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AANP EXAM > AANP EXAM NOTES 7 > Flashcards

AANP EXAM NOTES 7 Flashcards

1
Q

Lab results will reflect increased in band forms (immature WBCs) d/t increased bacterial infection. What term is used to describe this?

A

“Shift to the left”

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2
Q

This lab should be present in the greatest # in a healthy pt?

A

Total WBCs (leukocytes)

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3
Q

This lab is increased with acute bleeding?

A

Reticulocyte count

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4
Q

This psychiatric medication class has a black box warning for suicidal ideation in people < 24 years of age. Side effects include sexual dysfunction & serotonin syndrome

A

SSRIs
Ex: escitalopram (Lexapro)
sertraline (Zoloft)
paroxetine (Paxil)
citalopram (Celexa)

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5
Q

This class of psychiatric medication requires BMI/weight monitoring q 3 months

A

Atypical antipsychotics
Ex: olanzapine (zyprexa); risperidone (risperadol), & quetiapine (seroquel)

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6
Q

This psychiatric medication class requires monitoring for Steven Johnson syndrome.

A

Anticonvulsants
Ex: specifically lamotrigine (Lamicatal)
Others: Carbamazepine (Tegratol) & valproate (Depakote)

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7
Q

This psychiatric medication class can worsen acute narrow angle glaucoma

A

SNRIs
Ex: Venlafaxine (Effexor) & duloxetine (Cymbalta)

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8
Q

This hypnotic has a quick onset of 15 to 30 min

A

Zolpidem (Ambien)
Eszopiclone (Lunesta)

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9
Q

How should the following benzodiazapines be managed & why? (versed, halcion, xanax, ativan restoril, valium, librium, & klonopin)?

A

Must discontinue slowly d/t increased risk for seizures

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10
Q

This class of psychiatric medication are not to be combined with SSRIs & high tyramine or fermented foods (beer, wine, cheese, fava beans)

A

MAOIs
Ex: isocarboxazid (Marplan)
phenelzine (Nardil)
selegiline (Eldepryl, Zelapar)
tranylcypromine (Parnate)

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11
Q

This psychiatric medication class should not be combined with SSRIs or MAOIs d/t increased risk for serotonin syndrome. it is on the beers list for “SADCUB” sedation in elderly. Category x

A

TCAs
Ex: amitriptyline (Eleval) “end in ine”

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12
Q

2 examples of atypical antidepressants that are used to help pt. quit smoking. It is contraindicated in pt. with seizure disorder, anorexia, & bulimia.

A

Wellbutrin & Zyban

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13
Q

This SSRI drug can cause sexual dysfunction in both men & women & causes wt. gain more frequently

A

Paroxetine (Paxil)

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14
Q

This class of psychiatric medications may induce mania with bipolar patients & prolongs QT interval.

A

SSRIs

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15
Q

This antipsychotic medication class has a black box warning that may cause death in frail elderly

A

Typical antipsychotics
Ex: Geodon, Haldol, Seroquel, or Thorazine

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16
Q

Ranitidine (Zantac), Famotidine (Pepcid), & Nizatidine (Axid) are examples of what class GI med?

A

H2 antagonist

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17
Q

Omeprazole (Prilosec), Esomeprazole (Nexium), Lansoprazole (Pravacid), & Pantoprazole (Protonix) are examples of what class GI med that is a/w increased risk of osteoporosis?

A

PPI

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18
Q

Aluminum/magnesium/ simethicone (Mylanta, Maalox), calcium carbonate (Tumms, caltrate), & aluminum magnesium (Gaviscon) are all examples of what class GI medication?

A

Antacids

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19
Q

What potency is group/class 1 steroids?

A

Super potent

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20
Q

Hydrocortisone 0.5 to 1.5% is considered what group/level potency steroid?

A

Group/class 7

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21
Q

What is the most likely cause of elevated liver enzymes with norm BP, lipids, & normal hepatitis panel in a pt. ?

