NRNP 6550 MIDTERM QUESTIONS &
ANSWERS
Vaccinations and immunosuppression. 2 keypoints - ANSWER- give inactive agents
instead of live agents
- might not work as effectively
live virus vaccine types - ANSWERVirus:
- measles
- mumps
- polio (oral)
- rubella
- varicella
- yellow fever
- herpes zoster
Bacteria:
- typhoid
inactive vaccine virus - ANSWERVirus:
- Hep A and B
- HPV
- influenza
- polio (subq)
- rabies
Bacteria:
- anthrax
- cholera
- diphteria
- Lyme
- meningococcus
- pertussis
- plague
- pneumococcus
- tetanus
Immunization recommendation influenza - ANSWERall ages, all types (pregnant,
diabetes, immunocompromised, etc)
Immunization recommendation pregnancy and weakened immune system - ANSWER-
1 dose Tdap
- no varicella, zoster, MMR
HIV and vaccinations - ANSWERGive inactive agents when CD4 count is greater than
200 cells/ mm3
,health screening 18 - 45 years - ANSWER- BMI
- BP (q2years)
- at age 20: fasting lipid profile: total cholesterol, LDL, HDL, triglycerides (cardiac testing
if LDL greater than 200 or HDL lower than 40)
- annual breast exam, females
- Pap-smear annually
health screening 45 and up - ANSWER- blood glucose q3years
- 50 and up: colorectal screening (digital exam annually, sigmoidscopy q5years,
colonoscopy q10yrs)
- PSA with digital exam annually for males
- mammography q1 -2 yrs
- women 65 and up: screen for osteoporosis
top 5 leading causes of death - ANSWER1. heart disease
2. cancer
3. respiratory disease
4. stroke
5. accidents
Conjunctivitis; definition - ANSWER-Pink eyey
- Inflammation of conjuctiva (outer layer of eye)
Conjunctivitis: causes - ANSWERChemical, bacterial, viral, allergic, herpetic.
Adenovirus is the most common cause, but bacteria (Haemophilus influenzae and
Streptococcus pneumoniae) are also common causes in children.
Conjunctivitis: findings - ANSWER- redness
- itching
- discharge
- edema eyelid
- may find gonorrhea or chlamydia in eye discharge
Conjunctivitis: management - ANSWER- cooling
- rule out corneal abrasion
- bacteria: antibiotic solution (gentamicin, neomycin)
- chlamydia: oral tetracycline or erythromycin
- gonorrhea: single dose ceftriaxone
- herpes: refer to opthalmologist
Corneal abrasion: definition, cause, findings, treatment - ANSWER- disruption of cornea
(clear covering of eye)
- foreign body/ trauma
- pain, redness, photophobia, decreased visual acuity
- ab ointment: gentamicin, sulfacetamide, eye-patch, ophthalmologist
, diabetic retinopathy: definition, cause, findings, treatment - ANSWER- ocular retinal
disease due to DM
- DM, exac by smoking and HTN (macular edema)
- flashing lights in vision, blurred vision, black spots, loss of vision, sustained glucose
greater than 130
- Laser therapy for macular edema, smoking cessation, glucose control, BP control
retinal detachment: definition, cause, findings, treatment - ANSWER- separation of
retina and choroid
- trauma, intraocular mass, iris inflammation, cataract surgery, DM, sickle cell
- painless vision changes, blurred vision, light flashes, "curtain" over visual field, bullous
elevation without tears
- ophthalmologist for cryotherapy, laser therapy, vitrectomy. If from trauma: eye patch
Central & Branch Retinal Artery Occlusion: definition, cause, findings, treatment -
ANSWER- abrupt blockage of retinal artery causing sudden vision loss> will become
permanent without intervention
- thrombosis/ embolism, arteritis (migraine, older age, afib, DM, HTN, coagulopathies)
- sudden, painless vision loss, sluggish pupil, cherry-red spot at fovea
- EMERGENCY. Put pressure on eyelid, heparin, immediate consult opthalmolohgist.
check coagulopathies, check labs for artherosclerotic disease, blood cultures
(endocarditis?),
Glaucoma: definition, cause, findings, treatment - ANSWER- progressive visual loss,
first peripherally then centrally: chronic open angle or actute closed angle. Optic
neuropathy.
- open: too much intraocular fluid production without removal. Secondary from trauma,
tumor, or cataracts. Causes: age, steroids, trauma, family history
- Photophobia, visual blurring, unilateral headache. Increased intraocular
pressure.Acute closed: eye pain and visual disturbance with N/V.
