AANP Certification Exam 393 Questions with Answers,100% CORRECT

AANP Certification Exam 393 Questions with Answers diverticulum can be an infection of - CORRECT ANSWERS both gram - and + bacteria Which diuretic should be used for osteoporosis? - CORRECT ANSWERS Thiazide diu ...

AANP Certification Exam 393 Questions with Answers diverticulum can be an infection of - CORRECT ANSWERS both gram - and + bacteria Which diuretic should be used for osteoporosis? - CORRECT ANSWERS Thiazide diuretics: slows the kidneys excretion of calcium and increases reabsorption Lachman maneuver - CORRECT ANSWERS knee instability tear of ACL Infections of labia and vagina - CORRECT ANSWERS bacterial vaginosis, candidiasis, and trichomoniasis Chlamydia affects - CORRECT ANSWERS cervix, endometrial lining, fallopian tubes, pelvic cavity Acute abdomen symptoms - CORRECT ANSWERS involuntary guarding, rebound tenderness, board-like abdomen, +obturator and psoas sign Care of preecplampsia - CORRECT ANSWERS bed rest, weight and blood pressure monitoring Preeclampsia labs - CORRECT ANSWERS urine protein, serum protein, creatinine, platelet count Preeclampsia symptoms - CORRECT ANSWERS hypertension, proteinuria, edema (weight gain) Preeclampsia complications - CORRECT ANSWERS placental abruption, coagulopathy (DIC), renal failure, uteroplacental insufficiency, liver failure, hypertensive encephalopathy, retinal detachment, pulmonary edema, seizure, death community acquired pneumonia Most common bacteria least common bacteria Population treatment - CORRECT ANSWERS mycolpasma pneumoniae (atypical) h. influenza, strep pneumoniae atypical: psuedomonas aeruginosa college student, school children, military macrolides: azithromycin, clarithromycin Mantoux test - CORRECT ANSWERS Positive: 5mm Positive for recent immigrants: 10mm Murphy's sign - CORRECT ANSWERS biliary disorders deep inspiration by patient and deep palpation RUQ below costovertebral angle placenta previa - CORRECT ANSWERS implantation of the placenta over the cervical opening or in the lower region of the uterus painless bright red blood in the second or third trimester Order abdominal US Hashimoto's is most common in which population - CORRECT ANSWERS middle age to older women Hypertension Retinopathy - CORRECT ANSWERS AV nicking and copper or silver wire arterioles flame-shaped hemorrhages threatened abortion - CORRECT ANSWERS vaginal bleeding and cramping, soft uterus, cervix closed bacterial vaginosis - CORRECT ANSWERS fishy odor, milky white or dull gray discharge pH > 4.5 > 20% clue cells KOH whiff test squamous cells dotted with lots of bacteria that obscure borders - CORRECT ANSWERS clue cells Lichen sclerosis - CORRECT ANSWERS skin disease, white spots appear over time, most common genital and rectal most common in older woman itching, discomfort, bleeding order biopsy AV valves - CORRECT ANSWERS mitral and tricuspid semilunar valves - CORRECT ANSWERS pulmonary and aortic S1 - CORRECT ANSWERS systole closure of AV valves mitral regurgitation aortic stenosis S2 - CORRECT ANSWERS diastole closure of semilunar valves mitral stenosis aortic regurgitation S3 - CORRECT ANSWERS normal variant in children, healthy young adults, and athletes heart failure early diastole S4 - CORRECT ANSWERS left ventricle hypertrophy late diastole Tanner Stages Males: II - CORRECT ANSWERS no changes to penis, testes enlarge Pubic hair is sparse and straight Tanner Stages Males: III - CORRECT ANSWERS penis lengthens hair darker and starts to curl Tanner Stages Males: IV - CORRECT ANSWERS penis increases in length and width hair coarse, not yet on medial thigh Tanner Stages Females: II - CORRECT ANSWERS breast buds pubic hair sparse and straight Tanner Stages Females: III - CORRECT ANSWERS breast tissue and areola in one mound hair darker, starts to curl Tanner Stages Females: IV - CORRECT ANSWERS areola separates and forms a secondary mound hair coarse, not on medial thigh yet TORCH infections - CORRECT ANSWERS Toxoplasmosis Other Rubella Cytomegalovirus Herpes osteoarthritis vs rheomatoid arthritis - CORRECT ANSWERS OA: stiffness, heberden's nodes, increase age, overuse, family history RA: relies more on labs, increased ESR, Bouchard's nodes, fatigue, fever, body aches drawer test - CORRECT ANSWERS instability of the knee mediolateral and anteroposterior plane torn or ruptured ligament fundal height 12 weeks - CORRECT ANSWERS just above pubic bone fundal height 20 weeks - CORRECT ANSWERS level of umbilicus fundal height 20-35 weeks - CORRECT ANSWERS number of weeks gestation +/- 2 cm apraxia - CORRECT ANSWERS loss of ability to perform purposeful movements in the absence of sensory or motor damage ectopic pregnancy - CORRECT ANSWERS amenorrhea, new onset of vaginal spotting, left adnexal tenderness, and cervical motion tenderness G6PD anemia - CORRECT ANSWERS hereditary, RBC break down, hemolysis Meds that can trigger: antimalarial drugs, aspirin, nitrofurantoin, NSAIDs, quinidine, quinine, sulfa Pheochromocytoma - CORRECT ANSWERS a benign tumor of the adrenal medulla that causes the gland to produce excess epinephrine and norepinephrine these hormones control heart rate, metabolism, and blood pressure Fitz-Hugh-Curtis - CORRECT ANSWERS Perihepatic inflammation & fibrosis; Complication of Chlamydia and pelvic inflammatory disease Sharp pain in RUQ subconjunctival hemorrhage risk factors - CORRECT ANSWERS Bright red patches in conjunctiva of eyes due to ruptured blood vessels Risk factors: DM, HTN, coughing, sneezing, blood thinners, aspirin, ginkgo Benign, will spontaneously resolve atopic dermatitis - CORRECT ANSWERS Excess inflammation; dry skin, redness, and itching from allergies and irritants. linear Koplik spots - CORRECT ANSWERS Rubeola (measles) small white papules inside the cheeks by rear molars treponema pallidum symptoms - CORRECT ANSWERS syphilis painless chancre, maculopapular rash on palms and soles, lymphadenopathy, condyloma acata hCG is produced by - CORRECT ANSWERS placenta after implantation majority of AFP is produced by - CORRECT ANSWERS fetal liver Inevitable abortion - CORRECT ANSWERS bleeding and cramping/pain with cervical dilation but no passage of tissue incomplete abortion - CORRECT ANSWERS moderate to diffuse vaginal bleeding, passage of tissue, painful uterine cramping or contractions MMR and pregnancy - CORRECT ANSWERS contraindicated wait 4 weeks before becoming pregnant Positive signs of pregnancy - CORRECT ANSWERS ultrasound, auscultation of fetal HR with doppler Probable signs of pregnancy - CORRECT ANSWERS detected by examiner blood and urine tests, Chadwick's sign, Goodell's