FNP (AANP) STUDY GUIDE EXAM 2023/2024

FNP (AANP) STUDY GUIDE EXAM 2023/2024 Microcytic Anemias - CORRECT ANSWER-IDA, Thalassemia, Lead Toxicity Macrocytic Anemias - CORRECT ANSWER-B12 Deficiency and Folate deificiency IDA - CORRECT ANSWER-Microcytic, hypochromic Patient Presentation with microcytic anemia - CORRECT ANSWER-Weakness, headache, irritability, fatigue, and exercise intolerance. Worsening of angina or dementia TIBC - CORRECT ANSWER-Elevated with IDA Average lifespan of RBCs - CORRECT ANSWER-100-120 days RDW <15% - CORRECT ANSWER-Longstanding anemia in that all cells are small RDW > 15% - CORRECT ANSWER-New onset anemia; There is a mixture of normal and small RBCs Iron Rich foods - CORRECT ANSWER-Organ meats, red meats, dried peas and beans, whole grains, and dark, green, leafy vegetables Iron Replacement - CORRECT ANSWER-150-200 mg/d Elemental Iron x4-6 months Beta Thalassemia - CORRECT ANSWER-Avoid excessive iron consumption and will need genetic counseling Alpha Thalassemia - CORRECT ANSWER-Asians, Mediterranean origin, avoid inappropriate exposure to iron, no therapy needed in minima and minor Liver - CORRECT ANSWER-Where excess iron is stored Thalassemia Lab Results - CORRECT ANSWER-Decrease hct, hgb, MCV, and MCH Normal RDW, serum iron, serum ferritin, and TIBC IDA Lab Results - CORRECT ANSWER-Decrease in hgb, hct, MCV, MCH, serum iron, and serum ferritin Elevated RDW & TIBC RBC lifespan in chronic disease - CORRECT ANSWER-60-90 days Macrocytosis Etiologies - CORRECT ANSWER-ETOH abuse, substance abuse, celiac disease, IBS, pregnancy, lactation, certain medications, and myelodysplastic syndromes Which macrocytic anemia is characterized by neuro changes? - CORRECT ANSWERVit B12 (Folate does not usually present with neuro changes) Thrombocytopenia - CORRECT ANSWER-Platelet count less than 150,000 Thrombocytopenia Etiology - CORRECT ANSWER-Drug induced, SLE, recent infection, idiopathic, antiphospholipid syndrome, or leukemia Agranular WBCs - CORRECT ANSWER-Lymphocytes 20-25% Monocytes 3-8% Granular WBCs - CORRECT ANSWER-Basophils 0.5-1% Neutrophils 60-70% Eosinophils 2-4% Eosinophils will increase with... - CORRECT ANSWER-Allergic reactions and parasitic infections On a CBC think a viral infection when... - CORRECT ANSWER-Poly's and Lumphs are numerically close On a CBC think bacterial infection when... - CORRECT ANSWER-Poly's and Lymphs are numerically distant On a CBC, what will increase first with an infection? - CORRECT ANSWER-Poly's and Lymphs Mono's on a CBC react within what amount of time in an infection? - CORRECT ANSWER-24 hours What are bands? - CORRECT ANSWER-Immature WBCs and when present represents a bad infection Common medications that can cause anemia - CORRECT ANSWER-Metformin and PPIs Hgb to Hct ratio - CORRECT ANSWER-1:3 Only time you will see the Hgb : Hct ratio differ? - CORRECT ANSWER-Severe dehydration will decrease the Hct because it is volume dependent As MCV decreases, the RDW _____________? - CORRECT ANSWER-Increases As the MCV increases, the RDW ________________? - CORRECT ANSWERIncreases Normal response to anemia is________________ - CORRECT ANSWERReticulocytosis Most common etiology for normocytic normochromic anemia - CORRECT ANSWERAcute blood loss or anemia of chronic disease At risk groups for alpha Thalassemia minor - CORRECT ANSWER-AAA Asian, African ancestry At risk groups for beta Thalassemia minir - CORRECT ANSWER-BAMME African, Mediterranean, Middle Eastern ancestry Drug-Induced Macrocytosis without anemia - CORRECT ANSWER-MCV elevated and MCH/RDW normal. Can be caused