FNP 2 Study Material/guide with
Complete Verified Answers
Ulcerative colitis - ANSWER Antibiotic use in ulcerative colitis is discouraged because
of the increased risk of C. difficile infection. In Crohn's disease, metronidazole and
ciprofloxacin are used when perineal disease or an inflammatory mass is noted.
Medication therapy in inflammatory bowel disease is usually initiated at the time of a
flare, often the most common point of disease diagnosis. In Crohn's disease and
ulcerative colitis, oral aminosalicylates, including sulfasalazine and mesalamine, are
usually first-line therapy and are equally effective. In ulcerative colitis, when the
disease is limited to the distal colon, mesalamine and corticosteroids can be
administered rectally.
Warfarin - ANSWER The use of rifampin with warfarin decreases the
anticoagulant effects of warfarin.
The use of quinidine, tamoxifen, and cimetidine increase, rather than decrease
the anticoagulant effect of warfarin.
Ppi - ANSWER Protracted proton pump inhibitor (PPI) use is associated with reduced,
rather than increased, absorption of iron, copper, vitamin B12, and other
micronutrients in the elderly.
An increase in fracture risk of the hip, spine, wrist, and forearm has been noted with
long-term PPI use. Individuals with multiple health problems, when hospitalized or in
long-term care, who are online chronic PPI therapy have an increased risk of
contracting pneumonia and of developing C. difficile colitis.
,Cushings - ANSWER For endogenous Cushing's syndrome, the primary treatment of
choice is surgery.
For endogenous Cushing's syndrome, surgical resection is the primary treatment of
choice to remove a tumor of the adrenal gland overproducing cortisol, or to remove a
tumor of the pituitary gland or other sites that are overproducing
adrenocorticotropic hormone.
For those with Cushing's disease, first-line treatment is transsphenoidal surgery, which
results in an approximately 80% cure rate. Often surgery is curative though radiation
therapy may be needed in conjunction with surgery. Certain medications to control the
body's production of cortisol have been approved for use in patients with endogenous
Cushing's syndrome who have failed surgery or cannot have surgery. For patients
taking long-term treatment of corticosteroids, tapering the dose as soon as possible is
recommended. For endogenous Cushing's syndrome, surgical resection is the primary
treatment of choice.
Levodopa - ANSWER Levodopa continues to be used to minimize the symptoms of
Parkinson disease, but it tends to be less effective with more adverse effects as
the disease progresses. Most patients who take levodopa for more than 5 to 10
years develop dyskinesia.
Selegiline is a monoamine oxidase-B inhibitor which helps to increase levodopa's half-
life by reducing its metabolism. Amantadine is an antiviral drug with some
antiparkinsonian benefits, but its effects are time-limited. It can be used in the later
stages of the disease to help reduce dyskinesias. Benztropine is an anticholinergic, used
in Parkinson disease to help with tremor and dyskinesia. Side effects include dry
mouth, urinary retention, and altered mentation.
Zoledronic acid - ANSWER Zoledronic acid is administered as an IV infusion once a
year to treat osteoporosis or every two years to prevent osteoporosis.
, Zoledronic acid is a biophosphonate, not a RANKL inhibitor. It is administered as an
IV infusion, not given subcutaneously or orally.
Spleen - ANSWER The normal spleen weighs approximately 7 ounces, not 9 ounces.
The size of the normal spleen can be recalled by the "rule of odds": it is 1 x 3 x 5 inches
in size, weighs about 7 ounces, and is located between ribs 9 and 11. More than 50% of
patients with infectious mononucleosis develop splenomegaly; the risk of splenic
rupture is greatest in the second and third weeks of illness.
Cobblestone mucosal - ANSWER A cobblestone mucosal pattern is often identified
on endoscopy or contrast radiography in Crohn's disease.
Endoscopy is contraindicated in acute diverticulitis. A cobblestone mucosal pattern is
identified in Crohn's disease rather than in ulcerative colitis. Endoscopy is not used to
diagnose irritable bowel syndrome (IBS). Diagnosis of IBS is usually made via careful
history and clinical presentation, with a focus on excluding other conditions as there
are no clear diagnostic markers.
Blumbergs sign - ANSWER The presence of rebound tenderness, used to help with
the diagnosis of acute appendicitis, is also known as a positive Blumberg's sign.
Rebound tenderness, which is abdominal pain that worsens with the release of deep
palpation, indicates the likelihood of peritoneal irritation and helps with the diagnosis
of acute appendicitis. The presence of rebound tenderness is also known as a positive
Blumberg's sign.
