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FNP: Systems Review > Adult/Gero > Flashcards

Adult/Gero Flashcards

1
Q

Treatment for Acne Roscea

A

Metronidazole gel

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2
Q

Pernicious Anemia, Vitamin B-12 deficiency, Folic Acid deficiency, Liver disease, Hypothyroidsim, & Reticulocytosis are all considered as

A

Macrocytic Anemia (MCV > 100fL)

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3
Q

What is the cornerstone pharmacological therapy for COPD?

A

Anticholinergics (Ipratropium/Atrovent, Tiotropium/Spiriva) & L.A.B.A (Salmeterol, Formoterol, & Bambuterol)

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4
Q

Iron deficiency anemia, Lead Poisoning/Toxicity, Sideroblastic Anemia, & Thalassemia (Alpha & Beta) all are considered as

A

Microcytic Anemia (MCV

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5
Q

Treatment recommendation for Mild COPD include

A
  • Reduction of risk factors (i.e smoking cessation),
  • Get flu and PNA vaccines
  • Add S.A bronchodilators/(Levabulterol[Xopenex], Proventil [ProAir], Ipratropium [Atrovent])
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6
Q

Treatment recommendation for Moderate COPD include

A
  • Short acting bronchodilators, plus…
  • Add one or more long acting bronchodilators (long acting beta agonists/salmeterol, formoterol or long acting anticholinergic/tiotropium [Spiriva])
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7
Q

What are the most common forms of COPD?

A

Emphysema and Chronic Bronchitis

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8
Q

Hemolytic Anemia, Bone Marrow disorders, Hyperspleenism, Acute Blood loss, & Anemia of Chronic disease, are all considered as

A

Normocytic Anemia (MCV 80 - 100)

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9
Q

Treatment for Very Severe COPD

A

Along with short acting, long acting bronchodilators, and inhaled corticosteroids…

  • Add long term oxygen
  • Possible surgical treatments
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10
Q

A systolic B/P of 140-159, and diastolic BP of 90-99 is consider as:

A

Stage I Hypertension

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11
Q

Treatment recommendation for Severe COPD include

A

Along with short acting & long acting bronchodilators, add Inhaled steroids/glucocorticoids

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12
Q
  • A hemoglobin A1C > 6.5%
  • A random glucose or 2 hour plasma glucose > 200mg/dL
  • A fasting glucose > 126 mg/dL
  • The above mentioned are all criteria to diagnose…
A

Diabetes

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13
Q

Heberden’s nodes and Bouchard nodes are found in this disease

A

Osteoarthritis/Degenerative Joint Disease

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14
Q

A progressive “ASYMETRIC” degeneration of the articular/hyaline cartilage layer on the ends of bones at the joints. Can be monoarticular or polyarticular

A

Osteoarthritis

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15
Q

Symptoms of osteoarthritis include:

A
  • Pain or stiffness of one or more joints

* Pain is most prevalent upon arising and after prolonged activity and RELIEVED BY REST

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16
Q

Stage II Hypertension is diagnosed when:

A
  • A systolic BP is > 160 or, …

* A diastolic BP > 100

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17
Q

Treatment for Stage II Hypertension

A

“Dual Therapy”, usually with a thiazide diuretic, and a CCB, ACE-I, or ARB. (ACE-I & ARB cannot be a combo therapy)

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18
Q

A normal TSH level is _______

A

1 to 4

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19
Q

A normal Free T4 is ______

A

10 to 27

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20
Q

s1/Systole, which is the “lub” sound, is considered the closure of what valves

A

Mitral and triscupid valves (Atrioventricular valves = 3 leaflets)

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21
Q

s2/Diastole, which is the “dub” sound, is considered the closure of what valves

A

Aortic and Pulmonic valves (Semilunar valves = 2 leaflets)

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22
Q

An audible s3 sound is suggestive of ________

A

Congestive Heart Failure (CHF)

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23
Q

This heart sound is made due to a stiffness of the left ventricle, usually indicating Left Ventricular Hypertrophy (LVH)

A

s4

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24
Q

A holosystolic or pansystolic murmur, best heard at the apex, and can possibly radiate to the axillae, is suggestive of _______

A

Mitral Regurgitation

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25
Q

A midsystolic murmur heard at the 2nd intercostal space, on the right side of the sternum, that can radiate to the neck is suggestive of _____

A

Aortic Stenosis

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26
Q

The “GOLD STANDARD” for diagnosing Hashimoto’s thyroiditis is _______

A

ELEVATED antimicrosomal antibodies

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27
Q

An elevated TSH, with a low free T4 is the classic lab finding for ______

A

Hypothyroidsim

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28
Q

The “GOLD STANDARD” radiography for injuries of the menisci, cartilage, tendons, ligaments, and joints is _____

A

MRI

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29
Q
  • Fracture of the distal radius (with or without ulnar fracture) of the forearm, along with displacement of the wrist is what type of fracture?
  • Dinner Fork Fracture
A

Colles Fracture

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30
Q

Colles fractures are associated with a history of what?