by Dilantin, AZT, Depakote, or Tegretol Most common type of anemia in childhood - CORRECT ANSWER-IDA Most common type of anemia during pregnancy - CORRECT ANSWER-IDA Most common type of anemia in women during reproductive years - CORRECT ANSWER-IDA Most common type of anemia in the elderly - CORRECT ANSWER-Anemia of chronic disease Risk of pregnancy in having a child with Thalassemia when the mother and father both have beta Thalassemia minor - CORRECT ANSWER-1 in 4 chance with every pregnancy Sickle Cell Anemia risks if the mother and father both have one copy of the sickle cell gene with each pregnancy - CORRECT ANSWER-1:4 does not have sickle cell 2:4 one copy of sickle cell 1:4 has sickle cell anemia Most common enzymatic disorder of red blood cells in humans - CORRECT ANSWERG6PD Glucose-6-phosphate dehydrogenase What do patients with G6PD need to avoid? - CORRECT ANSWER-Sulfa drugs, aspirin, and fava beans because consumption will precipitate lysis of RBCs Primary cause of blindness in adults - CORRECT ANSWER-Macular degeneration Second leading cause of blindness in adults - CORRECT ANSWER-Cataracts Pterygium - CORRECT ANSWER-Common non-cancerous growth on cornea and conjunctiva; can grow and cause blindness Pinguecula - CORRECT ANSWER-Yellow, white deposit on the conjunctiva; asymptomatic Xanthasmas - CORRECT ANSWER-Yellow plaque on the inner canthus; 50% of these patients have increased lipids Chalazion - CORRECT ANSWER-Hard, non-tender nodule of the eyelid caused by inflammation of the Meibomian gland; treatment is laser Stye - CORRECT ANSWER-Inflammation of the sebaceous glands at the base of the eyelashes; often tender Macular degeneration symptom - CORRECT ANSWER-Loss of central vision over years; symptoms are scotoma and/or curving of straight lines Retinal veins vs retinal arteries - CORRECT ANSWER-Arteries are narrower than veins; VEINS PULSATE Cataract - CORRECT ANSWER-Opacity in the lens of the eye which decreases visual acuity; may not have red reflex present Most highly predictive symptom that leads to ARS - CORRECT ANSWER-Facial pain, pressure that worsens with bending forward along with purple to nasal discharge Scotoma - CORRECT ANSWER-Central blind spot; first sign of macular degeneration Goals in treating ARS - CORRECT ANSWER-Relieve symptoms Promote drainage Prevent complications Common etiologies for adult pharyngitis - CORRECT ANSWER-Group A Strept Viruses Other bacteria (<5%) Non-infectious causes Centor criteria to determine if pt has GAS... - CORRECT ANSWER-Cough, anterior cervical nodes, temp >100.4, tonsillar exudates or swelling, and most commonly found between the ages of 3-44yo What antibiotic group do you not use to treat ARS? - CORRECT ANSWER-Macrolides Infectious mononucleosis - CORRECT ANSWER-Viral infection caused by Epstein-Barr virus of the herpes family of viruses Characteristics of mono include.... - CORRECT ANSWER-Fever Fatigue Pharyngitis Lymphadenopathy Epiglottitis - CORRECT ANSWER-Infection of the epiglottis and surround tissues which can cause sudden and critical narrowing of the airway Symptoms of epiglottitis - CORRECT ANSWER-Sore throat; fever; muffled voice; drooling; stridor; hoarseness; hyperextension of neck; "thumb sign" What meds are most commonly found to cause epistaxis? - CORRECT ANSWERTopical vasoconstrictor SUV as Afrin Allergic rhinitis - CORRECT ANSWER-Inflammation of the mucous membranes of the nasal track Allergic rhinitis symptoms - CORRECT ANSWER-Mucosal edema; clear discharge; sneezing; itching; nasal stuffiness First line management for allergic rhinits - CORRECT ANSWER-Topical nasal steroids Common side effects for oral antihistamines - CORRECT ANSWER-Epistaxis Dry mucous membranes Common causes of hearing loss - CORRECT ANSWER-Otitis media externa Sensorineural (conductive) Flying in an airplane Traveling up a mountain Common causes of conductive hearing loss - CORRECT ANSWER-Cerumen impaction; ear plugs; fluid in middle ear; wearing of headphones Common causes of sensorineural hearing loss - CORRECT ANSWER-Involves 8th cranial nerve; hereditary; PRESBYCUSIS; noise exposure; Meniere's; acoustic tumors; trauma Likely findings in a pt with presbycusis - CORRECT ANSWER-Symmetrical hearing loss Worse with background noise Sensitivity to loud noises Tinnitus is present Audiogram shoes loss of high pitched tones Most common beginning in the 6th decade Tonometry - CORRECT ANSWER-Glaucoma screening test Measurement of IOP Amsler Grid Test - CORRECT ANSWER-Early detection of macular degeneration Snellen Chart - CORRECT ANSWER-General visual acuity test Slit-Lamp Exam - CORRECT ANSWER-Evaluation of anterior eye structures; including cornea, conjunctiva, sclera, and iris "Idine" - CORRECT ANSWER-H2 antagonist Ranitidine Wheal - CORRECT ANSWER-Fleeting, irregular shaped, elevated, itchy lesion of various sizes; pale at center and slightly red at borders CN III - CORRECT ANSWER-Oculomotor Pupillary constriction; eye movements; accommodation Macule - CORRECT ANSWER-Flat, nonpapable, discolored lesion; 1cm or smaller Comedo - CORRECT ANSWER-Plugged, dilated pore Open - blackhead Closed - whitehead Nodule - CORRECT ANSWER-Raised, firm, movable lesion with indistinct borders and deep palpable portion; less than or equal to 2cm Meds to avoid when pt is taking St John's wart? - CORRECT ANSWER-Antiretrovirals Oral contraceptives Cyclosporines Substrate - CORRECT ANSWER-Utilizes a specific enzymatic pathway Tumor - CORRECT ANSWER-Large module that may be soft or firm Pustule - CORRECT ANSWER-Raised lesion filled with pus, often in hair follicle or sweat pore Plaque - CORRECT ANSWER-Solid, raised, flat-topped lesion with distinct borders; greater than 1cm Papule - CORRECT ANSWER-Solid, raised lesion of varied color with distinct borders; less than 1cm Cyst - CORRECT ANSWER-Palpable lesion with definite borders filled with liquid or semisolid material Atrophy - CORRECT ANSWER-Thinning skin; may appear translucent Vesicle - CORRECT ANSWER-Blister filled with clear fluid Fissure - CORRECT ANSWER-Linear, wedge-shaped cracks extending into dermis Keloid - CORRECT ANSWER-Healed lesion of hypertrophied connective tissue Lichenification - CORRECT ANSWER-Thickening of skin with deep visible furrows Scales - CORRECT ANSWER-Thin, flaking layers of epidermis Striae - CORRECT ANSWER-Fine pink or silver lines in areas where skin has been stretched CN II - CORRECT ANSWER-Optic Snellen chart Visual acuity CN I - CORRECT ANSWER-Olfactory Smell CN V - CORRECT ANSWER-Trigeminal Sensation to face CN IV - CORRECT ANSWER-Trochlear Superior Oblique Muscle ( LR6SO4) Desquamation - CORRECT ANSWER-Peeing sheets of scale Cranial Nerves - CORRECT ANSWER-Oh Oh Oh To Take A Family Vacation Go Vega And Hawaii "Floxacin" - CORRECT ANSWER-Quinolones; broad spectrum abx; most serious side effects is tendon rupture Serum Ferritin - CORRECT ANSWER-Amount of iron in storage "Terol" - CORRECT ANSWER-Beta agonist; albuterol; side effects HA, anxiety, nervousness, increase HR "Tropium" - CORRECT ANSWER-Anticholinergics; ipratropium; blocks acetylcholine; can't pee/see/spit/shit Scar - CORRECT ANSWER-Healed lesion of connective tissue