AGNP Questions with complete solutions 2023

AGNP Questions with complete solutions 2023 What are the usual skin antibiotics? Keflex Penicillins *beta lactam activity What are skin antibiotics if someone is allergic to PNC? Macrolide - clarithromycin or azithromycin or Clindamycin Treatment for impetigo? topical mupirocin Herald patch is associated with what? pityriasis ABX for skin treatment with high MRSA suspicion? Bactrim Clinda Doxy What does angina show on ECG? ST depression What does infarction show on ECG? ST elevation *STEMI What are considerations for the elderly when starting them on thyroid replacement therapy? cardiac implications In new onset AF, what lab should you get? TSH What test do you do when a TSH comes back elevated? TSH and T4 Graves disease is what? autoimmune hyperthyroidism Fine needle aspirate any thyroid nodule greater than what? 1-1.5cm What drug for treatment of hyperthyroidism is safe to give in pregnancy? PTU Propylthiouracil For someone who has recurring headaches anxiety and hypertension all of which are waxing and waning, what should you consider and what test would you send? pheochromocytoma -urinary catecholamines What is treatment for pheochromocytoma? Alpha blockers and surgical resection -osins A FBS over what number on two occasions is diagnostic for DM? 126 A1C over what number is diagnostic for diabetes? 6.5% What A1C is prediabetes? 5.7-6.4 What races are most at risk of developing diabetes? African Americans, Hispanics, American Indians, and some Pacific Islanders and Asian Americans are all at higher risk for type 2 diabetes than Caucasians, What test should be run at diagnosis of DM? urinary microalbumin creatinine ratio What are the 4 categories in metabolic syndrome? -central obesity -DMII -HTN -HLD *you need three out of four What is initial treatment for metabolic syndrome? Lifestyle changes Diet Exercise Quit smoking Medications What is a physical finding that may indicate insulin resistance? acanthosis nigricans Addison's disease is also known as what? adrenal insufficiency What are S&S of addison's disease? *THINK JFK* Muscle weakness, anorexia, GI symptoms, fatigue, hyperpigmentation of skin & mucosa, hypotension, hypoglycemia hyponatremia hyperkalemia mental changes, confusion, apathy, emotional lability. What labs are sent for addison's disease? early morning cortisol ACTH stimulant test *CT and MRI of pituitary What is treatment for addison's? steroids *fludrocortisone for aldosterone insufficiency Cushing's disease is a result of what? too much cortisol What is the most common cause of Cushings? steroids long-term also pituitary adenoma What are labs for cushings? cortisol 24 hour urinary free cortisol What is treatment for cushings? taper off steroids remove tumor What are S&S of lupus? Joint pain, malar rash, renal disorder (due to excess protein destruction), anemia Serositis oral ulcers discoid rash What are potential pregnancy complications from lupus? preterm labor What labs are sent for lupus? ANA antiphospholipid antibody Anti-DNA antibody *if ANA is positive, refer to rheum What is treatment for lupus? 1) Acute flare ups: Prednisone and glucocorticoids 2) joint pain: NSAIDs 3) Rash and joint not responding to NSAIDs: hydroxychloroquine & antimalarials 4) Severe disease relapse upon cessation of steroids: belimumab, azathioprine, cyclophosphamide 5) Nephritis: steroids & mycophenolate mofetil What is important to tell patients about their lupus? There is no cure always include counseling and support What labs need to be sent for PCOS? LH FSH TSH what causes PCOS? insulin resistance and increased ovarian androgen production *causes masculinization Complications of PCOS? increased risk of endometrial cancer 2° to unopposed estrogen from repeated anovulatory cycles DM2 HLD CVD OSA HTN INTFERTILITY What criteria help diagnose PCOS? Rotterdam criteria Increase androgens Irregular menses ovarian cysts What is treatment for PCOS? -low dose OCP to suppress ovaries -Spironolactone to control hirsutism -Provera PO (Progestogen) -Metformin induces ovulation (use OCP) -Wgt. loss Which skin delivery vehicle is the gentlest? lotion Which skin delivery vehicle is the most potent? ointment What is test for RMSF? RMSF IFA assay When does RMSF rash appear? 2-4 days after bite *starts on hands wrists and ankles and moves centrally What is treatment for RMSF? Doxycycline What is treatment for RMSF if doxy allergic? chloramphenicol What is the rash associated with Lyme disease? erythema migrans bullseye lesion When does rash appear for Lyme disease? 2-14 days after bite What are S&S of latent Lyme disease? arthralgias and vague neurological problems What is treatment for Lyme disease? doxy What test do you do for Sjogren's syndrome? Schirmer test What test do you do for Lyme? Borrelia bergdorferi ELISA reflex to western blot if positive What medications are most likely to cause steven's johnson syndrome? Sulfa allopurinol NSAIDS penytoin tegretol anticonvulsants When can someone with scabies return to work? 24 hours after first treatment *may itch for weeks Treatment for scabies? Permethrin Ivermectin Treatment for tinea? antifungal treatment (topical azole, ketoconazole shampoo for scalp) lamisil Test for tinea? KOH prep will show hyphae