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, MSG, aspartame, menst
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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, MSG, 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?
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