TIFFENY'S COMPREHENSIVE AANP
REVIEW (LEIK-BARKLEY-
FITZGERALD) PT. 1 EXAM
QUESTIONS & DETAILED ANSWERS
PASSED ALREADY GRADED A+
Aldosterone antagonists tx (3)
Example (1)
Adverse effects (2)
Black box warning - CORRECT ANSWER Hirsutism, htn, severe heart failure
spironolactone (Aldactone)
Galactorrhea, hyperkalemia
Increase risk of benign and malignant tumors
Indicators that a headache can be the presenting symptom of a serious illness and may
require neuroimaging include all of the following except:
A]. headaches that occur periodically in clusters.
B.] increasing frequency and severity of headaches.
C.] headache causing confusion, dizziness, and/or lack of coordination.
D.] headache causing awakening from sleep. - CORRECT ANSWER A. headaches
that occur periodically in clusters.
Occurs from high levels of serotonin accumulating in the body due to the introduction of
a new drug (drug interaction) and an increase in the dose. Acute onset with rapid
progression.
Signs and symptoms are sudden onset of high fever, muscular rigidity, mental status
changes, hyperrefl exia/clonus, and uncontrolled shivering. Look for dilated pupils
(mydriasis). Higher risk if combining two drugs that both block serotonin (i.e., selective
serotonin reuptake inhibitors [SSRIs], monoamine oxidase inhibitors [MAOIs], tricyclic
,antidepressants [TCAs], triptans, tryptophan). If switching to another drug affecting
serotonin, wait a minimum of 2 weeks. Potentially life-threatening reaction. - CORRECT
ANSWER Acute Serotonin Syndrome
how long does it take a patient to seroconvert to HIV? - CORRECT ANSWER 3 weeks
to 6 months
The test of choice to confirm and assess developmental dysplasia of the hip (DHH) in a
3 month old is: - CORRECT ANSWER ultrasound of the hip.
A patient who has been treated for hypothyroidism presents for her annual exam. Her
TSH is 4.1 (normal = 0.4- 3.8). She feels well. How should she be managed? -
CORRECT ANSWER Repeat the TSH in 2-3 weeks.
Rare life-threatening idiopathic reaction from typical and atypical antipsychotics. These
drugs affect the dopaminergic system of the brain. Usually develops following initiation
or an increase in dose. Signs and symptoms are sudden onset of high fever, muscular
rigidity, mental status changes, fluctuating blood pressure, and urinary incontinence. -
CORRECT ANSWER Malignant Neuroleptic Syndrome
75 year-old patient has osteoarthritis and pain. Which of the following medications
increases the risk of a GI related ulceration? - CORRECT ANSWER Celecoxib
Celecoxib is an NSAID. All NSAIDs increase the risk of upper and lower GI ulcerations.
Other lower GI complications include perforation, stricture, anemia, and
hypoalbuminemia.
A 19 y/o man presents with a cc of a red, irritated rt eye for the past 48 hrs with eyelids
that were stuck together this morning when he awoke. exam reveals injected palpebral
and bulbar conjunctiva and reactive pupils; vision screen with the Snellen chart eval
reveals 2-/30 in the right eye, left eye and both eyes; and purulent eye discharge in on
the right. this presentation is most consistent with:
a. suppurative conjunctivitis
b. viral conjunctivitis
c. allergic conjunctivitis
d. mechanical injury - CORRECT ANSWER a. suppurative conjunctivitis
A 62 year old male presents with chills, fever, dysuria, urinary frequency, diffuse low
back pain and an exquisitely tender, boggy prostate on rectal exam.
What infection?
How will you treat? - CORRECT ANSWER acute bacterial prostatitis
Ciprofloxacin (Cipro)500mg BID Ofloxacin(Floxin) 200mg PO daily
TMP-SMX
,sit bath TID for 30min
No sex until resolved
Longstanding myopia, new onset presbyopia, corrected with eyeglasses, no HTN, no
ocular implant; examination finding that would be expected is...?
