AC-PNP Exam Review questions fully solved & updated.

List drug options that will cover a pseudomonas Ceftazidime, cefipime, Pipercillin/ticarcillin, Meropenem, imipenem,aztreonam, Flouroquinolones, Aminoglycosides Describe the differences in CSF findings between bacterial, viral, & herpes meningitis Bacterial- Decreased glucose and highly Increased WBC, Lactate, protein: Diff- PMN Viral- Glucose normal and lactate normal or decreased, protein and WBC mildly increased. DIff PMN first than monos Herpes- Glucose normal, protein and WBC increased, Diff PMN than monos, RBC 1000 in absence of traumatic tap. List signs & symptoms of malaria Fever, CNS dysfunction, anemia, hemoglobinuria, sweats, chills, HA, pulmonary edema, N&V, coagulopathy, myalgia, shock, fatigue, renal failure, hepatosplenomegaly, metabolic acidosis, tachypnea, hypoglycemia 3rd generation cephalosporins cover which organisms? Gram Positive, HENPEK, Serratia, Ceftazidime also covers pseudomonas Review the signs & symptoms, course, and treatment for the 2 organisms causing toxic shock. Which is worse? Early symptoms = pain is the most common initial symptom, fever/hypothermia, confusion, soft tissue infection, positive blood culture (60%), or rash S. pyogenes causes hypotension- 2 of the following: renal dysfunction, coagulopathy, ARDS, tissue necrosis, erythematous rash, skin desquamation 10-14 days after onset, high mortality, Tx with supportive care, clindamycin and debridement; S. aureus- fever, hypotention and rash -involvement of 3 or more organ systems, Absence of rocky mountain spotted fever, leptospirosis, measles, mono, or syphilis. High morbidity. Treat with supportive care, nafcillin, (vancomycin for MRSA) and debridement State one major pediatric theorist for each of the following: Psychosocial, cognitive and moral development Psychosocial: Erickson Cognitive: Piaget Moral: Kohlberg At what age should children first be able to combine words? 18 months Erikson's stage of Industry vs. inferiortiy coincides with which Piaget stage? Concrete Operations What are the adverse effects of ginkgo biloba? Bleeding events r/t inhibition of platelet activating factor, subdural hematoma, cerebral hemorrhage, hyphema and post-op bleeding complications, increased CBF may result in increased ICP, may potentiate anticoagulation What is St. John's Wort used for and what are the adverse effects? Used for mild depresssion, Generally well tolerated, Headache, GI disturbances, Phytophotoxic dermatitis, Reduces plasma levels of protease inhibitors Name two classes of medication that can be used as adjuvants to treat pain Antidepressants or anticonvulsants Name the 5 cranial nerves important to eating V Trigeminal SM, VII facial SM, IX Glossopharyngeal SM, X Vagus M, XII Hypoglossal M Describe Epidural Hemmorhages? Epidural, between inner table of skull and dura mater, lenticular shape, do not cross hemispheres, often follow middle meningeal artery tear, period of lucency followed by decreased LOA, emergent surgical evacuation if symptomatic Describe Subdural Hemmorhages? Subdural, between dura mater and arachnoid, may be associated with a skull fracture, often bilateral and will cross hemispheres, symptoms may be acute or insidious ICP- surgical evacuation if symptomatic Describe subarchnoid hemmorhage? Subarachnoid, between arachnoid and pia mater, severe headache and neck pain, surgical evacuation if symptomatic "Name and describe the type of migraine typical to adolescence? Common migraine without aura, throbbing or pounding headache that is usually unilateral, may have nausea and vomiting, often relieved by sleep Summarize signs and symptoms of depression? Usually coherent and clear thinking, history of deterioration of scoial/school activities, weight gain/loss, lethargic/apatheticvs anxious with angry outbursts, sleep disturbances, may have suicidal ideation Describe pertussis... course, diagnosis and treatment? Course, catarrhal phase, paroxysmal phase, convelescent phase. May have co-findings of pneumonia, otits, seizures or encephalitis Diagnosis- Lymphocytosis, Bordetella pertussis, a