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EXAM FNP > BOARD EXAM > Flashcards

BOARD EXAM Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

Treatment for patient dx with bronchitis?

A

breathing tx, nebulizer, albuterol, SABA

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2
Q

First line Treatment for CAP in healthy patient?

A

Macrolide

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3
Q

First line tx for child with CAP?

A

Amoxicillin (high dose) if presumed bacterial (s. pneumonia)
Azithromycin if presumed atypical
(atypical - mycoplasma; chlamydiphilia)

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4
Q

Auscultation with emphysema reveals

A

hyper-resonance

decreased tactile fremitis

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5
Q

What do you test if changing an asthma med?

A

PFT, Spirometry

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6
Q

Child with 104 fever for 4-5 days, peeling skin on hands and feet, strawberry tongue; what is it?

A

Kawasakis

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7
Q

What is treatment for Kawasaki’s? (2)

A
  1. High Dose ASA

2. IVIG

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8
Q

What diseases would you see a strawberry tongue?

A

Scarletina and Kawasakis

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9
Q

What disease would you see a sand paper rash?

A

Scarletina

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10
Q

What compound is common migraine trigger?

A

tyramine (aged/fermented foods)

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11
Q

Patient presents with unilateral pain behind one eye, light sensitivity, n/v? what do you suspect?

A

migraine

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12
Q

Abortive tx for migraine?

A

Triptans (Imitrex)

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13
Q

Prophylactic TX for migraine (2)

A
  1. TCA

2. Propranolol

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14
Q

Older white male with pain in head same time every day; what is it and what is TX (2)?

A

cluster;

  1. high dose O2 therapy
  2. CCB (needs vasodilation)
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15
Q

What CCB would you give to pt presents with cluster H/A?

A

Verapamil

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16
Q

What causes papilledema?

A

Increased ICP

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17
Q

What is this? swelling of optic disc, blurred edges of optic disc?(blurry vision?)

A

papilledema

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18
Q

Cause of papilledema?

A

HTN

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19
Q

Where does Weber lateralize?

A

Affected ear

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20
Q

Where do you test Rinne?

A

Rinne under the pinne

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21
Q

What is NL Rinne?

A

AC>BC

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22
Q

ABN Rinne?

A

BC>AC

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23
Q

What is THE most common organism in Otitis Media?

A

Streptococcus pneumoniae

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24
Q

In addition to s.pneumo, what other organisms cause AOM?

A
  1. haemophilus influenza

2. moraxella catarrhalis

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25
Q

What is first line TX Otitis Media?

A

Amoxicillin

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26
Q

If Amoxicillin TX failed in AOM, what is second line?

A

Augmentin

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27
Q

3rd line TX for AOM if Amox, Aug. fail?

A

Omnicef?

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28
Q

Beyond 3rd line TX for AOM?

A

Ceftin, Levoquin

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29
Q

What is TX for OME?(2)

A
  1. Antihistamine

2. decongestant

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30
Q

How long can OME last?

A

8 weeks

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31
Q

UTI TX in 1-2nd trimester? (weeks 1-28)

A

Macrobid (Nitrofurantoin)

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32
Q

UTI TX in 3rd trimester (weeks 29-40)?

A

Cephalosporin (Keflex)

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33
Q

PCN allergy, what do you give?

A

Macrolide (Azithromycin, erythromycin, clarithromycin)

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34
Q

IF allergy to PCN, intolerant of erythromycin, what would you give?

A

an different macrolide OR doxy

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35
Q

What is order of treatment (classes) if PCN allergy?

A

Macrolide -> Doxy -> Fluoroquinoline

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36
Q

Prophylaxis for Malaria? (PT traveling to tropical, etc.)

A

Doxycycline

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37
Q

WHAT IS INR GOAL IF ON COUMADIN?

A

2-3

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38
Q

WHAT IF INR IS 1.2 (low) on COUMADIN

A

adjust the dose (increase)

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39
Q

What if INR is 5.0 on coumadin (high)

A

HOLD DOSE

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40
Q

What foods to avoid on coumadin?

A

green leafy;
grapefruit
VIT K

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41
Q

What nerve is involved in Trigeminal Neuralgia?

A

CN V

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42
Q

What is another name for Trigeminal Neuralgia?

A

Tic Douloureux

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43
Q

What might this patient have: pain in face that is burning, electric shock, intense, lightening like, stabbing, intermittent?

A

Trigeminal Neuralgia/Tic Douloureux

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44
Q

What class of medications used for Tic Douloureux?