A

Forward falling with outstretched hands

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31
Q

The most common area of Colles fracture is ________

A

Wrist

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32
Q

An acute or sudden onset of “TEARING” severe low back/abdominal pain. Presents with abdominal bruit with abdominal pulsation. What is this indicative of?

A

Dissecting Aortic Anyeurysm

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33
Q

A diagnostic sign for a “torn or ruptured” ligament (AL or PCL). It is a test for “knee instability”. What is this test?

A

Drawer Test

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34
Q

Which orthopedic maneuver produces a “click” sound and knee pain, when performed?

A

McMurray’s test (suggest a medial meniscus injury)

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35
Q

The “Lachman’s” test screens for _______

A

Knee instability (more sensitive than Drawer test) suggests ACL damage.

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36
Q

Inflammation of the digital nerve of the foot, between the 3rd & 4th metatarsal (toe) is known as?

A

Morton Neuroma

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37
Q

Morton’s neuroma risk is increased by what?

A

Wearing high-heeled shoes, tight shoes, being obese, being a runner or dancer

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38
Q

This test is done by grasping the 1st and 5th toe, then squeezing the forefoot. It screens for Morton’s Neuroma

A

Mulder’s test

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39
Q

De’Quervain’s screen is considered “positive” when what happens?

A

Their is pain and tenderness at the wrist (on the thumb side)

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40
Q

The “Finklestein” test is a screening for what?

A

De’Quervain’s tenosynovitis (an inflammation of the tendon and its sheath, located at the base of the thumb).

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41
Q

Which is known to have longer joint stiffness, degenerative joint disease (osteoarthritis) or rheumatoid arthritis?

A

Rheumatoid Arthritis

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42
Q

A type of bursitis located behind the knee is called

A

Baker’s Cyst

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43
Q

Prolonged and painful erection of the penis (greater than 2 to 4 hours)

A

Priapism

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44
Q
  • Risk factors for priapism include?
A
  • Sickle cell
  • Cocaine users
  • High dose erectile dysfunction medication
  • Quadriplegics
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45
Q

What effect does mitral regurgitation have on cardiac output

A

It can “DECREASE” cardiac output

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46
Q

Symptoms of “decreased” cardiac output includes?

A

Dypsnea on exertion, chest pain, orthopnea, syncope, and near syncope

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47
Q

This goal is to: Achieve normal or near normal lung function, and prevent symptoms. Controlling inflammatory process reduces airway remodeling

A

Asthma goal

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48
Q

One of the main causes of Mitral Stenosis is ______

A

Rheumatic infection (a “streptococcal infection”)

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49
Q

Which nerve is affected by the “fibular” bone

A

Peroneal nerve

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50
Q

Mean corpuscular volume (MCV) range

A

80-100 fL

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51
Q

Mean Corpuscular Hemoglobin Concentration (MCHC) range is

A

33-36 g/dL

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52
Q

Population who are at increased risk for Tuberculosis include (8 populations)

A
  1. Foreign born people
  2. Minorities
  3. Prisoners
  4. Nursing Home residents
  5. Indigents
  6. Healthcare Providers
  7. Migrant workders
  8. People with blood disorders or prolong steroid therapy use.
    * Any population that is OVERCROWDED*
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53
Q

The nurse practitioner role was initially established to (3 things)

A
  1. Improve access to care and partially solve physician shortage.
  2. Provide accessible primary care services
  3. Illness prevention and health promotion
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54
Q

Standards of practice are

A

Authoritative statements used to measure quality

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55
Q

The knowledge base of the APRN is based on

A

Scientific content and theory

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56
Q

Indications for starting a person with diabetes on oral hypoglycemics include

A

Failure to control hyperglycemia with diet in a client with diabetes type 2

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57
Q

The goal of COPD is to:

A

Reduce the disease progression, reduce the symptoms and exacerbation, and improve exercise tolerance and quality of life

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58
Q

This insulin’s onset is 15-20 minutes, and peaks at 30 minutes to 2 hours.

A

Immediate (Lispro or Aspart)

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59
Q

This insulin’s onset is 30 minutes to 1 hour, and peaks at 2 to 3 hours.

