AANPxfAdultxfgerontologyxfprimaryxfcarexfnursexfpractiotionerxfstudyxf
guide
Pheochromocytomaxf-xfcorrectxfanswer✔ ✔
smallxfvascularxftumorxfofxfthexfadrenalxfmedulla,xfcausingxfirregularxfsecret
ionxfofxfepinephrinexfandxfnorepinephrine,xfleadingxftoxfattacksxfofxfraisedxfblo
odxfpressure,xfpalpitations,xfandxfheadache.xfTxxfwithxfAlphaxfblockers
Rovsing'sxfSignxf-xfcorrectxfanswer✔ ✔
PalpationxfinxfLLQxfilicitsxfpainxfinxfRLQxfindicatesxfappendicitis
NYHAxfclassesxfofxfHeartxfFailurexf-xfcorrectxfanswer✔ ✔
IxfNoxflimitationxfofxfphysicalxfactivity.xfOrdinaryxfphysicalxfactivityxfdoesxf
notxfcausexfunduexffatigue,xfpalpitation,xfdyspneaxf(shortnessxfofxfbreath).
IIxfSlightxflimitationxfofxfphysicalxfactivity.xfComfortablexfatxfrest.xfOrdinaryxf
physicalxfactivityxfresultsxfinxffatigue,xfpalpitation,xfdyspneaxf(shortnessxfofxfb
reath).
IIIxfMarkedxflimitationxfofxfphysicalxfactivity.xfComfortablexfatxfrest.xfLessxfth
anxfordinaryxfactivityxfcausesxffatigue,xfpalpitation,xforxfdyspnea.
IVxfUnablexftoxfcarryxfonxfanyxfphysicalxfactivityxfwithoutxfdiscomfort.xfSymp
tomsxfofxfheartxffailurexfatxfrest.xfIfxfanyxfphysicalxfactivityxfisxfundertaken,xfdis
comfortxfincreases.
Step-wisexfApproachxftoxfAsthmaxfDiagnosisxf&xfTreatmentxf-
xfcorrectxfanswer✔ ✔ Stepxf1-
, MildxfIntermittenxfFEV1/PEFxf>xf80%xfpredicted.xfSymptomsxf<2xfdays/we
xf
ek.xfAlbuterolxfasxfneeded.
Stepxf2-
xfMildxfpresistentxfAsthmaxf(FEV1/PEFxf>xf80%xfpredicted.xfSymptoms xf>xf2x
fdays/week.xfAlbuterolxfasxfneeded.xfLowxfdosexfICSxfexxfFlovent.xfAltxfcrom
olyn,xfmontelukast,xfnedocromil,xftheophylline.
Stepxf3-xfModxfpresistentxf(FEV1xforxfPEFxf60-
80%xfpredicted.xfDailyxfSymptoms.xfSABAxfplusxflowxfdosexfICSxforxfmedxfd
osexfICSxforxflowxfdosexfwithxfleukotrienexfinhibitorxf(singulair,xftheophylline
,xfzileuton).
Stepxf4-
xfSeverexfpresistentxfasthmaxf(FEV1/PEFxf<60%xfpredicted.xfSymptoms xfmo
stxfofxfday.xfHighxfdosexfICSxfplusxflongxfactingxfB2xfagonistxfplusxforalxfsteroid
xfdailyxf(prednisone).
PeakxfExpiratoryxfFlowxfRatexf(HAG):
GreenxfYellowxfRedxfZone:xf-xfcorrectxfanswer✔ ✔
PEFxfbasedxfonxfHeightxfAgexfGender.xfBlowxfhardxfusingxfspirometerxfhigh
estxfvaluexfrecorded.
80-100%xfexpectedxfvolumexfGreenxfZonexfmaintainxforxfreducexfmeds
, 50-
80%xfexpectedxfvolumexfYellowxfZonexfincreasexfmaintenancexftherapy.xfOrx
fHavingxfexacerbation.
Belowxf50%xfexpectedxfvolumexfRedxfZonexfcallxf911xfgivexfepinephrinexfinj.
PPDxf-xfcorrectxfanswer✔ ✔ Neg-
xfNoxffirmxfbump xfforms xfatxfthexftestxfsite,xforxfaxfbump xfformsxfthatxfisxfsmallerx
fthanxf5xfmmxf(0.2xfin.).
Axffirmxfbumpxfthatxfisxf5xfmmxf(0.2xfin.)xfinxfsizexfsuggestsxfaxfTBxfinfectionxfin
xfpeoplexfwhoxfarexfinxfaxfhigh-
riskxfgroup.xfHIV,xfimmunocompromise,xfexposed.xf
Axffirmxfbumpxfthatxfisxf10xfmmxf(0.4xfin.)xfinxfsizexfsuggestsxfaxfTBxfinfectionxfi
nxfpeoplexfwhoxfarexfinxfaxfmoderate-
riskxfgroup.xfhealthcarexfworkers,xfimmigrants,xfhomeless.
Axffirmxfbumpxfthatxfisxf15xfmmxf(0.6xfin.)xfinxfsizexfsuggestsxfaxfTBxfinfectionxfi
nxfpeoplexfwhoxfarexfinxfaxflow-riskxfgroupxfnoxfriskxfforxftb.
