Sarah Michelle AANP Board Exam - In Depth Diagnosis Study Guide Exam Questions and Complete Solutions Graded A+

  lifestyle modifications - Answer: how will you treat stage one HTN with ASCVD risk of <10%? medications - Answer: how will you treat stage one HTN with ASCVD risk of >10%? 130-139/80-89 - Answer: according to the AHA/ACC guidelines, stage one HTN is defined as BP of _______-_______/_____-_____ 140, 90 - Answer: according to the AHA/ACC guidelines, stage two HTN is defined as BP of >_______/>_____ lifestyle modifications - Answer: the mainstay of hyperlipidemia treatment, regardless of medication use as well, is _____________________ ________________________ strep pneumoniae - Answer: the typical culprit of bacterial pneumonia is ___________ _________________________ bacterial, viral - Answer: ________________________ pneumonia tends to be more significant/serious while _______________ pneumonia tends to be more of a "walking" pneumonia cough suppressants - Answer: do not given pneumonia patients ____________ _______________________, can give them expectorants 8 - Answer: follow-up CXR from pneumonia should be performed around the ________ week mark CAT assessment (COPD assessment test) - Answer: functional assessment tool that we can use to help us decide how much COPD is affecting our patients daily life, a score >10 is considered significant day to day disruption spirometry, 0.70 - Answer: COPD diagnosis is confirmed with ________________________, an FEV1/FVC ratio score of less than ___________ indicates COPD dyspnea, sputum, purulence - Answer: what 3 things must be present in order to diagnose a COPD exacerbation? 1) increased _____________________ 2) increased __________________ production 3) increased sputum __________________________ steroids - Answer: treatment options for Bell's palsy include __________________ (started within 72 hours of symptom onset), antivirals may be utilized depending upon the patient, and lubricating eye ointment should always be prescribed to avoid corneal abrasions essential tremor - Answer: tremor that worsens with intent, managed with beta blockers (propanolol) and regular physical activity MS (multiple sclerosis) - Answer: demyelination occurring in the CNS, very unpredictable, most patients go through remissions and exacerbations, commonly diagnosed between ages 20-40 trigeminal neuralgia - Answer: patients with MS are at an increased risk of developing what condition? absence seizures - Answer: type of seizure commonly diagnosed in childhood characterized by brief loss of consciousness lasting around 20-30 seconds, these children are often accused of daydreaming, most will outgrow this condition tonic clonic seizures - Answer: also known as convulsive seizures, typically last around 1-3 minutes, biggest concern is safety serotonin syndrome - Answer: this condition occurs when there is too much circulating serotonin, symptoms include shivering, seizures, agitation, tachycardia, tremors and possible death GAD7 scale - Answer: anxiety screening tool lupus, 4 - Answer: this condition, ________________, is often known as the "great mimicker" because the presentation is so vague, in order to diagnose this condition the patient must have ______ of 11 of the following criteria: -malar rash -discoid rash -photosensitivity -oral/nasal ulcers -non-erosive arthritis -cardiopulmonary complaints -renal complaints -neurological concerns -immunological disorder -hematological disorders -positive ANA test childbearing, African - Answer: lupus is most commonly seen in women of __________________________ age and in __________________ Americans rheumatology - Answer: which specialty should we refer lupus patients to? myxedema coma - Answer: Life-threatening condition associated with hypothyroidism, symptoms include abnormally low body temperature, swelling (including tongue thickening), confusion, lethargy and difficulty breathing. Can be precipitated by lithium and amiodarone HIV - Answer: ____________ is diagnosed through an HIV1/HIV2 antigen/antibody immunoassay, if this test is positive than order an HIV1/HIV2 antibody differentiation immunoassay, we no longer use the western blot CD4 - Answer: ____________ count must be monitored after a patients has been diagnosed with HIV 350 - Answer: antiretroviral drugs should be initiated at a CD4 count of ___________ or less increased - Answer: pain from a gastric ulcer is ____________________ by eating relieved - Answer: pain from a duodenal ulcer is ________________ by eating and then occurs 1-3 hours later fecal antigen - Answer: the best test for diagnosing H. pylori is the _____________ _____________________ test, can also use the urea breath test but patients must stop taking H2s or PPIs for 2 weeks before test or the serum antibody test but if they have ever had