A

Regular (Humulin R or Novolin R)

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60
Q
  • HBsAg (negative)
  • Anti-HBc (negative)
  • Anti-HBs (negative)
    What do these lab results mean?
A

Susceptible to Hepatitis B

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61
Q

This insulin’s onset is “UNKNOWN” (maybe 1 to 2 hours), and HAS NO PEAK

A

Long Acting (Lantus or Levemir)

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62
Q

They increase the release of insulin, increase the levels of incretin

A

Dipeptidyl peptidase-4 (DDP-4) Januvia

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63
Q

Metformin is contraindicated for which patient population

A

Reduced Kidney Function/Kidney Failure

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64
Q

They delay intestinal carbohydrate absorption by reducing post prandial digestion of starches

A

Alpha-Glucosidase inhibitors (Precose)

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65
Q

They increase peripheral insulin sensitivity and reduces insulin resistance, stimulates insulin production, slows gastric emptying. Used as an appetite suppressant for weight loss.

A

Incretin Mimetic (Byetta)

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66
Q

Hemoglobin A1c gives an indication of glucose control over the past?

A

60 to 90 days (Usually 3 months, but never less than 2 months)

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67
Q

Rheumatoid arthritis is often associated with

A

Systemic symptoms

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68
Q

Principle of therapy in rheumatoid arthritis include

A

Early treatment with disease-modifying therapy to minimize joint damage

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69
Q

The most common “METABOLIC” bone disease in the U.S. is

A

Osteoporosis

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70
Q

They decrease glucose production in the liver, decrease intestinal glucose absorption & they are insulin sensitizers (increase insulin action)

A

Biguanides [METFORMIN]….1st Line Recommended therapy for diagnosis of Type II Diabetes

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71
Q

Post-traumatic Stress Disorder is marked by which triad of findings?

A

Intrusive thoughts, nightmares, flashbacks

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72
Q

The diagnostic Xray for Osteoarthritis will show what?

A

Joint space narrowings

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73
Q

In diabetics, at what BP should pharmacological treatment begin

A

140/80

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74
Q

What is the preferred pharmacological therapy for patients with confirmed hypertension and DIABETES?

A
  • Ace-Inhibitors (Kidney protection)
  • Angiotensin Receptors Blockers (ARBs)
  • Beta-Blocker (Kidney protection)
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75
Q

For diabetics, what are the targets goal levels of a lipid profile

A
  • LDL 40-45 (Men) > 50-55 (Women)

* Triglyceride

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76
Q

How often should a fasting lipid profile be done in person with diabetes

A
  • Annually

* For patients with levels at or under goal, every 2 years if fine

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77
Q

This insulin’s onset is 1 to 2 hours, and peaks at 6 to 14 hours

A

NPH (Humulin N or Novolin N)

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78
Q

Diabetics with increased risk for CVD, should be placed on what, as a primary prevention

A
  • Aspirin (ASA) 75mg – 162mg per day

* For ASA allergy: clopidegrel (Plavix) 75mg

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79
Q

When should a Type I diabetic have an eye exam by the ophthalmologist or optometrist

A

Within 5 years of onset

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80
Q

When should a Type II diabetic have an eye exam by the ophthalmologist or optometrist

A

Shortly after the diagnosis of Type II diabetes

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81
Q

In diabetics, when should a foot examination be done

A

Annually

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82
Q

Signs and Symptoms of “Hypothyroidism” include

A 
Dry skin
Flat Mood or Affect
Slowed/Retard mentation
Cold Sensitivity
Fatigue
Voice Hoarseness/Changes
Muscle cramps
Constipation
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83
Q

When should hypothyroidism be treated

A

TSH above 10mIU/L
When a goiter is present
TSH above 5mIU/L in the present of antibodies

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84
Q

Medications that can cause Hypothyroidism

A

Post-radioactive iodine
Lithium
Amiodarone

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85
Q

The overproduction or excess release of thyroid hormone is known as

A

Hyperthyroidism

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86
Q

The most common cause of hyperthyroidism is

A

Grave’s Disease

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87
Q

Medications that can cause Hyperthyroidism include

A

Amiodarone

Interferon

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88
Q

Hyperthyroidsim signs and symptoms include

A 
Tachycardia
Heat sensitivity
Racing thoughts
Loose stools
Insomnia
Smooth Skin
Hyperreflexia
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89
Q

Treatment of hyperthyroidism includes

A

Beta-Blockers (propranolol)
Anti-thyroid meds (propylthiouracil/PTU, methimazole/Tapazole)
Radioiodine therapy
Possible Ablation

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90
Q

An autoimmune disease that over stimulates the thyroid.
A hyperthyroid state
Hyperfunction of the thyroid