A

Daily consumption of grapefruit juice for more than 10 days

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22
Q

This potency steroid can be used on face, intertriginous areas, & genitals.

A

Group/class 7 (least potent) ex: Hydrocortisone 1%

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23
Q

This class potency steroid can be used to tx severe dermatoses (psoriasis, severe eczema) on palms and soles of feet for up to 2 weeks

A

Group/class 1 (super potent) ex: temovate, ultrabate 0.5%

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24
Q

2 herbs thought to help with insomnia

A

Chamomile tea & melatonin

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25
Q

This herb is thought to improve blood sugar & cholesterol

A

Cinnamon

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26
Q

This herb is thought to shorten the duration of the common cold/flu

A

Echinachea (Purple coneflower)

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27
Q

This herb is thought to help with migraine, irregular mesus, & tinnitus

A

Feverfew (butterbur)

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28
Q

This herb is thought to help with high cholesterol & arthritis/ joint pain

A

Fish oil/ krill oil
Omega 3 oil

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29
Q

This herb is thought to help with dementia, memory problems, tinnitus but affects blood clotting.

A

Ginko

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30
Q

This herb provides estrogen like effects

A

Isoflavones (from soybeans)

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31
Q

This herb is thought to relieve anxiety & help with insomnia, but causes elevation of LFT’s.

A

Kava Kava (valerian root)

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32
Q

This natural cream is thought to help with premenstrual & menopausal (hot flashes) symptoms

A

Progesterone cream

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33
Q

This supplement is thought to help lower triglyceride cholesterol. It requires monitoring of Liver enzymes.

A

Red yeast rice

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34
Q

This herb is thought to treat mild depression, menopausal symptoms. It may decrease the efficiency of contraceptives

A

St. John’s wart

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35
Q

This herb is thought to help with alzheimer’s dz., arthritis, & cancer

A

Turmeric

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36
Q

This medication is used to promote wt. gain in HIV/cancer pt.s., but may take up to 3 months to work.

A

Megestrol (Megace)

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37
Q

3 strategies to help older adults gain weight.

A

1) increase calories with each meal
2) increase frequency of meals
3) Consider liquid supplements

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38
Q

This dietary liquid is an inhibitor of P450 enzyme

A

Grapefruit juice

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39
Q

This type burn causes destruction of all skin elements (epithelium, SQ layer, soft tissue facia, hair follicles, sweat glands, & nerve endings. )

A

Third degree full thickness burn

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40
Q

This type burn has local pain & is erythematous without blisters

A

Superficial thickness 1st degree burn

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41
Q

This type burn impacts the epidermis layer only (redness, no blistering/ open sores, appears dry & blanches with pressure. Ex: coffee burn, sunburn

A

Superficial partial thickness burn (2nd degree)

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42
Q

This type burn impacts the epidermis & part of the dermis appear wet, weeping with blisters. Does blanch with pressure

A

Partial thickness (stage 2)

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43
Q

When should pt.’s be referred to ED for a burn?

A

For facial/electrical burns, or burns involving the cartilage of the ear

44
Q

What percent according to the rule of nines is it if chest & abd affected (anterior)

45
Q

The head & arms are considered what % according to the rule of nines?

46
Q

Each leg anterior & posterior are considered what % according to the rule of nines?

47
Q

The genitals is what % according to the rule of nines?

48
Q

This is caused by sharing needles, blood transfusion, or mother to infant transfer?

49
Q

If a pt. has a + anti HCV what does this mean? What test should be ordered?

A

They are infected with Hep C order RNA test

50
Q

What is the HCV RNA used for?

A

To confirm if a pt. has Hep C

51
Q

This is transmitted via blood, semen, or other body fluids

52
Q

The HBs AG (surface antigen) detects what?

A

Current Hep B infection

53
Q

The anti HBs Ab (surface antibody) detects what?

A

Immunity/protected/previous recovery from Hep b

54
Q

The HBc Ab (Core antibody) detects what?

