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AANP Study Cards > Bronze Review > Flashcards

Bronze Review Flashcards

1
Q

If a patient has a fever, chills, nausea, rash on forearms and ankles, palms, and soles of feet after hiking or camping in the mountains

A

-Rocky Mountain spotted fever

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2
Q

How do you treat RMSF

A

-Doxycyline

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3
Q

Middle age lady has been out in the yard, long grass, has target bulls eye rash what is the likely diagnosis

A
  • lyme

- Erythema migrains

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4
Q

Middle-aged man notes a lesion on arm with irregular borders, different colors, with some black. What is the likely diagnosis?

A

-melanoma

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5
Q

Slivery white scales on an erythematous base that are pruritic

A

-psoriasis

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6
Q

Koebner phenomenon

A

when there is a trauma and a scab forms but psoriatic plaque forming over top

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7
Q

Auspitz sign

A

If you take a psoriatic plaque and it starts pinpoint bleeding

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8
Q

Mom brings in 5 year old child. Child is complaining of itching, mostly at night, interdigital burrowing happening

A

scabies

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9
Q

What tx or instructions do you give for scabies

A
  • permethrain cream
  • treat close contacts
  • wash everything in VERY hot water
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10
Q

Atopic triad is

A
  • allergies
  • asthma
  • atopic dermatitis
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11
Q

Mom brings in 10-year-old child, who is scratching his leg, notes a ring with central clearing that is pruritic

A

-tinea corporis

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12
Q

Actinic keratosis is the precursor

A

SCC

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13
Q

Where do you usually see actinic keratosis

A
  • sun-exposed area
  • face
  • nose
  • ears
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14
Q

Actinic keratosis is

A

-a dry, pink, raised lesion

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15
Q

How do you treat actinic keratosis

A

5-FU cream

Cryotherapy

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16
Q

What is the gold standard for diagnosing skin lesions

A

-punch biopsy

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17
Q

Black or tan lesion that looks pasted on the skin, waxy, wart-like

A

seborrheic keratosis

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18
Q

What is cellulitis

A
  • A skin infection

- Reddened

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19
Q

If you have a patient with diabetes and cellulitis you are concerned for:

A

-osteomyelitis

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20
Q

PAD presentation

A
  • intermittent claudication (feels better at rest, painful when walking)
  • feels better when dangling
  • shiny
  • hairless
  • no edema
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21
Q

What is the test for PAD

A

ABI

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22
Q

What is an ABI diagnostic level for PAD

A

<0.9

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23
Q

What is 1 thing PAD patients must do?

A

-STOP smoking

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24
Q

Venous insufficiency presentation

A
  • edema
  • discoloration: leg is red/purple/dark
  • varicose veins
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25
Q

What is happening in varicose veins and what is the risk associated with this?

A
  • Blood is pooling

- risk for DVT

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26
Q

Erysipelas treatment

A

-penicillins (usually dicloxacillin)

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27
Q

Erysipelas

A

-well-demarcated rash on the face, like cellulitis of the face

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28
Q

If you have inflamed/infection skin you would consider

A

Keflex/Cephalosporins/Penicillin

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29
Q

Mastitis treatment and education

A

Keflex or Penicillin

-educate to continue to breastfeed

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30
Q

What is the treatment of MRSA

A

BCD

  • Bactrim
  • Clindamycin
  • Doxycycline
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31
Q

If your patient is pen allergic, what medications would you give

A

Macrolide (ie. Azithromycin)

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32
Q

Whats the most common skin cancer

A

BCC

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33
Q

What does BCC look like

A
  • Pearly
  • Waxy
  • Ulcerated center
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34
Q

Patient presents at 7 years old with a dome-shaped lesion, belly button looking, white plug, umbilication

A

-Molluscum contagiousum

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35
Q

If you see molluscum contagiosum in the genital region of children you need to

A

-consider abuse and report

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36
Q

The maculopapular vesicular rash starts on the trunk and spreads to heads, pruritic

A

Varicella (chickenpox)

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37
Q

Patients with varicella can return to regular activities when

A

lesions have crusted over

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38
Q

Acne 1st line treatment

A

-Topicals (Benzoyl Peroxides)

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39
Q

Acne that is not improved by topicals you will next implement

A

-Oral antibiotic (Tetracyclines)

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40
Q

If acne is not improved by topical or oral antibiotics, then you want to consider