Digoxinxf(CardiacxfGlycosides)xf-xfcorrectxfanswer✔ ✔
Therapueticxf0.5-2.0
guide
Pheochromocytomaxf-xfcorrectxfanswer✔ ✔
smallxfvascularxftumorxfofxfthexfadrenalxfmedulla,xfcausingxfirregularxfsecret
ionxfofxfepinephrinexfandxfnorepinephrine,xfleadingxftoxfattacksxfofxfraisedxfblo
odxfpressure,xfpalpitations,xfandxfheadache.xfTxxfwithxfAlphaxfblockers
Rovsing'sxfSignxf-xfcorrectxfanswer✔ ✔
PalpationxfinxfLLQxfilicitsxfpainxfinxfRLQxfindicatesxfappendicitis
NYHAxfclassesxfofxfHeartxfFailurexf-xfcorrectxfanswer✔ ✔
IxfNoxflimitationxfofxfphysicalxfactivity.xfOrdinaryxfphysicalxfactivityxfdoesxf
notxfcausexfunduexffatigue,xfpalpitation,xfdyspneaxf(shortnessxfofxfbreath).
IIxfSlightxflimitationxfofxfphysicalxfactivity.xfComfortablexfatxfrest.xfOrdinaryxf
physicalxfactivityxfresultsxfinxffatigue,xfpalpitation,xfdyspneaxf(shortnessxfofxfb
reath).
IIIxfMarkedxflimitationxfofxfphysicalxfactivity.xfComfortablexfatxfrest.xfLessxfth
anxfordinaryxfactivityxfcausesxffatigue,xfpalpitation,xforxfdyspnea.
IVxfUnablexftoxfcarryxfonxfanyxfphysicalxfactivityxfwithoutxfdiscomfort.xfSymp
tomsxfofxfheartxffailurexfatxfrest.xfIfxfanyxfphysicalxfactivityxfisxfundertaken,xfdis
comfortxfincreases.
Step-wisexfApproachxftoxfAsthmaxfDiagnosisxf&xfTreatmentxf-
xfcorrectxfanswer✔ ✔ Stepxf1-
, MildxfIntermittenxfFEV1/PEFxf>xf80%xfpredicted.xfSymptomsxf<2xfdays/we
xf
ek.xfAlbuterolxfasxfneeded.
Stepxf2-
xfMildxfpresistentxfAsthmaxf(FEV1/PEFxf>xf80%xfpredicted.xfSymptoms xf>xf2x
fdays/week.xfAlbuterolxfasxfneeded.xfLowxfdosexfICSxfexxfFlovent.xfAltxfcrom
olyn,xfmontelukast,xfnedocromil,xftheophylline.
Stepxf3-xfModxfpresistentxf(FEV1xforxfPEFxf60-
80%xfpredicted.xfDailyxfSymptoms.xfSABAxfplusxflowxfdosexfICSxforxfmedxfd
osexfICSxforxflowxfdosexfwithxfleukotrienexfinhibitorxf(singulair,xftheophylline
,xfzileuton).
Stepxf4-
xfSeverexfpresistentxfasthmaxf(FEV1/PEFxf<60%xfpredicted.xfSymptoms xfmo
stxfofxfday.xfHighxfdosexfICSxfplusxflongxfactingxfB2xfagonistxfplusxforalxfsteroid
xfdailyxf(prednisone).
PeakxfExpiratoryxfFlowxfRatexf(HAG):
GreenxfYellowxfRedxfZone:xf-xfcorrectxfanswer✔ ✔
PEFxfbasedxfonxfHeightxfAgexfGender.xfBlowxfhardxfusingxfspirometerxfhigh
estxfvaluexfrecorded.
80-100%xfexpectedxfvolumexfGreenxfZonexfmaintainxforxfreducexfmeds
, 50-
80%xfexpectedxfvolumexfYellowxfZonexfincreasexfmaintenancexftherapy.xfOrx
fHavingxfexacerbation.
Belowxf50%xfexpectedxfvolumexfRedxfZonexfcallxf911xfgivexfepinephrinexfinj.
PPDxf-xfcorrectxfanswer✔ ✔ Neg-
xfNoxffirmxfbump xfforms xfatxfthexftestxfsite,xforxfaxfbump xfformsxfthatxfisxfsmallerx
fthanxf5xfmmxf(0.2xfin.).
Axffirmxfbumpxfthatxfisxf5xfmmxf(0.2xfin.)xfinxfsizexfsuggestsxfaxfTBxfinfectionxfin
xfpeoplexfwhoxfarexfinxfaxfhigh-
riskxfgroup.xfHIV,xfimmunocompromise,xfexposed.xf
Axffirmxfbumpxfthatxfisxf10xfmmxf(0.4xfin.)xfinxfsizexfsuggestsxfaxfTBxfinfectionxfi
nxfpeoplexfwhoxfarexfinxfaxfmoderate-
riskxfgroup.xfhealthcarexfworkers,xfimmigrants,xfhomeless.
Axffirmxfbumpxfthatxfisxf15xfmmxf(0.6xfin.)xfinxfsizexfsuggestsxfaxfTBxfinfectionxfi
nxfpeoplexfwhoxfarexfinxfaxflow-riskxfgroupxfnoxfriskxfforxftb.
Digoxinxf(CardiacxfGlycosides)xf-xfcorrectxfanswer✔ ✔
Therapueticxf0.5-2.0