The psoas test checks for tenderness of the psoas muscle by passively extending the
thigh of a patient lying on his side with knees extended, or asking the patient to
actively flex his thigh at the hip. The obturator sign is done through flexion and internal
rotation
Complete Verified Answers
Ulcerative colitis - ANSWER Antibiotic use in ulcerative colitis is discouraged because
of the increased risk of C. difficile infection. In Crohn's disease, metronidazole and
ciprofloxacin are used when perineal disease or an inflammatory mass is noted.
Medication therapy in inflammatory bowel disease is usually initiated at the time of a
flare, often the most common point of disease diagnosis. In Crohn's disease and
ulcerative colitis, oral aminosalicylates, including sulfasalazine and mesalamine, are
usually first-line therapy and are equally effective. In ulcerative colitis, when the
disease is limited to the distal colon, mesalamine and corticosteroids can be
administered rectally.
Warfarin - ANSWER The use of rifampin with warfarin decreases the
anticoagulant effects of warfarin.
The use of quinidine, tamoxifen, and cimetidine increase, rather than decrease
the anticoagulant effect of warfarin.
Ppi - ANSWER Protracted proton pump inhibitor (PPI) use is associated with reduced,
rather than increased, absorption of iron, copper, vitamin B12, and other
micronutrients in the elderly.
An increase in fracture risk of the hip, spine, wrist, and forearm has been noted with
long-term PPI use. Individuals with multiple health problems, when hospitalized or in
long-term care, who are online chronic PPI therapy have an increased risk of
contracting pneumonia and of developing C. difficile colitis.
,Cushings - ANSWER For endogenous Cushing's syndrome, the primary treatment of
choice is surgery.
For endogenous Cushing's syndrome, surgical resection is the primary treatment of
choice to remove a tumor of the adrenal gland overproducing cortisol, or to remove a
tumor of the pituitary gland or other sites that are overproducing
adrenocorticotropic hormone.
For those with Cushing's disease, first-line treatment is transsphenoidal surgery, which
results in an approximately 80% cure rate. Often surgery is curative though radiation
therapy may be needed in conjunction with surgery. Certain medications to control the
body's production of cortisol have been approved for use in patients with endogenous
Cushing's syndrome who have failed surgery or cannot have surgery. For patients
taking long-term treatment of corticosteroids, tapering the dose as soon as possible is
recommended. For endogenous Cushing's syndrome, surgical resection is the primary
treatment of choice.
Levodopa - ANSWER Levodopa continues to be used to minimize the symptoms of
Parkinson disease, but it tends to be less effective with more adverse effects as
the disease progresses. Most patients who take levodopa for more than 5 to 10
years develop dyskinesia.
Selegiline is a monoamine oxidase-B inhibitor which helps to increase levodopa's half-
life by reducing its metabolism. Amantadine is an antiviral drug with some
antiparkinsonian benefits, but its effects are time-limited. It can be used in the later
stages of the disease to help reduce dyskinesias. Benztropine is an anticholinergic, used
in Parkinson disease to help with tremor and dyskinesia. Side effects include dry
mouth, urinary retention, and altered mentation.
Zoledronic acid - ANSWER Zoledronic acid is administered as an IV infusion once a
year to treat osteoporosis or every two years to prevent osteoporosis.
, Zoledronic acid is a biophosphonate, not a RANKL inhibitor. It is administered as an
IV infusion, not given subcutaneously or orally.
Spleen - ANSWER The normal spleen weighs approximately 7 ounces, not 9 ounces.
The size of the normal spleen can be recalled by the "rule of odds": it is 1 x 3 x 5 inches
in size, weighs about 7 ounces, and is located between ribs 9 and 11. More than 50% of
patients with infectious mononucleosis develop splenomegaly; the risk of splenic
rupture is greatest in the second and third weeks of illness.
Cobblestone mucosal - ANSWER A cobblestone mucosal pattern is often identified
on endoscopy or contrast radiography in Crohn's disease.
Endoscopy is contraindicated in acute diverticulitis. A cobblestone mucosal pattern is
identified in Crohn's disease rather than in ulcerative colitis. Endoscopy is not used to
diagnose irritable bowel syndrome (IBS). Diagnosis of IBS is usually made via careful
history and clinical presentation, with a focus on excluding other conditions as there
are no clear diagnostic markers.
Blumbergs sign - ANSWER The presence of rebound tenderness, used to help with
the diagnosis of acute appendicitis, is also known as a positive Blumberg's sign.
Rebound tenderness, which is abdominal pain that worsens with the release of deep
palpation, indicates the likelihood of peritoneal irritation and helps with the diagnosis
of acute appendicitis. The presence of rebound tenderness is also known as a positive
Blumberg's sign.
The psoas test checks for tenderness of the psoas muscle by passively extending the
thigh of a patient lying on his side with knees extended, or asking the patient to
actively flex his thigh at the hip. The obturator sign is done through flexion and internal
rotation