A

History of past/ current infection

55
Q

This is transmitted via international travel, stool, unwashed food, or contaminated water?

56
Q

The anti HAV IgM detects what?

A

Current infection

57
Q

The anti HAV IgG detects what?

A

Immunity through past infection or vaccination

58
Q

When ALT is grossly higher than AST what should the NP suspect?

59
Q

When AST is double the ALT what should the NP suspect?

A

Acetaminophen toxicity, alcohol/drug abuse (alcoholic hepatitis)

60
Q

Cancer occurring on the bone (typically shoulders, elbows, knees, & hand) that are not well circumscribed & are fixed (not mobile) are called?

A

Osteosarcoma

61
Q

This condition typically affects ages 15 to 19. It presents as enlarged, painless cervical/axillary/groin/ supraclavicular lymphadenopathy. May have fever, unexplained wt. loss, & night sweats.

A

Hodgkin’s Lymphoma

62
Q

Unopposed estrogen therapy is the most common cause of this type of cancer.

A

Endometrial

63
Q

Women treated with unopposed estrogen therapy should receive?

A

Progesterone or progestin at least q 3 months to reduce the risk of endometrial hyperplasia & cancer

64
Q

Condition that causes bleeding, low grade fever, lymphadenopathy, non blanchable redeness (petechiae) over bil. knees/ elbows (joints) that can cause nosebleeds, bleeding gums, mid-shaft femur pain, or pain with ambulation? Peak incidence is between ages 2 & 5 years of age.

A

Acute lymphoblastic leukemia

65
Q

Treatment for women who do not want to have children or are menopausal with cervical cancer?

A

Total hysterectomy

66
Q

Treatment for women who want to have children diagnosed with cervical cancer?

A

Cervical conization
(Pronounced cone ah za shun)

67
Q

This type of cancer is seen in Ashkenazi Jewish populations? How should it be diagnosed?

A

Ovarian cancer
Transvaginal US & CA 125

68
Q

This is a type of cancer that starts on the nipple & spreads to the areola causing chronic scaly erythematous itchy rash. The nipple may be inverted, bleeding (straw colored) with the sensation of burning, tingling pain.

A

Paget’s Dz

69
Q

This type of cancer occurs when abnormal cells have not moved out of the mammary ducts into the surrounding tissue?

A

Ductal (in situ) carcinoma

70
Q

If breastfeeding mother experiences mastitis what should you instruct her to do in regards to breastfeeding?

A

Instruct her to continue nursing with both breasts

71
Q

This form of cancer is aggressive, fast growing and presents with swelling, warmth, peau d’ orange, retraction, & itching. Often no distinct mass/lump & more common in African Americans.

A

Inflammatory breast cancer

72
Q

1st line diagnostic test in pregnancy or < 30 years of age for breast cancer is?

A

ULTRASOUND!!!
(Note: 3D mammography in female/ men > 30 yrs)

73
Q

The following risk factors including age (> 50), sex, obesity, lack of physical activity, alcoholism, high dose radiation therapy to chest at young age, family h/o BRCA 1or 2 genetic mutations, low parity, early menarch (<12 yrs), late menopause (> 55yrs), & estrogen meds are seen in what condition?

A

Breast cancer

74
Q

The term for immature white blood cells produced by the bone marrow that leads to the diagnosis of leukemia?

A

Metamyelocytes

75
Q

This is a neoplastic proliferation the bone marrow that results in skeletal destruction. It is more common in older pts (> 65, African Americans) & causes pain in the long bones in the trunk & back?

A

Multiple myeloma

76
Q

How and what age range do you screen a pt. with smoking history for lung cancer?

A

Low dose CT of the chest in adults 55 to 80 years of age

77
Q

This type of cancer is associated with Lynch syndrome, familial adenomatous polyposis, & Juvenile polyposis syndrome?

A

Small bowel cancer

78
Q

This type of cancer may present with gradual pencil like/ ribbon shaped bloody/ dark tarry stool with wt. loss, N&V?