A

anticonvulsants

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45
Q

What is an example of an anticonvulsant used for trigeminal neuralgia?

A

Tegretol (carbamazepine)

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46
Q

If female patient has migraine with aura, what BC do you avoid?

A

estrogen (COC)

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47
Q

What kind of BC do you give pt. who has hx of migraine with aura?

A

progesterone only (progestin only)

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48
Q

Young adolescent male hit head; neurology exam is negative; what might he have?

A

concussion

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49
Q

Pt hit head and neurology exam has positive findings. what might be problem? What is next step?

A

subdural hematoma

ED

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50
Q

Protocol for PE? (TX, ST and LT therapy)

A
  1. heparin
  2. ST 2-3 mo
  3. LT 6+ mo
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51
Q

GOAL A1C for T2DM?

A

<7%

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52
Q

A1C goal for elderly?

A

<8

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53
Q

1st line TX T2DM?

A

metformin

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54
Q

A1c to start insulin?

A

9 or double digits

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55
Q

A1c greater than 9; what insulin do you start on?

A

Basal, long-actin (Lantus, Levimir)

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56
Q

What is #1 side effect/complaint with Metformin?

A

SSX of GI upset

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57
Q

What can happen to PT on metformin if receives contrast media for procedure?

A

Lactic acidosis

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58
Q

How long do you hold Metformin before procedure?

How long do you hold Metformin after procedure?

A
  1. before - 24 hours

2. after - 48 hours

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59
Q

What blood test can be run that is expensive but valuable?

A

fructosamine test

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60
Q

If pt is on Digoxin and Cr level increased, what does the NP do?

A

decrease the Digoxin (don’t stop)

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61
Q

If suspect patient has SLE, what lab do you run?

A

ANA

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62
Q

What are copper and silver wire finding associated with

A

HTN

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63
Q

What are cotton wool spots associated with?

A

DM

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64
Q

What are micro aneurysms assoc with?

A

DM

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65
Q

What is AV nicking assoc with?

A

HTN

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66
Q

What are retinal hemmorages assoc with?

A

HTN and DM

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67
Q

Your patient has papules, pustules on nose, mouth and chin; what could this be?

A

Rosacea

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68
Q

T/F - you would also see papules on cheeks and forehand in rosacea?

A

????- just nose, mouth, chin

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69
Q

what are the treatment for Rosacea? (3)

A
  1. Topical metrogel - flagyl
  2. Azelex
  3. low dose tetracycline (doxy)
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70
Q

What is this:

small flat topical bumps, grey and white streaks?

A

Lichen planus

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71
Q

Treatment for lichen planus?

A

Steroid

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72
Q

Most common skin CA?

A

BCC

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73
Q

What is this? waxy, pearly papule; may or may not be ulcerated in center?

A

BCC

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74
Q

Why might BCC bleed easily?

A

telangiectasia

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75
Q

Another name for Eczema?

A

Atopic dermatitis

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76
Q

Special instructions for Eczema?

A 
avoid hot water
no harsh soaps
tepid water
cool water
pat dry
cream based moisturizer: Eucerin, vaseline, aquifer
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77
Q

Where do you see atopic dermatitis

A

Flexural folds (excess)

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78
Q

How to treat flair of eczema?

A

Steroids

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79
Q

SSX of testicle torsion?

A

absent cremasteric reflex
pain
N/V

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80
Q

How much time in Testicular torsion before damage?

A

6 hours

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81
Q

Find patches/discolor on back of pt?

A

tinea versicolor

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82
Q

TX for tinea versicolor:

A 
anti fungal - azole
selsun blue (selenium sulfide)
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83
Q

how long tx tinea versicolor

A

everyday - daily for 2 weeks

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84
Q

What kind of exercise if pt has DJD?

A

isometric

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85
Q

example of isometric exercises in DJD?

A

swimming

aquatic

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86
Q

DJD is also known as

A

osteoarthritis

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87
Q

What is FIRST line TX in DJD/osteoarthritis?

A

Tylenol

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88
Q

What nodes are seen in DJD on hands?

A

Bouchards (PIP)

Heberden (DIP)

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89
Q

What type of exercise should patient with osteoporosis do?

A

weight bearing;

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90
Q

What is first line tx for osteoporosis?

A

bisphosphonates

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91
Q

what is most common bisphosphonate?

A

Fosomax

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92
Q

What are instructions for Fosomax?

A

sit up for 30 min after taking (even go for walk)
take with full glass of H2)
Do not lie down

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93
Q

Why specific instructions for Fosomax?

