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Cram FNP Flash Cards > General & Comprehensive > Flashcards

General & Comprehensive Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

Allopurinol and colchicine each is used when?

A

allopurinol - maintenance to keep uric acid low

colchicine - acute gout attack

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2
Q

Dysdiadochokinesia refers to:

A

Neuro triad of symptoms with gait, memory, and speech - common in MS.

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3
Q

How do antioxidants help MS?

A
  • MS is believed to be destruction of myelin sheaths via oxidation by oxygen-free radicals. Antioxidants (i.e. cranberries) may benefit.
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4
Q

Someone with post-polio symptoms, wearing leg brace, why do you have them keep their affected from the exposure to cold or chilling?

A
  • Cold temperatures can cause loss of muscle strength in the affected group muscle (“cold limb”)
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5
Q

How do you tell a migraine from a tension HA?

A
  • Sleep pattern disturbances (too little). Alcohol, lighting, noxious stimuli, stress can all trigger both HAs.
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6
Q

ALP is found mostly where?

A

Liver (mainly), then bones

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7
Q

ALP high, GGT high

A

liver problem

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8
Q

ALP high, GGT normal

A

bone disease (Paget’s disease)

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9
Q

AST high, GGT high

A

liver problem (alcohol abuse)

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10
Q

What chemical in the CNS change during a migraine?

A
  • Serotonin levels decrease
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11
Q

What are the differences of symptoms that show in a TIA of ANTERIOR cerebral circulation vs. POSTERIOR?

A
  • Anterior: behavior and cognition disorders

- Posterior: b/l vision disturbance with diplopia, dysarthria, motor/sensory b/l

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12
Q

In a pt who has sustained a closed head injury, lethargic, follow commands slowly, what abnormal VS will alert you?

A
  • Increase in BP, decrease HR  increasing cerebral edema and ICP
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13
Q

Child with purpuric rash with centrifugal distribution (with well-demarcated borders) and fever.

A
  • Meningococcemia; due to impairment of protein C anticoagulation pathway
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14
Q

Tx for myasthenia gravis:

A

Pyridostigmine (Mestinon) (Ach-ase inhibitor)

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15
Q

Horner’s syndrome:

A
  • Horney PAMELa = Ptosis, Anhidrosis, Miosis, Enophthalmos, Loss of ciliospinal reflex)
  • Due to lesion or compression of one side of the cervical or thoracic sympathetic chain which generates symptoms on the ipsilateral (same side as lesion) side of the body.
  • Congenital, tumor, iatrogenic (meds)
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16
Q

Where is AST and ALT found?

A

AST = S for skeletal, myocardium, brain, kidneys (major organs)

ALT = L for liver

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17
Q

What is the circulatory 1/2 life of AST and ALT? What is important about this?

A 
AST = 12-24 hrs
ALT = 37-57 (longer)

ALT can detect hepatic damage even after damage has ceased.
However, remember AST > ALT indicates alcohol, statin, and tylenol use. And ALT > AST indicates infectious hepatitis.

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18
Q

urine has conjugated or unconjugated bilirubin?

A

conjugated

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19
Q

what medication for gout oversecretors? undersecretors?

A
  • oversecretors: allopurinol

- undersecretors (90%): probenecid

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20
Q

Homonymous hemianopia:

A
  • Loss of vision in both eyes in either the R or L half of the visual field; due to CVA
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21
Q

Where is the best place to evaluate skin turgor in adult?

A
  • Just below the clavicle or abdomen
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22
Q

What skin disorder is sometimes associated with arthritis but may not be directed associated?

A
  • Psoriasis (psoriatic arthritis)
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23
Q

Difference between nummular eczema and dyshidrotic eczema?

A
  • Nummular: coin-liked plaques, discoid, chronic pruritic, papules and vesicles on erythematous base
  • Dyshidrotic: no evidence of sweating, bullous form called pompholyx, d/t emotional stress
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24
Q

Maculopapular skin lesion on back, warty, scaly, greasy, light tan.

A
  • Seborrheic keratosis (raised, tan-brown)
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25
Q

What is medical mgmt of a brown recluse spider bite?

A
  • Ice pack for inflammation, elevate area; also associated with black eschar of sloughing tissue
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26
Q

Severe reaction to black widow spider bite:

A
  • Abd rigidity, nausea, HA, bronchospasm, HTN, seizures, AMS
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27
Q

What is a major side effect of sulfa drugs?

A
  • Erythema multiforme – high fever, weakness, blisters, bulla, ulcerations of mucous membranes
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28
Q

When can kid with Fifth’s Disease (Erythema infectiosum) go back to school?

A
  • Communicable before rash erupts, so may go back to school when rash appears
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29
Q

Where does roseola and rubella start?

A
  • Roseola starts on trunk after fever; spreads to extremities; supportive care
  • Rubella starts on face and goes down trunk, while facial rashes disappear; clears in 3-5 days
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30
Q

How do BBs exacerbate psoriasis?

A
  • Decreases cAMP-dependent protein kinase (inhibitor of cell proliferation)
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31
Q

Do not give what med in true postherpetic neuralgia?

