few lesions and no bullae (NDKA)?

A

Topical 2% mupirocin ointment (Bactroban)

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34
Q

What acute bacterial infection is caused by Staph/Strep that ruptures easily and becomes superficial, bright red, weeping with honey crusted exudate on face, arms or legs.

A

Bullous Impetigo

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35
Q

What medication is used to treat Bullous Impetigo

A

Mupirocin

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36
Q

What highly contagious virus presents small spots with White centers (Koplik’s spots), round spots on a red base of the buccal mucosa by the rear lower molars & appears 2-3 days before onset of symptoms?

A

Measles

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37
Q

Measles is AKA

A

Rubeola

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38
Q

What infectious dz of the skin is caused by poxvirus?

A

Molluscum contagiosum

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39
Q

What infection dz of the skin presents smooth papules that arfe dome shaped with central umbiligation (belly button white plug)?

A

Molluscum contagiosum

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40
Q

What condition presents with a Christmas Tree pattern rash (on cleavage lines); Herald patch lesion appears initially

A

Pityriasis rosacea

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41
Q

Roseola typically occurs in children of what age?

A

6 mos to 3 years

42
Q

Roseola typically presents a fever lasting how long?

A

2-3 days

43
Q

Interdigital webs are associated with what skin infestation?

A

scabies

44
Q

What infectious dz presents with Sandpaper rash with sore throat (strep throat), fever.

A

Scarlet fever

45
Q

Compared to PTs with strep throat, PTs with scarlet fever are at higher risk for developing postglomerular nephritis. T/F

A

TRUE

46
Q

What is the 1st approved drug for smallpox?

A

TPOXX

47
Q

Smallpox vaccine can lessen severity if given within ….. days post exposure.

A

3

48
Q

What inflammatory condition is characterized by Multiple painful, reddened nodules on anterior surface of both legs seen in pt. with ulcerative colitis?

A

Erythema Nodosum

49
Q

What is prescribed to treat nodulocystic acne?

A

Isotretinoin

50
Q

If pt. with Nodulocystic acne has been Rx’d Isotretinoin & oral contraceptives but presents with sinus infection, who should be consulted?

A

call the dermatologist to report the BP and discuss the risk of stroke.

51
Q

What condx presents an extravasation of blood under the skin that is not present with Scarlet Fever?

A

Petechiae

52
Q

What is a Pruritic rash located on hands, flexural folds, and neck?

A

Eczema

53
Q

What can cause Urticaria?

A

Medications (e.g., Penicillin allergy rash), viral/bacterial infections, insect bites, latex allergies)

54
Q

Urticaria is AKA

A

Hives

55
Q

What is the best clue to differentiate between contact and atopic dermatitis?

A

Unilateral location and shape

56
Q

Dermatitis symptoms include a NON-Pruritic rash located on hands, flexural folds (antecubital, popliteal space), neck, cheeks, entire trunk, knees, & elbows. T/F

A

FALSE. Dermatitis symptoms include an EXTREMELY PRURITIC RASH on hands, flexural folds (antecubital, popliteal space), neck, cheeks, entire trunk, knees, & elbows.

57
Q

What is 1st line tx for dermatitis?

A

Topical steroids and emollients (hydrocortisone)

58
Q

Dermatitis may be treated with Hydrating baths (warm water) then applying skin lubricants (Eucerin, Keri Lotion, Crisco, Mineral oil) while skin is wet. T/F

A

TRUE

59
Q

What inflammatory skin reaction may present with just red skin or red skin with painful/ burning or stinging blisters. The blisters may be located anywhere, may/may not have a belt like pattern (linear).

A

Contact dermatitis

60
Q

Rashes caused by contact dermatitis may become crusted, very pruritic, & lichenified from chronic itching when they dry. T/F

A

True

61
Q

Cutaneous Lichen planus may present with purple plaques of what shape?

A

Polygonal

62
Q

Actinic Keratosis is a precancerous precursor to squamous cell carcinoma. T/F

A

TRUE

63
Q

What is the gold standard test for Actinic Keratosis?

A

Biopsy

64
Q

What is TX for actinic Keratosis?

A

Refer to dermatologist for surgery, cryotherapy, topical medications such as fluorouracil cream 5% or imiquimod.

65
Q

What condx may present soft, painless, wartlike, fleshy growths in the trunk that are located mostly on the back. They can look like they are “pasted” on the skin.

A

Seborrheic Keratosis

66
Q

The most appropriate tx for a steroid responsive condition includes: Gel, cream, ointment but NOT lotion. T/F

A

TRUE

67
Q

Autoimmune dz (Grave’s dz, Hashimoto’s thyroiditis, RA, psoriasis, pernicious anemia) are risk factors for what chronic autoimmune skin disorder?