sign, Hegar's sign, enlarged uterus Presumptive signs of pregnancy - CORRECT ANSWERS felt by woman amenorrhea, nausea, breast tenderness, deepening pigmentation, urinary frequency, quickening, fatigue testing HPV - CORRECT ANSWERS lesions will turn white with application of acetic acid OCD treatment - CORRECT ANSWERS SSRI first step for dementia assessment - CORRECT ANSWERS history from family and friends Phalen maneuver - CORRECT ANSWERS Tests carpel tunnel syndrome, pinches median nerve chronic cough causes - CORRECT ANSWERS postnasal drip, asthma, GERD, chronic bronchitis, bronchiectasis, allergic rhinitis Aspirin effect on platelets - CORRECT ANSWERS irreversible, can last 15-20 days Chromolyn sodium inhaler - CORRECT ANSWERS prevent symptoms of asthma Rovsign's sign - CORRECT ANSWERS acute abdomen palpate deep LLQ, referred pain to RLQ cauda equina - CORRECT ANSWERS caused by compression of lumbar, sacral, or coccygeal nerve roots loss of bladder and bowel control paralysis/numbness of legs cause: disc herniation. abscess, tumor, inflammation order MRI placenta abruptio - CORRECT ANSWERS premature separation of the placenta from the wall of the uterus bright red vaginal bleeding, board-like uterus on palpation, pain Jarisch-Herxheimer reaction - CORRECT ANSWERS Flu-like syndrome (fever, chills, headache, myalgia) after antibiotics are started; due to killed bacteria (usually spirochetes) releasing endotoxins. Treatment of syphilis, first 24 hours headache, myalgias, rigors, sweating, hypotension, worsening of rash spontaneously resolves in 12-24 hours coarctation of the aorta - CORRECT ANSWERS congenital cardiac condition characterized by a narrowing of the aorta blood pressure higher in arms than legs mitral valve prolapse - CORRECT ANSWERS improper closure of the mitral valve late systolic murmur in the apical area mid-systolic click pterygium - CORRECT ANSWERS triangular opaque tissue on the nasal side of the conjunctiva that grows toward the center of the cornea cause by long-term sun exposure corneal arcus senilis - CORRECT ANSWERS Lipid deposits in the periphery of the eye white to grey colored ring around the edge of the cornea in both eyes pingeucula - CORRECT ANSWERS benign growth on the conjunctiva caused by degeneration of collagen fibers cause by long-term sun exposure Lyme disease - CORRECT ANSWERS Tick-borne disease caused by the spirochete Borrelia burgdorferi. erythema migrans treat with doxycycline Epstein-Barr virus labs - CORRECT ANSWERS infectious mononucleosis triad: fever, pharyngitis, lymphadenopathy normal to moderate WBCs, increased lymphocytes, >10% atypical lymphocytes Cafe au lait spots - CORRECT ANSWERS Smooth edged tan-to-brown pigmentations on the skin seen in neurofibromatosis or von Recklinghausen's papilledema - CORRECT ANSWERS swelling of the optic disc caused by increased ICP usually bilateral enlarged blind spot on visual field test Fundoscopic exam - CORRECT ANSWERS The use of an ophthalmoscope to look through the pupil and examine the interior surface of the posterior eye visualizes vessels and assess intracranial tension recommended for new onset headache - CORRECT ANSWERS fundoscopic exam red reflex exam - CORRECT ANSWERS used to assess for cataracts Leukoplakia - CORRECT ANSWERS thickened, white, leathery-looking spots on the inside of the mouth from chronic tobacco use retinoblastoma fundoscopic exam - CORRECT ANSWERS white reflection on pupil high vitamin K levels effect with coumadin - CORRECT ANSWERS decrease INR HELLP syndrome - CORRECT ANSWERS hemolysis, elevated liver enzymes, low platelets complication of preeclampsia multipara, >25, 3rd trimester RUQ pain, n/v, malaise low H/H low AFP - CORRECT ANSWERS Down syndrome order triple screen high AFP - CORRECT ANSWERS indicates neural tube defects, multiple gestation order triple screen or sonogram HCG doubles every - CORRECT ANSWERS 48 hours during the first 12 weeks ectopic pregnancy HCG level - CORRECT ANSWERS lower levels inevitable abortion HCG level - CORRECT ANSWERS starts decreasing rapidly drawer sign - CORRECT ANSWERS knee instability, torn/ruptured ligament anterior: ACL posterior: PCL Finklestein's test - CORRECT ANSWERS Test for de Quervain's syndrome McMurray Test - CORRECT ANSWERS medial meniscus hear a click acute angle closure glaucoma - CORRECT ANSWERS sudden unilateral eye pain, redness, dilated oval shaped pupil with poor light response headache, n/v, halos around lights cloudy cornea fundoscope: cupping of optic nerve optic neuritis - CORRECT ANSWERS new-intermittent loss of vision in 1 eye nystagmus multiple sclerosis orbital cellulitis - CORRECT ANSWERS Redness, swelling, impaired motility, painful, proptosis retinal detachment - CORRECT ANSWERS floaters and flashes of light, curtain vision diabetic retinopathy - CORRECT ANSWERS Microaneurysms caused by new fragile arteries in the retina. cotton wool spots cataracts - CORRECT ANSWERS opacity of lens, halos around lights, develop slowly over time, causing symptoms such as blurry vision Fibromyalgia - CORRECT ANSWERS symptoms last more than 3 months diffuse pain, sleep abnormalities, fatigue Alzheimer's symptoms - CORRECT ANSWERS aphasia, apraxia, agnosia Mini-Mental State Examination (MMSE) mid-moderate score - CORRECT ANSWERS 10-26 Mini-Mental State Examination (MMSE) moderate-advanced score - CORRECT ANSWERS <17 Mini-Mental State Examination (MMSE) severe score - CORRECT ANSWERS <10 Diabetes screening tests - CORRECT ANSWERS fasting plasma glucose >/= 126 A1C > 6.5 random blood sugar > 200 with symptoms Most common risk factor for developing hyperbilirubinemia in newborn - CORRECT ANSWERS blood incompatibility with the mother Sports physical: limitations for participation - CORRECT ANSWERS hypertyrophic cardiomyopathy down syndrome juvenile RA marfan syndrome ehers-danlos infections rheumatic fever mitral valve prolapse Mono vs group a strep pharyngitis - CORRECT ANSWERS Mono: gradual, fatigue, LUQ pain Strep: sudden, white patches, red throat Grade I heart murmur - CORRECT ANSWERS only heard in optimal conditions Grade II heart murmur - CORRECT ANSWERS clearly audible but faint Grade III heart murmur - CORRECT ANSWERS loud, easily heard with stethoscope Grade IV heart murmur - CORRECT ANSWERS loud, associated with thrill Grade V heart murmur - CORRECT ANSWERS very loud, thrill easily palpable heard with edge of stethoscope off chest Grade VI heart murmur - CORRECT ANSWERS very loud, audible even with stethoscope not on chest, thrill palpable and visible BPH symptoms clinical findings - CORRECT ANSWERS weak urinary stream, post-void dribbling, feeling