A

avoid esophageal erosion

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94
Q

What is recommended daily amount of Ca++?

A

1200 mg

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95
Q

What is recommended daily amount of Ca++ in a pregnant patient?

A

1200 + 1000 mg = 2200

(add 1000 mg)

96
Q

What is the daily recommended vitamin D per day?

A

800 units/day

newer say 600

97
Q

If patient needs vitamin D replacement, what is it?

A

50,000 units weekly X 7 - 10 weeks

98
Q

After treating a patient with Vitamin D, what is daily maintenance dose?

A

800 units qd

newer regs say 600

99
Q

When to start screening for osteoporosis ?

How often to screen?

A

Start at age 65

Screen every 2 years

100
Q

What is used to screen for osteoporosis?

A

DEXA

101
Q

What is name of fall risk assessment?

A

Get up and GO

102
Q

Patient presents with bilaterally/symetrically swollen joints of wrists, fingers, that lasts longer than 60 min in the a.m. what is it?

A

RA

103
Q

Which hand nodes are affected in RA?

A

PIP

Bouchard

104
Q

What other appearance will you see in fingers of RA pt?

A

Swan neck
sausage like joints/fingers
tender

105
Q

What is 1st line TX for RA?

A

NSAIDS

106
Q

If pt has back pain, and sitting feels better, what might dx be?

A

spinal stenosis

Sciatica and disc problem always hurt

107
Q

What is GOLD Standard to DX back problem?

A

MRI

108
Q

What test do you perform if you suspect pt has sciatica?

A

Straight leg test

109
Q

What is the name of the test you do for scoliosis?

A

Adam forward bend test

110
Q

Patient presents with burning, numbness between 3 and 4 metatarsal; what is this?

A

Morton’s neuroma

also described as pebble

111
Q

What is test for Morton’s neuroma?

A

Mulder Test/ squeeze test

112
Q

Patient complains of chronic back, sacra-iliac night pain;
Imaging of back appears as bamboo spine
What is this?

A

Ankylosing Spondylitis

113
Q

Etiology of ankylosing spondylitis?

A

auto-immune

114
Q

Why ankylosing spondylitis flair/pain at night

A

not moving

115
Q

What eye problem is associated with ankylosing spondylitis?

A

iritis/uveietis (inflammation of iris)

116
Q

Patient presents with NV, diarrhea, fever, chills, stomach pain; works in post office/mail man? fine yesterday; what does he have?

A

Antrax exposure/bioterrorism

117
Q

Treatment for Anthrax?

A

Cipro for 60

500 X 60 days

118
Q

cloasma = ?

A

melasma = pregnancy mask

119
Q

what labs are ordered if suspect HIV (2)?

A
  1. Elisa
    2 Western blot to confirm
    (Newer guidelines say P24 antigen)
120
Q

What 3 antipsychotic/atypical meds need to monitor and why??

A 
1. zyprexa
2 seroquil
3. respirodol
Weight gain - monitor BMI
Blood glucose
(also lipids???)
121
Q

Pt. has BMI < 18.5 what is DX?

A

anorexia

122
Q

SSX of anorexia

A

amenorrhea, brittle nails, lanugo,

palpitations, peripheral edema due to low albumin and cardiac issues

123
Q

what ages does autism ssx appear?

A

18 mo - 24 months

124
Q

Medication contraindicated with seizures?

A

Wellbutrin

- lowers seizure threshold

125
Q

Medication contraindicated with anorexia?

A

Wellbutrin

weight loss is associated with

126
Q

T/F - ADHD is behavioral according to DSM-5

A

True

127
Q

How many setting must ADHD be document in for DX?

A

two (school and home, etc.)

128
Q

What size is MCV in microcytic anemia?

A

< 80

129
Q

What size is MC in macrocytic anemia?

A

> 100

130
Q

What anemias are microcytic?

A

IDA

Thalassemia

131
Q

What do you check if have microcytic anemia?

A

RDW

132
Q

What is RDA elevation in IDA?

A

> 15%

133
Q

What is ordered and checked for in anemia panel to look for IDA?

A

TIBC

Ferritin

134
Q

Pt presents with ataxia and persthesia; what suspected?

A

B12 deficiency

135
Q

another name for B12 deficiency?

A

Pernicious anemia

136
Q

What does tongue look like in anemia (B12/folate)

A

glossitis - beefy/red

137
Q

What blood problem mimics IDA?