A) retinal arteries wider than veins
B) equal sluggish pupillary response
c) sharp disc margins
D) lid ectropion - CORRECT ANSWER c) sharp disc margins
Causes the most deaths worldwide______
Ca with highest mortality____
Most common cause of death for adolescents_______
Most common ca in females__
Most common ca in males______
Most common ca overall______
Most common gynecological cancer_______ - CORRECT ANSWER Heart disease
Lung
MVA
Breast
Prostate
Skin
Uterine& Endometrial then Ovarian
Orientation:
What is the date today? (current day, month, year) Location (name the city, county,
state)
Immediate recall:
Recall three objects Instruct that you will be testing his/her memory. Say 3 unrelated
words (pencil, apple, ball). Ask patient to repeat words
Attention and calculation:
Counting backward Say "starting at 100, count backward and keep subtracting 7"
Backward spelling Spell the word "WORLD" backward
Writing and copying:
, Writing a sentence Give person one blank paper and ask him/her to write a sentence
Copying a figure:
Draw intersecting pentagons. Ask patient to copy the pentagons
Scoring:
Maximum score is 30 correctly done. Impaired is a score of less than 19 - CORRECT
ANSWER Folstein Mini-Mental State Exam (MMSE)
Will have Koplik spots - CORRECT ANSWER measles
Txt options for BV - CORRECT ANSWER flagyl po/intravaginal
clindamycin po/intravaginal
Match the female:male ratio for Migraine without aura:
A. 1:3 to 1:8
B. 3:1
C. 5:4 - CORRECT ANSWER B. 3:1
A pregnant patient (first trimester) with mild persistent asthma has used inhaled
budesonide (Pulmicort) BID prior to pregnancy with good results. What should be done
with this medication during pregnancy?
1. D/c. Use albuterol instead.
2. D/c & try Singulair (LTRA).
3. Continue @ same dose BID.
4. Continue once daily. - CORRECT ANSWER Cont at the same dose BID (#3)
Sandpaper rash with sore throat - CORRECT ANSWER scarlet fever
a 19 y/o woman presents with a complaint of bilaterally itchy, red eyes with tearing that
occurs intermittently throughout the year and is often accompanied by a rope-like eye
discharge and clear nasal discharge. this is most consistent with conjunctival
inflammation caused by a)n):
a. bacterium
b. virus
c. allergen
d. injury - CORRECT ANSWER c.) allergen
A pregnant patient has taken sertraline for the past 10 years with excellent results. She
asks if this is safe to take while she is pregnant. How should this be answered?
1. It is safe; Category A.
2. It is safe; Category B.
3. It might be safe; Category C. 4. It is not safe; Category D. - CORRECT ANSWER
Category C - it might be safe
REVIEW (LEIK-BARKLEY-
FITZGERALD) PT. 1 EXAM
QUESTIONS & DETAILED ANSWERS
PASSED ALREADY GRADED A+
Aldosterone antagonists tx (3)
Example (1)
Adverse effects (2)
Black box warning - CORRECT ANSWER Hirsutism, htn, severe heart failure
spironolactone (Aldactone)
Galactorrhea, hyperkalemia
Increase risk of benign and malignant tumors
Indicators that a headache can be the presenting symptom of a serious illness and may
require neuroimaging include all of the following except:
A]. headaches that occur periodically in clusters.
B.] increasing frequency and severity of headaches.
C.] headache causing confusion, dizziness, and/or lack of coordination.
D.] headache causing awakening from sleep. - CORRECT ANSWER A. headaches
that occur periodically in clusters.
Occurs from high levels of serotonin accumulating in the body due to the introduction of
a new drug (drug interaction) and an increase in the dose. Acute onset with rapid
progression.
Signs and symptoms are sudden onset of high fever, muscular rigidity, mental status
changes, hyperrefl exia/clonus, and uncontrolled shivering. Look for dilated pupils
(mydriasis). Higher risk if combining two drugs that both block serotonin (i.e., selective
serotonin reuptake inhibitors [SSRIs], monoamine oxidase inhibitors [MAOIs], tricyclic
,antidepressants [TCAs], triptans, tryptophan). If switching to another drug affecting
serotonin, wait a minimum of 2 weeks. Potentially life-threatening reaction. - CORRECT
ANSWER Acute Serotonin Syndrome
how long does it take a patient to seroconvert to HIV? - CORRECT ANSWER 3 weeks
to 6 months
The test of choice to confirm and assess developmental dysplasia of the hip (DHH) in a
3 month old is: - CORRECT ANSWER ultrasound of the hip.
A patient who has been treated for hypothyroidism presents for her annual exam. Her
TSH is 4.1 (normal = 0.4- 3.8). She feels well. How should she be managed? -
CORRECT ANSWER Repeat the TSH in 2-3 weeks.
