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Main points Flashcards

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Family Nurse Practitioner (FNP) flashcards
1
Q

temporal arteritis s/s

A

L temporal headache, scalp tenderness, indurated temporal artery. Pt with elevated WBC (>12,000), shift to the left, neurtrophilia (>70%) likely is bacterial infection

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2
Q

sensitivity

A

rule out, do Not have the disease

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3
Q

specificity

A

rule in, have the disease

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4
Q

cuada equina syndrome

A

a rare disorder that usually is a surgical emergency. In patients with cauda equina syndrome, something compresses on the spinal nerve roots. You may need fast treatment to prevent lasting damage leading to incontinence and possibly permanent paralysis of the legs.

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5
Q

meningococcoal meningitis

A

caused by Neisseria meningitides.

affects the the lining of the brain and spinal cord (meningitis) and bloodstream infections (bacteremia or septicemia).

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6
Q

Kiesselbach’s plexus

A

Over 90% of nose bleeds occur in the anteroinferior (front bottom) nasal septum and is formed by anastomoses (coming together) of 5 arteries

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7
Q

test for sickle cell anemia, g6pd anemia, alpha/beta thalassemia

A

hemoglobin electrophoresis

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8
Q

otitis media 1st and 2nd line rx

A

1st line: amoxicillin

2nd line: amoxicillin-claculanate (augmentin) bid x 10-14 dAYS if no improvement

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9
Q

alternative for PCN allergy

A

macrolides (azithro/z pack, eryrho, clarithro) or clindamycin (lincosamide)

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10
Q

s/e erythromycin

A

n/v. switch patient to azithro (z pack)

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11
Q

If COPD patient on ipratronium bromide (Atrovent) for sob, add what rx if s/s still there?

A

add albeterol inhaler (Ventolin)

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12
Q

Triad for mono

A

sore throat, prolonged fatigue, enlarged cervical nodes ( if present in older patient, reactivated mono)

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13
Q

lupus or SLE (systemic lupus) s/s

A

butterfly rash (malar rash). advise spf

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14
Q

polymyalgic rheumatica (PMR) s/s

A

An inflammatory disorder causing muscle pain and stiffness around the shoulders and hips. long term low dose steroids. PMR >risk for temporal arteritis

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15
Q

gold standard for temporal arteritis

A

biopsy of the temporal artery. refer pt to ophthalmologist for management

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16
Q

finkelstein test

A

thumb in fist, pain to radial wrist is positive for de quervains tenosynovitis

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17
Q

diabetic retinopathy

A

neovascularization, microaneurysyms, cotton wool spots, hard exudates

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18
Q

hypertensive retinopathy

A

av nicking, silver/copper wire arterioles

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19
Q

scoring for reflex

A 
0 absent
1 hypoactive
2normal
3 hyperative
4 clonus
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20
Q

benign variants

A

s4 in elderly, torus palatinus, fishtail uvula

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21
Q

1st line for htn

A

arb/ace, esp with diabetic pts and mild renal disease

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22
Q

ipratropium (atrovent) is an anticholingeric

A

true

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23
Q

Penicillin drugs

A

amoxicillin (broad spectrum), penicillin VK

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24
Q

macrolide

A

erythromycin, azithromycin (zpack), clarithromycin (biaxin)

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25
Q

cephalopsorin 1st generation

A

Keflex

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26
Q

cephalosporin2nd generation

A

cefaclor, ceftin, cefzil

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27
Q

cephalosporin 3rd generation

A

rocephin, suprax, omnicef

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28
Q

quinolones

A

levofloaxacin (levaquin), moxiflozacin (avelox), gatifloxacin (tequin)

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29
Q

sulfa

A

bactrim/septra (trimethroprim/sulfamethazole), nitrofurantoic (macrobid)

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30
Q

tetracyclines

A

tetracycline, doxy, mino (minocin)

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31
Q

antitussives

A

dextromorphan (robitussin), benzonate (tessalon perles)

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32
Q

avoid nitrofurantoin and sulfa drugs (bactrim/septra/macrovid)during pregnancy,

A

true

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33
Q

tx for cutaneous anthrax

A

cipro 500mg bid for 2 months

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34
Q

prochaska theory

A

change theory ( decision theory)