A

Lead poisoning

138
Q

what year houses for lead poisoning?

A

before 1978

139
Q

Why no cows milk before 1 year old and what cause?

A

causes IDA due to GI bleeding

140
Q

what deficiency is seen with macrocytic anemia?

A

B12/folate

141
Q

What is toxic level for lead?

A

> 5 or >10

142
Q

Level for lead poisoning?

A

> 80

143
Q

What is concern for lead poisoning?

A

irreversible neurotoxicity

144
Q

GOLD standard test for Sickle Cell and Thalassemia?

A

hemoglobin electrophoresis

145
Q

First intervention in SSA crisis?

A

HYDRATE (reduce blood viscosity)

146
Q

Patient treated with Iron for 6 months and no change; what do you check?

A

reticulocyte count

147
Q

How do you treat IDA?

A

Fe

148
Q

What do you take IDA with to improve absorption?

A

Vit C

149
Q

What is long term maintenance drug used for gout?

A

allopurinol

150
Q

what medications are used to treat gout flairs?

A

NSAIDS (colchicine and indomethacin)

151
Q

T/F - use steroids to tx gout?

A

false

152
Q

If patient is put on allopurinol and has flare within 4 weeks what does the NP do? (3)

A
  1. Stop the allopurinol
  2. Give NSAID through flair
  3. restart allopurinol

(pt starts allopurinol likely to have flare)

153
Q

If pt on allopurinol for 3 months and has flare, what does NP do?

A
  1. continue allopurinol

2. NSAIDS

154
Q

What foods to avoid in Gout? (3…)

A
  1. ETOH - beer
  2. red meat
  3. shell fish
    (organ meat, processed food)
155
Q

What is hearing loss in an older person called?

A

presbycussis

156
Q

what is vision loss in an older person called?

A

presbyopia

157
Q

What is another name for PPD

A

Mantoux

158
Q

What patients are considered positive with 5mm induration on PPD?

A

HIV or immunocompromised

159
Q

What pt considered positive with 100 mm induration?

A

healthcare, migrant worker (farmer), immigrant

160
Q

What part of lobes are affected on CXR in Pneumonia?

A

middle to lower

161
Q

What lobes of lungs affected in TB on CXR?

A

upper

162
Q

patient with SSX of night sweats, productive cough, upper lobes consolidation on CXR; what is it?

A

TB

163
Q

Dull aching pain in rt or left shoulder which doesn’t go away and interrupts sleep. What is it?

A

Rotator cuff tear

164
Q

Who has highest rate of suicide?

A

elderly white males

165
Q

What is most common STI in adolescents?

A

clamydia

166
Q

treatment for clamydia?

A

Azithromycin 1 g

167
Q

Treatment for ghonorrea?

A

Ceftriaxone

168
Q

What is no. 1 killer in US?

A

cardiovascular disease

169
Q

what is no. one cancer killer?

A

lung

170
Q

what is no. 2 ca in women? men?

A

breast; prostate

171
Q

What is 1st line TX for GERD?

A
  1. PPI

2. H2 (used to be first line)

172
Q

Steps in TX of GERD if recurs:

A
  1. PPI

2. H2

173
Q

Velvety skin on neck is what and what causes?

A

acanthosis nigracans; insulin resistance

174
Q

You would see acanthosis nigracans in what female population?

A

PCOS

175
Q

what med is given to PCOS pt trying to get pregnant?

A

Metformin

176
Q

If pt. doesn’t want to get pregnant and have PCOS, what do you give them?

A

COC

177
Q

If a child has acanthosis nigoracans, what might you tell parents?

A

Teach about possible DM

178
Q

What labs do you get for pt with PCOS, if having difficulty getting pregnant?

A

TSH, LH, FSH

179
Q

COPD patient - always talk about _________ if applicable

A

smoking cessation

180
Q

T/F patient with enlarged prostate has severe pain

A

false; no pain

181
Q

what does prostate feel like?

A

tip of nose

182
Q

what are the signs and symptoms of acute prostatitis?

A

FLU like:
fever, N/V, chills
this is an infection

183
Q

How to distinguish flu from acute prostatitis?

A

suprapubic pain
perineal pain
hurts to poop
lasts longer than flu

184
Q

What labs for prostatitis?

A

UA/CBC

185
Q

What lab findings if prostatitis?

A

UTI, (blood maybe)

186
Q

Acute prostatitis, what does prostate feel like?

A

warm and boggy

187
Q

Why do you Not do a real exam on prostate if suspect prostatitis?

