AANP Certification Exam (2023 – 2024)
Complete Solution
Diverticulum can be an infection of - both gram - and + bacteria
Which diuretic should be used for osteoporosis? - Thiazide diuretics:
slows the kidneys excretion of calcium and increases reabsorption
Lachman maneuver - knee instability
tear of ACL
Infections of labia and vagina - bacterial vaginosis, candidiasis, and trichomoniasis
Chlamydia affects - cervix, endometrial lining, fallopian tubes, pelvic cavity
Acute abdomen symptoms - involuntary guarding, rebound tenderness, board-like
abdomen, +obturator and psoas sign
Care of preecplampsia - bed rest, weight and blood pressure monitoring
Preeclampsia labs - urine protein, serum protein, creatinine, platelet count
Preeclampsia symptoms - hypertension, proteinuria, edema (weight gain)
Preeclampsia complications - placental abruption, coagulopathy (DIC), renal failure,
uteroplacental insufficiency, liver failure, hypertensive encephalopathy, retinal
detachment, pulmonary edema, seizure, death
community acquired pneumonia
Most common bacteria
least common bacteria
Population
treatment - mycolpasma pneumoniae (atypical)
h. influenza, strep pneumoniae
atypical: psuedomonas aeruginosa
college student, school children, military
macrolides: azithromycin, clarithromycin
Mantoux test - Positive: 5mm
Positive for recent immigrants: 10mm
Murphy's sign - biliary disorders
deep inspiration by patient and deep palpation RUQ below costovertebral angle
,placenta previa - implantation of the placenta over the cervical opening or in the
lower region of the uterus
painless bright red blood in the second or third trimester
Order abdominal US
Hashimoto's is most common in which population - middle age to older women
Hypertension Retinopathy - AV nicking and copper or silver wire arterioles
flame-shaped hemorrhages
threatened abortion - vaginal bleeding and cramping, soft uterus, cervix closed
bacterial vaginosis - fishy odor, milky white or dull gray discharge
pH > 4.5
> 20% clue cells
KOH whiff test
squamous cells dotted with lots of bacteria that obscure borders - clue cells
Lichen sclerosis - skin disease, white spots appear over time, most common genital
and rectal
most common in older woman
itching, discomfort, bleeding
order biopsy
AV valves - mitral and tricuspid
semilunar valves - pulmonary and aortic
S1 - systole
closure of AV valves
mitral regurgitation
aortic stenosis
S2 - diastole
closure of semilunar valves
mitral stenosis
aortic regurgitation
S3 - normal variant in children, healthy young adults, and athletes
heart failure
early diastole
S4 - left ventricle hypertrophy
late diastole
,Tanner Stages Males: II - no changes to penis, testes enlarge
Pubic hair is sparse and straight
Tanner Stages Males: III - penis lengthens
hair darker and starts to curl
Tanner Stages Males: IV - penis increases in length and width
hair coarse, not yet on medial thigh
Tanner Stages Females: II - breast buds
pubic hair sparse and straight
Tanner Stages Females: III - breast tissue and areola in one mound
hair darker, starts to curl
Tanner Stages Females: IV - areola separates and forms a secondary mound
hair coarse, not on medial thigh yet
TORCH infections - Toxoplasmosis
Other
Rubella
Cytomegalovirus
Herpes
osteoarthritis vs rheomatoid arthritis - OA: stiffness, heberden's nodes, increase age,
overuse, family history
RA: relies more on labs, increased ESR, Bouchard's nodes, fatigue, fever, body aches
drawer test - instability of the knee
mediolateral and anteroposterior plane
torn or ruptured ligament
fundal height 12 weeks - just above pubic bone
fundal height 20 weeks - level of umbilicus
fundal height 20-35 weeks - number of weeks gestation +/- 2 cm
apraxia - loss of ability to perform purposeful movements in the absence of sensory
or motor damage
ectopic pregnancy - amenorrhea, new onset of vaginal spotting, left adnexal
tenderness, and cervical motion tenderness
G6PD anemia - hereditary, RBC break down, hemolysis
, Meds that can trigger: antimalarial drugs, aspirin, nitrofurantoin, NSAIDs, quinidine,
quinine, sulfa
Pheochromocytoma - a benign tumor of the adrenal medulla that causes the gland to
produce excess epinephrine and norepinephrine
these hormones control heart rate, metabolism, and blood pressure
Fitz-Hugh-Curtis - Perihepatic inflammation & fibrosis;
Complication of Chlamydia and pelvic inflammatory disease
Sharp pain in RUQ
subconjunctival hemorrhage
risk factors - Bright red patches in conjunctiva of eyes due to ruptured blood vessels
Risk factors: DM, HTN, coughing, sneezing, blood thinners, aspirin, ginkgo
Benign, will spontaneously resolve
atopic dermatitis - Excess inflammation; dry skin, redness, and itching from allergies
and irritants.
linear
Koplik spots - Rubeola (measles)
small white papules inside the cheeks by rear molars
treponema pallidum
symptoms - syphilis
painless chancre, maculopapular rash on palms and soles, lymphadenopathy,
condyloma acata
hCG is produced by - placenta after implantation
majority of AFP is produced by - fetal liver
Inevitable abortion - bleeding and cramping/pain with cervical dilation but no
passage of tissue
incomplete abortion - moderate to diffuse vaginal bleeding, passage of tissue, painful
uterine cramping or contractions
MMR and pregnancy - contraindicated
wait 4 weeks before becoming pregnant
Positive signs of pregnancy - ultrasound, auscultation of fetal HR with doppler
Probable signs of pregnancy - detected by examiner
blood and urine tests, Chadwick's sign, Goodell's sign, Hegar's sign, enlarged uterus
Complete Solution
Diverticulum can be an infection of - both gram - and + bacteria
Which diuretic should be used for osteoporosis? - Thiazide diuretics:
slows the kidneys excretion of calcium and increases reabsorption
Lachman maneuver - knee instability
tear of ACL
Infections of labia and vagina - bacterial vaginosis, candidiasis, and trichomoniasis
Chlamydia affects - cervix, endometrial lining, fallopian tubes, pelvic cavity
Acute abdomen symptoms - involuntary guarding, rebound tenderness, board-like
abdomen, +obturator and psoas sign
Care of preecplampsia - bed rest, weight and blood pressure monitoring
Preeclampsia labs - urine protein, serum protein, creatinine, platelet count
Preeclampsia symptoms - hypertension, proteinuria, edema (weight gain)
Preeclampsia complications - placental abruption, coagulopathy (DIC), renal failure,
uteroplacental insufficiency, liver failure, hypertensive encephalopathy, retinal
detachment, pulmonary edema, seizure, death
community acquired pneumonia
Most common bacteria
least common bacteria
Population
treatment - mycolpasma pneumoniae (atypical)
h. influenza, strep pneumoniae
atypical: psuedomonas aeruginosa
college student, school children, military
macrolides: azithromycin, clarithromycin
Mantoux test - Positive: 5mm
Positive for recent immigrants: 10mm
Murphy's sign - biliary disorders
deep inspiration by patient and deep palpation RUQ below costovertebral angle
,placenta previa - implantation of the placenta over the cervical opening or in the
lower region of the uterus
painless bright red blood in the second or third trimester
Order abdominal US
Hashimoto's is most common in which population - middle age to older women
Hypertension Retinopathy - AV nicking and copper or silver wire arterioles
flame-shaped hemorrhages
threatened abortion - vaginal bleeding and cramping, soft uterus, cervix closed
bacterial vaginosis - fishy odor, milky white or dull gray discharge
pH > 4.5
> 20% clue cells
KOH whiff test
squamous cells dotted with lots of bacteria that obscure borders - clue cells
Lichen sclerosis - skin disease, white spots appear over time, most common genital
and rectal
most common in older woman
itching, discomfort, bleeding
order biopsy
AV valves - mitral and tricuspid
semilunar valves - pulmonary and aortic
S1 - systole
closure of AV valves
mitral regurgitation
aortic stenosis
S2 - diastole
closure of semilunar valves
mitral stenosis
aortic regurgitation
S3 - normal variant in children, healthy young adults, and athletes
heart failure
early diastole
S4 - left ventricle hypertrophy
late diastole
,Tanner Stages Males: II - no changes to penis, testes enlarge
Pubic hair is sparse and straight
Tanner Stages Males: III - penis lengthens
hair darker and starts to curl
Tanner Stages Males: IV - penis increases in length and width
hair coarse, not yet on medial thigh
Tanner Stages Females: II - breast buds
pubic hair sparse and straight
Tanner Stages Females: III - breast tissue and areola in one mound
hair darker, starts to curl
Tanner Stages Females: IV - areola separates and forms a secondary mound
hair coarse, not on medial thigh yet
TORCH infections - Toxoplasmosis
Other
Rubella
Cytomegalovirus
Herpes
osteoarthritis vs rheomatoid arthritis - OA: stiffness, heberden's nodes, increase age,
overuse, family history
RA: relies more on labs, increased ESR, Bouchard's nodes, fatigue, fever, body aches
drawer test - instability of the knee
mediolateral and anteroposterior plane
torn or ruptured ligament
fundal height 12 weeks - just above pubic bone
fundal height 20 weeks - level of umbilicus
fundal height 20-35 weeks - number of weeks gestation +/- 2 cm
apraxia - loss of ability to perform purposeful movements in the absence of sensory
or motor damage
ectopic pregnancy - amenorrhea, new onset of vaginal spotting, left adnexal
tenderness, and cervical motion tenderness
G6PD anemia - hereditary, RBC break down, hemolysis
, Meds that can trigger: antimalarial drugs, aspirin, nitrofurantoin, NSAIDs, quinidine,
quinine, sulfa
Pheochromocytoma - a benign tumor of the adrenal medulla that causes the gland to
produce excess epinephrine and norepinephrine
these hormones control heart rate, metabolism, and blood pressure
Fitz-Hugh-Curtis - Perihepatic inflammation & fibrosis;
Complication of Chlamydia and pelvic inflammatory disease
Sharp pain in RUQ
subconjunctival hemorrhage
risk factors - Bright red patches in conjunctiva of eyes due to ruptured blood vessels
Risk factors: DM, HTN, coughing, sneezing, blood thinners, aspirin, ginkgo
Benign, will spontaneously resolve
atopic dermatitis - Excess inflammation; dry skin, redness, and itching from allergies
and irritants.
linear
Koplik spots - Rubeola (measles)
small white papules inside the cheeks by rear molars
treponema pallidum
symptoms - syphilis
painless chancre, maculopapular rash on palms and soles, lymphadenopathy,
condyloma acata
hCG is produced by - placenta after implantation
majority of AFP is produced by - fetal liver
Inevitable abortion - bleeding and cramping/pain with cervical dilation but no
passage of tissue
incomplete abortion - moderate to diffuse vaginal bleeding, passage of tissue, painful
uterine cramping or contractions
MMR and pregnancy - contraindicated
wait 4 weeks before becoming pregnant
Positive signs of pregnancy - ultrasound, auscultation of fetal HR with doppler
Probable signs of pregnancy - detected by examiner
blood and urine tests, Chadwick's sign, Goodell's sign, Hegar's sign, enlarged uterus
