10/15/24, 8:36 AANPAdul2 - Which tw o processes are involved in platelet
AM activation? Cy…
AANP Adult-Gerontology Primary Care
Nurse Practitioner (AGPCNP) Final
Board Exam 2024 Review Questions and
Answers 100% Pass
What are the conditions needed for RBC Formation? -
Answer>> -Functional Erythropoietin mechanism (90%
from kidney, 10% hepatic production)
----Erythropoietin supply is diminished in advancing renal
failure, usually beginning with GFR<49ml.min
-Uncompromised DNA Synthesis
---- Chronic inflammation, from autoimmune disorders
(systemic lupus erythematous, rheumatoid arthritis and
chronic infection)
-Hemoglobin synthesis unimpaired by lack of iron,
vitamin or global production
-Intact marrow microenvironment
Hemoglobin- what is it and what do you need to produce it?
- Answer>> iron-containing oxygen-transport protein found
in red blood cells
Adequate nutrition (iron, B vitamins, Vit C, Protein) and
absorption (heme=iron, globin= protein)
How do you know if the bone marrow is working - Answer>>
check the reticulocytes
Healthy: reticulocytes=1-2% of total RBC or replacement of
RBC
In the presence of acute anemia:
Healthy pt should increase reticulocytes
If pt's reticulocytes don't increase(reticulocytopenia) ->
bone marrow might not be working appropriately
about:blan 1/
k 62
,10/15/24, 8:36 AANPAdul2 - Which tw o processes are involved in platelet
AM activation? Cy…
Reticulocyte-cell, osis-increase in number of cells, penia-
decreased number
Causes of anemia - Answer>> -blood loss (need 1 L or
more
for significant drop of hgb) (acute or chronic blood loss-
erosive
gastritis, menorrhagia, GI malignancy)
-reduced RBC production (Vit B12, Folic acid, iron
deficiency, use of chronic PPI)
-Premature destruction of RBC (lifespan: 90-120d)
Chronic PPI use can cause which type of deficiency? -
Answer>> Vit B12 and iron malabsorption
Metformin use can cause which type of deficiency? -
Answer>>
Vit B12 malabsorption and deficiency
Beta Thalassemia minor - Check homogenetic
Answer>>
electrophoresis once
microcytic hypochromic
anemia Mediterranean
ancestry
To have a child with a thalassemia major both parents
must have trait (1 in 4 chance with each pregnancy)
Genogram Symbols - Answer>>
Hypothyroidism causes - -hashimoto thyroiditis
Answer>>
(autoimmune in origin)
- Post-radioactive iodine (RAI) treatment (s/p graves
disease thyroid cancer tx)
-Medications (lithium, amiodorone)
When do you check the TSH after starting Synthroid for a
patient
that has hypothyroidism? - Check TSH 8 weeks
Answer>>
after starting Synthroid
about:blan 2/
k 62
,10/15/24, 8:36 AANPAdul2 - Which tw o processes are involved in platelet
AM activation? Cy…
Symptoms of hyperthyroidism - - Skin is smooth and
Answer>>
silky
-hyperreflexia
-Mentation-> mind is racing
-weight loss (10 lbs on average)
- frequent loose stool
(hyperdefecation)
-oligomenorrhea
-Heat intolerance Graves disease
etiologies for hyperthyroidism -
Answer>>
(autoimmune)
Toxic Adenoma (active thyroid
nodule) Thyroiditis (viral, postpartum)
Select medication use (Amiodarone, interferon)
Thyroid testing - Answer>> TSH (thyrotropin)
-comes from the anterior pituitary lobes
Free T4 (free thyroxine)
-unbound, metabolically active portion of
thyroxin Total T4
-rarely indicated
What do the TSH and free T4 look like in a person with
hypothyroidism? - Elevated TSH (nl: 0.4-4)
Answer>>
Decreased Free T4 (nl: 10-
27)
TSH is increased because it is trying to make the Thyroid
work
Medication Dosing for hypothyroidism - Synthryoid,
Answer>>
Levoxyl (have a long 1/2 life)
-bioidentical hormone
Use ideal body weight in obesity, because they are not
usually bound to fat
about:blan 3/
k 62
, 10/15/24, 8:36 AANPAdul2 - Which tw o processes are involved in platelet
AM activation? Cy…
1.6 msg/kg/d in adults
1.0 msg/kg/d in elderly
4.0 msg/kg/d in children (children are still growing
they need more- most likely refer)
>/= 50% increase during pregnancy
(increase levothyroxine dose by 33% as soon as
pregnancy is confirmed, also check the TSH same day)
Consider titrating up over a 1-2 month time frame in the
elderly population
SE: may feel jittery
Take at the same time with water on an empty stomach
should not be taken within 2 hours of cation such as
calcium, iron, aluminum, magnesium
Desiccated thyroid preparations, what should you know?
