AANP EXAM 1| AANP STUDY GUIDE RECENT
VERSION 2025-2026 ALL 200 QUESTIONS AND
CORRECT ANSWERS/ BEST GRADED A+
normal heart anatomy - ANSWER: - base at top, apex at bottom
- aortic, pulmonic, tricuspid, mitral
- S1 heart sound = closure of AV valves, mitral & tricuspid
- S2 heart sound = closure of SL valves, aortic & pulmonic
- S3 = extra fluid, HF, preg
- S4 = uncontrolled HTN, LV hypertrophy
Split S2 - ANSWER: - during inspiration and expiration is bad
- normal = only during inspiration
where do you hear heart sounds - ANSWER: - S2 at base
- S1, S3, S4 at apex
Diastolic murmurs - ANSWER: - DOOM!
- refer!
- MS. ARD
1. mitral senosis
2. aortic regurgitation
systolic murmurs - ANSWER: - only systolic murmurs radiate
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MR. ASS MVP
mitral regurg
aortic stenosis
mitral valve prolapse
aortic stenosis - ANSWER: - closest to neck
- radiates to neck
- systolic
Mitral regurgitation - ANSWER: - radiates to armpit
- systolic
Mitral valve prolapse - ANSWER: - systolic murmur
- normally hear a click
- commonly seen with marfan syndrome
palpable thrill murmur - ANSWER: = grade 4 or higher
peripheral arterial disease - ANSWER: - purple and shiny
- intermittent claudication: pain relieved with rest and dangling, pain with activity
- ulcer on toes
- DX: Ankle Brachial Index (ABI) < 0.9 = PAD
- ABI calculated for each leg by dividing BP in artery of ankle by BP in artery of
arm
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- risks: smoking
- tx: keep walking and take breaks as needed
chronic venous insufficiency - ANSWER: - red, brown skin
- edema
- vericose veins
- high risk for DVTs: no good venous return to heart so it starts to pool
- refer to vascular
DVTs - ANSWER: - s/s = localized swelling, redness, calf pain
- DX: venous doppler, D-dimer, homan's sign (no longer specific enough)
Raynaud's phenomenon - ANSWER: - decreased blood flow to fingers
- caused by exposure to cold, stress
- Tx = CCBs, avoid triggers
asthma severity - ANSWER: - predominant symptom = cough
- intermittent, mild, moderate, severe
asthma tx - ANSWER: - peak flow readings at home
- NOT determined on how often they use rescue inhaler
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- NEVER prescribe long acting beta agonist by itself (formoterol, salmeterol),
always with ICS. Increases risk of asthma related death
- all pts need low dose ICS (decrease overall mortality in pts)
Peak flow readings - ANSWER: height
age
gender
HAG
ASthma meds - ANSWER: - ICS-LABA PRN: intermittent
- ICS-LABA daily: mild
- ICS-LABA daily OR low dose ICS with LRTA (singulair): moderate
- REFER to pulm: severe
*budesonide-formoterol = preferred ICS-LABA combo
bronchodilators - ANSWER: - "terol"
steroids - ANSWER: - "ide"
- "zone"
COPD Dx - ANSWER: - FEV1/FVC ratio < 0.70
- s/s: barrel chest, clubbing of fingers, chronic caugh