A

Vitiligo

68
Q

Cherry Angioma presents benign small, smooth round papules that are bright cherry red. They may bleed if ruptured. T/F

A

TRUE

69
Q

What is an Inherited/ chronic skin disorder in which squamous epithelial cells undergo rapid mitotic division & abnormal maturation?

A

Psoriasis

70
Q

Methotrexate absolute contraindications includes Chronic alcohol use, acute renal failure, & breastfeeding. T/F

A

TRUE

71
Q

Symptoms of this condx may be a/w inflammatory bowel disease (IBD) or psoriatic arthritis.

A

Psoriasis

72
Q

Superficial candidiasis in the vagina presents with vaginal irritation and a non-malodorous discharge of what color.

A

White-ish

73
Q

What is the tx for superficial candidiases in the vagina?

A

Miconazole cream (Monistat)

74
Q

What condx presents an acute skin infection of the deep dermis & underlying tissue?

A

Cellulitis

75
Q

Cellulitis is caused by what bacteria?

A

Staph aureus (Gram + bacteria)

76
Q

What is a virulent strain of cellulitis?

A

MRSA

77
Q

PT in office with diffused pink colored skin that is poorly demarcated with advancing margins and warm to the touch. PT has temp, fever, chills, and c/o malaise. What is a possible diagnosis?

A

Cellulitis

78
Q

MRSA is a strain of cellulitis that presents with/without abscess?

A

WITH

79
Q

What antibiotics are used to TX MRSA?

A

Note: Vancomycin or daptomycin are the agents of choice for treatment of MRSA (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5204005/)

80
Q

Is orbital cellulitis more common in adults or younger children?

A

younger children

81
Q

What type of cellulitis is more common in younger children

A

orbital cellulitis

82
Q

What type of cellulitis involving upper dermis & superficial lymphatics is usually caused by group A Streptococcus?

A

Erysipelas

83
Q

PTs with clenched fist injury is at high/low risk for infection to joints (knuckles), fascia, nerves, & bones (osteomyelitis) esp. if punched in mouth or bitten by a human.

A

HIGH

84
Q

Pt presents to office after being in a fight. He was punched in mouth and bitten. What is next step?

A

Refer to ED for xray to r/o foreign body or fracture

85
Q

Furuncles are AKA

A

BOILS

86
Q

How are furuncles usually treated?

A

antibiotic ointment

87
Q

PT presents with painful nodules, abscesses, & pustules in groin and axilla areas. A ruptured lesion is draining
purulent green colored discharge. What is DX?

A

HIDRADENITIS SUPPURATIVA

88
Q

How is HIDRADENITIS SUPPURATIVA treated?

A

Antibiotics: Clindamycin, cholorhexidine (Hibiclens) 4% sol

Oral antibiotics: Tetracycline

89
Q

PT presents with broken hair shafts that leave a dot like pattern on scalp. What is likely Dx?

A

Tinea Capitis

90
Q

What antifungal medication considered to be the gold standard TX for tinea capitis?

A

Griseofulvin

91
Q

Tinea pedis is AKA

A

Athlete’s foot

92
Q

PT presents with itchy, scaly rash on foot. Microscopic exam shows hyphae (skin lesion that fluoresces under wood’s lamp). What is likely dx?

A

Tinea Pedis

93
Q

What is common TX for athlete’s foot?

A

antifungal cream (clotrimazole (Lotrisone), econazole (Ecoza, Spectazole) or ciclopirox (Loprox, Penlac).

94
Q

Tinea unguium, is a fungal infection of the …

A

fingernail

95
Q

Tinea unguium, is treated with

A

Terbinafine (Lamisil)

96
Q

PT presents with unguium. What should you require prior to initiation of Lamisil? Why?

A

LFT. Lamisil is an inhibitor of CYP 2D6 enzyme can lead to liver failure

97
Q

Why does FDA recommend avoiding prescribing oral ketoconazole (Nizoral) for fungal skin & nail infections?

A

May cause serious harm (liver damage)

98
Q

What fungal skin infection presents hypopigmented or hyperpigmented (reddish, brown hue) round to oval macular rash/ patch?
most lesions on upper shoulders/back

A

Tinea Versicolor

99
Q

Where do most Tinea Versicolor lesions appear on the body?

A

upper shoulders/back

100
Q

KOH test reveals “spaghetti & meatballs” hyphae & spore pattern on PT’s back. What is likely DX?

A

Tinea Versicolor

AANP EXAM (8 decks)

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