2023-2024 AANP Exam Study Notes A+ Review

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2023-2024 AANP Exam Study Notes A+ Review Migranes - ANS-- Symptoms: Throbbing pain behind one eye Photophobia, phonophobia, N/V - At-Risk Patients: Adult females - Aggravating Factors: Red wine, M ... SG, aspartame, menstruation, stress Trigeminal neuralgia - ANS-- Symptoms: Type 1: Intense, sharp, shock-like, stabbing pain; Type 2: constant, aching, burning pain - At-Risk Patients: Older adults and elderly - Aggravating Factors: Cold food, cold hair, chewing, talking, touch Cluster HA - ANS-- Symptoms: "Icepick" piercing pain behind one eye/temple Tearing, rhinorrhea, ptosis, miosis Homer's syndrome - At-Risk Patients: Middle-aged females - Aggravating Factors: Occurs at same time, daily, in clusters Weeks to months Tension HA - ANS-- Symptoms: b/1 "band-like" pain; dull, may last a day; may have spasms of trapezius muscles - At-Risk Patients: Adults - Aggravating Factors: Stress Migrane - ANS-- Acute tx: Ice pack, rest, dark room Sumatriptan or Toradol Prochlorperazine for - Prophylaxis/Other: TCA, BBs, Effexor, Topamax {not if hx of kidney stones) Pharmacokinetics - ANS-Movement of drugs through body Pharmacodynamics - ANS-Physiologic and biochemical effects of drugs Pharmacogenomics - ANS-Study of how genes affect response to meds Half-life - ANS-Amount of time it takes for drug concentration to decrease 50% First-Pass Effect - ANS-Oral drug enters portal circulation - in liver, CYP450 metabolizes drug, then it is released to body; can bypass first-pass effect via IV, gels/creams/patches, buccal When asked about drug interactions, think of these - ANS-· Macrolides · Antifungals · Cimetidine · Citalopram · Protease inhibitors · Grapefruit juice (Interacts with statins, erythromycin, CCBs, antivirals, amiodarone, benzos, cisapride, carbamazepine, buspirone) Safety Issues with Common Meds Drug: Thiazolidinediones e.g. pioglitazone - ANS-Safety Issue: Black box: exacerbate CHF, do not use if NYHA Class Ill or IV HF Contraindications: Ml, stroke, bladder CA, TlDM, eye/liver Safety Issues with Common Meds Drug: H2 antagonists e.g. ranitidine, famotidine - ANS-Safety Issue: Mental status changes w/ kidney disease Avoid if creatinine clearance< 50 ml/min Safety Issues with Common Meds Drug: PPls e.g. omeprazole, pantoprazole - ANS-Safety Issue: Risk of fractures, PNA, CDiff, hypomagnesemia, B12 and iron malabsorption, atrophic gastritis, kidney disease Interactions: warfarin, diazepam, carbamazepine, phenytoin, ketoconazole Safety Issues with Common Meds Drug: Warfarin - ANS-Safety Issue: Interacts with "G" herbs - garlic, ginger, ginkgo, ginseng D/C 7 days before surgery Aortic regurgitation presentation - ANS-Long asymptomatic period followed by exercise intolerance then dyspnea at rest. The left ventricle fails unless the aortic valve is replaced AV nicking is most commonly seen? - ANS-Retinal exam of patients with hypertension Carotid artery bruits can indicate? - ANS-Generalized atherosclerosis The USPSTF recommends a 1-time abdominal aortic aneurysm screening with ultrasonography is done in men - ANS-Age 65 to 75 who have ever smoked Hypertension is the most common cause of? - ANS-Hemorrhagic stroke Patients with acute coronary syndrome typically have? - ANS-Plaque erosion caused by accumulation of hyaluronan and neutrophils The ductus arteriosus is a blood vessel that connects? CONTINUES... [Show More]

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