H. pylori in the past this test will be positive viral - Answer: most cases of gastroenteritis are ________________ in nature fluoroquinolones, macrolides, flagyl - Answer: treatment of bacterial gastroenteritis caused by salmonella, shigella, E. coli and campylobacter should be with _______________________ or _____________________ while treatment of bacterial gastroenteritis caused by giardia should be with __________________ 90, 60-89, 30-59, 15-29, 15 - Answer: stage 1 CKD: GFR >_______ stage 2 CKD: GFR ______-______ stage 3 CKD: GFR ______-______ stage 4 CKD: GFR ______-______ stage 5 CKD: GFR <______ 3 - Answer: patients with CKD are usually asymptomatic until stage _____, symptoms beginning at this stage would include fatigue, dry and itchy skin, hematuria, edema pregnancy - Answer: we should always treat asymptomatic UTIs during _______________________ 28, 21-40 - Answer: a typical menstrual cycle is around ______ days, with a normal range anywhere between ______-______ days if the periods are occurring regularly primary dysmenorrhea - Answer: painful menstruation not related to underlying disease, the pt has a normal physical exam and no pelvic issues secondary dysmenorrhea - Answer: painful menstruation that is related to an underlying cause, most commonly endometriosis endometriosis - Answer: condition in which endometrial tissue grows outside the uterus, symptoms include heavy, painful menstrual cycles, pain with intercourse, issues with fertility, these patients should be referred to GYN menopause - Answer: defined as amenorrhea present for 12 months later in life due to the fact that the ovaries are no longer producing estrogen and progesterone malignancy - Answer: a postmenopausal woman presenting with vaginal bleeding may indicate an underlying _________________________ and they should be referred immediately for biopsy Rotterdam criteria - Answer: criteria for diagnosis PCOS in which 2 of the following 3 signs/symptoms must be present for diagnosis: 1) anovulation (oligo- or amenorrhea) 2) increased androgen levels 3) multiple cysts present on US PCOS - Answer: hormonal disorder where it is common to see menstrual irregularities, acne, weight gain, fertility concerns, hirsutism and insulin resistance spironolactone - Answer: this medication can be used to help the androgen excess associated with PCOS LSIL/HSIL - Answer: what result from a pap smear do you immediately refer? 50, 2, 75 - Answer: we typically begin screening with mammograms at age ________ and perform them every ______ years until age _________ when we can discontinue them 21, 3, 5 - Answer: we start screening with pap tests at age _______ and perform them every _______ years until age 30 with no routine HPV co-testing. At age 30 we move to every ________ years with HPV co-testing fibrocystic breasts - Answer: the most common cause of breast lumps, often related to the menstrual cycle, pt's often describe the lumps as enlarging right before their menstrual period and shrinking right after, they are often tender, sore and moveable while breast cancer lumps are painless and immovable Nagele's, 9, 7 - Answer: ________________________ rule is used to calculate estimated due date, it is calculated by taking the LMP + _____ months + _____ days 25-35 - Answer: expected weight gain during pregnancy for a person with a normal BMI is ______-______ lbs negative, positive, 28 - Answer: if a mother is Rh-___________________ and the baby is Rh-___________________ then an incompatibility is present and RhoGAM should be given at the _______ week gestation mark and again 72 hours after delivery pre-eclampsia - Answer: pregnancy complication where there is hypertension in combination with signs of damage to other organ systems, symptoms include high BP, edema, headache, visual changes and proteinuria, usually occurs after the 20 week mark zika virus - Answer: illness that is spread by mosquitos that can be passed to the fetus and cause brain defects listeria - Answer: foodborne illness that can be passed to the fetus and lead to illness, miscarriage and preterm labor 1 - Answer: postpartum depression most commonly occurs in the first few weeks after delivery but can occur up to ______ year postpartum BPH - Answer: DRE findings for this prostate condition include a non-tender, enlarged symmetrically, rubbery prostate prostatitis - Answer: DRE findings for this prostate condition include a warm, tender, swollen boggy prostate, massage of the prostate is absolutely contraindicated with this condition prostate cancer - Answer: DRE findings for this prostate condition include a firm, fixed, asymmetric nodule on prostate that is painless epididymitis - Answer: inflammation of the epididymis, commonly presents as unilateral testicular pain and swelling, pt will have a positive Prehn's sign (relief of