LEIK FNP CERTIFICATION EXAM 4 2024

LEIK FNP CERTIFICATION EXAM 4
s s s s




2024 s s

s

Chapter s4 s(Preventive sHealth) s- s s
s

Sensitivity s- s(SNOUT) sNegative sresults srules sout sthe sdisease. sSensitivity stest sare sgood sat
sidentifying sthe spositive smarkers sof sdisease. sSo sgood sthat sit sis smore sprone sto sreport sfalse

spositives. sSo sa snegative sresult sis smore sdefinitive s
s

Specificity s- s(SPIN) sPositive sresults srules sin sthe sdisease. sSpecificity stests sare sgood sat
sidentifying sthe snegative smarker sof sa sdisease. sSo s good sthat sis smore sprone sto sreport sfalse

snegatives. sSo sa spositive sresult sis smore sdefinitive. s
s

Primary sPrevention s- sPrevent sthe sdisease sin sits sentirety. sExamples sinclude shealthy
sdiet, s
s
exercise, ssafety s(helmets/seatbelts), simmunizations, sand sjob
ssafety
s

Secondary sPrevention s- sEarly sdetection sof sa sdisease. sExamples sinclude sscreening stests s
s

Tertiary sPrevention s- sRehabilitation sof sa sdisease. sExamples sinclude ssupport sgroups,
seducation sfor spts swith spre-existing sdisease, sdrug sside seffect ssafety, smedical s equipment

ssafety, sany stype sof srehab slike sPT sor sOT s
s

Breast sCancer sScreening sGuidelines s(USPSTF) s- sOnset s= s50yo. sBiannual. sStop sat sage
s74yo. s
s
No
sSBE.
s

Breast sCancer sScreening sGuidelines s(ACA) s- sOnset s= s40yo. sAnnual. sNo sstop sage. s
s

Cervical scancer sscreening sguidelines s- sOnset=21yo s(immunocompromised sindividuals sstart
sat sonset sof ssexual sactivity). sEvery s3 syears sPap s w/ sno sHPV stest suntil s30yo. sPap sand sHPV

stest safter s30 syo sand scan sbegin s screening s every s5 syears. sStop sat sage s65yo. sComplete

shysterectomy smeans sno sPap sunless spt shas shistory sof scervical s cancer sor shigh sgrade slesion.
s
s

Colorectal scancer s- sOnset s50yo. s1) scolonoscopy sq s10 syears sif swnl, s2) ssigmoidoscopy sq s5
syears s
s
if swnl, s3) sannual sFOBT swith s3 sstool ssamples. sStop sage s75
syo.
s

Prostate scancer s- sUSPSTF sdoes snot srecommend sscreening swith sPSA sbut sit sbased
son s
s
individual
spt.
s

Lipid sscreening s- sOnset s18-35/45yo sscreen sif sat sincreased srisk sof sheart sdisease. sMales
s>35yo s
s
and sFemales

s>45yo
s

,Flu svaccine s- sLAIV s- sLive svirus scan sonly sbe sgiven sto shealthy snon-pregnant s2 s-49 syo sw/o
srecent shx sof s asthma s(Peds). sCautioned sor s C/I sin s pts swith segg, sgentamicin sor sgelatin

sallergy sand skids sreceiving saspirin stherapy s(Reye's ssyndrome). sTIV s(trivalent sinactivated

svaccine) sis sapproved sfor s>6months. s
s
s
Tetanus svaccine s- sQ s10 syears. sBooster sfor sdirty swounds sif slast sTDAP/Td sis s> s5 syears
sold.
s
>7yo sreceive sTd/TDAP. sAvoid sin segg sallergy sand sGullian sBarre. s5 sdoses sof sDTAP
saka


Pediarix s(2,4,6,15 smonths sand s5 syo) sFirst sTDAP sis sat sage s11-12yo. sTd sis sthe sbooster severy
s10 s


years sor sif ssomeone shas snever shad sTDAP s(came sout sin s2005) sthen sthey sshould shave sa
sone s
s
time sdose sof sTDAP sand sthen scontinue swith sTd
sboosters.
s

Pneumococcal svaccine s- sPCV s23 sgiven sone stime sat sage s65 syo sin shealthy sadults sand sfor
spersons swho sare s2 syears sand solder sand sat shigh srisk sfor spneumococcal sdisease s(e.g., sthose

swith ssickle scell sdisease, sHIV sinfection, sor sother s immunocompromising sconditions).

