AANP FNP CERTIFICATION
COMPREHENSIVE MEDICAL EXAM
QUESTIONS AND ANSWERS| CORRECT
ANSWERS! | LATEST VERSION! GRADED
A+
Kawasaki disease - Answer - acute high fever, enlarged lymph. BRIGHT RED RASH,
conjunctivitis, dry cracked lips, strawberry tongue, Swollen hands, feet, AFTER the fever resides
the rash PEELS on hands/feet. Treated with high dose aspirin and gamma globulin. This is
TOXIC and VASCULAR, think blood clots, heart problems etc. Treat: high dose aspirin. EXAM
Erythema migrans - Answer Erythema Migraines- (stage 1 Lyme) Target bulls-eye, usually
appears in 7-14 days POST bitten tick. Rash is hot to touch with rough texture, flu like
symptoms. DX: B. Burgdorferi via ELISA, confirm with western blot. Increased ESR.
TREATMENT: Less than 7 Amoxicillin or cefuroxime axetil. Older than 7 Doxycycline. EXAM
Rocky Mountain Spotted Fever - Answer Inc. fever, chills, N/v, photophobia, myalgia,
arthralgias THEN 2-5 days later you develop a petechial rash on forearms, ankles, wrists, that
spreads towards trunk and becomes generalized. Think rocky NC/OK/AK/TN/MO. DX: PCR
essay with Rickessetti Antigen TREATMENT- doxycycline. EXAM
Addison's - Answer Addison's- deficient in cortisol (think low sodium, blood sugar, but Increase
K. You must give cortisol. (Diagnosis Plasma Cortisol <5 mcg/dl @ 0800.) EXAM
rheumatoid arthritis - Answer Early morning stiffness, sausage joints. Symmetrical involvement.
Longer stiffness than OA. Joint space narrowing. Pain, warm, tender, swollen, things. TREAT:
NSAIDS, steroids, DMARDS, TNF. Only has BOUCHARDS, SWAN NECK IS DESCRIPTION
ON EXAM
, Osteoarthritis - Answer Large weight bearing joints. Early morning stiffness with inactivity. Has
both nodes. FIRST LINE Acetaminophen. EXERCISE: Isometric exercises for knee OA. Non-
weight bearing, like biking, swimming, stationary bike. EXAM
Osteoporosis - Answer OSTEOPOROSIS = WEIGHT BEARING- walking, lifting weights etc.
bones are forced against gravity. EXAM
Fibromyalgia polymyalgia - Answer Fibro- 11/18 points. Widespread pain for at least three
months. EXAM. polymyalgia Tx prednisone 12 months. Must taper off. RISK for Temporal
arteritis, DX BX, elevated ESR
Serotonin syndrome - Answer Acute Serotonin Syndrome- Dilated pupils, high fever, muscular
rigidity, mental status changes, hyperreflexes, clonus, uncontrolled shivery. You get this from
SSRI, MAOIs, TCA. Could be potentially life threatening. EXAM
Fundal Height - Answer Fundal Height 12 weeks above symphysis pubis. EXAM TOPICS
Fundus 16 weeks between symphysis pubis and umbilicus.
Fundus at 20 weeks is at umbilicus.
2 cm more of less from # of wk gestation is normal if more or less order US.
Psoriasis - Answer Psoriasis- Inherited. Pruritic erythematous plaques, fine silvery-white scales
with pitted fingernails. Scalp, elbows, knees, sacrum, intergluteal folds.
(Koebner phenomenon- new psoriatic plaques form over skin trauma)
(Auspitz sign- pinpoint bleeding when plaques are removed).
TREATMENT: Topical steroids, Tar preps (mild). For (severe) do anti-TNF, or immunologic.
D
Dacrocystitis - Answer Darcryotosis lacrimal sac, rub down towards mouth. If think secondary
infection abx. EXAM how it presents.
,Acne Rosacea - Answer Acne Rosacea- chronic small acne like papules/pustules around nose
mouth chin. TREATMENT- Metrogel, Azelex. Low dose tetracycline. EXAM
Parathyroid hormone - Answer PTH is responsible for calcium loss or gain from bones, kidneys,
and GI tract. EXAM
Diabetic Retinopathy - Answer Diabetic Retinopathy-Cotton wool spots (moderate retinopathy),
micro-aneurysms. ALSO RETINAL HEMORRHAGES ON CENTER OF EYE APPEAR
ORANGE RED
Pencil-like stools occur in an obstruction of what - Answer Sigmoid descending colon
It's a thin narrow stool and possible causes include colon cancer, diarrhea, IBS. Refer for GI
colonoscopy
headache after trauma - Answer SDH
migraine headache - Answer -paroxysmal (sudden, periodic) attacks of mostly unilateral
headache, often accompanied by disordered vision, nausea, or vomiting, lasting hours or days
and caused by dilation of arteries.
4-12 hours,
abortive triptans
prophylaxis propranolol, TCA amitriptyline, anticonvulsants topiramate
Vitamin B12 - Answer Folate shares a close relationship with this other B Vitamin.
Vitamin B12 - Answer Cognitive deficits, glossitis, pernicious anemia,
, Folate shares a close relationship with this other B Vitamin.
88/yr. old patient in for follow up secondary. She's been treated with Tylenol for Joint arthritis.
Her SED rate was checked after 6 weeks of treatment and it was 28. Normal range is from
something to 25. How would you treat the pt. - Answer be changed to NSAID, SED rate is a sign
of inflammation
Which medication causes low sperm count for a patient - Answer SSRI
3-months old infant with down syndrome, due to milk intolerance, mom started on goats milk;
now has pale conjunctiva but otherwise healthy. Low HCT. What additional test would you
order? - Answer Iron, TIBC
Chronic Bronchitis Treatment - Answer Smoking cessation
Pulmonary rehabilitation
Pharmacologic therapy
Supplemental oxygen
TB... PPD is positive if area of induration is: - Answer >5 mm in an immunocompromised
patient or close contact
>10 mm in immigrant, health care workers, drug user
>15 mm in a patient who lives in an area where TB is very rare.
what condition would make you order Lateral X-ray of the neck. Options include: Drooling,
Unable to do ROM of the neck / stiff neck. - Answer Croup/Epiglottitis
AV nicking (Arterioles pressing on vein of the eye) - Answer HTN retinopathy
COMPREHENSIVE MEDICAL EXAM
QUESTIONS AND ANSWERS| CORRECT
ANSWERS! | LATEST VERSION! GRADED
A+
Kawasaki disease - Answer - acute high fever, enlarged lymph. BRIGHT RED RASH,
conjunctivitis, dry cracked lips, strawberry tongue, Swollen hands, feet, AFTER the fever resides
the rash PEELS on hands/feet. Treated with high dose aspirin and gamma globulin. This is
TOXIC and VASCULAR, think blood clots, heart problems etc. Treat: high dose aspirin. EXAM
Erythema migrans - Answer Erythema Migraines- (stage 1 Lyme) Target bulls-eye, usually
appears in 7-14 days POST bitten tick. Rash is hot to touch with rough texture, flu like
symptoms. DX: B. Burgdorferi via ELISA, confirm with western blot. Increased ESR.
TREATMENT: Less than 7 Amoxicillin or cefuroxime axetil. Older than 7 Doxycycline. EXAM
Rocky Mountain Spotted Fever - Answer Inc. fever, chills, N/v, photophobia, myalgia,
arthralgias THEN 2-5 days later you develop a petechial rash on forearms, ankles, wrists, that
spreads towards trunk and becomes generalized. Think rocky NC/OK/AK/TN/MO. DX: PCR
essay with Rickessetti Antigen TREATMENT- doxycycline. EXAM
Addison's - Answer Addison's- deficient in cortisol (think low sodium, blood sugar, but Increase
K. You must give cortisol. (Diagnosis Plasma Cortisol <5 mcg/dl @ 0800.) EXAM
rheumatoid arthritis - Answer Early morning stiffness, sausage joints. Symmetrical involvement.
Longer stiffness than OA. Joint space narrowing. Pain, warm, tender, swollen, things. TREAT:
NSAIDS, steroids, DMARDS, TNF. Only has BOUCHARDS, SWAN NECK IS DESCRIPTION
ON EXAM
, Osteoarthritis - Answer Large weight bearing joints. Early morning stiffness with inactivity. Has
both nodes. FIRST LINE Acetaminophen. EXERCISE: Isometric exercises for knee OA. Non-
weight bearing, like biking, swimming, stationary bike. EXAM
Osteoporosis - Answer OSTEOPOROSIS = WEIGHT BEARING- walking, lifting weights etc.
bones are forced against gravity. EXAM
Fibromyalgia polymyalgia - Answer Fibro- 11/18 points. Widespread pain for at least three
months. EXAM. polymyalgia Tx prednisone 12 months. Must taper off. RISK for Temporal
arteritis, DX BX, elevated ESR
Serotonin syndrome - Answer Acute Serotonin Syndrome- Dilated pupils, high fever, muscular
rigidity, mental status changes, hyperreflexes, clonus, uncontrolled shivery. You get this from
SSRI, MAOIs, TCA. Could be potentially life threatening. EXAM
Fundal Height - Answer Fundal Height 12 weeks above symphysis pubis. EXAM TOPICS
Fundus 16 weeks between symphysis pubis and umbilicus.
Fundus at 20 weeks is at umbilicus.
2 cm more of less from # of wk gestation is normal if more or less order US.
Psoriasis - Answer Psoriasis- Inherited. Pruritic erythematous plaques, fine silvery-white scales
with pitted fingernails. Scalp, elbows, knees, sacrum, intergluteal folds.
(Koebner phenomenon- new psoriatic plaques form over skin trauma)
(Auspitz sign- pinpoint bleeding when plaques are removed).
TREATMENT: Topical steroids, Tar preps (mild). For (severe) do anti-TNF, or immunologic.
D
Dacrocystitis - Answer Darcryotosis lacrimal sac, rub down towards mouth. If think secondary
infection abx. EXAM how it presents.
,Acne Rosacea - Answer Acne Rosacea- chronic small acne like papules/pustules around nose
mouth chin. TREATMENT- Metrogel, Azelex. Low dose tetracycline. EXAM
Parathyroid hormone - Answer PTH is responsible for calcium loss or gain from bones, kidneys,
and GI tract. EXAM
Diabetic Retinopathy - Answer Diabetic Retinopathy-Cotton wool spots (moderate retinopathy),
micro-aneurysms. ALSO RETINAL HEMORRHAGES ON CENTER OF EYE APPEAR
ORANGE RED
Pencil-like stools occur in an obstruction of what - Answer Sigmoid descending colon
It's a thin narrow stool and possible causes include colon cancer, diarrhea, IBS. Refer for GI
colonoscopy
headache after trauma - Answer SDH
migraine headache - Answer -paroxysmal (sudden, periodic) attacks of mostly unilateral
headache, often accompanied by disordered vision, nausea, or vomiting, lasting hours or days
and caused by dilation of arteries.
4-12 hours,
abortive triptans
prophylaxis propranolol, TCA amitriptyline, anticonvulsants topiramate
Vitamin B12 - Answer Folate shares a close relationship with this other B Vitamin.
Vitamin B12 - Answer Cognitive deficits, glossitis, pernicious anemia,
, Folate shares a close relationship with this other B Vitamin.
88/yr. old patient in for follow up secondary. She's been treated with Tylenol for Joint arthritis.
Her SED rate was checked after 6 weeks of treatment and it was 28. Normal range is from
something to 25. How would you treat the pt. - Answer be changed to NSAID, SED rate is a sign
of inflammation
Which medication causes low sperm count for a patient - Answer SSRI
3-months old infant with down syndrome, due to milk intolerance, mom started on goats milk;
now has pale conjunctiva but otherwise healthy. Low HCT. What additional test would you
order? - Answer Iron, TIBC
Chronic Bronchitis Treatment - Answer Smoking cessation
Pulmonary rehabilitation
Pharmacologic therapy
Supplemental oxygen
TB... PPD is positive if area of induration is: - Answer >5 mm in an immunocompromised
patient or close contact
>10 mm in immigrant, health care workers, drug user
>15 mm in a patient who lives in an area where TB is very rare.
what condition would make you order Lateral X-ray of the neck. Options include: Drooling,
Unable to do ROM of the neck / stiff neck. - Answer Croup/Epiglottitis
AV nicking (Arterioles pressing on vein of the eye) - Answer HTN retinopathy