pain when examiner lifts the scrotum) STIs, BPH - Answer: in those <35 epididymitis is often due to ____________ and they should be treated with rocephin and doxycycline as well as their partners, in those >35 epididymitis is often due to bladder outflow obstruction such as _____________ and they should be treated with fluoroquinolones hydrocele - Answer: fluid in the scrotum, most common in infants, conservatively managed varicocele - Answer: enlargement of the veins in the scrotum, often first noticed in puberty, "bag of worms" presentation, conservatively managed balanitis - Answer: inflammation of the glans penis most commonly seen in those who are uncircumcised, commonly caused by candida and tx with a topical antifungal, also more common in diabetics due to urine rich in sugar Lachman - Answer: the most specific/sensitive test to evaluate the ACL, patient is positioned supine, examiner puts one hand on lower thigh and one on lower leg, bend the knee to a 20 degree angle and pull the lower leg forward while keeping the thigh stable, assess whether the knee has too much ROM immediately, delayed - Answer: in those with ACL injuries swelling occurs almost _____________________ after the injury while in those with meniscus injuries swelling is __________________ (up to 24 hours after injury) 30 - Answer: normal urine microalbumin level is <_______ 12-18, 36-54 - Answer: normal Hgb range is _____-______ and normal Hct range is _____-______ (with women being on the lower end of these and men on the higher end) 80-100 - Answer: normal MCV range is _____-_______ 6.5 - Answer: an HgbA1c of >_______% indicates DM 200 - Answer: a random plasma glucose of >_______ with symptoms indicates DM 200 - Answer: an oral glucose tolerance test of >_______ indicates DM Katz index - Answer: what tool do we use to assess functional capacity/activities of daily living in the elderly? TUG test - Answer: this screening tool is used to assess for potential fall risk in the elderly, have the patient in a sitting position and tell them to get up, start a timer, if it takes them longer than 13.5 seconds they are considered a fall risk mini-mental (MMSE) - Answer: screening tool used to assess for cognitive impairment in the elderly, maximum score is 30, 10-20 indicates moderate decline in cognitive impairment and 0-10 indicates severe impairment mini-cog - Answer: screening tool used to assess for cognitive impairment in the elderly, instruct the pt to remember 3 words, instruct the pt to draw a clock to a specific time, ask pt to recall the original 3 words 9, 8 - Answer: precocious puberty, otherwise known as early puberty, is defined as puberty prior to age ______ in males and age ________ in girls 9, 11 - Answer: HPV vaccine can be administered as early as age _____ although it is typically initiated at age _______, the goal is to be administered before sexual activity begins seborrheic dermatitis - Answer: also known as cradle cap, will often resolve on it's own within a few months but can soften with oil or shampoo to remove scales if need be hemangioma - Answer: red, flat birth marks that typically resolve on their own by age 4 scarlatina - Answer: a sandpaper-esque rash that occurs due to untreated strep throat dexamethasone - Answer: what is the treatment for croup? azithromycin - Answer: antibiotic used in the treatment of pertussis, does not shorten the length of symptoms but can shorten how long they are contagious for Hib - Answer: it is important to stress the _________ vaccine as it can prevent epiglottitis from occurring Nursemaid's elbow - Answer: radial head subluxation that occurs in children after swinging motions (i.e. being swung between arms of parents, monkey bars, etc.), tx with closed reduction in office genu varum - Answer: bow-legged, typically resolves on it's own by age 2-3 genu valgum - Answer: known-kneed, typically resolves on it's own by age 7 Legg-Calve-Perthes - Answer: osteonecrosis of the femoral head, typically occurs in children age 4-6 c-spine - Answer: what do we need to assess via x-ray prior to clearing a child with down syndrome for sports? Turner syndrome - Answer: a chromosomal disorder in females in which one X chromosome is missing, will often have webbed neck, short stature Kleinfelter's syndrome - Answer: a chromosomal disorder in males in which they have an extra X chromosome and there is testosterone deficiency due to this, will often have large head circumference, delayed milestones, mental disabilities spina bifida - Answer: this condition occurs when the neural tube does not close properly, often presents with a sacral dimple or patch of hair on the lumbosacral region of spine M-CHAT - Answer: screening tool for autism ADHD - Answer: the three core signs of this condition include hyperactivity, impulsivity and inattention