A

-refer to derm for accutane

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41
Q

If patient is experiencing skin irritation from acne treatments suggest

A
  • decrease frequency

- sun safety

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42
Q

Honey crusted lesions

A

Impetigo

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43
Q

How is impetigo treated

A

Mupirocin (Bactroban)

“iMpetigo and Mupirocin”

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44
Q

Scarlet Fever or Scarletina rash

A

sandpaper rash

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45
Q

Herald patch that starts on truck that then turns into a Christmas tree pattern

A

-pityriasis rosacea

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46
Q

1st-degree burn

and treatment

A
  • redness, stinging and burning

- cold water, ice, topical burn cream or gel

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47
Q

2nd-degree burn and treatment

A
  • partial-thickness
  • redness
  • blisters form** (BUZZWORD)
  • pain
  • tx: Silver, abx ointment, don’t pop blister
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48
Q

3rd-degree and treatment

A
  • full-thickness
  • painless
  • go to ED
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49
Q

Rule of 9’s in burns adults

A
  • Chest 18%
  • Back 18%
  • Arms: 9% each
  • Head (front and back)= 9%
  • Legs: 18% each
  • Perineum 1%
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50
Q

Rule of 9’s in burns children

A
  • Head (front and back) 18%
  • Back 18%
  • Chest 18%
  • Arms 9% each
  • Legs 13.5% each
  • perineum 1%
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51
Q

Marijuana lowers ____ count

A

sperm count

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52
Q

Cocaine can cause ____ bleed

A

nosebleeds

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53
Q

Macular degeneration is a loss of ____ vision

A

Central

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54
Q

Patient presents with eye pain, cloudy cornea, tearing, halos what is the dx and mgmt

A
  • acute angle closure

- “close the door” get them to the ER

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55
Q

What should the intraocular eye pressure be?

A

8-21

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56
Q

Patient presents saying they are seeing floater, flashes and like someone has closed the curtain on their vision

A

-retinal detachment

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57
Q

A cauliflower-like growth in the ear and the management

A

Cholesteatoma; refer to ENT

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58
Q

Ulceration on the inside of cheek or lip

A

-stomatitis
There is viral and apthous
-viral is multiple
-apthous is just 1

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59
Q

Optic disc that is swollen with blurred edges what is this?

A

-Papilledema

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60
Q

What is the underlying disease process in papilledema?

A

-Hypertension

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61
Q

When the artery in the eye crosses over the vein this is called

A

AV nicking; decreased blood flow to the eye; can have blurry vision or diplopia

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62
Q

AV nicking is seen in

A

hypertension

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63
Q

Whats the first thing to do if you have a patient present with a visual complain

A

-visual acuity

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64
Q

Koplik spots are associated with

A

Measles (Rubeola)

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65
Q

Measles presents with ___ and the 3 c’s

A

Fever +

  • conjunctivitis
  • cough
  • coryza

and koplik spots

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66
Q

sensorineural hearing loss is always categorized y a ____ because conductive is simply a blockage

A

drug or otoxic drug

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67
Q

Meniere’s disease presents with

A
  • vertigo
  • tinnitus
  • N/V
  • nystagmus
  • hearing loss
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68
Q

Weber lateralizes to ____ in conductive hearing loss

A

affected ear in conductive hearing loss

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69
Q

Rinne in the affected ear will be ____ in conductive

A

BC > AC

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70
Q

Weber lateralizes to ____ in sensorineural hearing loss

A

opposite ear

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71
Q

Rinne will be ____ in sensorineural loss

A

Normal

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72
Q

First line treatment for otitis media is

A

amoxicillin

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73
Q

If patient has had an antibiotic within 30 days and has OM treat with

A

Augmentin

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74
Q

What is the main organism that causes OM

A

-Strep pneumo

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75
Q

OME is treated with

A

decongestant

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76
Q

How is OE treated

A

Corticosporin drops

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77
Q

Xanthelasma is

A

Lipid deposits around the eye

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78
Q

Allergic Conjunctivits presents like

A
  • bilaterally
  • tearing
  • *Stringy mucous
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79
Q

Bacterial Conjunctivitis presents like

A
  • unilateral can go to bilateral (cross contamination)
  • profuse tearing
  • a lot of excuadte
  • yellow crusted
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80
Q

What is the test for mono

A
  • mono

- heterophile

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81
Q

Viral conjunctivitis presents like

A
  • unilateral but can go to bilateraly
  • a little tearing
  • not a lot of exudate
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82
Q

Mono presents with

A
  • fatigue
  • pharyngitis
  • cervical lymphadenopathy
  • enlarged spleen
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83
Q

Mono patients can return to physical activity

A

when spleen is no longer enlarged ~`4-6 weeks; check by ultrasound

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84
Q

Viral rhinitis first-line treatment is

A

intranasal corticosteroid spray

85
Q

You can only use afrin for ___ days otherwise patients will experience

A

3 days or less; rhinitis medicamentosa

86
Q

Mitral Regurgitation

A
  • Systolic

- Harsh, loud, blowing

87
Q

Mitral Stenosis

A
  • Diastolic

- soft, blowing

88
Q

What murmur radiates to the axilla

A

-Mitral Regurge

MR wants to be the head but hes not

89
Q

When will you hear S3

A
  • pregnancy

- CHF

90
Q

When will you hear S4

A
  • elderly

- left ventricular hypertrophy

91
Q

What is the treatment for ISH

A

-CCB

92
Q

An EKG with a prolonged PR interval is

A

A 1st degree block

93
Q

An EKG with no P wave is

A

atrial fibrillation

94
Q

Thiazides benefits and AE

A

-stimulates osteoclasts good in osteoporosis

  • Hyperglycemia
  • Hyperuricemia
  • Hypertriglycerides
95
Q

Metabolic sydrome

A

Have at least

  • Hypertension
  • DM
  • Hyperlipidemia
  • Waist circumference >40 in men; >38 in women
96
Q

What is the presentation with endocarditis

A
  • fever
  • chills
  • osler nodes (only on 1 digit)
  • janeway lesions (on palms)
  • Splinter hemorrhages on the finger nails
97
Q

Asthmatic patient presents with a BP drop of 10mmHg or more on inspiration

A

-pulsus paradoxus

98
Q

If a patient has diabetes what is 1st line for hypertension

A

ACEi or ARBs (renal protective)

99
Q

If a patient has BPH and hypertension what would you give

A

Hytrin

100
Q

What is 1st line in Raynaud’s

A

CCB

101
Q

In a patient with GERD and hypertension what medication do you not want to give?

A

CCB

102
Q

Would you give CCB to a patient with CHF?

A

No

103
Q

In patients with gout or kidney stones what hypertensive medications would you not want to give

A

Thiazide diuretics

104
Q

What hypertensive medication is contraindicated in COPD

A

Beta Blockers

105
Q

If you put a patient on a statin you need to avoid ___ juice

A

Grapefruit juice

106
Q

Group A COPD minimally symptomatic low risk of exacerbations treatment

A

SABA or in combination with SAMA

107
Q

Group B COPD more symptomatic but low risk of exacerbations

A

LAMA or LABA or SABA PRN

108
Q

Group C COPD minimally symptomatic but high risk for exacerbation

A

LAMA is first line; SABA for sx relief

109
Q

Group D COPD

A

Refer

110
Q

If a COPD patient has poor symptom relief with a SAMA (ipratropium) then you should add

A

SABA

111
Q

Intermittent asthma 1st line treatment

A

SABA

112
Q

Mild asthma 1st line treatment

A

low dose ICS

113
Q

Moderate asthma 1st line treatment

A

low dose ICS + LABA

114
Q

Mod to Severe asthma 1st line

A

Med dose ICS = LABA

115
Q

GINA Stepwise approach to asthma

A
  • Step 1 (Sx <2x/mth): Low dose ICS- formoterol PRN
  • Step 2: (sx >2x/mth but less than daily) Low dose ICS-Formeterol daily
  • Step 3 (sx daily, waking with asthma 1x/wk or more) low dose ICS + LABA, or med dose ICS + Laba or low dose ICS + LTRA
  • Step 4: Refer
116
Q

CURB-65

A

-Confusion
-Urea (>19.6)
-Respiratory (>30)
-Blood pressure >90/60
Age >65

117
Q

If you hear a bruit you should consider the following diagnosis

A
  • renal vascular hypertension

- renal vascular stenosis

118
Q

A TB test induration of 5mm is + in

A

HIV; Immunocompromised; recent exposure

119
Q

A TB Test induration of 10mm is + in

A

Migrant farmers; healthcare workers and immigrants

120
Q

If you find a single nodule on a thyroid it is more likely to be ____ than multinodular

A

malignant

121
Q

An A1C >9 you should

A

start basal insulin

122
Q

Addison disease presents like

A
  • hyperpigmentation (bronzing skin)
  • Salt craving
  • thin
  • low cortisol levels
  • low sodium (sodium follows cortisol)
  • High potassium (has inverse relationship with sodium)
123
Q

Cushing presents like

A
  • obesity
  • buffalo hump
  • fatigued
  • high cortisol levels
  • High sodium levels
  • Low potassium
124
Q

Dawn phenomenon management

A

manage with night time insulin

125
Q

Somgyi phenomenon management

A
  • is a dip and it goes back up think backwards S
  • manage by giving them a snack before bed
  • decrease nighttime insulin
126
Q

Currant jelly stools and sausage shape mass

A

-Intussception

127
Q

Projectile vomiting and olive shape mass

A

-pyloric stenosis

128
Q

Pencil thin stools signify

A

-descending colon cancer

129
Q

CKD labs will show

A
  • Hyperkalemia
  • Elevated Creatinine
  • eGFR will be low
130
Q

Urge
Stress
Overflow
Functional

Incontinence

A
  • Urge: Strong urges to go, need to go now
  • Stress: Increased intra-abdominal pressure
  • Overflow: Difficulty emptying the bladder (think BPH)
  • Functional: Inability to make it to the bathroom (think like disability or injury)
131
Q

Child with uti consider ordering

A

U/S

132
Q

Pyelonephritis key finding in the UA

A
  • Nitrates +

- WBC with casts***

133
Q

glomeurlonephritis key finding in the UA is

A

RBC casts

and proteinuria

134
Q

Trigeminal nerve is cranial nerve #

A

5

135
Q

Which cranial nerves control occular movement

A

3,4,6

136
Q

Shoulder shrugs is cranial nerve

A

8

137
Q

Cranial nerve ___ is indicated in bells palsy

A

7

138
Q

Cranial nerve ___ is smell

A

1 (1 nose)

139
Q

What is the treatment for cluster headache

A

100% O2 at 12L x 15 minutes

140
Q

What can you use to prophylactically treat a migraine

A

propranolol

141
Q

What are abortive treatment for migraines

A

Triptans

142
Q

How do you dx fibromyalgia

A

-need 11 out of 18 tender points for 3 months

143
Q

Subarchnoid hemorrhage what is the key finding

A

-WORSE HEADACHE OF MY LIFE

144
Q

Subdural hemorrhage the neuro exam is ____ and how do you dx

A

Positive; CT

145
Q

What labs will you order to distinguish between Dementia and Delirium

A

CBC, CMP, TSH, UA, Folate and B12

146
Q

Alzhemiers
Lewy Body
Vascular

A
  • Alzhemiers: affects frontal lobe think loss of executive function
  • Lewy body : mimics parkinsons; postural tremors, instability
  • Vascular: mimics alzheimers but due to a vascular event (like after a stroke)
147
Q

Shoulder, hip, pelvic girdle pain, elevated ESR/CRP what is this

A

polymyalgia rheumatica

148
Q

How is polymyalgia rheumatica treated?

A

High dose steroid

can be up to 9-12 months

149
Q

If polymyalgia rheumatica patient has sudden vision loss what do they likely have

A

-temporal arteritis

150
Q

What is gold standard for sickle cell and thlassemia

A

hemoglobin electrophoresis

151
Q

Bicep tendon rupture presents with

A
  • arm pain

- big bulge

152
Q

What is 1st line treatment for OA

A

Acetaminophen

153
Q

What is 1st line for osteoporosis

A

Bisphosphonates

154
Q

Symmetrical joint swelling, takes a while to get moving in the morning >1 hr, morning stiffness

A

RA

155
Q

What is 1st line treatment for RA?