A

Grave’s Disease

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91
Q

Patient with high risk of Grave’s Disease includes

A

Rheumatoid Arthritis (RA)
Pernicious Anemia
Osteoarthritis

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92
Q

It is the movement of gastric contents from the stomach to the esophagus or beyond, into the oral cavity or lungs.
The most common disease of Gastroenterology

A

G.E.R.D

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93
Q

Treatment of Giant Cell Arteritis includes

A

Corticosteroids

Get to E/R immediately

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94
Q

Common Signs and Symptoms of G.E.R.D include

A 
Heartburn
Chest Pain
Wheezing
Post-prandial fullness
Hoarseness
Regurgitation
Chronic Cough (especially at night)
Post nasal drip
Bloating & Belching
Dyspepsia
Epigastric Pain
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95
Q

1st line treatment for G.E.R.D includes

A 
Lifestyle modifications which include:
Weight loss
Smoking cessation
↓ caffeine, spicy foods, ETOH, chocolate
Limit NSAID use
H.O.B on 4-6 inch blocks
Do not lie down for 2-4 hours after a meal
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96
Q

2nd line treatment for G.E.R.D include

A

Antacids ( for immediate symptoms relief)
H2 receptor blockers (Zantac, Tagamet)
PPI (Prilosec, Protonix = superior at suppressing post prandial acid surges)

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97
Q

Considered as an emergency of the abdomen

A

Appendicitis

98
Q

Signs and Symptoms of Appendicitis

A

Abrupt onset
RLQ pain that moves toward umbilicus
Fever /Chills

99
Q
  • NON-Infectious epididymitis is common in which group of men?
A
  • Men Who Sit for Long Periods of Time*
  • Truck Drivers
  • Also men who do “Heavy” lifting and vigorous abdominal workouts.
100
Q

Usually systemic
Joint inflammation, redness, & warmth
Swan deformity of the hand

A

Rheumatoid Arthritis

101
Q

Treatment for Rheumatoid

A

Early intervention/prevention is necessary
Corticosteroids
Disease Modifying agents (Humera)

102
Q

A temporal pain
It is unilateral
It is considered an EMERGENCY OF THE EYE

A

GIANT CELL ARTERITIS

103
Q

1st line treatment for Uncomplicated Chlamydia includes

A

Azythromycin 1gm p.o or,

Doxycycline 100mg p.o B.I.D x 7 days

104
Q

1st line treatment for Uncomplicated Genital/Rectal Gonorrhea includes

A

Dual Therapy: Ceftriaxone 200mg I.M + Azithromycin 1gm p.o or Doxycycline 100mg p.o B.I.D x 7 days

105
Q

1st line treatment for Acute Migraine

A

N.S.A.I.Ds

106
Q

Prophylactic Migraine medications includes

A

Beta-Blockers (propranolol, metoprolol, nadolol) & triptylines (Amitriptyline & Nortriptyline

107
Q

The goal of this level of prevention is “Preventing the health problem, and the most cost effective form of healthcare

A

Primary Prevention

108
Q

The goal of this level of prevention is “Minimizing negative disease induced outcomes

A

Tertiary Prevention

109
Q

The goal of this level of prevention is “Detecting disease in early, asymptomatic, or preclinical state to minimize its impact

A

Secondary Prevention

110
Q

This type of immunity is: Resistance developed in response to an antigen (infecting agent or vaccine) and usually characterized by the presence of an antibody produced by the host.

A

Active Immunity

111
Q

This type of immunity is conferred by an antibody produced in another host, acquired naturally by an infant from mother, or artificially by administration an antibody-containing preparation (antiserum or immune globulin [IgG])

A

Passive Immunity

112
Q

Major Coronary Heart Disease risk factors include

A 
Elevated LDL
Cigarette Smoking
Hypertension
Low HDL
Family History of premature CHD (1st degree relative)
Age (Men > 45 years; Women > 55 years)
113
Q

Coronary Heart Disease risk equivalents include

A 
Clinical CHD
Diabetes
Symptomatic Carotid Artery Disease
Peripheral Artery Disease
Abdominal Aortic Aneurysm
114
Q

Primary cause of hyper/dyslipidemia is

A

Familial genetic defect

115
Q

Secondary causes of hyper/dyslipidemia include

A

Excessive intake of saturated fats, trans fat, & cholesterol (Check Lipid Panel)
Diabetes (Check glucose)
Hypothyroidism (Check TSH, T3 & T4)
Chronic Kidney Disease (Check CMP)
Alcohol overuse (Check CMP)
Primary biliary cirrhosis (Check CMP, liver profile)
Meds (Thiazides, Beta-Blockers, HAARTs)

116
Q

Which class of medications is frequently used to improve long-term outcomes in patients with systolic dysfunction?

