NSG 6420 LATEST 2026 STUDY GUIDE QUESTIONS AND
SOLUTIONS RATED A+
✔✔Findings on blood test for thalassemia - ✔✔TEAR DROP CELLS (dacrocytes) and
acanthocytes
✔✔Blood test for thalassemia? - ✔✔hgb electrophoresis
✔✔Macrocytic anemia? - ✔✔megaloblastic, vit b12 and folate deficiency, pernicious
anemia
✔✔s/sx of vit b12 deficiency? - ✔✔beefy-red shiny tongue (glossitis), abd tenderness,
hepatosplenomegaly, tachycardia, tachypnea, pallor, loss of fine motor control, pos
rhomberg and babinski
✔✔s/sx of folate deficiency? - ✔✔fatigue, DOE, pallor, tachy, anorexia, glossitis, HA,
neural tube disorders; NO NEURO SIGNS
✔✔Foods rich in folic acid? - ✔✔bananas, PB, green leafy veggies, fortified bread and
cereal
✔✔foods rich in vB12? - ✔✔shellfish, liver, fish, fortified cereals and breads, low fat
dairy, red meat, poultry,eggs, soy
✔✔Diseases of primarily bronchospasm with superimposed inflammation - ✔✔COPD
✔✔Inflammation of cells lining bronchial walls, hyperplasia of mucous glands and
narrowing of small airways - ✔✔Chronic bronchitis
✔✔enlargement and destruction of inter alveolar septa within the terminal bronchiole
with wall destruction in absence of fibrosis - ✔✔emphysema
✔✔Most common complaint of COPD - ✔✔dyspnea on exertion
✔✔COPD dx test? - ✔✔spirometry confirms diagnosis
✔✔COPD stage I tx - ✔✔SABA prn
✔✔COPD stage II tx - ✔✔SABA plus 1 or more long acting bronchodilators
✔✔COPD stage III tx - ✔✔SABA plus 2 or more LABAs; inhaled glucocorticoids
✔✔COPD stage IV tx - ✔✔SABA plus one or more LABAs; inhaled glucocorticoids; tx of
complications
, ✔✔sx of COPD exacerbations? - ✔✔cough increases in frequency and/or severity;
increased production of sputum/changes in color or viscosity; SOB increases; VS
changes
✔✔Theophylline - ✔✔Bronchodilitation
*Therapeutic window- seizures, cardiac if too high
*watch drug interactions with antibiotics and statins
✔✔Anticholinergics precautions - ✔✔narrow-angle glaucoma
✔✔Beta adrenergic agonists precautions - ✔✔caution with cardiac dx, hyperthyroidism,
DM, seizures
✔✔Otitis externa s/sx - ✔✔usually unilateral
**Tragus tenderness is hallmark**
pruritis, pain, hearing loss, ear d/c
*pt usually well
✔✔What is chronic otitis externa? - ✔✔Usually PSEUDOMONAS
✔✔External otitis - ✔✔topical antimicrobial x7days
*non-aminoglycoside + corticosteroid
*aminoglycoside + corticosteroid (not in perf. TM)
*topical preps containing only antibiotic
*antifungal (usually yeast) or something containing all three
✔✔Malignant otitis externa - ✔✔facial nerve palsy in 50% of patients
*severe infection d/t pseudomonas and anaerobes causing OM of skull base
*Otalgis, otorrhea, hoarseness, swelling, trismus
✔✔AOM s/sx - ✔✔unwell, pyrexia, otalgia/discharge, loss of outline of drum and
landmarks
*Red, bulging edematous TM
✔✔AOM causes - ✔✔MOSTLY VIRAL (15-44%)
Strep pneumo (20-35%)
H.flu (20-30%)
M.cat (15%)
✔✔Bullous AOM - ✔✔cover mycoplasma pneumo and strep pneumo
✔✔TX for AOM - ✔✔amox 1st line tx
augmentin if severe or previous AOM in last month