of incomplete emptying, urinary retention, nocturia prostate feels boggy and uniformly enlarged Initial assessment of depression in geriatric patients - CORRECT ANSWERS mental status exam Risk factors for post menopausal osteoporosis - CORRECT ANSWERS history of tobacco or alcohol use family history thin, bony chronic steroid use anorexia, bulimia PPI use decreased intake of calcium and vitamin D sedentary lifestyle gastric bypass celiac disease hyperthyroidism ankylosing spondylitis RA causes of CKD - CORRECT ANSWERS DM, HTN, ischemia, infection, obstruction, toxins, autoimmune diseases (SLE, amyloidosis) exacerbations of urinary incontinence - CORRECT ANSWERS impacted stool atrophic vaginitis UTI positive IgG Anti-HAV - CORRECT ANSWERS history of hepatitis A infection or vaccination positive IgM Anti-HAV - CORRECT ANSWERS acute hepatitis A infection HbsAg - CORRECT ANSWERS screening test for Hepatitis B +: current infection positive HbeAg - CORRECT ANSWERS persistent chronic Hepatitis B infection positive Anti-Hbs - CORRECT ANSWERS antibodies past Hepatitis B infection or vaccination positive Anti HCV - CORRECT ANSWERS current infection Order HCV RNA or PCR to rule out chronic infection enlarged parotid gland - CORRECT ANSWERS mumps vulvar cancer symptoms - CORRECT ANSWERS bump on vulva, pruritus, malodorous drainage, ulcerate lesion syphilis symptoms - CORRECT ANSWERS one painless ulcer, enlarged groin lymph nodes genital herpes - CORRECT ANSWERS shallow, small ulcers with red base, painful, swollen lymph nodes Osgood-Schlatter disease - CORRECT ANSWERS pain relieved with rest, swelling of the tibial tubercle Multiple myeloma symptoms - CORRECT ANSWERS anemia, back pain, osteoporosis, increased ESR lab frequency when changing synthroid dose - CORRECT ANSWERS 6 weeks labs with stable synthroid dose - CORRECT ANSWERS 6-12 months best medication for hypertension with diabetic patients - CORRECT ANSWERS ACE inhibitor treatment of retentive encopresis - CORRECT ANSWERS laxative protocol if no improvement: refer to GI rhogam administration after spontaneous abortion - CORRECT ANSWERS 72 hours when can infants have solid foods? - CORRECT ANSWERS 6 months first line treatment of parkinson's - CORRECT ANSWERS sinemet treatment of otitis media - CORRECT ANSWERS Amoxicillin PCN allergy: cefidinir Treatment of cat bites - CORRECT ANSWERS Augmentin treatment of anthrax - CORRECT ANSWERS Ciprofloxacin and doxycycline Asthma Step 1 - CORRECT ANSWERS intermittent FEV1>80% daytime symptoms <2 days/week nighttime awakenings <2/month SABA PRN Asthma Step 2 - CORRECT ANSWERS mild persistent FEV1>80% daytime symptoms >2 days/week, not daily nighttime awakenings 3-4/month SABA PRN Asthma Step 3 - CORRECT ANSWERS moderate persistent FEV1: 60-80% daytime symptoms nighttime awakenings >1/week, not nightly SABA PRN PLUS low dose ICS + LABA or medium dose ICS Advair, symbicort combo Steroids: budesonide (pulmicort) or fluticasone (flovent) Asthma Step 4 - CORRECT ANSWERS sever persistent FEV1 <60% symptoms throughout the day nighttime awakenings nightly SABA PRN PLUS medium dose ICS + LABA Advair, symbicort combo OR medium dose ICS + montelukast optic disc normal exam - CORRECT ANSWERS has sharp margins, yellow-orange to creamy pink color and round or oval in shape veins to arteries ratio- 3:2 veins are darker and larger Snellen test results - CORRECT ANSWERS Numerator: the test distance, 20 ft denominator: the distance at which average eye can see letters on line Symogi effect - CORRECT ANSWERS also called the rebound effect caused by too much insulin (or missing a meal) in the evening, resulting in hypoglycemia in the early morning (2-3 am) body secretes glucagon and epinephrine, resulting in high blood sugars in the morning Dawn phenomenon - CORRECT ANSWERS high blood glucose levels occur between 2 a.m. and 8 a.m treat: avoid high carb snacks before bed, adjust night time insulin dose intermittent claudication evaluation - CORRECT ANSWERS ankle and brachial blood pressure before and after exercise interactions with theophylline - CORRECT ANSWERS erythromycin, phenytoin, cimetidine Theophylline - CORRECT ANSWERS used to control inflammation of the lungs and for maintenance as a bronchodilator cover/uncover test - CORRECT ANSWERS screening for strabismus Ishihara test - CORRECT ANSWERS test for color blindness Peak expiratory flow is determined by - CORRECT ANSWERS height, gender, age pap smear sample must contain - CORRECT ANSWERS squamous cells: sample from transition area endocervical cells: upper limit of transformation zone physiological jaundice - CORRECT ANSWERS caused by build up of unconjugated bilirubin because the infant's immature live cannot metabolize and excrete it quickly enough starts 2nd-4th day phototherapy is usually not indicated pathological jaundice - CORRECT ANSWERS occurs before 24 hours and may indicate early hemolysis most common type of jaundice - CORRECT ANSWERS physiological Koilonychia - CORRECT ANSWERS spoon shaped nails in iron deficiency anemia pernicious anemia - CORRECT ANSWERS a macrocytic (high MCV) normochromic (normal MCHC) megaloblastic characterized by an inadequate supply of vitamin B12, causing red blood cells to become large, varied in shape, and reduced in number diagnostic: increased antiparietal antibodies Tetanus vaccine - CORRECT ANSWERS given in adults every 10 years DPT and DT should not be given beyond 7 years side effects: induration at the injection site blood pressure goal for patients with CKD, any age - CORRECT ANSWERS less than 140/90 Blood pressure treatment for patients with CKD - CORRECT ANSWERS ACE inhibitors, ARBs, alone or in combination with another drug class visual fields by confrontation test is used to evaluate - CORRECT ANSWERS peripheral vision Snellen chart is used to evaluate - CORRECT ANSWERS central vision Tonometer is used to assess - CORRECT ANSWERS glaucoma Ophthalmoscope is used to test - CORRECT ANSWERS cataracts Macule - CORRECT ANSWERS flat, nonraised lesion on the skin freckle, petechiae, flat birthmark Papules - CORRECT ANSWERS raised, erythemic lesions of the skin acne tetanus vaccine booster recommendation for recent injuries - CORRECT ANSWERS if it has been more than 5 years since the last dose cranial nerve I - CORRECT ANSWERS Olfactory (smell) cranial nerve II - CORRECT ANSWERS Optic - distance and near vision cranial nerve III - CORRECT ANSWERS Oculomotor extraocular movements, visual fields of gaze cranial nerve IV - CORRECT ANSWERS Trochlear extraocular movements, visual fields of gaze cranial nerve V - CORRECT ANSWERS Trigeminal motor portion: clench jaws sensory portion: corneal reflex, facial sensation Testing: inspection for muscle atrophy and tremors, palpation of jaw muscles for tone and strength when clenching, superficial pain and touch in each branch, temperature sensation if there are unexpected findings to pain or touch wisp of cotton for corneal reflex cranial nerve VI - CORRECT ANSWERS Abducens extraocular movements, visual fields of gaze cranial nerve VII - CORRECT ANSWERS Facial - controls most facial expressions secretion of tears & saliva taste cranial nerve VIII - CORRECT ANSWERS Vestibulocochlear vestibular nerve is primarily responsible for maintaining body balance and eye movements, cochlear nerve is responsible for hearing cranial nerve IX - CORRECT ANSWERS Glossopharyngeal - taste senses carotid blood pressure swallowing and the gag reflex production of saliva cranial nerve X - CORRECT ANSWERS Vagus - senses aortic blood pressure slows heart rate stimulates digestive organs taste cranial nerve XI - CORRECT ANSWERS spinal accessory Test trapezius muscle strength: shrug the shoulders against resistance Test sternocleidomastoid strength: turn the head to each side with resistance cranial nerve XII - CORRECT ANSWERS Hypoglossal movement of most of the muscles in your tongue primary prevention - CORRECT ANSWERS Efforts to prevent an injury or illness from ever occurring. secondary prevention - CORRECT ANSWERS Efforts to limit the effects of an injury or illness that you cannot completely prevent. tertiary prevention - CORRECT ANSWERS actions taken to contain damage once a disease or disability has progressed beyond its early stages physical rehab (swimming) cardiac rehab speech therapy ptosis - CORRECT ANSWERS drooping of the upper eyelid cluster headaches - CORRECT ANSWERS Severe, unilateral, periorbital or temporal area last from 15 minutes to 3 hours Lacrimation, rhinorrhea, ptosis, miosis, eyelid edema Occur in clusters with 1-8xper day for 4-6 weeks 8:1 men predominance treat with 100% oxygen at 12 L/min beta thalasemia minor - CORRECT ANSWERS genetic disorder, common in mediterranean countries- greece and italy diagnostic test: hgb electrophoresis RBCs are small, pale Hypochromic (low MCHC) Microcytic (low MCV) mitral valve prolapse complications - CORRECT ANSWERS mitral regurgitation endocarditis TIA,CVA Most sensitive test for active H. pylori infection - CORRECT ANSWERS urea breath test condyloma acuminatum - CORRECT ANSWERS lesion that appears as a result of human papilloma virus; on the skin, lesions appear as cauliflower-like warts, and on mucous membranes, they have a flat appearance; also known as venereal or genital warts Condyloma lata - CORRECT ANSWERS Secondary syphilis Molluscum contagiosum - CORRECT ANSWERS viral skin infection spread by skin-to-skin contact adults: appears on the face, abdomen, neck, armpits, arms, and hands Lesions begin as small, firm, dome shaped growths surface feels smooth, waxy, or pearly flesh-colored or pink have a dimple in the center, filed with thick, white substance that is cheesy or waxy painless but itch differential diagnosis for microcytic anemia - CORRECT ANSWERS iron deficiency anemia thalasemias anemia of chronic disease sideroblastic anemias- lead poisoning differential diagnosis for macroctyic anemia - CORRECT ANSWERS folate-deficiency, vitamin B12 deficiency, pernicious anemia Cullen's sign - CORRECT ANSWERS ecchymosis in umbilical area, seen with pancreatitis Romberg test - CORRECT ANSWERS used to evaluate cerebellar function and balance stand up straight with eyes closed Enterobiasis - CORRECT ANSWERS occurs most frequently in school-aged children and presents with perianal pruritus. Diagnosis is made by the Scotch tape test Tx: Albendazole is first line. most common cause of LVH - CORRECT ANSWERS chronic HTN exercise-induced asthma is best controlled by - CORRECT ANSWERS using proventil inhaler 10-15 minutes before exercise Podagra - CORRECT ANSWERS gout of the big toe which type of hepatitis virus is more likely to result in increased risk of chronic hepatitis and increased risk of hepatocellular carcinoma? - CORRECT ANSWERS Hepatitis B and C caloric content of formula and breast milk - CORRECT ANSWERS 20kcal/30mL normocytic anemia - CORRECT ANSWERS associated with chronic autoimmune or inflammatory disorders and chronic infection diagnostic: normal sized RBCs Kernig's maneuver - CORRECT ANSWERS performed by having the patient flex both hips and legs and then straighten the legs against resistance, testing for meningeal and spinal inflammation Brudzinski's maneuver - CORRECT ANSWERS performed by placing the patients hands behind head and gently tucking chin to chest meningitis Homan's sign - CORRECT ANSWERS flexion of the foot causing pain in the posterior calf, suggestive of DVT RhoGAM's mechanism of action given in the ___ week of pregnancy - CORRECT ANSWERS destruction of Rh-positive fetal red blood cells that are present in the mother's circulatory system given to Rh negative mothers during the 28th week of pregnancy. Auspitz sign - CORRECT ANSWERS bleeding that occurs after psoriasis scales have been removed also found in actinic keratoses cheilosis - CORRECT ANSWERS acute or chronic inflammation of the mouth due to excessive moisture corners of the mouth are macerated with fissures and painful reddened skin fracture of the navicular area of the wrist - CORRECT ANSWERS caused by falling forward and landing on the hands affected wrist is hyperextended to break the fall pain, swelling, and tenderness over the thumb side of the wrist, crunchiness and pain with gripping has a higher rate of nonunion compared with other bones in the wrist frequently does not show up on xray immediately after fracture xray will show fracture at 2 weeks bullous impetigo cause treatment - CORRECT ANSWERS cause by staph aureus, produces an exfoliative toxin flaccid large blisters filled with serous fluid bullae rupture and fluid dries, resembling honey-colored crusts limited number of lesions: mupirocin extensive lesions: systemic antibiotics- dicloxacillin and cephalexin regular insulin - CORRECT ANSWERS onset: 30 minutes peak: 1-5 hours Duration 6-8 hours NPH insulin - CORRECT ANSWERS onset: 1 hours peak: 6-14 hours duration: 18-24 hours insulin glargine - CORRECT ANSWERS onset: 1 hour no peak duration: 20-36 hours pulsus paradoxus - CORRECT ANSWERS drop in blood pressure >10 mmHg with inspiration asthma, emphysema tamponade, pericarditis, cardiac effusion varicocele - CORRECT ANSWERS varicose veins, bag of worms, in the scrotum associated with reduced fertility testicular torsion - CORRECT ANSWERS