AGNP AANP 2027 ANSWERS AND QUESTIONS SET
A+
✔✔osteoporosis DEXA results - ✔✔T score > -1.0 SD = normal
-1.0 - -2.5 = osteopenia
below -2.5 = osteoporosis
start testing in all women >65 or all postmenopausal women <65 with Rfs (FMH,
smoking, excessive exercise, alcohol, steroids, hyperthyroidism, slender body)
✔✔osteoporosis prevention - ✔✔estrogen therapy, weight bearing exercise, increased
calcium intake or supps
male 51-70: Ca+ 1,000mg/day
female 51-70: Ca+ 1200mg/day
diet sources of ca+: dairy, sardines, salmon /w bones, green leafy veggies, tofu, ca+
fortified foods, take vit D (800-1000 IU/d)
avoie auminum antacids with ca+ supps
✔✔osteoporosis therapy - ✔✔bisphosphonates - inhibit osteoclast activity
-"dronate"
-take with full glass of water, NPO 30 mins to 1 hr, sit upright for 30mins to 1 hr
✔✔systemic lupus erythematosus - ✔✔sx: butterfly rash, Raynauds, photosensitivity
labs: ANA (+) in 95% pts
tx:
-mild: bed rest, midafternoon naps, avoid fatigue
-sun protection, topical glucocorticoid for skin lesions
-NSAIDs, hydroxychloroquine, glucocorticoids
, lots of drugs implicated in lupus like syndrome
✔✔lower UTI - ✔✔E. coli is most common causative organism**
lower UTI
-sx: dysuria, hematuria, urgency
-dx: UA shows pyuria (>10 WBC), nitrates, esterase
Tx
-uncomplicated cystitis: nitrofurantoin (macrobid) 100mg BID x5d or Bactrim BID x3d
-during pregnancy: amoxicillin #1, augmentin, macrobid, keflex
**no cipro or levaquin for uncomplicated UTIs**
✔✔acute pyelonephritis - ✔✔upper UTI
-sx: flank, low back or abd pain, fever, chills, n/v, mental status change in elderly
-labs: WBC casts on UA, ESR elevated
Tx
-cipro 500 BID x7 if uncomplicated
-levofloxacin okay
-ceftriaxone 1gm IV daily x14d
**bactrim not rec and macrobid does not reach therapeutic concentrations in kidney**
✔✔urinary incontinence - ✔✔stress (urethral incompetence)
-urine leakage from lifting, coughing, execise, sneezing, laughing, climbing stairs
-tx: timed voids, pessary, surgery, "squeeze before you sneeze"
urge (detrusor overactivity)- signal issue, pee before making it to bathroom
-CNS abnormalities such as stroke, UTI, urinary stones, neoplasm, fecal impaction
-urgency, involuntary urine loss, nocturia, frequency
-aka overactive bladder
-tx: quick pelvic contractions, medication, "freeze and squeeze"
✔✔stress vs urge incontinence - ✔✔stress: d/t activity, immediate small/moderate
leakage
urge: urge to go, timing is delayed, amount is large, frequency and nocturia common
✔✔contraceptive methods most to least effective w/ failure rates - ✔✔1. sterilization
(<1%), abstinence (0%), IUD (<1%), implant (0.1%) (procedures)
2. pill (7%), nuvaring (7%), transdermal patch (7%), injection (4%)
3. cervical cap/diaphragm (17%), male condoms (13%), sponge (barrier methods)
4. fertility awareness (23%), withdrawal, spermicides (21%)
A+
✔✔osteoporosis DEXA results - ✔✔T score > -1.0 SD = normal
-1.0 - -2.5 = osteopenia
below -2.5 = osteoporosis
start testing in all women >65 or all postmenopausal women <65 with Rfs (FMH,
smoking, excessive exercise, alcohol, steroids, hyperthyroidism, slender body)
✔✔osteoporosis prevention - ✔✔estrogen therapy, weight bearing exercise, increased
calcium intake or supps
male 51-70: Ca+ 1,000mg/day
female 51-70: Ca+ 1200mg/day
diet sources of ca+: dairy, sardines, salmon /w bones, green leafy veggies, tofu, ca+
fortified foods, take vit D (800-1000 IU/d)
avoie auminum antacids with ca+ supps
✔✔osteoporosis therapy - ✔✔bisphosphonates - inhibit osteoclast activity
-"dronate"
-take with full glass of water, NPO 30 mins to 1 hr, sit upright for 30mins to 1 hr
✔✔systemic lupus erythematosus - ✔✔sx: butterfly rash, Raynauds, photosensitivity
labs: ANA (+) in 95% pts
tx:
-mild: bed rest, midafternoon naps, avoid fatigue
-sun protection, topical glucocorticoid for skin lesions
-NSAIDs, hydroxychloroquine, glucocorticoids
, lots of drugs implicated in lupus like syndrome
✔✔lower UTI - ✔✔E. coli is most common causative organism**
lower UTI
-sx: dysuria, hematuria, urgency
-dx: UA shows pyuria (>10 WBC), nitrates, esterase
Tx
-uncomplicated cystitis: nitrofurantoin (macrobid) 100mg BID x5d or Bactrim BID x3d
-during pregnancy: amoxicillin #1, augmentin, macrobid, keflex
**no cipro or levaquin for uncomplicated UTIs**
✔✔acute pyelonephritis - ✔✔upper UTI
-sx: flank, low back or abd pain, fever, chills, n/v, mental status change in elderly
-labs: WBC casts on UA, ESR elevated
Tx
-cipro 500 BID x7 if uncomplicated
-levofloxacin okay
-ceftriaxone 1gm IV daily x14d
**bactrim not rec and macrobid does not reach therapeutic concentrations in kidney**
✔✔urinary incontinence - ✔✔stress (urethral incompetence)
-urine leakage from lifting, coughing, execise, sneezing, laughing, climbing stairs
-tx: timed voids, pessary, surgery, "squeeze before you sneeze"
urge (detrusor overactivity)- signal issue, pee before making it to bathroom
-CNS abnormalities such as stroke, UTI, urinary stones, neoplasm, fecal impaction
-urgency, involuntary urine loss, nocturia, frequency
-aka overactive bladder
-tx: quick pelvic contractions, medication, "freeze and squeeze"
✔✔stress vs urge incontinence - ✔✔stress: d/t activity, immediate small/moderate
leakage
urge: urge to go, timing is delayed, amount is large, frequency and nocturia common
✔✔contraceptive methods most to least effective w/ failure rates - ✔✔1. sterilization
(<1%), abstinence (0%), IUD (<1%), implant (0.1%) (procedures)
2. pill (7%), nuvaring (7%), transdermal patch (7%), injection (4%)
3. cervical cap/diaphragm (17%), male condoms (13%), sponge (barrier methods)
4. fertility awareness (23%), withdrawal, spermicides (21%)