sPPSV23 sis salso srecommended sfor suse sin sadults s 19 sthrough s64 syears sof sage swho ssmoke

scigarettes sor swho shave sasthma. s One stime sbooster sgiven s5 syears safter sfirst sdose s(So snon-

healthy spts swill sreceive s2 sdoses sof sPSV23 sover stheir slifetime). sPCV s13 sis sfor s<5 syo.
sWhen sboth sPCV13 sand sPPSV23 sare sindicated, sPCV13 sshould sbe sadministered sfirst;

sPCV13 sand sPPSV23 sshould snot sbe sadministered sduring sthe ssame svisit. sWhen sindicated,

sPCV13 sand sPPSV23 sshould sbe sadministered sto s adults swhose spneumococcal svaccination

shistory sis sincomplete sor sunknown. s
s

Varicella sVaccine s- s60 syo. sMay sbe sgiven sto spts swho shave spreviously shad sshingles. sMay
sbe sgiven s earlier sat sage s50yo. sLive svirus sso sc/I sinclude spregnancy s and

simmunocompromised. s
s

Chapter s5 s(EENT) s- s s
s

Herpes sKeratitis s- sInflammation sof sthe scornea. sC/O sabrupt ssevere seye spain, sphotophobia
sand sblurred svision. sDiagnose swith sfluorescein sdye sand sblack slamp. sLook sfor sfernlike slines

s(corneal sabrasions sappear smore slinear). sInfection spermanently sdamages scorneal sepithelium

swhich smay sresult sin sblindness. s
s

Acute sangle sclosure s- sGlaucoma s(Increased sICP sr/t sblocked sdrainage sduct). sElderly spt sc/o
sabrupt sonset sof ssevere seye spain, sHA, sN/V, shalos saround seyes, sand sdecreased svision.

sExam sreveals smid-dilated spupil sthat sis soval sshaped, scloudy scornea, sand sfundoscopic sexam

sshows scupping sof sthe soptic snerve. sTx s= skeep spt s supine, strx sto sED sfor sacetazolamide, sB

sblockers, sand stopical ssteroids. sSx smay sbe srequired s
s

Cholesteatoma s- sCauliflower slike sgrowth sin sthe smiddle sear. sPt sc/o sfoul ssmelling sdischarge
sand s
s
hearing sloss. sOn sexam, sno sTM sor sossicles svisible. sPMhx sof schronic sOM. sThe smass sis
snot


cancerous sbut sit scan serode sin sto sthe sbones sof sthe sface sand sdamage sCN7. sTx s= sENT sreferral
sfor s

, s
sx, sabx. sMass sis susually smade sof sepithelium sand scholesterol. sAKA spearl
stumor.
s

Battle's ssign s- sBruise sbehind sthe sear sover sthe smastoid sprocess. sHx sof strauma, sand
sindicates sa sfracture sof sthe sbasilar s skull. sGolden s serous sdischarge sfrom sear sor snose. s Refer

sto sED sfor sabx sand simaging s(CSF swill sbe s + sfor s glucose. sMucous swill sbe s- sfor sglucose). s
s

Cavernous ssinus sthrombosis s- sBlood sclot sin sw/I scavernous ssinus. sThis scavity shouses
sinternal scarotid sartery sand s CN sIII, sIV, sV sand sVI). sPmHx sof ssinus sor sfacial sinfection. sPt

sc/o ssevere sHA, shigh sfever, sdecreased sLOC, sunilateral speriorbital sedema, sphotophobia,

sproptosis sand sinability sto smove seye sappropriately. s
s
s
Peritonsillar sabcess s- sPt sc/o ssevere ssore sthroat, sdifficult sand spainful
sswallowing
s
(odonophagia) sand sLOCKJAW s(trimus), sand sa shot spotato svoice. sUnilateral
sswelling


peritonsillar sarea sand ssoft spalate swith sdisplaced suvula. sTx s= sI&D sin sED sor sneedle
saspiration
s

Diptheria s- sBull sneck, sdysphagia, sand sgray/yellow spsuedomembrane sthat sis snot sto
sdisplace s
s
(stuff sis slike sconcrete) sand smay sobstruct
sairway
s

Geographic stongue s- sBenign sfinding s
s

Torus sPalatinus s- sPainless sbony sprotuberance son shard spalate sthat sis sbenign s
s