A

ACE-Inhibitors

117
Q

When starting a patient on an ACE-I, what is most important to monitor

A

Potassium Level = ACE-I can impair renal excretion of potassium with normal kidney function, and can increase the risk of hyperkalemia in patients with impaired renal function.

118
Q

The most common form of skin cancer

A

Basal Cell Carcinoma

119
Q

What treatment is effective in inflammatory and non-inflammatory acne

A

Topical Retinoids

120
Q

What treatment is effective in moderate to severe acne

A

Oral Antibiotics

121
Q

Skin lesion which has a solid “elevated” mass up to 1.0cm

122
Q

What pharmacological treatment is effective in nodulocystic acne

A

Isotretinoin (Accutane)

123
Q

1st line pharmacological treatment for Group “A” Strept Pharyngitis

A

PCN 500mg B.I.D or T.I.D x 10 days

124
Q

Pharmacological treatment for Group “A” Strep, with a penicillin allergy

A

Clarithromycin 250mg B.I.D x 10 days or Erythromycin

125
Q

Pharmacological treatment for uncomplicated UTIs caused by “Gram Positive” bacteria (E.Coli or Staph Saprophyticus)

A

Nitrofurantoin 50mg to 100mg Q.I.D

126
Q

Pharmacological treatment for uncomplicated community-acquired cystitis is

A

Bactrim (Trimethoprim/Sulfamethoxazole) 160/800mg B.I.D x 3 days

127
Q

An alternative pharmacological for TMP/SMZ for UTIs is

A

Fluroquinolones (‘floxacin’ drugs) ciprofloxacin, ofloxacin, levofloxacin)

128
Q

Most common bacteria in Otitis Externa

A

Pseudomonas

129
Q

1st line pharmacological treatment for Otitis Externa

A

Topical “flouroqulinolones”. ciprofloxacin with dexamethasone (Ciprodex)

130
Q

1st line pharmacological treatment for Otitis Media

A

Amoxicillin 80-90mg/kg per day

131
Q

Pharmacological treatment for Otitis Media, with penicillin allergy

A

Cephalosporin drugs (Cefdinir, Cefuroxime, Cefpodoxime)

132
Q
  • They are intended to provide accountability to professional and help protect the public from unethical behavior.
  • They are established to regulated and control practice.
A

Standards of Practice

133
Q

Who certifies nurse practitioner?

A

Nurse Practitioner certifying body

134
Q

The authority to practice as a nurse practitioner is determined by

A

State Legislatures

135
Q

The legal right to select (as from a stock) and/or label a medication to be self-administered by a patient/client. Can be done by a Registered Nurse, Nurse Practitioner, Physician Assistant, or M.D

A

Dispensing

136
Q

A ‘cohort study’ normally ask the question of____

A

“What WILL happen?”. Cohort studies describes a study that is prospective in nature

137
Q

A ‘case control study’ normally ask the question of ___

A

“What happened?”. Case Control studies describe a study that is retrospective in nature.

138
Q

Members of a study who have a “specific disease (i.e HTN. D.M, H.I.V)” or “specific condition of interest (i.e disease free, “, or who are receiving a “specific treatment”

A

Studied Subjects

139
Q

A duty, a breach of duty, and subsequent “injury” due to the breach of duty, is known as

A

Malpractice

140
Q
  • Failing to exercise the care that reasonable person would exercise.
  • Injury DOES NOT have to occur
A

Negligence

141
Q

This occurs when medication intended for a person, ends up in the hands of another person.

142
Q

Loss of please or interest in things that have always brought pleasure or interest

143
Q

Which population has the highest risk for suicide

A

Elderly Men

144
Q

What is the most common side effect of lithium therapy

A

Nephrogenic Diabetes Insipidus

145
Q

What MCV would an alcohol abuser be

A

Macrocytic (MCV > 100) = Due to the high rate of Vitamin B12 and Folate deficiency

146
Q

In an alcohol (ethanol) abuser, if the ALT and/or AST is not elevated, which lab value would be elevated

A

GGT (gamma-glutamyl transferase). In patients who abuse ETOH daily, ALT and AST may not be elevated, but the GGT will

147
Q

Symptoms of SSRI (selective serotonin reuptake inhibitors) include

A
  • Headache
  • Nausea
  • Insomnia
  • Restlessness
  • Agitation
148
Q

The usual age of onset of bipolar is ____

A

Age 15 to 30 years

149
Q

Cephalosporins do NOT covers which organisms (remember LAME)

