2023 AANP Exam Study Notes questions and answers well illustrated.

2023 AANP Exam Study Notes questions and answers well illustrated. Migranes - correct answers.- Symptoms: Throbbing pain behind one eye Photophobia, phonophobia, N/V - At-Risk Patients: Adult females - Aggravating Factors: Red wine, MSG, aspartame, menstruation, stress Trigeminal neuralgia - correct answers.- Symptoms: Type 1: Intense, sharp, shock-like, stabbing pain; Type 2: constant, aching, burning pain - At-Risk Patients: Older adults and elderly - Aggravating Factors: Cold food, cold hair, chewing, talking, touch Cluster HA - correct answers.- Symptoms: "Icepick" piercing pain behind one eye/temple Tearing, rhinorrhea, ptosis, miosis Homer's syndrome - At-Risk Patients: Middle-aged females - Aggravating Factors: Occurs at same time, daily, in clusters Weeks to months Tension HA - correct answers.- Symptoms: b/1 "band-like" pain; dull, may last a day; may have spasms of trapezius muscles - At-Risk Patients: Adults - Aggravating Factors: Stress Migrane - correct answers.- Acute tx: Ice pack, rest, dark room Sumatriptan or Toradol Prochlorperazine for - Prophylaxis/Other: TCA, BBs, Effexor, Topamax {not if hx of kidney stones) Pharmacokinetics - correct answers.Movement of drugs through body Pharmacodynamics - correct answers.Physiologic and biochemical effects of drugs Pharmacogenomics - correct answers.Study of how genes affect response to meds Half-life - correct answers.Amount of time it takes for drug concentration to decrease 50% First-Pass Effect - correct answers.Oral drug enters portal circulation - in liver, CYP450 metabolizes drug, then it is released to body; can bypass first-pass effect via IV, gels/creams/patches, buccal When asked about drug interactions, think of these - correct answers.• Macrolides • Antifungals • Cimetidine • Citalopram • Protease inhibitors • Grapefruit juice (Interacts with statins, erythromycin, CCBs, antivirals, amiodarone, benzos, cisapride, carbamazepine, buspirone) Safety Issues with Common Meds Drug: Thiazolidinediones e.g. pioglitazone - correct answers.Safety Issue: Black box: exacerbate CHF, do not use if NYHA Class Ill or IV HF Contraindications: Ml, stroke, bladder CA, TlDM, eye/liver Safety Issues with Common Meds Drug: H2 antagonists e.g. ranitidine, famotidine - correct answers.Safety Issue: Mental status changes w/ kidney disease Avoid if creatinine clearance< 50 ml/min Safety Issues with Common Meds Drug: PPls e.g. omeprazole, pantoprazole - correct answers.Safety Issue: Risk of fractures, PNA, CDiff, hypomagnesemia, B12 and iron malabsorption, atrophic gastritis, kidney disease Interactions: warfarin, diazepam, carbamazepine, phenytoin, ketoconazole Safety Issues with Common Meds Drug: Warfarin - correct answers.Safety Issue: Interacts with "G" herbs - garlic, ginger, ginkgo, ginseng D/C 7 days before surgery Aortic regurgitation presentation - correct answers.Long asymptomatic period followed by exercise intolerance then dyspnea at rest. The left ventricle fails unless the aortic valve is replaced AV nicking is most commonly seen? - correct answers.Retinal exam of patients with hypertension Carotid artery bruits can indicate? - correct answers.Generalized atherosclerosis The USPSTF recommends a 1-time abdominal aortic aneurysm screening with ultrasonography is done in men - correct answers.Age 65 to 75 who have ever smoked Hypertension is the most common cause of? - correct answers.Hemorrhagic stroke Patients with acute coronary syndrome typically have? - correct answers.Plaque erosion caused by accumulation of hyaluronan and neutrophils The ductus arteriosus is a blood vessel that connects? - correct answers.The aorta and the pulmonary artery in fetus so that blood flow skips the lungs In patients with ductus arteriosus, the murmur is best heard where? - correct answers.At the left clavicle and is both systolic and diastolic Cardiovascular: Diabetics, females and elderly