Reticulocyte Count - CORRECT ANSWER-Ability of bone marrow to produce RBCs CN XII - CORRECT ANSWER-Hypoglossal Motor fibers to the muscles of the tongue Telangiextasia - CORRECT ANSWER-Collection of macular or raised, dilated capillaries CN XI - CORRECT ANSWER-Spinal accessory Sternocleidomastoid Trapezius muscles CN X - CORRECT ANSWER-Vagus Parasympathetic fibers to the viscera of the chest and abdomen Angioma Hemangioma - CORRECT ANSWER-Papule made of blood vessels Ecchymosis - CORRECT ANSWER-Bruise, purple to brown, macular or papular, varies in size Hematoma - CORRECT ANSWER-Collection of blood from ruptured blood vessel, larger than 1cm "One" - CORRECT ANSWER-Steroids Patch - CORRECT ANSWER-Macule; larger than 1cm Petechiae - CORRECT ANSWER-Pinpoint, pink to purple macular lesions that do not blanch 1-3mm Purpura - CORRECT ANSWER-Purple macular lesion; larger than 1cm CN IX - CORRECT ANSWER-Glossopharyngeal Sensation to pharynx CN VIII - CORRECT ANSWER-Vestibulocochlear Hearing, balance, awareness of position Microcytic - CORRECT ANSWER-<80 Normocytic - CORRECT ANSWER-80-96 Macrocytic - CORRECT ANSWER->96 Calculate pack year history - CORRECT ANSWER-PPD x # years smoked Do not give live vaccines to what populations? - CORRECT ANSWER-Pregnancy Immunocompromised HIV with cell counts <200 Ages <2 or >49 "Cytic" - CORRECT ANSWER-Cell CN VII - CORRECT ANSWER-Facial Face muscles and taste on the tongue CN VI - CORRECT ANSWER-Abducens Lateral Rectus Muscle (LR6SO4) Erosion - CORRECT ANSWER-Oozing or moist, depressed area with loss of superficial epidermis "Chromic" - CORRECT ANSWER-Color Inhibitor - CORRECT ANSWER-Blocks a specific enzymatic pathway; keeps substrate from exiting Inducer - CORRECT ANSWER-Pushes the substrate out the exit pathway Excoriation - CORRECT ANSWER-Abrasion or removal of epidermis scratch "Ide" - CORRECT ANSWER-Thiazide diuretics "Azole" - CORRECT ANSWER-PPI Pantoprazole Can cause vit b12 deficiency Crusts - CORRECT ANSWER-Dried exudate or scab of varied color Ulcer - CORRECT ANSWER-Deeper than erosion; open lesion extending into dermis Increased risks for antibiotic resistance - CORRECT ANSWER-<2yo or >65yo Daycare Abx within past month Hospitalization within past 5 days Immunocompromised Primary skin lesion - CORRECT ANSWER-Result from a diseas process; example zoster Secondary skin lesion - CORRECT ANSWER-Lesions altered by outside manipulation, treatment, natural course of disease; crust that develops when vesicles rupture Excoriation - CORRECT ANSWER-Usually linear, raised, often covered with crust; nickel allergy Lichenification - CORRECT ANSWER-Skin thickening usually found over pruritic or friction areas; eczema Scales - CORRECT ANSWER-Raised, superficial lesions that flake with ease; dandruff or psoriasis Erosion - CORRECT ANSWER-Loss of epidermis layer; open vesicle Ulcer - CORRECT ANSWER-Loss of epidermis and dermis; arterial ulcer or syphilitic chancre Fissure - CORRECT ANSWER-Narrow, linear crack into epidermis exposing the dermis; athletes foot Linear - CORRECT ANSWER-In streaks such as typical phytodermatitis cause by exposure to urushiol Clustered - CORRECT ANSWER-Occurring in a group without pattern; example being HSV-1 Dermatomal - CORRECT ANSWER-Limited to boundaries of a single or multiple dermatomes; example zoster Scattered - CORRECT ANSWER-Generalized over body without a specific pattern or distribution; rubella or roseola Clustered - CORRECT ANSWER-Multiple lesions blending together; psoriasis vulgaris Annular - CORRECT ANSWER-In a ring; bull's eye lesion seen in Luke's disease