FNP AANC/ AANP REVIEW TEST STUDY GUIDE EXAM 2023/2024

FNP AANC/ AANP REVIEW TEST STUDY GUIDE EXAM 2023/2024 Mean Corpuscular Hgb Concentration (MCHC) - CORRECT ANSWER--A measure of the average color of the RBCs in a sample of blood -Decreased in iron-deficiency anemia and thalassemia (hypochromic); normal in macrocytic and normocytic anemias -Normal: 31.0 to 37.0 g/dL Mean Corpuscular Hemoglobin (MCH) - CORRECT ANSWER--Available transferrin that is left unbound (to iron) -Elevated if there is not enough iron -Normal: Range is 250 to 410 mcg/dL. serum ferritin - CORRECT ANSWER--stored iron -Normal: Range is 20 to 400 ng/mL. Red Cell Distribution Width (RDW) - CORRECT ANSWER-Determines the range of sizes of RBCs Reticulocytes - CORRECT ANSWER-immature red blood cells Iron-Deficiency Anemia Labs - CORRECT ANSWER--DECREASED Hemoglobin and hematocrit MCV <80 fL MCHC (paler color) Ferritin and iron level -INCREASED TIBC RDW >15 Peripheral Smear Anisocytosis (variations in size) poikilocytosis (variations in shape) S/S of Iron-Deficiency Anemia (IDA) - CORRECT ANSWER--fatigue -exertional dyspnea. -May have glossitis -Cravings for nonfood items such as ice or dirt (pica). -- -spoon-shaped nails (koilonychia), systolic murmurs tachycardia Thalassemia Minor (or Trait) Labs - CORRECT ANSWER-NO IRON PRODUCTS EVER Ethnic groups: Mediterranean MCV <80 OTHER LABS WNL Sickle Cell Anemia - CORRECT ANSWER-- genetic disorder that causes abnormal hemoglobin, resulting in some red blood cells assuming an abnormal sickle shape. -Gold-standard test is the hemoglobin electrophoresis (HbS) pernicious anemia - CORRECT ANSWER--Vitamin B12 deficiency -red beefy tongue -MCV >80 Clinical Pearls Hematology - CORRECT ANSWER--with normal bone marrow, supplementing the deficient substance (iron, B12, folate) will cause the hemoglobin/hematocrit to increase starting at 1 to 2 weeks; the hemoglogin/hematocrit will be back to normal within 4 to 8 weeks. -Serum vitamin B12 levels may be normal in up to 5% of patients with vitamin B12 deficiency. Do not rely on vitamin B12 levels alone. Also check antibodies, urine MMA, etc. -Missing a diagnosis of vitamin B12 deficiency can result in irreversible neurological damage. -Any patient complaining of neuropathy or who has dementia should have vitamin B12 levels checked. -Almost one out of every 500 African Americans in the United States has sickle cell anemia. arterial insufficiency (PAD) - CORRECT ANSWER-Intermittent Clauddication -NO EDEMA -NO PULSE OR FAINT -NO DRAINAGE -ROUND SMOOTH SORES ON TOES/ FEET -COOL TO TOUCH TX: ANTIPLATLET / FEM POP Venous insufficiency (PVD) - CORRECT ANSWER--DULL/ ACHY LOWER EXTS -EDEMA -PULSE NORMAL -SORES W/ IRREG BOARDERS ON LEGS -YELLOW SKIN SLOUGH - RUDDY SKIN - DX: ABI TX: STATIN, CCB, ANGIOPLASTY MI TX - CORRECT ANSWER--BETA BLOCKER -ACE -STATIN -ASA/ PLAVIX -LIFESTYLE CHANGES S/S Isolated systolic hypertension - CORRECT ANSWER--systolic pressure is greater than 140 -diastolic pressure is WNL (less than 90 mm Hg) Isolated systolic hypertension TX - CORRECT ANSWER--CCB -THIAZIDE Kawasaki disease TX - CORRECT ANSWER--HOSPITAL -IVIG -High-dose aspirin - Can lead to blood clots, aneurysm, MI - May S/S Kawasaki disease - CORRECT ANSWER--strawberry tongue, -Skin Peeling hands/feet -Swollen lips -Fever 104-105 -Occurs in 3 stages - Typically <5 yrs Pityriasis Rosea - CORRECT ANSWER--Herald Patch on trunk -Christmas Tree Pattern -Fine Pink Scales -Self-limiting Acne vulgaris treatment - CORRECT ANSWER-1st- Topicals Benzoyl peroxide (antimicrobial) Vitamin A derivatives (isotretinoin) 2nd Retinoids (e.g., tretinoin), 3rd Accutane Basal cell carcinoma - CORRECT ANSWER-Most common THINK PEARLY WAXY Melanoma - CORRECT ANSWER--Malignant skin tumor - >6mm THINK ABCD Scarlet fever - CORRECT ANSWER-- THINK Strep Infection acute/ recovering - Sandpaper rash - Strawberry Tongue Gram-negative bacteria - CORRECT ANSWER-THINK SECS (strep, Enterococcus, Cdiff, Staph) ALL OTHERS GRAM POSITIVE Lichen Planus - CORRECT ANSWER--Pink -Red -small flat bumps (papules) -Wickham's striae -Topical steroids for itching/Self-limiting Impetigo - CORRECT ANSWER-THINK HONEY CRUSTED/ INFECTED -TX: Bactroban ointment if sm area - Bactrim w/ larger areas Tx of MRSA - CORRECT ANSWER-Bactrim Doxy Erysipelas S/S / TX - CORRECT ANSWER--subcutaneous tissue infection -caused strep -redness/ swelling of affected areas -Normally face TX: PCN, if allergic Azithromycin Herpes Keratitis - CORRECT ANSWER--Photophobia. -ACUTE EYE PAIN/ TEARING - Blurred Vision - Vesicular rash near eye acute angle closure glaucoma - CORRECT ANSWER--sudden unilateral eye pain -redness /dilated pupil - poor light response - THINK HALOS