AANP EXAM, PRACTICE EXAM AND STUDY GUIDE NEWEST 2024 ACTUAL EXAM 450 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES

AANP EXAM, PRACTICE EXAM AND STUDY GUIDE NEWEST 2024 ACTUAL EXAM 450 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES Erythropoetin - CORRECT ANSWER 90 % renal, 10% hepatic, need supplementation when GFR is less than 49 Reticulocytes - CORRECT ANSWER In health, make up 1-2 % of total RBCs, increased in response to anema. Absence of reticulocytosis or presence of reticulocytopenia shows inadequate bone marrow response. Hemoglobin - CORRECT ANSWER normal is 12 for females and 15 for males. Ratio to hematocrit is 1:3 MCV - CORRECT ANSWER determines red blood cell size - normal is 80-96 MCH - CORRECT ANSWER reflects hgb content and color, normal is 31-37 RDW - CORRECT ANSWER variation of RBC size - normal is 11.5-15% Normocytic, normochromic , normal RDW - CORRECT ANSWER acute blood loss, anemia of chronic disease Microcytic, hypochromic anemia, elevated RDW - CORRECT ANSWER Iron deficiency anemia Microcytic, hypochromic, normal RDW - CORRECT ANSWER alpha or beta thalassemia minor Macrocytic, normochromic, elevated RDW - CORRECT ANSWER Vitamin B12 deficiency, folate deficiency, pernicious anemia Macrocytosis without anemia - CORRECT ANSWER use of medications like tegretol, AZT, depakote, dilantin, alcohol Heart murmur seen in b12 deficiency - CORRECT ANSWER Hemic murmur Most common pathogen in CAP, ABRS, AOM - CORRECT ANSWER S. pneumoniae Common pathogen in ABRS, AOM, CAP particularly with recurrent infections and tobacco use - CORRECT ANSWER H. influenzae, more than 30% now pcn resistant via beta lactamase production First line treatment for Acute Bacterial Rhinosinusitis - CORRECT ANSWER Augmentin 500/125 TID or 875/125 BID Second line treatment for Acute Bacterial Rhinosinusitis - CORRECT ANSWER Augmentin 2000/125 BID or doxy 100 mg BID or 200 mg QD Treatment for ABRS if allergic to PCN, Cephalosporins - CORRECT ANSWER Doxy, Levofloxacin, Moxifloxacin Treatment for ABRS if antibiotic resistance of failed initial therapy - CORRECT ANSWER Doxy, levofloxacin, moxifloxacin Presbycusis - CORRECT ANSWER slowly progressive hearing loss that is symmetric and high frequency 1st line controller therapy in allergic rhinitis - CORRECT ANSWER Intranasal corticosteriods like Flonase, Nasonex, Nasacort, Omnaris. Side effects are that nasal irritation and bleeding may occur. Optimal efficacy may take 1-2 weeks. 1st line rescue treatment in allergic rhinitis - CORRECT ANSWER Nasal antihistamines, esp if there is nasal congestion. sedation could occur. Drugs like astelin, Astepro, and patanase 1st generation oral antihistamines - CORRECT ANSWER significant potential to cause sedation and anticholinergic effects so not a first line therapy. Ex. benadryl, chlor trimeton, dimetapp, vistaril. 2nd generation oral antihistamines - CORRECT ANSWER These are preferred over because no anticholinergic effects but not as helpful with nasal congestion. Ex. claritin, clarinex, zyrtec, allergra Oral decongestants - CORRECT ANSWER alpha adrenergic agonist so vasoconstrictive. Take caution with the elderly, young children, HTN, bladder neck obstruction, glaucoma, and hyperthyroidism. Ex. sudafed Nasal decongestants - CORRECT ANSWER Alpha adrenergic agonist so vasoconstrictive. Can cause rebound congestion/medicamentosa so limit use to 5-7 days. Intranasal anticholinergics - CORRECT ANSWER reduce runny nose because of drying action. No effect on other nasal symptoms. Dryness can occur. Ex.. Atrovent Found on fundoscopic exam of person with angle-closure glaucoma - CORRECT ANSWER deeply cupped optic disc because of increase intraocular pressure than pushes the optic disc backwards., acute, painful Amsler grid - CORRECT ANSWER screening test for macular problems. Tonometry - CORRECT ANSWER measurement of intraoccular pressure, screen for glaucoma Presbyopia - CORRECT ANSWER Hardening of the lens, close vision problems, adults over 45 Senile cataracts - CORRECT ANSWER lens clouding, progressive vision dimming, distance vision problems, close vision usually retained and often improves. Risk factors are tobacco use, poor nutrition, sun exposure, systemic corticosteriod therapy. Potentially correctable