twisting of the spermatic cord causing decreased blood flow to the testis severe acute unilateral scrotal pain, nausea, and vomiting absence of cremasteric reflex affected testicle is elevated, warm must be corrected within 6 hours weber test - CORRECT ANSWERS can detect unilateral conductive and sensorineural hearing loss vibrating tuning fork is placed in the middle of the forehead or on top of the head equidistance from the ears normal: sound is heard equally loud in both ears hearing loss: heard louder in one ear (lateralization) Rinne test - CORRECT ANSWERS Place the base of a struck tuning fork on the mastoid bone behind the ear. Have the patient indicate when sound is no longer heard. Move fork (held at base) beside ear and ask if now audible. Normal: AC (beside the ear) > BC (mastoid) conductive hearing loss: BC > AC span of normal of adult liver - CORRECT ANSWERS 6-15 cm in the midclavicular line treatment for strep throat in pregnancy - CORRECT ANSWERS PCN VK Anthrax prophylaxis - CORRECT ANSWERS ciprofloxacin levofloxacin antibiotics for 60 days and anthrax vaccine pes planas - CORRECT ANSWERS flat foot fetal alcohol syndrome - CORRECT ANSWERS small palpebral fissures and microcephaly with a small jaw AIDs diagnosis - CORRECT ANSWERS hairy leukoplakia, Kaposi's sarcoma, thrush Down syndrome characteristics - CORRECT ANSWERS A flattened face, especially the bridge of the nose Almond-shaped eyes that slant up A short neck Small ears A tongue that tends to stick out of the mouth Tiny white spots on the iris (colored part) of the eye Small hands and feet A single line across the palm of the hand (palmar crease) Small pinky fingers that sometimes curve toward the thumb Poor muscle tone or loose joints Shorter in height as children and adults MCV - CORRECT ANSWERS size of RBC MCHC - CORRECT ANSWERS average color of RBC iron deficiency anemia - CORRECT ANSWERS diagnostic: ferritin/serum iron decreased, TIBC increased microcytic hypochromic Folate deficiency anemia - CORRECT ANSWERS diagnostic: folate level decreased, homocysteine increased macrocytic megaloblastic (large, immature) RBCs normochromic vitamin B12 anemia - CORRECT ANSWERS diagnostic: decreased vitamin B12, hypersegmented neutrophils macrocytic megaloblastic normochromic paresthesias, numbness sickle cell anemia - CORRECT ANSWERS diagnostic: hgb electrophoresis, HbS and hbF both elevated, reticulocytosis, hemolytic sickle-shaped RBCs with shortened life span of 10-20 days Howell-Jolly bodies and target cells on peripheral smear normochromic normocytic neonates should regain weights by ___ double birth weight by ___ triple birth weight by _____ - CORRECT ANSWERS 2 weeks 6 months 12 months head circumference will increase by ___ in the first 12 months - CORRECT ANSWERS 12 cm developmental stages: newborns eating, BM, diaper frequency - CORRECT ANSWERS strong primitive reflexes: moro, rooting, fencing, babinski, grasp eats every 2-3 hours or nurses 8-10 times per day sleeps 16 hours/day 6-8 BM/day wet diapers: 8/day developmental stages: 2 months - CORRECT ANSWERS coos and makes gurgling sounds lifts head 45 degrees when prone smiles in response to another developmental stages: 4 months - CORRECT ANSWERS smiles spontaneously (social smile) begins to babble holds head unsupported rolls from front to back developmental stages: 6 months - CORRECT ANSWERS palmar grasp of objects sit up independently without support rolls over in both directions starts to say consonants (dada) developmental stages: 9 months - CORRECT ANSWERS pulls up to stand crawls peak-a-boo stranger anxiety developmental stages: 12 months - CORRECT ANSWERS stands independently cruises from one piece of furniture to another 2-4 words follows simple directions (pick up toy) developmental stages: 15 months - CORRECT ANSWERS feeds self walks independently follows commands with gestures 4-6 words developmental stages: 18 months - CORRECT ANSWERS walk up steps can point to 4 body parts 10-20 words developmental stages: 2 years - CORRECT ANSWERS speaks in 2-3 word sentences (understood by family) 2-3 step instructions parallel play can copy straight line toilet training in progress developmental stages: 3 years - CORRECT ANSWERS speaks in 3-5 word sentences speech understood by strangers copies a circle pedals a tricycle 3 numbers and 3 colors Oedipal stage group play developmental stages: 4 years - CORRECT ANSWERS draws a cross draw person with 3 body parts plays mom and dad hops and stands on one foot briefly developmental stages: 5 years - CORRECT ANSWERS can draw a person with 6 body parts counts to 10 aware of gender speaks clearly developmental stages: 6 years - CORRECT ANSWERS copies a triangle ties shoes rides a bike AAA screening - CORRECT ANSWERS US men 65-75 who smoked mammogram - CORRECT ANSWERS age 50-74 every 2 years Colorectal cancer screening age - CORRECT ANSWERS 50-75 years FOBT every year colonoscopy every 10 years lung cancer screening - CORRECT ANSWERS low dose CT if currently smokes or quit within the last 15 years insulin lispro - CORRECT ANSWERS onset: 15 minutes peak: 30 minutes-2.5 hours duration: 4.5 hours Anticholinergic side effects - CORRECT ANSWERS SAD CUB sedation anorexia dry mouth confusion and constipation urinary retention BPH Cervical cancer screening - CORRECT ANSWERS less than 20: do not screen 21-29: Pap test every 3 years 30-65: pap smear, co-testing, every 5 years, every 3 if no co-testing >65: no testing total hysterectomy: no testing Chlamydia treatment - CORRECT ANSWERS azithromycin 1g PO one dose OR doxy 100 mg BID 7 days Gonorrhea treatment - CORRECT ANSWERS Ceftriaxone 250 mg IM PLUS Azithromycin 1 gm PO Syphilis treatment - CORRECT ANSWERS Benzathine penicillin G 2.4 mU IM one dose Hand-foot-mouth disease - CORRECT ANSWERS Coxsackie virus multiple small blisters on the hands and feet small ulcers inside the mouth, throat, tonsils, and tongue varicella - CORRECT ANSWERS chicken pox generalized rash in different stages papules -> vesicles -> pustules -> crusts pruritic scarlet fever cause rash other symptoms - CORRECT ANSWERS strep pyogenes sandpaper rash rash starts on neck and trunk and spreads to extremities sore throat, strawberry tongue, fever desquamation may occur pediculosis capitis - CORRECT ANSWERS ovoid white nits on hair hards to dislodge red papules that are very itchy scabies - CORRECT ANSWERS located in interdigital webs of hands, waist, axillae, penis very pruritic especially at night cranial nerves pneomonic - CORRECT ANSWERS Oh Oh Tim Tried and Forgot Victoria Gives Very Strong Handshakes cranial nerves order - CORRECT ANSWERS I: olfactory