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35
Q

age 11 most children can understand abstract thinking

A

ie NP asks child about proverbs

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36
Q

hemoglobin males

A

14-17.4 g/dl

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37
Q

hemoglobin females

A

12-16 g/dl

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38
Q

hematocrit males

A

42%-52%

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39
Q

mcv

A

80-100

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40
Q

rdw

A

> 15%

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41
Q

platelet

A

> 140,000 increased risk for bleeding

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42
Q

reticulocytes

A

.5-1.5% of red blood cells (increased in acute bleed). starting tx for vitamin def (iron, b12, folate)

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43
Q

neutrophils

A

> 50%= increased risk for bacterial infection

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44
Q

band forms (immature abc)

A

> 6%,increased risk for bacterial infection. aka “shift to the left)

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45
Q

eosinophils

A

> 3% (increased in allergies)

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46
Q

TSH

A

> 5.0 (hypo)

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47
Q

psa

A

> 4 (BPH, prostate cancer)

48
Q

ferritin

A
49
Q

ESR (sed rate)

A

elevated in RA, lupus, temporal arteritis

50
Q

potassium

A

3-5

51
Q

primary prevention

A

anything “that will prevent the disease or social condition”

ex: youth violence, safety promotion, immunizations, spf, lifestyle, osha laws

52
Q

secondary prevention

A

“screening” for disease;

cbc for anemia, tsh for thyroid, uspstf, suicide risk assessment, depression assessment, cancer tests (bse, gse)

53
Q

tertiary prevention

A

limiting harm

ie:exercise for obese patient
supports groups (AAA), rehab (PT, OT, speech therapy)
54
Q

microscopy for candidiases

A

large number of WBC, psuedohyphae, spores ( spaghetti and meatballs)

55
Q

1st line for CAP

A

macrolides

56
Q

s/e ca channel blocker

A

swollen ankles/headache

57
Q

s/e of diuretics

A

hyperuricemia, hyperglycemia

58
Q

s/e bb

A

depression and fatigue

59
Q

highest prevalence of cancer

A

skin cancer (basal cell)

60
Q

highest mortality of cancer (both sexes)

A

lung

61
Q

disease causing most deaths overall

A

heart disease

62
Q

most common gyn cancer

A

uterine

63
Q

tarus palatinus

A

benign bony growth midline of hard palate

64
Q

leukoplakia

A

slow growing white plaque on the tongue or inside the mouth. considered precancerous legion dt poorly fitted dentures, tobacco. refer for biopsy

65
Q

oral hairy leukoplakia

A

“PAINLESS” white corrugate patch associated with HIV and AIDS of the EBV

66
Q

initial workup for ovarian cancer

A

intravaginal US and CA 125

67
Q

risk factors for ovarian cancer

A

early menarche, late menopause, nulliparity, endometriosis, pcps, family hx, vrca1 and via 2 higher risk for BOTH breast and ovarian

68
Q

breast cancer screen

A

50-74, every 2 years

69
Q

cervical cancer

A

21-65, every 3 years

70
Q

colon

A

50-75. fecal occult every year, sigmoidoscopy every 5 years, colonscopy q 10yrs

71
Q

skin cancer counseling

A

spf 10a-3p

72
Q

smoking cessation

A

ask all adolescents and adults

73
Q

fall prevention

A

age 65+. recommend mod-int aerobic activity 150 min or 2/5 hours/week

74
Q

high risk ovarian cancer

A

ashkenazi jew, brca gene, family history of 2 or more first or 2nd degree relative

75
Q

AAA

A

one time screen for men 65-75 who are cigarette smokers. test is US of the abdomen

76
Q

barretts esophagus

A

precancerous lesion of the esophageal. managed by gastroenterologists. tx is lifetime of PPI.

77
Q

high risk for esophagus cancer

A

> 50yo, chronic GERD, smoker

78
Q

s/s of gynecomastia

A

disc like breast tissue that is mobile, tender, and asymmetric

79
Q

food interactions with tetracycline

A

dairy

80
Q

high potassium content food (avoid in warfarin)

A

potatoes, apricots, brussel sprouts, banana, oranges, raisins, green veges

81
Q

avoid what foods with warfarin

A

Vit K (kale, collard greens, broccoli)

82
Q

migraine headaches and maoi avoid which foods

A

high tyramine ( cheese, lava beans, beer, wine, fermented foods)