- Answer>> T3/T4 combinations, porcine (pork) and
Bovine (beef) origin-> some religious groups or vegans
may want to
know
Ex: Armour Thyroid, Nature-Thyroid, Bio-Thyroid,
Westhroid 1 grain= 60-65 mg Thyroid =
Levothyroxine
typical daily dose: 60-120 mg/d
Treatment of Hyperthyroidism - Answer>> At time of
diagnosis:
-beta-adrenergic antagonist with Beta 1 or 2 blocker
(Propranolol,
nadolol) to help with tremors
about:blan 4/
k 62
AM activation? Cy…
AANP Adult-Gerontology Primary Care
Nurse Practitioner (AGPCNP) Final
Board Exam 2024 Review Questions and
Answers 100% Pass
What are the conditions needed for RBC Formation? -
Answer>> -Functional Erythropoietin mechanism (90%
from kidney, 10% hepatic production)
----Erythropoietin supply is diminished in advancing renal
failure, usually beginning with GFR<49ml.min
-Uncompromised DNA Synthesis
---- Chronic inflammation, from autoimmune disorders
(systemic lupus erythematous, rheumatoid arthritis and
chronic infection)
-Hemoglobin synthesis unimpaired by lack of iron,
vitamin or global production
-Intact marrow microenvironment
Hemoglobin- what is it and what do you need to produce it?
- Answer>> iron-containing oxygen-transport protein found
in red blood cells
Adequate nutrition (iron, B vitamins, Vit C, Protein) and
absorption (heme=iron, globin= protein)
How do you know if the bone marrow is working - Answer>>
check the reticulocytes
Healthy: reticulocytes=1-2% of total RBC or replacement of
RBC
In the presence of acute anemia:
Healthy pt should increase reticulocytes
If pt's reticulocytes don't increase(reticulocytopenia) ->
bone marrow might not be working appropriately
about:blan 1/
k 62
,10/15/24, 8:36 AANPAdul2 - Which tw o processes are involved in platelet
AM activation? Cy…
Reticulocyte-cell, osis-increase in number of cells, penia-
decreased number
Causes of anemia - Answer>> -blood loss (need 1 L or
more
for significant drop of hgb) (acute or chronic blood loss-
erosive
gastritis, menorrhagia, GI malignancy)
-reduced RBC production (Vit B12, Folic acid, iron
deficiency, use of chronic PPI)
-Premature destruction of RBC (lifespan: 90-120d)
Chronic PPI use can cause which type of deficiency? -
Answer>> Vit B12 and iron malabsorption
Metformin use can cause which type of deficiency? -
Answer>>
Vit B12 malabsorption and deficiency
Beta Thalassemia minor - Check homogenetic
Answer>>
electrophoresis once
microcytic hypochromic
anemia Mediterranean
ancestry
To have a child with a thalassemia major both parents
must have trait (1 in 4 chance with each pregnancy)
Genogram Symbols - Answer>>
Hypothyroidism causes - -hashimoto thyroiditis
Answer>>
(autoimmune in origin)
- Post-radioactive iodine (RAI) treatment (s/p graves
disease thyroid cancer tx)
-Medications (lithium, amiodorone)
When do you check the TSH after starting Synthroid for a
patient
that has hypothyroidism? - Check TSH 8 weeks
Answer>>
after starting Synthroid
about:blan 2/
k 62
,10/15/24, 8:36 AANPAdul2 - Which tw o processes are involved in platelet
AM activation? Cy…
Symptoms of hyperthyroidism - - Skin is smooth and
Answer>>
silky
-hyperreflexia
-Mentation-> mind is racing
-weight loss (10 lbs on average)
- frequent loose stool
(hyperdefecation)
-oligomenorrhea
-Heat intolerance Graves disease
etiologies for hyperthyroidism -
Answer>>
(autoimmune)
Toxic Adenoma (active thyroid
nodule) Thyroiditis (viral, postpartum)
Select medication use (Amiodarone, interferon)
Thyroid testing - Answer>> TSH (thyrotropin)
-comes from the anterior pituitary lobes
Free T4 (free thyroxine)
-unbound, metabolically active portion of
thyroxin Total T4
-rarely indicated
What do the TSH and free T4 look like in a person with
hypothyroidism? - Elevated TSH (nl: 0.4-4)
Answer>>
Decreased Free T4 (nl: 10-
27)
TSH is increased because it is trying to make the Thyroid
work
Medication Dosing for hypothyroidism - Synthryoid,
Answer>>
Levoxyl (have a long 1/2 life)
-bioidentical hormone
Use ideal body weight in obesity, because they are not
usually bound to fat
about:blan 3/
k 62
, 10/15/24, 8:36 AANPAdul2 - Which tw o processes are involved in platelet
AM activation? Cy…
1.6 msg/kg/d in adults
1.0 msg/kg/d in elderly
4.0 msg/kg/d in children (children are still growing
they need more- most likely refer)
>/= 50% increase during pregnancy
(increase levothyroxine dose by 33% as soon as
pregnancy is confirmed, also check the TSH same day)
Consider titrating up over a 1-2 month time frame in the
elderly population
SE: may feel jittery
Take at the same time with water on an empty stomach
should not be taken within 2 hours of cation such as
calcium, iron, aluminum, magnesium
Desiccated thyroid preparations, what should you know?
- Answer>> T3/T4 combinations, porcine (pork) and
Bovine (beef) origin-> some religious groups or vegans
may want to
know
Ex: Armour Thyroid, Nature-Thyroid, Bio-Thyroid,
Westhroid 1 grain= 60-65 mg Thyroid =
Levothyroxine
typical daily dose: 60-120 mg/d
Treatment of Hyperthyroidism - Answer>> At time of
diagnosis:
-beta-adrenergic antagonist with Beta 1 or 2 blocker
(Propranolol,
nadolol) to help with tremors
about:blan 4/
k 62