A

introduce septicemia or bacteremia

188
Q

What is treatment for prostatitis?

A

CIPRO
Levaquin
Bactrim

189
Q

How long do you treat prostatitis?

A

4-6 weeks

think - prostate is hard to penetrate - like a nut

190
Q

If 30 y/o patient presents with six similar to prostatitis (fever, perineal pain, N/V), what would you do?

A

run STI panel

191
Q

what might you find on lower back of black pt. looks like bruises?

A

mongolian spots

192
Q

what drugs do you use to treat sinusitis?

A

amoxicillin or augmentin

193
Q

where does sinusitis pain radiate?

A

maxillary; jaws, teeth, mouth

194
Q

when should strabismus be gone?

A

6 months

195
Q

if baby has strabismus at 7 months, what do you do?

A

refer

196
Q

what is name of test for strabismus?

A

cover/uncover

197
Q

where is most vascular place for nose bleeds?

A

anterior

Keisselbach plexus

198
Q

what virus causes GI issues/pooping in kids?

A

rotavirus

199
Q

When does baby double weight?

A

6 mo

200
Q

when does baby triple weight?

A

12 mo

201
Q

how young to start gardisil?

A

9 y/o

202
Q

how young to give flu shot?

A

6 mo

203
Q

Do not give TDap in a patient younger than

A

7 years

204
Q

Don’t give MMR to a patient younger than

A

12 months

205
Q

How long to wait if give varicella before give MMR?

A

28 days if not given on same day together

206
Q

what is care for varicella?

A

supportive: calamine, oatmeal baths

207
Q

when can pt go back with varicella

A

when lesions have crusted over

208
Q

when do you give acyclovir?

A

shingles in older person (altho think you give to young adult/teen with varicella)

209
Q

What is this: tingling on forehead and on tip of nose?

A

herpetic keratosis

210
Q

T/F: herpetic keratosis is emergency

A

TRUE - don’t want vesicles to form; result in blindness

211
Q

What is test for mono?

A

monospot

heterophile antibody

212
Q

How long does mono last?

A

4-6 weeks

213
Q

When can pt with mono return to contact sports/ativities?

A

when spleen is normal verified by US

214
Q

If patient had mono and returns 3 months later, do you think it is mono or something else?

A

something else - possibly due to decreased immune system making them susceptible; fatigue can last a while

215
Q

Where is stood schlatter ?

A

tibial tuberosity/knees

216
Q

What disease has sudden, violent, paroxysmal cough?

A

pertussis

217
Q

what is the worrisome sign of GERD?

A

dysphasia - cannot swallow

218
Q

what is the worrisome sign of GERD?

A

dysphasia - cannot swallow

219
Q

green, frothy vaginal d/c is what?

A

trichomoniasis

220
Q

what is defining lab for trichomoniasis?

A

Wet mount/wet prep/wet smear

221
Q

what herbal medication useful for migraine and H/A?

A

fever few

222
Q

what herb for prostate in male?

A

saw palmetto

223
Q

what her for memory in older pt?

A

“Ginko!”

224
Q

What herb to manage anxiety and insomnia?

A

kava kava

225
Q

what herb to boost immune system in children (URI SSX)?

A

echinacea

226
Q

male patient presents with scrotum that feels like bag of worms; what is this?

A

varicocele

227
Q

baby’s testicle illuminated by flashlight; what is this?

A

hydrocele

228
Q

when should hydrocele resolve in baby?

A

12 mo

229
Q

Pt presents with coughing for 3 weeks; no fever, no chest pain, no productive cough, no wheezing; what is it?

A

mycoplasma pna (this is an atypical presentation due to atypical pathogen)

230
Q

middle age lady presents coughing for 3 weeks; what should rule out?

A

pna

231
Q

T/F patient coughing for 3 weeks, but no fever has pneumonia

A

NOT SURE; no fever no pan
no fever no URI
bronchitis has cough but no fever

232
Q

what do you give pt dx with bronchitis?

A

breathing treatment; nebulizer, albuterol, SABA

cough suppressant, tesslon pears,

233
Q

patient presents with fever, coughing for 3 weeks; you treated her for bronchitis but now has cough - what do you suspect?

A

PNA - CAP; atypical/walking/mycoplam/

234
Q

when do you see rust colored sputum?

A

pneumonia!

235
Q

Best tx for PNA (if DRSP)

A

Levoquin

236
Q

TX for PNA in healthy pt?

A

Macrolide

EXAM FNP (1 decks)

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