Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

AGACNP > rosh review questions > Flashcards

rosh review questions Flashcards

1
Q

what are the different mechanism of action between PPIs and H2 receptor blockers?

A

Proton-pump inhibitors directly block the hydrogen-potassium ATPase action on parietal cells to effectively decrease acid suppression.
H2 Blockers: competitively bind with gastric parietal cells to inhibit gastric acid secretion
Proton-pump inhibitors have greater effectiveness in treating esophagitis because they act on the final pathway of acid secretion rather than one of its receptors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is pre-tibial myedema?

A

it is a skin condition in Grave’s disease- hyperthyroidism- looks like peripheral vascular disease - it is caused by the deposition of hyaluronic acid (hydrophilic glycosaminoglycans in the dermis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

when do you add dextrose to IV fluid replacement in DKA treatment?

A

when anion gap is still elevated but glucose is < 200.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when would you give sodium bicarb in DKA?

A

if pH is < 6.9. otherwise it’s controversial to add this when bicarb level is low.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how is anion gap calculated?

A

Anion Gap = Sodium - (Chloride + Bicarbonate).

Potassium may or may not be included in anion gap calculation- if it is, it changes the normal range.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are physical barriers of innate immune system?

A

physical barriers which include the skin, sweat, oral secretions, stomach acid, and mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are physical exam findings of bacterial infective endocarditis?

A

fever, Roth spots, Osler nodes, murmur, Janeway lesions, anemia, nailbed hemorrhages, emboli (FROM JANE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are Roth spots

A

retinal changes from infective endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are osler nodes vs janeway lesions

A

infective endocarditis
osler nodes- on hands, more like hard bumps or moles
janeway lesions- hemorrhagic lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are the most common bacteria for endocarditis- mechanical vs. natural valve

A

IVDA: Staphylococcus aureus, tricuspid

Native valve: Staphylococcus aureus, viridans streptococci (most common in previously diseased), mitral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pneumopericardium- what are the impacts on hemodynamic status? what’s the severe complication?

A

increased pulmonary capillary wedge pressure, decreased cardiac output, and increased systemic vascular resistance.
can develop into cardiac tamponade and cardiogenic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is risk with succinylcholine? which patients to avoid this for rapid sequence intubation?

A

succinylcholine (suxamethonium) is a rapid-acting depolarizing skeletal muscle relaxant that can cause fatal hyperkalemia and, less commonly, malignant hyperthermia
avoid in ESRD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what does positive Murphy’s sign indicate?

A

acute cholecystitis- RUQ pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

imaging recommendations for acute cholecystitis workup

A

initial: ultrasound- better detection of gallstones compared to CT scan
gold standard: HIDA scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

basal cell carcinoma defining features

A

translucent, pearly nodule and rolled raised edge.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

thyroid storm medication regimen

A

propranolol, propylthiouracil, potassium iodide, dexamethasone
Grave’s disease
propranolol first because decreasing peripheral conversion of T4 to T3. Propylthiouracil- block synthesis of thyroid hormone potassium iodide- prevent release of stored thyroid. dexamethasone- concern for adrenal insufficiency and decrease peripheral conversion of T4 to T3

Beta-blocker (propranolol)
Thioamide (propylthiouracil or methimazole)
Iodine solution
Glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is treatment for 3rd degree HB?

A

electrophysiology consult: permanent pacemaker placement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what anticoagulant is approved during/after pregnancy

A

enoxaparin- low molecular weight heparin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

describe hyperparathyroidism

A

Labs will show high PTH, high calcium, low phosphorus

Most commonly caused by an adenoma with unregulated overproduction of PTH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

hereditary angioedema

A

deficiency of C1 inhibitor- part of the compliment system
excessive bradykinin
Tx: replase C1 esterase inhibitor- FFP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

levothyroxine dosing adults vs older adults

A

Lower for older adults because; due to risk for cardiac dysrhythmias, myocardial infarction, and angina pectoralis

22
Q

what is a risk factor for non-Hodgkin lymphoma?