Rare life-threatening idiopathic reaction from typical and atypical antipsychotics. These
drugs affect the dopaminergic system of the brain. Usually develops following initiation
or an increase in dose. Signs and symptoms are sudden onset of high fever, muscular
rigidity, mental status changes, fluctuating blood pressure, and urinary incontinence. -
CORRECT ANSWER Malignant Neuroleptic Syndrome
75 year-old patient has osteoarthritis and pain. Which of the following medications
increases the risk of a GI related ulceration? - CORRECT ANSWER Celecoxib
Celecoxib is an NSAID. All NSAIDs increase the risk of upper and lower GI ulcerations.
Other lower GI complications include perforation, stricture, anemia, and
hypoalbuminemia.
A 19 y/o man presents with a cc of a red, irritated rt eye for the past 48 hrs with eyelids
that were stuck together this morning when he awoke. exam reveals injected palpebral
and bulbar conjunctiva and reactive pupils; vision screen with the Snellen chart eval
reveals 2-/30 in the right eye, left eye and both eyes; and purulent eye discharge in on
the right. this presentation is most consistent with:
a. suppurative conjunctivitis
b. viral conjunctivitis
c. allergic conjunctivitis
d. mechanical injury - CORRECT ANSWER a. suppurative conjunctivitis
A 62 year old male presents with chills, fever, dysuria, urinary frequency, diffuse low
back pain and an exquisitely tender, boggy prostate on rectal exam.
What infection?
How will you treat? - CORRECT ANSWER acute bacterial prostatitis
Ciprofloxacin (Cipro)500mg BID Ofloxacin(Floxin) 200mg PO daily
TMP-SMX
,sit bath TID for 30min
No sex until resolved
Longstanding myopia, new onset presbyopia, corrected with eyeglasses, no HTN, no
ocular implant; examination finding that would be expected is...?
A) retinal arteries wider than veins
B) equal sluggish pupillary response
c) sharp disc margins
D) lid ectropion - CORRECT ANSWER c) sharp disc margins
Causes the most deaths worldwide______
Ca with highest mortality____
Most common cause of death for adolescents_______
Most common ca in females__
Most common ca in males______
Most common ca overall______
Most common gynecological cancer_______ - CORRECT ANSWER Heart disease
Lung
MVA
Breast
Prostate
Skin
Uterine& Endometrial then Ovarian
Orientation:
What is the date today? (current day, month, year) Location (name the city, county,
state)
Immediate recall:
Recall three objects Instruct that you will be testing his/her memory. Say 3 unrelated
words (pencil, apple, ball). Ask patient to repeat words
Attention and calculation:
Counting backward Say "starting at 100, count backward and keep subtracting 7"
Backward spelling Spell the word "WORLD" backward
Writing and copying:
, Writing a sentence Give person one blank paper and ask him/her to write a sentence
Copying a figure:
Draw intersecting pentagons. Ask patient to copy the pentagons
Scoring:
Maximum score is 30 correctly done. Impaired is a score of less than 19 - CORRECT
ANSWER Folstein Mini-Mental State Exam (MMSE)
Will have Koplik spots - CORRECT ANSWER measles
Txt options for BV - CORRECT ANSWER flagyl po/intravaginal
clindamycin po/intravaginal
Match the female:male ratio for Migraine without aura:
A. 1:3 to 1:8
B. 3:1
C. 5:4 - CORRECT ANSWER B. 3:1
A pregnant patient (first trimester) with mild persistent asthma has used inhaled
budesonide (Pulmicort) BID prior to pregnancy with good results. What should be done
with this medication during pregnancy?
1. D/c. Use albuterol instead.
2. D/c & try Singulair (LTRA).
3. Continue @ same dose BID.
4. Continue once daily. - CORRECT ANSWER Cont at the same dose BID (#3)
Sandpaper rash with sore throat - CORRECT ANSWER scarlet fever
a 19 y/o woman presents with a complaint of bilaterally itchy, red eyes with tearing that
occurs intermittently throughout the year and is often accompanied by a rope-like eye
discharge and clear nasal discharge. this is most consistent with conjunctival
inflammation caused by a)n):
a. bacterium
b. virus
c. allergen
d. injury - CORRECT ANSWER c.) allergen
A pregnant patient has taken sertraline for the past 10 years with excellent results. She
asks if this is safe to take while she is pregnant. How should this be answered?
1. It is safe; Category A.
2. It is safe; Category B.
3. It might be safe; Category C. 4. It is not safe; Category D. - CORRECT ANSWER
Category C - it might be safe