coccobacillus. Treatment erythromycin Review the signs, symptoms , and etiology of Guillain-Barre vs. Botulism Guillain-Barre' -- May follow non specific viral infection or commonly, Campylobacter, Landry's ascending. Paralysis. CSF in notable for few white cells and high protein. Botulism- Clostridium botulinum -A gram positive Anaerobe. Rapid descending . Paralysis. CSF is normal. Avoid antibiotics " What is transient tachypnea of the newborn? Usually follows uneventful deliveries . May be related to slower absorption of fetal lung fluid resulting. Decreased pulmonary compliance and increased dead space. Usually resolves in approximately 3 days without therapy. Review the criteria for ARDS Acute onset of symptoms following, precipitating infection of insult, frontal chest xray biliateral infiltrates. No clinical evidence of LA HTN, PsO2 to Fio2 ratio /= 200 What are the radiologic findings for asthma? Asthma, flattened diaphragm, narrow cardiac silhouette, hyperinflation, narrow cardiac silhouette, peribronchial thickening, subsegmental atelectasis Describe methods to treat hyperkalemia Push K into cells- Albuterol, Insulin/glucose, Sodium bicarbonate - Remove K- Kayexalate, dialysis; Stabilize cardiac cell membrane- Ca chloride What is the equation to calculate creatinine clearance in children? K x ht (cm)/serum creatnine - K equals Preemie 0.33, Term 0.45, 2-21yrs female, 0.55 2-21 yrs male .70 Review the diagnostic criteria, treatment, and followup for urinary tract infection in young children Diagnostic Criteria- Unexplained fever( 2mos- 2yrs), + nitrite test, + leukoesterase test, 5 WBC's, Colony coutn 100,000, Culture of 2 or less organisms; Oral treatment and followup- Amoxicillin, TMP/SMX, Cephalosporin-Treat for 7-14 days US and VCUG to follow Describe the signs and symptoms, lab findings, and treatment for nephrotic syndrome Signs and symptoms- edema, especially periorbital, HTN, Anorexia, abd. Pain and or abd distension; Lab findings- Albumin 2.5, Heavy proteinuria, Cholesterol 250, hematuria; Treatment-Steroids- Diuretics- Sodium/fluid restriction, albumin What are some of the clinical findings with systemic lupus erythematosus? 4 or more of the following are diagnostic, Malar rash of the face, discoir rash, photosensitivity, oral ulcers usually painless, arthritis in 2 or more joints, pericarditits or effusion, kidney disease, hemolytic anemia, Leukopenia, Thrombocytopenia, Antiphospholipid antibody, Anti-DNA antibody, false positive for syphillis, Antinuclear antibody " State the onset, peak, and duration of the following insulins: Humalog, regular, NPH, Glargine Humalog onset 0.25/hr, peak .5-1.5hr, duration 3-5 hr Regular onset .5-1hr, peak 1-5 hr, duration 3-10hrs NPH onset 1-4hr, peak 4-14hr, duration 10-24hr Glargine, (Lantus) onset 1-2 hrs, peak 2-20hr, duration 20-24hr Describe the differences between the Syndrome of Inappropriate Diuretic Hormone and Diabetes Insipidus SIADH - Inappropriate ADH secretion, decreased Na with decreased serum osmo, increased urine osmo, Normal kidney function, often follow cerebral illness, or injury esp. spinal surgery, Tx with supp theray and fluid restriction. DI--Inadequate antidiuretic, Hormone effect, Disease of free water, Polyuria/polydipsia, Decreased urine osmo/. even, When serum osmo increased, Increased NA, Central or nephrogenic, Often follows Cerebral illness of injuryTreat with supportive, Therapy and vasopressin List the clinical features of DiGeorge Syndrome Hypoparathyroidism, hypoplastic thymus, conotruncal heart defects, cleft lip and /or palate, Flattened facies with hypertelorism and low set ears Review the signs, symptoms, and treatment for adrenocortical insufficiency Signs and symptoms- hypoglycemia, hyponatremia, hyperkalemia, metabolic acidosis, hypotension, gastroenteritis/fever; Treatment- Pretreatment labs:ACTH, plasma renin,Cortisol, DHEAS, 17-OH, aldosterone. Supportive therapy, Hydrocortisone What are the laboratory findings in hypothyroidism? Euthyroid Sick Syndrome- TSH decreased, free T4 decreased.- Classic- Hypothyroidism, TSH increased, total T4 decreased, free T4 decreased