83
Q

maoi rx

A

marplan nardil, parnate

84
Q

plant sterols that reduce LDL

A

benecol spread, wheat germ, sesame/corn oil, peanuts

85
Q

magnesium

A

nuts, whole west, laxatives, antacids

86
Q

iron

A

beef, liver, black eye peas

87
Q

pityriasis rosea

A

maculopapular rash oval shaped with a herald patch ( xmas tree formation)

88
Q

maculopapular rash in a lace like pattern

A

fifth disease, Fifth disease (also called erythema infectiosum) is caused by parvovirus B19. “slapped cheek”

89
Q

classic location of scabies

A

finger webs, waist, penis. “excoriated pruiritic rash”. high risk group is health care worker, prison. Treat all family members, clean used clothes with hot water

90
Q

scarlatina

A

sandpaper like texture, “strawberry tongue”, skin desquamination ( peeling) of the palms and soles. Not itchy .

91
Q

Impetigo

A

initially appear as papules that develop into bullae. “weeping” rash with honey exdate. Very itchy

92
Q

cutaneus larva migranes

A

red wavy lines, red, itchy. common locations are body exposed to contaminated soil, sand (soles of feet). Cutaneous larva migrans is a parasitic skin infection caused by hookworm larvae that usually infest cats, dogs and other animals. Humans can be infected with the larvae by walking barefoot on sandy beaches or contacting moist soft soil that have been contaminated with animal faeces

93
Q

tx for cutaneus larva migrans

A

ivermectin once a day for 2 days or albendazole for 3 days

94
Q

1st line for AOM and acute sinusitis in children and adults

A

amoxicillin. If recent antibiotics 3 mos or tx failture, 2nd line is augmenten bid or cefdinir (Omnicef) bid.

if PCN allergy, alternative is azithromycin (z pack) or clarithromiycin (niacin)

95
Q

Best place to listen for s3

A

pulmonic area. s3 is pathognomic for heart failure

96
Q

PPD

A

must have induration, not just “red” . Gold standard is sputum culture, Tx is with 3 anti tubercular drugs, base lie LFT level and follow up are recommended for pts on INH.

97
Q

senile arcus or

A

arcus senilis

98
Q

AOM or

A

purulent otitis media

99
Q

Group a beta strep or

A

strep pyogenes

100
Q

enterobiasis or

A

pinworms

101
Q

b12 or

A

cobalamin or cyanocobalamin

102
Q

scarlet fever or

A

or scarlatina

103
Q

condyloma acuminata or general warts

A

or genetical warts

104
Q

tic douloureux or

A

or trigeminal neuralgia

105
Q

tinea cruris or

A

jock itch

106
Q

giant cell arteritis

A

temporal arteritis

107
Q

light reflex or

A

hirschberg test (test for strabismus)

108
Q

sentinel nodes or

A

virchows nodes. Virchow’s node (or signal node) is a lymph node in the left supraclavicular fossa (the area above the left clavicle). The finding of an enlarged, hard node (also referred to as Troisier’s sign) has long been regarded as strongly indicative of the presence of cancer in the abdomen, specifically gastric cancer, that has spread through the lymph vessels.

109
Q

erythema migraines or

A

lyme disease.

110
Q

lyme disease

A

erythema migraines. Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. The two most-used antibody tests are the enzyme-linked immunosorbent assay (ELISA) and the Western blot

111
Q

1st line for depression, OCD, generalized anxiety disorder, panic and social disorder, premenstrual mood

A

SSRI. ie fluoxetine or Prozac (pms), citalopram (celexa), escitalopram ( lexapro), fluoxetine (prozac), sertraline (Zoloft), paroxetine (Paxil)

112
Q

TCA used for

A

depression, ocd ( 2nd line), migraine headache prophylactic, neuropathic pain. amitriptyline (Elavil), nortriptiline (Pamelor). Do not give to suicidal patients as they can hoard and OD (cardiac and CNS toxicity)

113
Q

carbamazepine ( Tegretol)

A

anticonvulsants used for chronic pain and trigeminal neuralgia

114
Q

1st line drug for HTN uncomplicated

A

Thiazide diuretic. TZD mech of action on the bone is decreases calcium excretion by the kidneys and stimulates osteoclast. Helps with bone formation

115
Q

1st line drug for HTN in diabetic or renal disease

A

ace/arb

116
Q

HTN pts with migraines or DM with no chronic lung disease best rx

A

BB (contraind in chronic long; asthma, COPD etc)

joy's deck for FNP (24 decks)

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