ACPNP Board Review Flashcards
List drug options that will cover a pseudomonas infection
Ceftazidime (3rd gen.), cefipime (4th)
Pipercillin/Tazobactam (Zosyn, PCN/Beta lactamase inhib)
Meropenem
Fluoroquinolones (levofloxicin, moxifloxicin, etc)
Aminoglycosides (amikacin, gentamicin)
What age should children first be able to combine words?
18 months
Erickson’s stage of Industry vs Inferiority coincides with what Piaget stage?
Concrete operations
What are the adverse effects of ginkgo biloba?
Bleeding events related to inhibition of platelet activating factor
Increased ICP
What are some adverse effects of St. John’s Wart
HA, GI disturbance, Phytophotoxic dermatitis, reduces plasma levels of protease inhibitors
Name 2 classes of medications that can be used as adjuvants to treat pain.
- Antidepressants
- Anticonvulsants
Name the 5 cranial nerves important to eating
- V Trigeminal SM
- VII Facial SM
- IX Glossopharyngeal SM
- X Vagus M
- XII Hypoglossal M
Discuss anatomy, S/S,. and Tx for an epidural bleed.
- Between inner table of skull and dura mater
- Lenticular shape- does not cross hemispheres
- Often follows middle meningeal artery tear
- Period of lucency followed by decreased LOC
- Emergent evacuation if symptomatic
Discuss anatomy, S/S,. and Tx for an subdural bleed.
- Between the dura mater and arachnoid
- May be associated with skull fx
- Often bilateral and will cross hemispheres
- Symptoms may be acute or insidious
- Surgical evacuation if symptomatic
Discuss anatomy, S/S,. and Tx for an subarachnoid bleed.
- Between arachnoid and pia mater
- Severe HA and neck pain
- Surgical evacuation if symptomatic
Describe the course, diagnosis, and tx for pertussis.
- 3 stages- catarrhal, praoxysmal, and convalescent phase
- may have co-finidings of PNA, otitis, sz, or encephalitis.
- Dx- lymphocytosis, Bordetella pertussis- a coccobacillus
- Tx- erthromycin
What is the criteria for ARDS?
- Acute onset of symptoms followinga precipitating infection or insult
- Frontal CXR with bilat infiltrates
- No clinical evidence of LA HTN
- pO2 to FiO2 ratio <200
What are radiologic findings for ashtma?
-Hyperinflation, flattened diaphragm, narrow cardiac silhouette, peribronchial thickening, subsegmental atlectasis
Describe methods to treat hyperkalemia.
- Push K into cells- albuterol, insulin/glucose, sodium bicarbonate
- Remove K- kayexalate, dialysis
- Stabilize cardiac cell membrane- calcium chloride
Describe the S/S, lab findings, and tx for nephrotic syndrome.
S/S- edema (periorbital) HTN, anorexia, abd pain/distension
Lab findings- Albumin 250, hematuria
Tx- steroids, diuretics, Na/fluid restriction, albumin
What are the clinical features of DeGeorge Syndrome?
- hypoparathyroidism
- hypoplastic thymus
- conotruncal heart defects
- cleft lip and/or palate
- flattened facies with hypertelorism and low set ears
Discuss the S/S and tx for adrenocortical insufficiency
S/S- hypoglycemia, hyponatremia, hyperkalemia, metaboic acidosis, hypotension, gastroenteritis/fever
Tx- Pre-tx labs- ACTH, plasma renin, cortisol, DHEAS, 17-OH, aldosterone. Supportive therapy and hydrocortisone
Describe the S/S, diagnostic study, and tx for Meckel’s Diverticulum.
S/S- painless rectal bleeding, bowel obstruction, abd pain
Dx- Meckel’s scan
Tx- Supportive therapy and diverticulotomy
State the lab findings for Hep B and which test notes its presence the earliest
Increased ALT, AST, GGT, PT
Decreased albumin
HBsAg- first to show
HBeAg
Which immunizations are not recommened for the severely immunosurpressed or with HIV or malignancy?
OPV, MMR, Varicella, any live vaccine
Review S/S and treatment of anti-cholinergic syndrome.
Hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter.
Treat with physostigmine.
Review S/S and treatment of cholinergic syndrome.
Diarrhea/diaphoresis, urination, miosis/fasiculations, bradycardia, bronchospasm, emesis, lacrimation, salivation.
Treat with atropine.
Describe hyphema and its treatment.
-Ruptured iris blood vessel or ciliary body resulting in blood and increased pressure in the anterior chamber.
May result in glaucoma or vision loss.
May require surgical correction.
Tx- Acetazolamide, amicar, bedrest, eye patching, elevated HOB, avoidence of valsalva maneuver.
Discuss S/S, lab findings, and tx of ITP.
Hx- under 10 yrs, recent viral infection, appears non-toxic
S/S- bruising, gum bleeding
Lab- thrombocytopenia
Tx- Usually self-limited without tx, may consider IVIG.
List electrolyte and lab abnormalities in tumor lysis syndrome
Increased potassium, phosphorus, uric acid, BUN/Cr
Decreased calcium
What is the management of acute pulmonary hyptertension?
hyperventilation, normothermia, hyperoxygenation, sedation, paralysis, nitric oxide
A fixed split S2 is commonly found in which disorder?
ASD
Describe the S/S and tx for post-pericadiotomy syndrome.
S/S- Inflammatory process that may occur up to 2 months after any cardiac surgery open or closed. Low grade fever, malaise, irritability, non-specific chest pain, GI disturbance, pericardial rub, plueral and/or cardiac effusion.
Tx- ASA, NSAIDs, Indomethacin, prednisone, effusion drainage
Mafan’s is associated with which cardiac disorders?
Dilation/dissection of ascending aorta Mitral valve prolapse Aortic regurg Tricuspid valve prolapse Dilation of main pulmonary artery
Review S/S and tx for Kawasaki’s disease.
S/S- bilateral conjunctival injection, change in oral mucosa, changes in hands or feet, polymorphic examthem, cervical lymphandenopathy, fever > 5 days, increased ESR, plts, WBC
Tx- IVIG, ASA
Describe “double-effect”
A decision that may cause both desirable and undesirable effects. Intent is key to definition.
Define sensitivity and specificity.
Sensitivity refers to the proportion of people who have positive test result and who really have the disease.
Specificity refers to people who do not have the disease and who who test results are negative.
What are the S/S of Ipecac toxicity?
Dysrrhythmia, amenorrhea, cardiomyopathy
Describe the symptoms and treatment of calcium channel blocker toxicity.
Hyperglycemia, metabolic acidosis, hypotension, bradycardia, cardiac arrest.
Tx- Monitor, ABCs, activated charcoal, calcium infusion, and glucagon
Describe the S/S and tx of iron toxicity.
Bloody diarrhea, abd pain
Tx- with deferxamine (DFO), activated charcoal WILL NOT work