- Acute: Emergency. immediate medication and surgery. Chronic: consult
opthalmologist and monitor. Bimatropost, and beta-blockers. Laser-therapy
Bell's Palsy: definition, cause, findings, treatment - ANSWER- sudden self-limited
unilateral facial paralysis
- Idiopathic. Cranial nerve VII (7), sometimes viral cause (herpes), HTN, DM, Lyme's
- Unilateral paralysis of face (can't close eye, upper and lower face involved), herpetic
lesions, taste disturbances
- artificial tears, steroids (to treat CN 7 inflammation), antivirals
otitis externa: definition, cause, findings, treatment - ANSWER- inflammation of the
outer ear (swimmers ear)
- water, fungi, bacterial, trauma, viral
- pain with fullnes of ear, itching, edema, otorrhea
- suction of debris, ab and steroid solution in ear, oral ab's (based on bld culture)
ANSWERS
Vaccinations and immunosuppression. 2 keypoints - ANSWER- give inactive agents
instead of live agents
- might not work as effectively
live virus vaccine types - ANSWERVirus:
- measles
- mumps
- polio (oral)
- rubella
- varicella
- yellow fever
- herpes zoster
Bacteria:
- typhoid
inactive vaccine virus - ANSWERVirus:
- Hep A and B
- HPV
- influenza
- polio (subq)
- rabies
Bacteria:
- anthrax
- cholera
- diphteria
- Lyme
- meningococcus
- pertussis
- plague
- pneumococcus
- tetanus
Immunization recommendation influenza - ANSWERall ages, all types (pregnant,
diabetes, immunocompromised, etc)
Immunization recommendation pregnancy and weakened immune system - ANSWER-
1 dose Tdap
- no varicella, zoster, MMR
HIV and vaccinations - ANSWERGive inactive agents when CD4 count is greater than
200 cells/ mm3
,health screening 18 - 45 years - ANSWER- BMI
- BP (q2years)
- at age 20: fasting lipid profile: total cholesterol, LDL, HDL, triglycerides (cardiac testing
if LDL greater than 200 or HDL lower than 40)
- annual breast exam, females
- Pap-smear annually
health screening 45 and up - ANSWER- blood glucose q3years
- 50 and up: colorectal screening (digital exam annually, sigmoidscopy q5years,
colonoscopy q10yrs)
- PSA with digital exam annually for males
- mammography q1 -2 yrs
- women 65 and up: screen for osteoporosis
top 5 leading causes of death - ANSWER1. heart disease
2. cancer
3. respiratory disease
4. stroke
5. accidents
Conjunctivitis; definition - ANSWER-Pink eyey
- Inflammation of conjuctiva (outer layer of eye)
Conjunctivitis: causes - ANSWERChemical, bacterial, viral, allergic, herpetic.
Adenovirus is the most common cause, but bacteria (Haemophilus influenzae and
Streptococcus pneumoniae) are also common causes in children.
Conjunctivitis: findings - ANSWER- redness
- itching
- discharge
- edema eyelid
- may find gonorrhea or chlamydia in eye discharge
Conjunctivitis: management - ANSWER- cooling
- rule out corneal abrasion
- bacteria: antibiotic solution (gentamicin, neomycin)
- chlamydia: oral tetracycline or erythromycin
- gonorrhea: single dose ceftriaxone
- herpes: refer to opthalmologist
Corneal abrasion: definition, cause, findings, treatment - ANSWER- disruption of cornea
(clear covering of eye)
- foreign body/ trauma
- pain, redness, photophobia, decreased visual acuity
- ab ointment: gentamicin, sulfacetamide, eye-patch, ophthalmologist
, diabetic retinopathy: definition, cause, findings, treatment - ANSWER- ocular retinal
disease due to DM
- DM, exac by smoking and HTN (macular edema)
- flashing lights in vision, blurred vision, black spots, loss of vision, sustained glucose
greater than 130
- Laser therapy for macular edema, smoking cessation, glucose control, BP control
retinal detachment: definition, cause, findings, treatment - ANSWER- separation of
retina and choroid
- trauma, intraocular mass, iris inflammation, cataract surgery, DM, sickle cell
- painless vision changes, blurred vision, light flashes, "curtain" over visual field, bullous
elevation without tears
- ophthalmologist for cryotherapy, laser therapy, vitrectomy. If from trauma: eye patch
Central & Branch Retinal Artery Occlusion: definition, cause, findings, treatment -
ANSWER- abrupt blockage of retinal artery causing sudden vision loss> will become
permanent without intervention
- thrombosis/ embolism, arteritis (migraine, older age, afib, DM, HTN, coagulopathies)
- sudden, painless vision loss, sluggish pupil, cherry-red spot at fovea
- EMERGENCY. Put pressure on eyelid, heparin, immediate consult opthalmolohgist.
check coagulopathies, check labs for artherosclerotic disease, blood cultures
(endocarditis?),
Glaucoma: definition, cause, findings, treatment - ANSWER- progressive visual loss,
first peripherally then centrally: chronic open angle or actute closed angle. Optic
neuropathy.
- open: too much intraocular fluid production without removal. Secondary from trauma,
tumor, or cataracts. Causes: age, steroids, trauma, family history
- Photophobia, visual blurring, unilateral headache. Increased intraocular
pressure.Acute closed: eye pain and visual disturbance with N/V.
- Acute: Emergency. immediate medication and surgery. Chronic: consult
opthalmologist and monitor. Bimatropost, and beta-blockers. Laser-therapy
Bell's Palsy: definition, cause, findings, treatment - ANSWER- sudden self-limited
unilateral facial paralysis
- Idiopathic. Cranial nerve VII (7), sometimes viral cause (herpes), HTN, DM, Lyme's
- Unilateral paralysis of face (can't close eye, upper and lower face involved), herpetic
lesions, taste disturbances
- artificial tears, steroids (to treat CN 7 inflammation), antivirals
otitis externa: definition, cause, findings, treatment - ANSWER- inflammation of the
outer ear (swimmers ear)
- water, fungi, bacterial, trauma, viral
- pain with fullnes of ear, itching, edema, otorrhea
- suction of debris, ab and steroid solution in ear, oral ab's (based on bld culture)