A

Hashimoto disease (hypothyroidism)

23
Q

what is mechanism of action of carvidopa-levodopa combination agent

A

Carbidopa is usually combined with levodopa to inhibit decarboxylase from converting levodopa to dopamine in the systemic circulation

24
Q

importance of dicrotic notch

A

aortic valve closure- measured on arterial wave form. use to time opening of aortic balloon pump with aortic valve closure

25
Q

asymptomatic AAA

A

feel for abdominal mass

26
Q

what does abdominal bruit signal

A

renal artery stenosis

27
Q

what antibiotic medications cause QTc prolongation

A

Antimicrobials known to cause QT prolongation include macrolides, fluoroquinolones, and high-dose fluconazole

28
Q

aortic stenosis atributes

A 
crescendo-decrescendo murmur
systolic ejection murmur
diminished carotid pulses
split S2
narrow pulse pressure
decreases murmur with Valsalva maneuver
29
Q

burn: painless, escar =

A

full thickness burn

30
Q

when is PSA screening indicated

A

age 55-69, with consideration of family history of prostate cancer. this is a soft recommendation because the risks can outweigh the benefits

Screening for prostate cancer is generally based on individual risk, with age 40 being a reasonable time to start screening for those at highest risk (genetic predispositions or strong family histories of prostate cancer at a young age).This risk is further increased if the cancer was diagnosed at a younger age (less than 55 years of age) or affected three or more family members.

31
Q

diarrhea vs vomiting metabolic abnormalities

A

Diarrhea is the most common cause of external loss of alkali resulting in metabolic acidosis. Biliary, pancreatic, and duodenal secretions are alkaline and are capable of neutralizing the acidity of gastric secretions
vomiting- metabolic alkalosis because of loss of gastric acid.

32
Q

what is mydriasis?

A

fixed pupil; brain herniation

33
Q

define assault (legal terms)

A

occurs when one individual is in immediate fear or apprehension of harmful touching without their consent. It does not include physical harm

34
Q

define abuse in legal terms

A

the intentional harm or injury to another individual. In medicine, abuse includes practices that are inconsistent with recommended medical treatment resulting in services rendered that are not medically necessary or fail to meet the recognized standards of care.

35
Q

define battery in legal terms

A

the unlawful touching of an individual with the intent of causing harm

36
Q

define intimidation in legal terms

A

the act of filling with fear through strength of position or force of personality that encourages a specific action.

37
Q

define secondary prevention

A

early detection of a disease

38
Q

define primary prevention

A

prevent disease well before it develops and reduce risk factors

39
Q

define tertiary prevention

A

treat established disease to prevent deterioration

40
Q

positive Trousseau’s sign or Chovstek’s sign

A

hypOcalcemia

41
Q

alcoholic hepatis lab trends

A

2:1 ratio AST:ALT

42
Q

viral hepatitis lab trends

A

10x higher AST/ALT levels

43
Q

adduction testing

A

Varus. lateral colateral ligament LCL

ankle in, knee out

44
Q

abduction testing

A

Valgus test, ankle out (abduction), knee force in

MCL testing

45
Q

ACL

A

anterior drawer test/ Lachman’s test

46
Q

PCL

A

posterior drawer test

47
Q

what is most common dysrhytmia in Wolf Parkinson White syndrome/

A

Orthodromic AVRT is the most common tachydysrhythmia seen in WPW syndrome and accounts for 65% of dysrhythmias seen in WPW patients

48
Q

what are the EKG characteristics of Wolf Parkinson White Syndrome?

A

Short PR interval < 0.12 seconds
Delta wave- curved upstroke of QRS complex
Wide QRS > 0.12 seconds

49
Q

what is the accessory pathway of WPW syndrome?

A

Bundle of Kent

50
Q

what is characteristic of WPW syndrome? what is treatment?

A

Tachyarrhythmias; palpitations, syncope
1st tx: vagal maneuver
2nd: adenosine push
3rd: beta blocker or calcium channel blocker
definitive treatment: ablation of alternative pathway

If unstable: emergent cardioversion

51
Q

describe presentation of acute appendicitis, physical exam findings and diagnostic testing

A

Presentation: periumbilical pain that migrates to RLQ pain, nausea, vomiting, fever, anorexia, diarrhea, general malaise, flatulence, dyspepsia (last 4 are atypical signs)
McBurney’s point (RLQ), Rosvig’s sign- referred RLQ pain from palpation of LLQ.
Psoas sign; hip extension while left side lying
Obturator sign; flexion of knee and internal rotation of hip elicits pain
Diagnostic: CT scan is gold standard

52
Q

what is antiphospholipid antibody syndrome

A

autoimmune multisystem disorder characterized by arterial venous or small vessel thromboembolic events. may be associated with Lupus
testing: anticardiolipin antibodies or lupus anticoagulant levels or anti-beta-2-glycoprotein I antibodies

AGACNP (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions