AANP STUDY GUIDE EXAM TEST 2023/2024 QUESTIONS AND ANSWER

AANP STUDY GUIDE EXAM TEST 2023/2024 QUESTIONS AND ANSWERS normal heart anatomy - CORRECT ANSWER-- base at top, apex at bottom - aortic, pulmonic, tricuspid, mitral - S1 heart sound = closure of AV valves, mitral & tricuspid - S2 heart sound = closure of SL valves, aortic & pulmonic - S3 = extra fluid, HF, preg - S4 = uncontrolled HTN, LV hypertrophy Split S2 - CORRECT ANSWER-- during inspiration and expiration is bad - normal = only during inspiration where do you hear heart sounds - CORRECT ANSWER-- S2 at base - S1, S3, S4 at apex Diastolic murmurs - CORRECT ANSWER-- DOOM! - refer! - MS. ARD 1. mitral senosis 2. aortic regurgitation systolic murmurs - CORRECT ANSWER-- only systolic murmurs radiate MR. ASS MVP mitral regurg aortic stenosis mitral valve prolapse aortic stenosis - CORRECT ANSWER-- closest to neck - radiates to neck - systolic Mitral regurgitation - CORRECT ANSWER-- radiates to armpit - systolic Mitral valve prolapse - CORRECT ANSWER-- systolic murmur - normally hear a click - commonly seen with marfan syndrome palpable thrill murmur - CORRECT ANSWER-= grade 4 or higher peripheral arterial disease - CORRECT ANSWER-- purple and shiny - intermittent claudication: pain relieved with rest and dangling, pain with activity - ulcer on toes - DX: Ankle Brachial Index (ABI) < 0.9 = PAD - ABI calculated for each leg by dividing BP in artery of ankle by BP in artery of arm - risks: smoking - tx: keep walking and take breaks as needed chronic venous insufficiency - CORRECT ANSWER-- red, brown skin - edema - vericose veins - high risk for DVTs: no good venous return to heart so it starts to pool - refer to vascular DVTs - CORRECT ANSWER-- s/s = localized swelling, redness, calf pain - DX: venous doppler, D-dimer, homan's sign (no longer specific enough) Raynaud's phenomenon - CORRECT ANSWER-- decreased blood flow to fingers - caused by exposure to cold, stress - Tx = CCBs, avoid triggers asthma severity - CORRECT ANSWER-- predominant symptom = cough - intermittent, mild, moderate, severe asthma tx - CORRECT ANSWER-- peak flow readings at home - NOT determined on how often they use rescue inhaler - NEVER prescribe long acting beta agonist by itself (formoterol, salmeterol), always with ICS. Increases risk of asthma related death - all pts need low dose ICS (decrease overall mortality in pts) Peak flow readings - CORRECT ANSWER-height age gender HAG ASthma meds - CORRECT ANSWER-- ICS-LABA PRN: intermittent - ICS-LABA daily: mild - ICS-LABA daily OR low dose ICS with LRTA (singulair): moderate - REFER to pulm: severe *budesonide-formoterol = preferred ICS-LABA combo bronchodilators - CORRECT ANSWER-- "terol" steroids - CORRECT ANSWER-- "ide" - "zone" COPD Dx - CORRECT ANSWER-- FEV1/FVC ratio < 0.70 - s/s: barrel chest, clubbing of fingers, chronic caugh - exam: percussion hyperresonance - chronic bronchitis and emphysema chronic bronchitis or emphysema BEFORE COPD - CORRECT ANSWER-= bronchodilator COPD Tx - CORRECT ANSWER-- Group A: SABA or LABA - Group B: LABA or LAMA - Group C: LAMA - Group D: LAMA or LAMA-ICS *albuterol - formoterol - tiotropium - combo LAMA-ICS (trelegy) Pneumonia - CORRECT ANSWER-- infiltrates and consolidation in lower lobes - exam: increased tactile fremitis - s/s: cough, fever, chills, rhonchi, wheezes pneumonia tx - CORRECT ANSWER-- MAD: macrolide, amoxicillin, doxycycline = healthy outpt adults - comorbidities or abx in last 90 days = levaquin or augmentin AND macrolide CURB-65 criteria - CORRECT ANSWER-- hospital admission criteria for elderly - confusion, BUN > 19, RR > 20/30, BP < 90/60, > 65 yrs - 1pt for criteria. 2 pts might be admission. 3 or greater is ad