A

Colon cancer

79
Q

Cancer in this pt. may present with sensation of fullness/heaviness swelling in one scrotum that radiates to lower abdomen. Mass does not transilluminate, it is non tender (painless), cremasteric reflex is abscent, & testicle may be high riding with a transverse lie?

A

Testicular cancer

80
Q

Prostate cancer screening may begin at what age if high risk, but normally should start at what age?

A

High risk 40
Normally at 50 yrs

81
Q

This is clinically insignificant in increasing the prostate specific antigen (PSA)?

A

Digital rectal exam (DRE)

82
Q

If prostate cancer is suspected what should the NP order?

A

Transrectal US with guided needle biopsy

83
Q

What is the most specific & sensitive imaging test for bone metastases?

84
Q

Screening mammogram, annual breast MRI, & clinical breast exam q 6 to 12 months beginning 10 years prior to the age at diagnosis of the youngest family member should be done in pt.’s with?

A

BRCA 1 & 2 genes

85
Q

What does ABCD stand for in assessing cancer?

A

Asymmetry, border, color, & diameter

86
Q

This is a wart like raised cauliflower like lesion that is painless & commonly caused by HPV is known as what?

A

Condyloma Acuminata
(Pronounced acuma na ta)

87
Q

Podofilox (condylox) or Imiquimod (Aldara) is used to treat what condition?

A

Condyloma Acuminata

88
Q

How is condyloma Acuminata treated in pregnant women?

A

Mechanical methods (cryotherapy, laser, excision)

89
Q

What 2 strains of HPV are oncogenic/carcinogenic?

90
Q

This is a viral skin infection of the fingers that is extremely painful with red bumps/ blisters on the sides of the fingers caused by herpes simplex 1 or 2 that results from direct contact with a sore? how is it treated?

A

Herpetic Whitlow
Tx: acyclovir

91
Q

When should a pregnant pt be treated if h/o or recent outbreak of herpes genitals (HSV 2)?

A

Viral therapy should start at 36 weeks or near term

92
Q

How many days of coverage is required for breakouts of herpes genitals (HSV 2)? How many days for primary?

A

5 days
7 to 10 days

93
Q

How long can asymptomatic herpes shedding last?

A

2 to 4 weeks

94
Q

What test is used for herpes?

A

Viral culture, PCR assay for HSV 1&2 RNA is the diagnostic test

95
Q

This “old test “ showed multinucleated giant cells in herpes? It is also used to test for chlamydia & gonorrhea.

96
Q

How is latent syphilis (> 1yr) treated?

A

Penicillin G 2.4 units IM q week x 3

97
Q

How is primary, secondary, or early syphilis (< 1yr) treated?

A

Penicillin G 2.4 units IM x 1

98
Q

How should pt.’s with syphilis who are allergic to pcn be treated?

A

Doxycycline or tetracycline x 28 days

99
Q

What are 2 screening tests for syphilis?

A

RPR & VDRL

100
Q

If RPR or VDRL are + for syphilis what test should be ordered?

A

Fluorescent treponemal antibody absorption (FAT ABS)

101
Q

What can happen to a fetus is the mother is infected with syphilis?

A

Can be born stillborn or die as a newborn from infection

102
Q

Infants presenting at birth with skin rashes, yellowing of the skin or whites of the eyes, liver/spleen enlargement, severe anemia, developmental delay, or seizures may have been infected from what condition from the mother?

103
Q

Lesions from this condition may persist up to 6 weeks & present with lesions/ rash on the palms of the hands, soles of feet or painless genital chancre typically resolving without tx in 6 to 9 weeks.

104
Q

How is trichomonas treated?

A

Metronidazole (Flagyl) x 7 days

105
Q

This is a small flat wart like or fleshy or grey/white lesion that is painless, typically grows on hands, feet, & genitals. it is a manifestation of syphilis, this is known as what?

A

Condylomata Lata

106
Q

AST/ ALT scores > 2 are strongly suggestive of what dz?

A

Alcoholic liver diz

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