II: optic III: oculomotor III: trochlear IV: trigeminal V: trigeminal VI: abducens VII: facial VIII: vestibulocochlear IX: glossopharyngeal X: vagus XI: spinal accessory XII: hypoglossal hypertension treatment black - CORRECT ANSWERS black: thiazide diuretics and CCBs blood pressure goal 60+, no DM or CKD - CORRECT ANSWERS <150/90 blood pressure goal <60 - CORRECT ANSWERS <140/90 Thiazide diuretics side effects contraindications labs examples: - CORRECT ANSWERS avoid if patient has sulfa allergy side effects hyper: hyperglycemia, hyperuricemia, hypertriglyceridemia, hypercholesteremia hypo: hypokalemia, hyponatremia, hypomagnesemia monitor: cmp, lipid profile examples: HCTZ, chlorthalidone, indapamide loop diuretics side effects contraindications labs examples: - CORRECT ANSWERS side effects: hypokalemia, hyponatremia, hypomagnesemia, altered secretion of lithium and salicylates contraindications: sulfa allergy labs: digoxin level, CMP examples: furosemide, bumetanide aldosterone receptor antagonist diuretics indication side effects contraindications labs examples: - CORRECT ANSWERS indication: HTN, HF, hirsutism, precocious puberty side effects: gynecomastia, galactorrhea, hyperkalemia, GI (V/D, cramping), postmenopausal bleeding, ED contraindications: hyperkalemia, renal insufficiency, DM 2 with microalbuminuria labs: CMP examples: spirinolactone, eplerenone beta blockers indications cautions contraindications examples: - CORRECT ANSWERS indications: acute MI, migraine, glaucoma, angina, resting tachycardia avoid abrupt discontinuation after chronic use and wean slowly- rebound HTN contraindications: asthma, COPD, chronic bronchitis, emphysema, 2nd/3rd degree heart block, sinus bradycardia examples: olol calcium channel blockers side effects contraindications examples: - CORRECT ANSWERS side effects: headache, ankle edema, heart block or bradycardia, reflex tachycardia contraindications: 2nd/3rd degree heart block, HF, bradycardia examples: nifedipine, amlodipine, verapamil, diltiazem ACEI/ARB indication side effects contraindications labs examples: - CORRECT ANSWERS indication: drug of choice for DM and CKD side effects: dry hacking cough, hyperkalemia, angioedema contraindications: do not use in pregnancy, moderate to severe kidney disease, renal artery stenosis, hyperkalemia labs: potassium level examples: pril/sartan alpha 1 blockers/antagonists indication cautions side effects examples: - CORRECT ANSWERS indication: men with both HTN and BPH give at bedtime at very low doses and slowly titrate up side effects: first dose orthostatic HTN, dizziness, reflex tachycardia contraindications examples: zosin, tamsulosin hypertension treatment non-blacks - CORRECT ANSWERS non-blacks: thiazide diuretics, ACEI, ARB, CCB hypertension treatment elderly - CORRECT ANSWERS thiazide diuretics at low dose, long-acting CCBs (amlodipine, nifedipine) and/or ACEI or ARB hypertension treatment stable HF - CORRECT ANSWERS ACE/ ARB-first line Plus BB Plus diuretic hypertension treatment DM - CORRECT ANSWERS ACE/ ARB-first line black: can start with CCB or thiazide hypertension treatment CKD - CORRECT ANSWERS ACE/ ARB-first line can add CCB or thiazide hypertension treatment stroke history - CORRECT ANSWERS ACE/ ARB-first line can add CCB or thiazide as second-line posterior fontanel closes by - CORRECT ANSWERS 3 months anterior fontanel closes by - CORRECT ANSWERS 12-18 months morton's neuroma - CORRECT ANSWERS pain, burning, or numbness between 2 adjacent toes with weight bearing walking on a pebble acne vulgaris characteristics treatment - CORRECT ANSWERS common acne inflammation of the sebaceous glands cause: high androgen levels, bacterial infection (propionibacterium acnes), genetics lesions located mainly on face, shoulders, chest, and back puberty and adolescence treatment: over the counter medicated soap, prescription topicals, oral antibiotics (tetracycline) severe cystic acne characteristics treatment - CORRECT ANSWERS All of the preceding findings plus PAINFUL indurated nodules and cysts over face, shoulders, and chest. Medications Isotretinoin (ACCUTANE) is a category X drug (extremely TERATOGENIC). Hidradenitis suppurativa - CORRECT ANSWERS chronic skin condition found in apocrine glands in the axilla, groin causes painful nodules under the skin abscesses open and drain fluid and pus scrarring Erysipelas - CORRECT ANSWERS a contagious disease of the skin and subcutaneous tissues caused by infection with group a beta hemolytic strep; redness and swelling of affected areas first degree burn - CORRECT ANSWERS Superficial burns through only the epidermis erythema without blistering, painful sunburn can be treated by NP second degree burn - CORRECT ANSWERS superficial partial-thickness burn involving the epidermis and the superficial dermis red with clear blisters, blanches with pressure, has a moist texture, painful takes 2-3 weeks to heal can be treated by NP third degree burn - CORRECT ANSWERS involves destruction of epidermis, dermis and subcutaneous layer electrical burns, severe burns of the face, and burns involving cartilage (ear and nose) painless split S2 heart sound is heard best at - CORRECT ANSWERS 2nd intercostal space, left sternal border pulmonic precocious puberty - CORRECT ANSWERS boys: before 9 girls: before 8 delayed puberty - CORRECT ANSWERS boys: no testicular/scrotal growth by 14 girls: no breast development by age 12 endocrine consult2 tanner stage: puberty - CORRECT ANSWERS 2 menarche - CORRECT ANSWERS average age: 12 after stage 2 starts, start menses within 1-2 years metformin starting dose max dose contraindications - CORRECT ANSWERS initial therapy for DM 2 can help with weight loss starting dose: 500 mg daily max dose: 2 g/day contraindications: significant renal and hepatic disease, alcoholism, hypoxia, sepsis, dehydration, advanced age atrial fibrillation risk factors - CORRECT ANSWERS increased age heart disease- valve problems, HF, CAD, history of MI HTN chronic conditions: hyperthyroidism, OSA, DM, CKD, lung disease alcohol obesity family history medications: theophylline, sudafed bacterium responsible for highest mortality rate with CAP - CORRECT ANSWERS strep pneumoniae because it is the leading cause of CAP Wilms' tumor - CORRECT ANSWERS malignant congenital tumor of the kidney commonly crosses midline of the abdomen when it is discovered children and patients may complain of an abdominal mass should never be palpated once discovered to avoid spread of tumor cells microscopic or gross hematuria may be present Osteoporosis t score osteopenia t score - CORRECT ANSWERS -2.5 and below -1.0 to -2.5 Thayer-Martin culture - CORRECT ANSWERS Used to diagnose gonorrheal pharyngitis or proctitis blue dot sign - CORRECT ANSWERS torsion of the testicular appendage a tender nodule located underneath the skin that appears as a round, blue-to-purple mass can mimic testicular torsion not an emergent condition treatment is symptomatic contraindications for hormonal contraception - CORRECT ANSWERS migraine cigarette smoking >35 obesity >35 history of thromboembolic disease HTN or vascular disease >35 SLE with vascular disease nephritis antiphospholipid antibodies breastfeeding (progesterone only) hypertroglyceridemia CAD CHF strokes Trichomoniasis - CORRECT ANSWERS caused by a protozoan parasite symptoms: dysuria, severe vaginal pruritis, malodorous vaginal discharge wet prep microscopic exam: trichomonads- pear-shaped and have several flagella treatment: metronidazole single dose treatment plan for patients with AIDS and CD4 count less than 200 - CORRECT ANSWERS preventative therapy for pneumocytis carinii pneumonia (PCP): bactrim DS one tablet daily dapsone aerosolized pentamidine Zollinger-Ellison syndrome - CORRECT ANSWERS tumors in the intestine, pancreas, or lymph nodes near the pancreas produce excessive amounts of gastrin, increasing the amount of acid produced by the stomach or duodenum can lead to severe ulceration of the stomach or duodenum pitting fingernails - CORRECT ANSWERS Psoriasis acute epididymitis - CORRECT ANSWERS STD fever, pain in scrotum, frequency, dysuria scrotum edematous and tender pain is lessened when using scrotal support acute orchitis - CORRECT ANSWERS testicular pain and edema associated with Mumps Spermatogenesis take place - CORRECT ANSWERS testes Sperm are stored in the __________. - CORRECT ANSWERS epididymis Benign Paroxysmal Positional Vertigo - CORRECT ANSWERS Acute onset of vertigo and horizontal nystagmus in response to a rapid change of head position treatment of strep pharyngitis - CORRECT ANSWERS PCN PCN allergy: erythromycin, cephalexin treatment of UTI - CORRECT ANSWERS First: nitrofurantoin, bactrim second: cipro, levofloxacin drugs that interfere with the metabolism of oral contraceptives - CORRECT ANSWERS anticonvulsants, antibiotics, rifampin, griseofulvin, ascorbic acid, and acetaminophen Side effects of levothyroxine - CORRECT ANSWERS palpitations, tachycardia, anxiety, irritability, HTN, flushing, insomnia Giant cell arteritis - CORRECT ANSWERS sed rate elevated can cause blindness if not treated treat with high dose steroids refer to ED fever, fatigue, headache, jaw claudication, transient vision loss history of polymyalgia rheumatica at very high risk Mini-Cog Test - CORRECT ANSWERS Assesses dementia by having patients remember and repeat three common objects and draw a clock face indicating a particular time. dementia: 0-2 pericarditis - CORRECT ANSWERS symptoms: chest pain over the center/left side of the chest, shortness of breath, especially lying down, low grade fever, weakness, fatigue, dry cough, abdominal or leg swelling pericardial rub ulcerative colitis - CORRECT ANSWERS bloody diarrhea mixed with mucus, n/v, abdominal pain, weight loss, anemia, fatigue treatment: NSAIDs, steroids, immunosuppressive drugs Crohn's disease - CORRECT ANSWERS A chronic inflammatory bowel disease that affects the lining of the digestive tract. abdominal pain, diarrhea, weight loss, anemia, and fatigue treatment: NSAIDs, steroids, immunosuppressive drugs Bell's Palsy - CORRECT ANSWERS temporary paralysis of the seventh cranial nerve that causes paralysis only on the affected side of the face complication: corneal ulceration initial intervention for ectopic pregnancy - CORRECT ANSWERS urine hCG balantitis - CORRECT ANSWERS yeast infection inflammation of the glans penis increased risk: uncircumcised, DM Treatment of essential tremor - CORRECT ANSWERS 2 drugs are first line: -Primidone -propanolol atypical antipsychotics used to treat examples and side effects - CORRECT ANSWERS anxiety side effects: hypotension, sedation, sleepiness, anorexia, hyperglycemia, increase the risk of sudden death in frail elders Olanzapine (obesity) Clozapine (agranulocytosis) Respiradone (increase prolactin) monitor: fasting blood glucose and lipid panel, weight Diverticultis symptoms treatment labs - CORRECT ANSWERS abdominal pain, fever mild management: oral antibiotics and clear liquid diet follow up in 24-48 hours order CBC, CMP, UA Soy Isoflavones mimic the action of - CORRECT ANSWERS estrogen supplementation may help woman with hot flashes prebycusis - CORRECT ANSWERS Sensorineural hearing loss associated with middle and older ages; characterized by hearing loss, especially at high frequency at first; poor auditory discrimination and comprehension, especially with background noise tinnitus damage to the hair cells in the cochlea COPD PFT findings - CORRECT ANSWERS reduction in FEV1 increase RV and TLC Prostatitis clinical findings - CORRECT ANSWERS boggy and warm prostate with tenderness prostate cancer clinical findings - CORRECT ANSWERS hard nodules and indurated areas rule of nines- child - CORRECT ANSWERS 9% each arm 14% each leg 18% front trunk 18% back trunk rule of nines- adult - CORRECT ANSWERS 9% per arm 9% for head 18% each leg 18% anterior trunk 18% posterior trunk Chvostek's sign - CORRECT ANSWERS Hypocalcemia-facial muscle spasm upon tapping tetany tinea cruris - CORRECT ANSWERS jock itch red, itchy rash that is often ring shaped tinea corporis - CORRECT ANSWERS ringworm of the body Klinefelter syndrome - CORRECT ANSWERS males have an extra X chromosome XXY gynecomastia, long limbs, lack of secondary sex characteristics, small testes complications of PCOS - CORRECT ANSWERS DM, HTN, HLD, CVD, metabolic syndrome, endometrial cancer measles - CORRECT ANSWERS Preceded by three C's (Cough, Coryza, Conjunctivitis) Koplik spots Starts on the face and spreads down the arms and trunk, then over the thighs, lower legs and feet first permanent teeth to develop - CORRECT ANSWERS first molars 6 years old ____ is responsible for the symptoms of dysmennorhea - CORRECT ANSWERS prostaglandins released before menses and cause the uterus to contract to shed the endometrial lining stethoscope diaphragm most useful for listening to - CORRECT ANSWERS high pitched sounds S1, S2 aortic/mitral regurgitation pericardial friction rubs stethoscope bell most useful for listening to - CORRECT ANSWERS low-pitched tones S3, S4 mitral stenosis Osler's nodes - CORRECT ANSWERS painful nodules on finger pads seen in endocarditis Janeway lesions - CORRECT ANSWERS endocarditis located on palms and soles painless red papules