Page 1 of 173
AANP BOARDS EXAM REVIEW/ AANP STUDY
GUIDE RECENT VERSION 2024 ALL QUESTIONS
AND CORRECT ANSWERS/ BEST GRADED A+
ARBS causative pathogens - ANSWER: - S. pneumoniae
- H. influenzae
- M. catarrhalis
S. Pneumoniae - ANSWER: - Gram +
- Commonly causes ABRS, AOM, CAP
- >25% drug resistance (DRSP)
H. Influenzae - ANSWER: - Gram -
- Commonly causes ABRS, AOM, CAP
- Common in tobacco users
- >30% PCN-resistant d/t beta lactamase
M. Catarrhalis - ANSWER: - Gram -
- Least common pathogen in ABRS, AOM, CAP
- >90% PCN-resistant d/t beta lactamase
- Usually self-limiting
DSRP risk factors - ANSWER: - Age <2 or >65
- Daycare
- Prior abx in past month
- Hospitalization in last 5 days
,Page 2 of 173
- Comorbidities
- Immunosuppression
ABRS abx indications - ANSWER: - Persistent and not improving >10 days
- Severe for >3-4 days (i.e. fever, sinus pain, purulent D/C)
- Worsening or double sickening >3-4 days
ABRS abx regimen - ANSWER: - First line: Augmentin (covers gram +/-)
- Second line: initiate if no improvement in 3-5 days; high-dose Augmentin or
doxycycline (gram -, pregnancy category D!)
- Beta-lactam (PCN, cephalosporin) allergy: doxycycline, levofloxacin,
moxifloxacin (gram -, BL ring)
- DSRP: Augmentin, levofloxacin, moxifloxacin
"Respiratory" flouroquinolones - ANSWER: - Levofloxacin & moxifloxacin
- Cover gram - and beta lactamase
- Used for DRSP patients
- Risk of deep tendon rupture--only use if absolutely necessary!
5 main drug isoenzymes - ANSWER: - 1A2
- 2D6
- 2C9
- 2C19
- 3A4--responsible for most drug interactions
Isoenzyme 3A4 substrates - ANSWER: - Sildenafil (Viagra)
,Page 3 of 173
- Atorvastatin, simvastatin, lovastatin
- Venlafaxine (Effexor)
- Alprazolam (Xanax)
- Do not mix with 3A4 inhibitors (erythromycin, clarithromycin, antifungals,
grapefruit juice)--will cause increased substrate levels!
- Do not mix with 3A4 inhibitors (St. John's Wort, oral contraceptives,
antiretrovirals, cyclosporine)--will cause decreased substrate levels!
Isoenzyme 3A4 inhibitors - ANSWER: - Erythro- and clarithromycin
- "-azole" antifungals
- Grapefruit juice
- Do not mix with 3A4 substrates (Viagra, statins, Effexor, Xanax)--will cause
increased substrate levels!
Isoenzyme 3A4 inducers - ANSWER: - St. John's Wort
- Oral contraceptives
- Antiretrovirals
- Cyclosporine
- Do not mix with 3A4 substrates (Viagra, statins, Effexor, Xanax)--will decrease
substrate levels!
Allergic rhinitis treatment plan - ANSWER: - First line: avoidance of allergen
- Second line: intranasal corticosteroid (Flonase, Nasacort); may add Singulair as
add-on
- Acute symptoms: 2nd-gen oral antihistamine (Claritin, Zyrtect), intranasal
antihistamine (Astelin, Astepro), or ocular antihistamine (Patanol, Optivar,
Bepreve)
- Immunotherapy: send to allergist
, Page 4 of 173
- Acupuncture
Cranial nerves - ANSWER: 1. Olfactory
2. Optic
3. Oculomotor
4. Trochlear
5. Trigeminal
6. Abducens
7. Facial
8. Acoustic
9. Glossopharyngeal
10. Vagus
11. Spinal accessory
12. Hypoglossal
OH OH OH, TO TOUCH AND FEEL A GREAT VEIN, AH HEAVEN!
Olfactory nerve - ANSWER: - Cranial nerve I
- Smell
Optic nerve - ANSWER: - Cranial nerve II
- Vision
Oculomotor nerve - ANSWER: - Cranial nerve III
- Eyelid and eyeball movement
AANP BOARDS EXAM REVIEW/ AANP STUDY
GUIDE RECENT VERSION 2024 ALL QUESTIONS
AND CORRECT ANSWERS/ BEST GRADED A+
ARBS causative pathogens - ANSWER: - S. pneumoniae
- H. influenzae
- M. catarrhalis
S. Pneumoniae - ANSWER: - Gram +
- Commonly causes ABRS, AOM, CAP
- >25% drug resistance (DRSP)
H. Influenzae - ANSWER: - Gram -
- Commonly causes ABRS, AOM, CAP
- Common in tobacco users
- >30% PCN-resistant d/t beta lactamase
M. Catarrhalis - ANSWER: - Gram -
- Least common pathogen in ABRS, AOM, CAP
- >90% PCN-resistant d/t beta lactamase
- Usually self-limiting
DSRP risk factors - ANSWER: - Age <2 or >65
- Daycare
- Prior abx in past month
- Hospitalization in last 5 days
,Page 2 of 173
- Comorbidities
- Immunosuppression
ABRS abx indications - ANSWER: - Persistent and not improving >10 days
- Severe for >3-4 days (i.e. fever, sinus pain, purulent D/C)
- Worsening or double sickening >3-4 days
ABRS abx regimen - ANSWER: - First line: Augmentin (covers gram +/-)
- Second line: initiate if no improvement in 3-5 days; high-dose Augmentin or
doxycycline (gram -, pregnancy category D!)
- Beta-lactam (PCN, cephalosporin) allergy: doxycycline, levofloxacin,
moxifloxacin (gram -, BL ring)
- DSRP: Augmentin, levofloxacin, moxifloxacin
"Respiratory" flouroquinolones - ANSWER: - Levofloxacin & moxifloxacin
- Cover gram - and beta lactamase
- Used for DRSP patients
- Risk of deep tendon rupture--only use if absolutely necessary!
5 main drug isoenzymes - ANSWER: - 1A2
- 2D6
- 2C9
- 2C19
- 3A4--responsible for most drug interactions
Isoenzyme 3A4 substrates - ANSWER: - Sildenafil (Viagra)
,Page 3 of 173
- Atorvastatin, simvastatin, lovastatin
- Venlafaxine (Effexor)
- Alprazolam (Xanax)
- Do not mix with 3A4 inhibitors (erythromycin, clarithromycin, antifungals,
grapefruit juice)--will cause increased substrate levels!
- Do not mix with 3A4 inhibitors (St. John's Wort, oral contraceptives,
antiretrovirals, cyclosporine)--will cause decreased substrate levels!
Isoenzyme 3A4 inhibitors - ANSWER: - Erythro- and clarithromycin
- "-azole" antifungals
- Grapefruit juice
- Do not mix with 3A4 substrates (Viagra, statins, Effexor, Xanax)--will cause
increased substrate levels!
Isoenzyme 3A4 inducers - ANSWER: - St. John's Wort
- Oral contraceptives
- Antiretrovirals
- Cyclosporine
- Do not mix with 3A4 substrates (Viagra, statins, Effexor, Xanax)--will decrease
substrate levels!
Allergic rhinitis treatment plan - ANSWER: - First line: avoidance of allergen
- Second line: intranasal corticosteroid (Flonase, Nasacort); may add Singulair as
add-on
- Acute symptoms: 2nd-gen oral antihistamine (Claritin, Zyrtect), intranasal
antihistamine (Astelin, Astepro), or ocular antihistamine (Patanol, Optivar,
Bepreve)
- Immunotherapy: send to allergist
, Page 4 of 173
- Acupuncture
Cranial nerves - ANSWER: 1. Olfactory
2. Optic
3. Oculomotor
4. Trochlear
5. Trigeminal
6. Abducens
7. Facial
8. Acoustic
9. Glossopharyngeal
10. Vagus
11. Spinal accessory
12. Hypoglossal
OH OH OH, TO TOUCH AND FEEL A GREAT VEIN, AH HEAVEN!
Olfactory nerve - ANSWER: - Cranial nerve I
- Smell
Optic nerve - ANSWER: - Cranial nerve II
- Vision
Oculomotor nerve - ANSWER: - Cranial nerve III
- Eyelid and eyeball movement