A
  • Antiviral (acyclovir or valcyclovir); bc won’t work anymore (must give during early symptoms of tingling pain)
32
Q

Tx of rosacea:

A
  • Low-dose tetracycline or topical metronidazole
33
Q

Lidocaine with Epi 1-2% as local anesthesia maximum dose allowed is:

A
  • 7mg/kg
34
Q

Motor function of L4

A

foot dorsiflexion

knee jerk reflex

35
Q

Motor function of L5

A

great toe dorsiflexion

36
Q

Motor function of S1

A

foot eversion

37
Q
  1. What drugs can cause hyperglycemia?
  2. What drugs can precipitate gout attack?
  3. What drugs can cause acute pancreatitis?
A
  • corticosteroids, niacin, thiazide diuretics
  • niacin, thiazide diuretics, ASA, cyclosporine
  • corticosteroids, thiazides (causes increase of Ca2+), alcohol
38
Q

Lab that tests for autoimmune thyroid disease

A

TPOAb (thyroid peroxidase antibody)

39
Q

Sulfonylurea mechanism of action.

A

insulin secretagogues (they stimulate pancrease to release more insulin); long-acting.

40
Q

Meglitinides mech of action.

A

same like sulfonylureas, but SHORT-acting (works in 20 minutes).

41
Q

Metformin mech of action.

A

Inhibits hepatic gluconeogenesis; ↑ peripheral sensitivity

to insulin.

42
Q

Why is weight loss seen in Metformin?

A
  • decreases intestinal absorption of glucose.
43
Q

Thiazolidinediones mech of action.

A

↑ insulin sensitivity

44
Q

Caution what when giving sulfonylureas?

A
  • make sure pt has functioning beta cells.

- make sure pt does not have sulfa allergy.

45
Q

Caution what when giving Metformin?

A
  • impaired renal function
46
Q

Caution what when giving Thiazolidinediones?

A

must monitor for hepatic toxicity (ALTs)

47
Q

Januvia must be used in combo with?

A
  • Metformin or a TZD.
48
Q

Acute weight loss –> think 6 reasons:

A 
cancer
leukemia/lymphoma
TB
AIDS
depression
DM type 1
49
Q

Dawn phenomenon

A

insulin wears DOWN by DAWN

solution: move PM dose of insulin closer to bedtime.

50
Q

Somogyi effect

A

Pt is hypoglycemic in middle of night and REBOUNDS to hyperglycemia in morning.

solution: eliminate or reduce PM insulin.

51
Q

How do corticosteroids cause hyperglycemia?

A

Steroids prevent the uptake of glucose in cells.

52
Q

How do steroids cause HTN?

A

steroids cause vasoconstriction.

53
Q

pt taking ethambutol for TB. Monitor what?

A
  • visual acuity, green-red preception (optic neuritis)
54
Q

prophylactic migraine treatment

A

BB (propranolol?)
CCB (Verapamil)
TCAs (amitriptyline)

55
Q

Most common pathogen in Acute Bronchitis?

A

RSV

56
Q

A BOGGY and tender prostate gland is consistent with __? Treatment for man >35yo? <35yo?

A

acute bacterial prostatitis.

Tx with bactrim or cipro x 14 days if >35yo

Tx with ceftriaxone 250mg IM + doxy if <35yo

57
Q

What are 3 causes of secondary hypertriglycemia?

A
  • excessive alcohol use
  • uncontrolled DM
  • untreated or undertreated hyperthryoidism
58
Q

Dilatory

A

delaying; tending to delay, slow to act : he had been dilatory in appointing a solicitor.

59
Q

What can you Rx to PREVENT duodenal ulcers?

A

antibiotics

60
Q

does serum albumin increase or decrease in elderly?

A
  • decrease
61
Q

The general principle of how drug absorption is altered in the eldery is:

A

rate of absorption

62
Q

How does age affect ACE-I?

A

less effective in elderly because they have reduced renal elimination.

63
Q

T or F: majority of ectopics resolve unpredictably without intervention.

A

True

64
Q

What do you use to treat chlamydia in a pregnant woman?

A

Erythromycin is recommended.

65
Q

The best advice to give someone who is taking a medication with a narrow therapeutic index is to tell them to take the medication HOW?

A
  • take it at the same time every day.
66
Q

When you prescribe a drug >90% protein-bound, it means that ___.

A

Only protein-bound portion of the drug is therapeutically active.

67
Q

T/F: The charge of the State Board of Nursing is to ensure public safety.

A

True

68
Q

T/F: Once I am certified, I can practice as a nurse practitioner.

A

False, you practice even without certification.

69
Q

T/F: State level authorization dictates the ability of the NP to obtain a Federal DEA number.

A

True.

70
Q

What is the ethical principle of beneficence?

A
  • to help people in need.
71
Q

someone taking TZD, monitor what?

A

ALT

72
Q

crescendo-decrescendo murmur

A

aortic stenosis

73
Q

clue cells on smear

A

bacterial vaginosis

74
Q

First-line treatment of:

1) syphillis
2) gonorrhea
3) chlamydia

A

1) penicillin G
2) Suprax or ceftriaxone
3) azithromycin or doxy

75
Q

boggy prostate gland

A

acute prostatitis

76
Q

prevent recurrence of duodenal ulcers, Rx:

A

abx

77
Q

when is a child allowed to sit in a forward-facing car seat?

A
  • 1 year AND at least 20 lbs

Cram FNP Flash Cards (1 decks)

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