and macules Roseola infantum rash cause complication - CORRECT ANSWERS high-grade fever for 3-5 days followed by an erythematous macupapular rash on the trunk after fever breaks caused by the virus HHV-6 Febrile seizures Fifth's Disease (Erythema Infectiosum) cause stages - CORRECT ANSWERS caused by parvovirus B19 3 stages: prodromal: URI- low grade fever, headache, chills, malaise 1st: rash appears on the cheeks and resolves in 2-3 days 2nd: progresses to lacy rash on trunk, arms, and legs that is flat and appears purple 3rd: rash disappears but will reappear if the child is exposed to sunlight, heat, or exercise Rocky Mountain Spotted Fever cause symptoms - CORRECT ANSWERS Rickettsia rickettsii - tick rash on palms and soles, migrating to wrists, ankles, then trunk, HA, fever Endemic to East Coast Meniere's disease - CORRECT ANSWERS episodic vertigo, tinnitus, sensorineural hearing loss Addison's disease - CORRECT ANSWERS primary adrenal insufficiency low cortisol high ACTH low aldosterone hyperkalemia hyponatremia Cushing's triad - CORRECT ANSWERS Signs of increased intracranial pressure: bradycardia irregular respirations widened pulse pressure Cushing's disease - CORRECT ANSWERS Elevated cortisol hypernatremia hypertension hypokalemia hyperglycemia immune process responsible for anaphylactic reactionsT - CORRECT ANSWERS IgE pityriasis versicolor - CORRECT ANSWERS fungal infection patches of skin that are lighter or darker than the surrounding skin, often on the trunk and shoulders Glucosamine sulfate is used for - CORRECT ANSWERS OA skin cancer that causes most deaths - CORRECT ANSWERS melanoma pelvic inflammatory disease - CORRECT ANSWERS cervical motion tenderness, adnexal tenderness, uterine tenderness cervical infection withgonorrhea and chlamydia elevated ESR, CRP structure of the eve responsible for sharpest vision - CORRECT ANSWERS fovea of the macula finasteride - CORRECT ANSWERS 5-alpha reductase inhibitor helps decrease size of prostate used for male baldness Sildenafil - CORRECT ANSWERS phosphodiesterase (PDE) inhibitors Grey Turner's sign - CORRECT ANSWERS bruising in flank area (lower back area) severe acute pancreatitis most common bacteria seen in otitis externa treatment - CORRECT ANSWERS pseudomonas aeruginosa 2nd: staph aureus treatment: cortisporin, quinolone ear drops fragile x disorder - CORRECT ANSWERS most common form of inherited intellectual disability higher incidence of autism males > females face is long and narrow with a prominent forehead and chin and large ears hyperlaxity of joints, flat feet, high arched palate most common location for TB in lungs - CORRECT ANSWERS upper lobe Thiazolidinediones example contraindication - CORRECT ANSWERS pioglitazone (actos) do not give in heart failure patients Prediabetes diagnosis - CORRECT ANSWERS A1C: 5.7-6.4 fasting plasma glucose: 100-125 which murmur can radiate to the right side of the neck - CORRECT ANSWERS aortic stenosis which condition is caused by trauma to the blood vessels in Kiesselbach's triangle? - CORRECT ANSWERS anterior epistaxis Kiesselbach's triangle is located inside the nose anteriorly HPV strains associated with cervical cancer - CORRECT ANSWERS 16 and 18 Bacterial conjunctivitis symptoms treatment - CORRECT ANSWERS Mucopurulent unilateral or bilateral discharge. normal vision, photophobia, conjunctival injection and edema, gritty sensation preschoolers otitis media no adenopathy treatment: gentamicin (Garamycin), tobramycin (Tobrex) and neomycin topical Viral conjunctivitis - CORRECT ANSWERS adenovirus; highly contagiouS swimming pools - epidemic keratoconjunctivitis erythema, unilateral watery discharge older children pharyngitis adenopathy treatment: eye lavage with normal saline, vasoconstrictor-antihistamine drops HMG-CoA Reductase Inhibitors - CORRECT ANSWERS Statins which murmur can radiate to the left axilla - CORRECT ANSWERS mitral regurg markle test (heel jar test) - CORRECT ANSWERS assess for PID or peritonitis worrisome symptoms in patients with GERD - CORRECT ANSWERS odynophagia early satiety weight loss iron-deficiency anemia GI bleeding weight loss screen for esophageal cancer treatment of otitis media with perforation - CORRECT ANSWERS oxafloxacin first line treatment for allergic rhinitis - CORRECT ANSWERS topical glucocorticoid nasal spray budesonide (rhinocort) interactions with levothyroxine - CORRECT ANSWERS anticoagulants, tricyclic antidepressants, antacids, calcium, iron, multivitamins, PPI, estrogen, statin, metformin triple therapy for peptic ulcer disease - CORRECT ANSWERS clarithromycin, amoxicillin, omeprazole quadruple therapy for peptic ulcer disease - CORRECT ANSWERS bismuth subcitrate, metronidazole, tetracycline, PPI/H2 IBS inflammation/bleeding? symptoms - CORRECT ANSWERS considered a functional disorder no inflammation or bleeding chronic abdominal pain, flatulence, bloating, changes in BM ankylosing spondylitis - CORRECT ANSWERS autoimmune disease inflammation, pain, stiffness, in spinal joints typically young adult early: pain and stiffness in lower back then moves up the spine and into the neck have flares risk of uveitis sensitive screening test for HIV - CORRECT ANSWERS combination HIV-1 and HIV-2 antibody immunoassay and p24 antigen labyrinthitis cause symptoms treatment - CORRECT ANSWERS caused by viral or postviral inflammation that affects the vestibular portion of CN VIII usually self-limiting vertigo with N/V, nystagmus symptoms provoked by changes in head position treatment: corticosteroids (methylprednisone), antivirals (valacyclovir), and antihistamines (meclizine) 10-year ASCVD risk enhancers - CORRECT ANSWERS family history of early ASCVD current high cholesterol metabolic syndrome CKD chronic inflammatory conditions history of pre-eclampsia or early menopause South Asian ancestry high triglycerides high CRP low ABI 10-year ASCVD risk calculator - CORRECT ANSWERS age sex race total cholesterol HDL cholesterol SBP BP meds DM smoking 10-year ASCVD risk <5% - CORRECT ANSWERS low risk lifestyle changes 10-year ASCVD risk 5-7.5% - CORRECT ANSWERS borderline if risk enhancers: moderate intensity statin 10-year ASCVD risk 7.5-20% - CORRECT ANSWERS intermediate risk risk enhancers: moderate intensity statin 10-year ASCVD risk >20% - CORRECT ANSWERS high risk high dose statin Melanoma - CORRECT ANSWERS Asymmetry Border- uneven, ragged, notched Color- brown, black, tan Diameter- > pencil eraser Evolution- changing Basal cell carcinoma - CORRECT ANSWERS most common skin cancer telangiectasia squamous cell carcinoma - CORRECT ANSWERS thick, rough, scaly patches that may crust or bleed