A

NSAIDs

156
Q

Shin splint education

A

RICE, anti-inflammatory

157
Q

Burning and numbness between 3/4th metatarsal

A

Morton’s neuroma

158
Q

Vit D is recommended at ____ units for those 19-70

A

600 units

159
Q

How much calcium is recommended per day

A

1200

160
Q

Atypical antipsychotics

A

Risperdal
Zyprexa
Seroquel

161
Q

With atypical antipsychotics you need to check

A
  • weight
  • BMI
  • blood glucose
162
Q

Serotonin syndrome presents like

A
  • high fever
  • hyperreflexia
  • tachycardia
  • muscular ridgidity
163
Q

What is the #1 reason men stop taking psych meds

A

ED

164
Q

What is the #1 reason women stop taking psych meds

A

Weight gain

165
Q

Herbal treatment for anxiety and sleep

A

Kava Kava

166
Q

Acute prostatitis presents like

A
  • Suprapubic and perineal pain
  • flu like symptoms
  • warm and boggy prostate
167
Q

The prostate exam on a patient with BPH

A
  • firm

- symmetrically enlarged

168
Q

If you just wanted to shirk the prostate you can use

A

Proscar

169
Q

If you want to use a natural herb for BPH

A

Saw palmetto

170
Q

Ectopic pregnancy presents with

A
  • spotting
  • jarring movements are painful
  • hypotensive
171
Q

What is natural estrogen treatment

A
  • Black cohosh
  • Isoflavone
  • soy beans
172
Q

In postmenopausal bleeding you will need to order

A
  • transvaginal ultrasound

- endometrial biopsy

173
Q

LSIL management

A
  • 21-24: watching and repeat in 12 months

- 25+: colposcopy

174
Q

HSIL

A

Colposcopy for everyone

175
Q

Suspected galactorrhea order

A

Prolactin

176
Q

What is 1st line treatment for UTI

A

Macrobid

177
Q

Screening tests for syphillis

A

VDRL

RPR

178
Q

What is the confirmation test for syphilis

A

FTA-ABS

179
Q

5ths disease or erythema infectiosum is caused by

A

parvovirus B19

180
Q

Slapped cheek, lacy rash is

A

5th’s disease or erythema infectiosum

181
Q

Positive signs of pregnancy

A

you verified these !!

  • Fetal Heart Tones
  • Ultrasound
182
Q

Probable signs of pregnancy

A
  • Hegars sign
  • Chadwicks
  • Urine pregnancy tests
183
Q

Presumptive signs of pregnancy

A

(verified by mom)

  • fetal movements
  • weight gain
  • nausea/vomiting
  • breast tenderness
184
Q

Fundus above symphilis pubis occurs at

A

12 Weeks

185
Q

Fundus at the umbilicus

A

20 weeks

186
Q

Give rhogam at ____ and ____

A

28 weeks and 72 hours

187
Q

What test, tests mom and baby antibodies

A

Coombs

188
Q

When there is a traumatic delivery, or there is a resulting cephalohematoma then you should consider that the baby is at risk for

A

-Elevated bilirubin levels

189
Q

Where will you see jaundice first

A

-sclera

190
Q

Where will you see cyanosis 1st

A

-mouth/mucous membranes

191
Q

When do anterior fontanelles close

A

15 to 18 months

192
Q

Posterior fontanelle closes at

A

2-3 months

193
Q

If you see white eye when trying to elicit red reflex

A

-leukocoria

194
Q

Neuroblastmoas do they cross the midline

A

Yes

195
Q

Babies weight doubles at ____ months and triples at _____

A

6 months and triples at 1 year

196
Q

Legg-Calve-Perthes (avascular necrosis or osteonecrosis)

A

+ Trendelenburg test

197
Q

What cardiac finding in marfans

A

MVP click

198
Q

Klinefelter’s syndrome

A
  • wider hips
  • smaller penis
  • smaller testicles
  • softer features
  • worry is infertility
199
Q

Turner’s

A

-ovarian failure (concern is infertility)
-webbed neck
-

200
Q

If your parents are heterogeneous for sickle cell what is the percent chance you will have it

A

25%

201
Q

At 2 months babys are expected to

A

Coo

202
Q

At 4 months babys are expected to

A

Smile spontaneously
Babble
Hands to mouth

203
Q

At 6 months babys are expected to

A

Sit up

204
Q

At 9 months babys are expected to

A

Wave bye

Try and feed self

205
Q

At 12 months babys are expected to

A

Stand and walk
Use a sippy cup
Can say 2-4 words (mama, dada)
Know their name

206
Q

A 2 years old they can

A

speak 2-3 word sentences
understand simple directions
running, active
No

207
Q

At 3 year old they can

A
  • speak in 3-5 word sentences
  • stranger can understand them
  • Can copy a circle and throw a ball
  • Ride a tricycle
208
Q

At 4 years old they can

A
  • Draw a cross

- Playing mom and dad

AANP Study Cards (20 decks)

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