A
  • Listeria monocytogens
  • Atypicals (Mycoplasma, Chlamydia
  • MRSA
  • Enterococci
150
Q

Erythromycin, Azithromycin, and Clarithromycin are known as ___

A

Macrolide Antibiotics

151
Q

Macrolide antibiotics are used for _____

A
  • H. Influenza
  • Atypical Pneumonia (Mycoplasm)
  • Streptococcus (S. Pneumoniae)
152
Q

Levofloxacin, Ciprofloxacin, Ofloxacin, are known as

A

2nd generation Fluoroquinolones

153
Q

2nd generation fluroroquinolones are used for

A
  • Streptococcus (S. Pneumonaie)
  • Atypical Pneumoniae (Mycoplasms)
  • Aerobic Gram positive
  • Pseudomonas
154
Q

Gentamycin, Neomycin, Streptomycin, Tobramycin are known as ____

A

Aminoglycosides

155
Q

Acne vulgaris with inflammatory lesions is treated with _____

A

Topical Antibiotics

156
Q

Aminoglycoside antibiotics are used for _____

A

Aerobic Gram Negatives

157
Q

Doxycycline, Tetracycline, Monocycline are known as ____

A

Tetracyclines

158
Q

Tetracycline antibiotics are used for ____

A
  • Rickettsiae
  • Mycoplasm
  • Spirochettes (Lyme Disease)
159
Q

Cephalexin and Cefalozin are known as _____

A

1st generation Cephalosporins

160
Q

1st generations Cephalosporins are used for

A
  • Staph Aureus
  • Staph Epidermis
  • E. Coli
  • Klebsiella
161
Q

Streptococcus Pyogenes (Group A) and Streptococcus Agalactiae (Group B) are best treated with ____

A

Penicillin (PCN V or G)

162
Q

Asthma patients should never run out of what type of inhaler?

A

Rescue/Short Acting Inhaler (Albuterol)

163
Q

To be considered in “good control” of asthma, rescue inhalers should be used _____

A

No more than 2 times per week (2 x/weekly or less)

164
Q

Rust colored sputum is mostly associated with what pathogen?

A

Streptococcus Pneumoniae/Pneumococcal Pneumonia

165
Q

This tests for the presence of a virus in the blood

A

Surface Antigen (for example HBsAg)

166
Q

This test for the presence of immunity to a virus

A

Surface Antibody (for example HBsAb)

167
Q

This test for the “Past” or “Present” virus in the blood

A

Core Antibody (for example HBcAb)

168
Q

The only medications that reduces elevated lipid levels and has proven efficacy in reducing risk of cardiac events, even for primary prevention is:

A

HMG Co-A reductase Inhibitors (Statins)

169
Q

What should patients with dyslipidemia be screened for?

A
  • Diabetes (check blood glucose)
  • Renal Disease (check BUN and Creatinine)
  • Hypothyroidism (check TSH)
170
Q

If a patient who is taking statin medication complains of myalgias (muscle and joint pain), which labs should be checked

A
  • CPK
  • CK
  • CK-Mb
    These labs should breakdown of muscle tissue, which statins are known to due
171
Q

The pharmacological mainstay of primary dysmenorrhea is:

A
  • Combined contraceptives (hormone therapy and NSAIDS)
172
Q
  • Absence of menstruation for 12 month or more

* An increase in Follicle Stimulation Hormone

173
Q

Medications that reduce bone density are

A
  • Corticosteroids

* Anticonvulsants

174
Q

A fluctuation or decrease in what hormone causes hot flashes

175
Q

When does low back pain need radiography

A
  • Pain at or greater than 4 weeks, with no relief

* Numbness or paresthesia is present

176
Q

Hypertension medications for Post - MI patients

A
  • Beta-blockers
  • Calcium Channel Blockers
  • Spironolactone
177
Q

Where is pain located in medial knee pain, medial meniscus tear, medial collateral ligament tears

A

Along the joint

178
Q

1st line treatment for Osteoarthritis

A

Exercise and Weight Loss

179
Q

1st line pharmacological treatment for Osteoarthritis is

A

Acetaminophen

180
Q

These rules guide practitioners of when to order radiologic studies on ankle and foot injuries

A

Ottawa Ankle Rules

181
Q

Hip pain from Osteoarthritis is normally located where

A

Anterior Hip

182
Q

The most prevalent skeletal problem is the U.S is:

A

Osteoarthritis

183
Q
  • They are cyclical headaches that last between 2-2 weeks

* These headaches last about 30-90 minutes

A

Cluster headaches

184
Q
  • The most widely used screen tool to assess/evaluate cognitive impairment
  • It evaluates orientation, short term memory retention/recall, language, attention, calculation, and constructional praxis
A

Mini Mental Exam

185
Q

How long does Acetylcholinesterase Inhibitors (ACH-I) take to work on dementia patients

A

6 to 12 months

186
Q

Bell’s Palsy affects which cranial nerve

A

Cranial Nerve VII (Facial)

187
Q

An increase in cough, increase in purulent sputum, increase dyspnea, increase mucus production, Fever, FEV1

A

Very Severe COPD

188
Q

What is the highest dose of Bactrm per dose

A

800/160 per dose

189
Q

The most common type of headaches ares

A

Migraine and Tension-type

190
Q

Carpel Tunnel affects which nerve

A
  • Median nerve within the wrist

* Affects the thumb, index, middle, and ring finger

191
Q
  • It is the loss of sense of smell

* Cranial nerve I is affected

192
Q
  • Herniation of bowel/omentum into the scrotum

* Can produce inguinal or abdominal tenderness/pain

A

Inguinal Hernia

193
Q

The American Cancer Society recommends screening the average risk male for prostate cancer when:

A
  • Caucasian men at age 50

* African American men: start conversing at age 40-45

194
Q

What is the most common cause of infectious epididimytis in men under 35?

A

Chlamydia Trachomatis

195
Q

Which medication should be avoided in men with BPH

A

Pseudoephedrine (they increase the urge to urinate, which is a bothersome symptom in BPH)

196
Q

Tumors of the prostate are usually

A
  • Asymmetrical
  • Indurated
  • Nodular
197
Q

Post-Menopausal bleeding is usually found to be of:

A
  • Uterine Pathology
198
Q

Beta-blockers, which are used for hypertension and migraines, are also known to mask the signs and symptoms of

A

HYPOGLYCEMIA

199
Q

The pharmacological mainstay for dysmenorrhea is

A
  • Combined contraceptives

* Hormone therapy and NSAIDs

200
Q

In CHF, cardiomyopathy, or left ventricular hypertrophy from long standing hypertension, the PMI is located where?

A

5th intercostal space, to the “Left” of the mid-clavicular line

201
Q

Systolic Murmurs include

A
  • Aortic Stenosis
  • Mitral Regurgitation
  • Pulmonic Stenosis
  • Tricuspid Regurgitation
202
Q

Diastolic Murmurs include

A
  • Aortic Regurgitation
  • Mitral Stenosis
  • Pulmonic Regurgitation
  • Tricuspid Stenosis
203
Q

The most common arrhythmia from valvular heart disease

A

Atrial fibrillation

204
Q

Low dose steroid creams are used for what skin issues:

A

Atopic Dermatitis

205
Q

Oral or system antibiotics are used for what skin issues:

A

Cellulitis (subcutaneous infection)

206
Q

High dose steroid preparation or systemic agents are used for what skin issues

207
Q

Topical antibiotics are used for what skin issues

208
Q

It is a circular or oval shape spot normally found on the trunk (chest, back or abdomen) and is related to the skin condition of Pityriasis Rosea

A

Herald Patch

209
Q

Rounding/Clubbing of the distal parts of the fingers are associated with “chronic hypoxia” as seen in which disorders

A
  • Cigarette smokers and COPD
  • Cirrhosis
  • Cystic Fibrosis
  • Pulmonary Fibrosis
  • Cyanotic Heart Disease
210
Q

Koilonychia is associated with which MCV issue

A

Microcytic Anemia (long standing iron deficiency anemia)

211
Q

The most appropriate screen for diabetic nephropathy is

A

Microalbuminuria (tested 2 times 3 to 6 months apart)

212
Q

The earliest glycemic abnormality in Type II diabetes

A

Post prandial glucose elevation

213
Q

Therapeutic effect of Iprotropium (Atrovent)

A

Brochodilator (anticholinergic)

214
Q

Hyperthyroidism can cause what cardiac issue

A

Systolic and/or diastolic hypertension

215
Q

Hypothyroidism adversely affects

A
  • Lipid metabolism
  • Hyponatremia
  • Hyperprolactemia
  • Hyperhomocysteinemia
  • Anemia
  • Creatine Phosphokina (CPK)
216
Q

Changing of substituting Levothyroxine medication will cause what?

A

Fluctuation/elevation in TSH

217
Q

Symptom triad for Mononucleosis is

A
  • Fever
  • Lymphadenopathy
  • Pharyngitis
218
Q

Most common complication of influenza is

A

Pneumonia (bacterial is the most common)

219
Q

Conduction hearing loss is one in which sound cannot enter the external canal, or middle ear due to:

A

Blockage from something, either fluid, cerumen, or a foreign body

220
Q

What is the highest dose of Clarythromycin per dose?

A

250mg/dose

221
Q
  • HBsAg (negative)
  • Anti-HBc (positive)
  • Anti-HBs (positive)
    What do these lab results indicate?
A

Immune to Hepatitis B, due to natural infection

222
Q
  • HBsAg (negative)
  • Anti-HBc (negative)
  • Anti-HBs (positive)
    What do these lab results mean?
A

Immune to Hepatitis B, due to vaccination

223
Q
  • HBsAg (positive)
  • Anti-HBc (positive)
  • IgM Anti-HBc (positive)
  • Anti-HBs (negative)
    What do these lab results indicate?
A

Acutely infected with Hepatitis B

224
Q
  • HBsAg (positive)
  • Anti-HBc (positive)
  • IgM Anti-HBc (negative)
  • Anti-HBs (negative)
    What do these lab results mean?
A

Chronically infected with Hepatitis B

225
Q

1st line pharmacological treatment for uncomplicated UTI’s are

A

Nitrofuritoin

226
Q

2nd line pharmacological treatment for uncomplicated UTIs are

A

Fluoroquinolones (Quinolones)

227
Q

Medication that has a sulfa ring and can increase lipoprotein

A

Hydrochlorothiazide (HCTZ)

228
Q

A spleenectomy increases the risk of _______

A

Infections (bacterial). Make sure that immunization/vaccines are up to date

229
Q

Passive flexion of the neck, causes flexion of the hip and knee

A

Brudzinski (meningeal irritation - meningitis)

230
Q

Acne vulgaris with cystic lesions are treated with _____

A

Isotrentinoin (Accutane)

231
Q

Which medications are used for hypertensive patients with renal impairment

A
  • ACE-Inhibitors

* Angiotensin Receptor Blockers

232
Q

Treatment for acne vulgaris with closed comedones

A
  • Benzoyl peroxide
233
Q

Flexing the knee and hip cause pain in the back

A

Kernig (meningeal irritation - meningitis)

234
Q
  • It starts “AUTOMATICALLY” at age 65, if the person has paid into it. (automatically deducted from employer)
  • Also covers “End-Stage” renal disease at any age.
  • Pays for “INPATIENT MEDICALLY NECESSARY” services.
A
  • Medicare Part “A”
235
Q
  • Medicare Part “A” covers…
A
  • Inpatient hospitalization (including psych hospitalization)
  • Hospice Care
  • Home Health Care
  • Skilled Nursing Facility (NOT NURSING HOMES OR RETIREMENT HOMES).
236
Q
  • Also known as the Medicare prescription drug benefit.
  • One type of coverage is called the “Medicare Advantage” (M.A)
  • All prescription drug plans have a list of preferred drugs (the formulary).
  • Non-formulary may not be covered by this, and patient may have to pay out of pocket
A
  • Medicare Part “D”
237
Q
  • Medicare Part “B” covers…
A
  • Outpatient visits (E.R, Urgent Care, and Clinics)
  • Diagnostics Labs and Tests (Xray, Echo, EKG, CT, MRI)
  • Durable Medical Equipment
  • Kidney Dialysis, Organ Transplant
  • Primary Care Preventative Services
238
Q
  • The Primary Prevention Services covered under Medicare Part “B” include…
A
  • Flu vaccine (1 per year)
  • PNA vaccine (1 per lifetime)
  • Mammogram screening (1 per year for female > 40)
  • Prostate screening (1 per year for male > 50)
  • Colonoscopy and Sigmoidoscopy screening (1 per 10 year for adults 50 years and older)
  • Routine Pap smear (1 per 2 years, or 1 per year for high risk)
  • Physical Exams, HIV Screens, and Smoking Cessation
239
Q
  • Menarche starts in which Tanner Stage
A
  • 1 to 2 years after Tanner Stage II (Breast Bud Stage)

* Menses are very IRREGULAR for 6 months to up to 2 years, once started

240
Q
  • Acute viral illness that mainly affects children younger than 10 years of age.
    Most common cause is coxsackievirus A16.
  • Spread through direct contact with nasal discharge, saliva, blister fluid, or stool.
  • Acute fever, severe sore throat, headache and anorexia.
  • Multiple small blisters appear on the hands, feet, and diaper area.
  • Ulcers appear in mouth, on tonsils, throat, and on tongue.
A
  • Hand Foot Mouth Disease

FNP: Systems Review (10 decks)

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