clarithromycin for PCN allergy
SOLUTIONS RATED A+
✔✔Findings on blood test for thalassemia - ✔✔TEAR DROP CELLS (dacrocytes) and
acanthocytes
✔✔Blood test for thalassemia? - ✔✔hgb electrophoresis
✔✔Macrocytic anemia? - ✔✔megaloblastic, vit b12 and folate deficiency, pernicious
anemia
✔✔s/sx of vit b12 deficiency? - ✔✔beefy-red shiny tongue (glossitis), abd tenderness,
hepatosplenomegaly, tachycardia, tachypnea, pallor, loss of fine motor control, pos
rhomberg and babinski
✔✔s/sx of folate deficiency? - ✔✔fatigue, DOE, pallor, tachy, anorexia, glossitis, HA,
neural tube disorders; NO NEURO SIGNS
✔✔Foods rich in folic acid? - ✔✔bananas, PB, green leafy veggies, fortified bread and
cereal
✔✔foods rich in vB12? - ✔✔shellfish, liver, fish, fortified cereals and breads, low fat
dairy, red meat, poultry,eggs, soy
✔✔Diseases of primarily bronchospasm with superimposed inflammation - ✔✔COPD
✔✔Inflammation of cells lining bronchial walls, hyperplasia of mucous glands and
narrowing of small airways - ✔✔Chronic bronchitis
✔✔enlargement and destruction of inter alveolar septa within the terminal bronchiole
with wall destruction in absence of fibrosis - ✔✔emphysema
✔✔Most common complaint of COPD - ✔✔dyspnea on exertion
✔✔COPD dx test? - ✔✔spirometry confirms diagnosis
✔✔COPD stage I tx - ✔✔SABA prn
✔✔COPD stage II tx - ✔✔SABA plus 1 or more long acting bronchodilators
✔✔COPD stage III tx - ✔✔SABA plus 2 or more LABAs; inhaled glucocorticoids
✔✔COPD stage IV tx - ✔✔SABA plus one or more LABAs; inhaled glucocorticoids; tx of
complications
, ✔✔sx of COPD exacerbations? - ✔✔cough increases in frequency and/or severity;
increased production of sputum/changes in color or viscosity; SOB increases; VS
changes
✔✔Theophylline - ✔✔Bronchodilitation
*Therapeutic window- seizures, cardiac if too high
*watch drug interactions with antibiotics and statins
✔✔Anticholinergics precautions - ✔✔narrow-angle glaucoma
✔✔Beta adrenergic agonists precautions - ✔✔caution with cardiac dx, hyperthyroidism,
DM, seizures
✔✔Otitis externa s/sx - ✔✔usually unilateral
**Tragus tenderness is hallmark**
pruritis, pain, hearing loss, ear d/c
*pt usually well
✔✔What is chronic otitis externa? - ✔✔Usually PSEUDOMONAS
✔✔External otitis - ✔✔topical antimicrobial x7days
*non-aminoglycoside + corticosteroid
*aminoglycoside + corticosteroid (not in perf. TM)
*topical preps containing only antibiotic
*antifungal (usually yeast) or something containing all three
✔✔Malignant otitis externa - ✔✔facial nerve palsy in 50% of patients
*severe infection d/t pseudomonas and anaerobes causing OM of skull base
*Otalgis, otorrhea, hoarseness, swelling, trismus
✔✔AOM s/sx - ✔✔unwell, pyrexia, otalgia/discharge, loss of outline of drum and
landmarks
*Red, bulging edematous TM
✔✔AOM causes - ✔✔MOSTLY VIRAL (15-44%)
Strep pneumo (20-35%)
H.flu (20-30%)
M.cat (15%)
✔✔Bullous AOM - ✔✔cover mycoplasma pneumo and strep pneumo
✔✔TX for AOM - ✔✔amox 1st line tx
augmentin if severe or previous AOM in last month
clarithromycin for PCN allergy