Fishtail suvula s- sSplit suvula sis susually sbenign s(rarely sa ssign sof scleft spalate) s
s

Nystagmus s- sVertical snystagmus sis salways sabnormal. sHorizontal snystagmus sthat soccurs
son s
s
prolonged slateral sgaze sand sresolves swhen seye smoves stoward smidline sis
sbenign
s

Papilledema s- sOptic sdisc sswollen sw sblurred sedges sr/t sincreased sICP s(most scommonly
sfrom s
s
bleeding, sbrain stumor, sabscess sor spseudo stumor
scerebri).
s
s
HTN sRetinopathy sincludes s- sresult sfrom sdamage sand sadaptive schanges sin sthe sarterial
sand


arteriolar scirculation sin sresponse sto sthe shigh sblood spressure ssuch sas sCopper/silver
sarterioles, s
s
av snicking, sblot/flame shemorrhages, scotton swool sspots, shard sexudates sand
spapilledema
s

Copper/silver sarterioles s- sIndicates ssclerosis sand shyalinization sof sthe sarterioles. sSilver
sis s
s
worse sthan

scopper.
s

, Diabetic sRetinopathy s- sMicroaneurysms scaused sby snew sfragile sarteries sin sthe
sretina. s
s
Examples ssee scotton swool sspots, sflame shemorrhages sand sdot-blot
shemorrhages.
s

Cataracts s- sOpacity sof scornea s
s

Koplik's sspots s- sSmall ssized sred spapules sw/ sblue swhite scenters sinside sthe scheeks sby sthe
slower s
s
molars. sThey sare sthe sprodromic sviral senathem sof smeasles
s(Rubeola)
s

Hairy sLeukoplakia s- sPathognomic sfor sEpstein sbarr svirus sin simmunocompromised spts s
s

Sjogren's ssyndrome s- sChronic sautoimmune sdisorder scharacterized sby sdecreased sfunction
sof s


lacrimal sand ssalivary sglands. sPt sc/o sdry seyes/mouth sfor s> s3 smonths sand/or sgritty seyes.
sOTC s
s
eye sdrops sand srefer sto sophthalmology sand
srheumatologist
s

Blepharitis s- sChronic scondition. sBase sof seyelids sare sinflamed. sIthcy/irritation swith
ssome s
s
crusting. sTx sis sjohnson's sbaby sshampoo sand smay sneed serythromycin soptho
sointment
s

Epitaxis s- sPosterior snasal sbleeds scan sresult sin ssevere shemorrhage. sTx sfor santerior sbleeds sis
stilt s
s
head sforward sand sapply spressure sover snasal sbridge. sAfrin snasal sspray scan sbe
shelpful.
s

Strep sthroat s- s- sBeta shemolytic sstreptococcus sgroup sA. sClassic striad sis sno scough, ssore
sthroat, sand senlarged scervical santerior slymph snodes. sPossible sfever, spetechiae son shard

spalate. sTx s= s C&S sor srapid s strep stest. sPCN sx s10 s days. sPCN s alternative sare sZpak sor

sLevaquin s(for spts s>18yo). sSequalae sincludes sscarlet sfever, srheumatic sfever sand

speritonsillar sabscess. s
s

AOM s- sCommon sorganisms sare sstreptococcus spneumoniae s(gram s+), shaemophilus
sinfluenza s(gram s- s), sMoraxella scatarrhalis s(gram s - s). sWeber shas slateralization sto saffected

sear. sDecreased smobility s(flat strace sline son stypanogram). sTx s= samoxicillin s(80mcg/kg/day

sfor speds sand s500875mg/day s BID sfor sadults). s2nd sline sagents sare sAugmentin, sCeflin sand

sCefzil. sPCN salternatives sinclude sMacrolides, sBactrim sor sLevaquin. s
s

Bullous smyringitis s- sAOM swith sblisters s(bulla) son sTM. s
s

Hordeolum s(aka sstye) s- sAcute sbacterial sinfection sof sa shair sfollicle son sthe seyelid. sPt sc/o
sitching s
s
w spainful spustule. sTx sabx sand swarm scompress s(Remember sHorders slive sin sa spig
sstye)
s

Chalazion s- sChronic sinflammation sof sthe smeibomian sgland s(aka ssweat sgland sof sthe
seyelid).