SARAH MICHELLE LIVE REVIEW STUDY GUIDE
Sarah Michelle
Live Review Study Guide
2000 Questions & Answers
NP Exam Preparation
Main Features:
• Focused NP exam review
• Questions and Answers
• Extensive collection of Review questions and answers
• Helpful for identifying knowledge gaps
• Covers high-yield concepts
• Supports structured study and final revision
Sarah Michelle Live Review Study Guide | Page 1
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
1. What is the screening tool for the thyroid?
TSH Level
2. What is the screening tool for the thyroid?
TSH Level
3. What is the normal range for TSH?
0.5-5.0
4. What is the normal range for TSH?
0.5-5.0
5. When do you order a full thyroid profile?
If thyroid screening of TSH comes back abnormal, then we will
reorder TSH and T3, T4.
6. When do you order a full thyroid profile?
If thyroid screening of TSH comes back abnormal, then we will
reorder TSH and T3, T4.
7. What disorder demonstrates a low TSH level and high T3 and T4 levels?
Hyperthyroidism
8. What disorder demonstrates a low TSH level and high T3 and T4 levels?
Hyperthyroidism
9. What disorder demonstrates a high TSH level and low T3 and T4 levels?
Hypothyroidism
10. What disorder demonstrates a high TSH level and low T3 and T4 levels?
Hypothyroidism
11. What medication is used to treat hypothyroidism?
Levothyroxine (Synthroid)
Sarah Michelle Live Review Study Guide | Page 2
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
12. What medication is used to treat hypothyroidism?
Levothyroxine (Synthroid)
13. What dose of Synthroid do you want to start your patient on?
If patient is elderly or if they have a significant cardiac history
then we are going to start at a lower dose of 12.5-25 mcg po
daily.
In a normal healthy patient, we will start at 25-50 mcg po daily.
14. What dose of Synthroid do you want to start your patient on?
If patient is elderly or if they have a significant cardiac history
then we are going to start at a lower dose of 12.5-25 mcg po
daily.
In a normal healthy patient, we will start at 25-50 mcg po daily.
15. After initiation of medication for treatment of hypothyroidism, when do you recheck
TSH level?
6-8 weeks
16. After initiation of medication for treatment of hypothyroidism, when do you recheck
TSH level?
6-8 weeks
17. When TSH level is stabilized, how often do you recheck their level?
Every 6-12 months
18. When TSH level is stabilized, how often do you recheck their level?
Every 6-12 months
19. What is the go to medication for treatment of hyperthyroidism?
Tapazole and PTU
20. What is the go to medication for treatment of hyperthyroidism?
Tapazole and PTU
21. How do you manage treatment for hyperthyroidism in a pregnant patient?
We need to use PTU instead if they are in their first trimester.
After first trimester, then they can be switched to tapazole.
Sarah Michelle Live Review Study Guide | Page 3
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
22. How do you manage treatment for hyperthyroidism in a pregnant patient?
We need to use PTU instead if they are in their first trimester.
After first trimester, then they can be switched to tapazole.
23. What medication class is used to treat symptoms of hyperthyroidism?
Beta-blockers- these help manage tachycardia and palpitations
24. What medication class is used to treat symptoms of hyperthyroidism?
Beta-blockers- these help manage tachycardia and palpitations
25. What are 2 other treatments for the hyperthyroidism?
Thyroidectomy and radioactive iodine
26. What are 2 other treatments for the hyperthyroidism?
Thyroidectomy and radioactive iodine
27. What labs are used to measure and evaluate kidney function?
GFR, BUN, Creatinine
28. What labs are used to measure and evaluate kidney function?
GFR, BUN, Creatinine
29. What lab value is most accurate description of kidney function?
GFR- this is going to tell us how the kidneys are filtering the
blood and how well they are removing waste.
30. What lab value is most accurate description of kidney function?
GFR- this is going to tell us how the kidneys are filtering the
blood and how well they are removing waste.
31. What is a normal GFR value?
>90
32. What is a normal GFR value?
>90
33. What GFR value indicates an absolute need to start a patient on dialysis?
<15- this means that patient is in CKD stage 5
Sarah Michelle Live Review Study Guide | Page 4
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
34. What GFR value indicates an absolute need to start a patient on dialysis?
<15- this means that patient is in CKD stage 5
35. What is the second most important lab value to measure kidney function?
Creatinine
36. What is the second most important lab value to measure kidney function?
Creatinine
37. What is creatinine?
A waste product in the blood. If your kidneys are functioning
properly, then this waste product is removed by your kidneys.
When kidney function decreases, your creatinine level starts to
rise.
38. What is creatinine?
A waste product in the blood. If your kidneys are functioning
properly, then this waste product is removed by your kidneys.
When kidney function decreases, your creatinine level starts to
rise.
39. What is a normal creatine value?
Around 1
40. What is a normal creatine value?
Around 1
41. Why is BUN least telling for kidney function?
Blood urea nitrogen is a normal waste product when your body
breaks down urea. However, this is not specific to the kidneys. It
can also indicate liver issues.
42. Why is BUN least telling for kidney function?
Blood urea nitrogen is a normal waste product when your body
breaks down urea. However, this is not specific to the kidneys. It
can also indicate liver issues.
43. What is a normal BUN level?
10-20
Sarah Michelle Live Review Study Guide | Page 5
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
44. What is a normal BUN level?
10-20
45. With which first-line BP medication do we want to check the BUN/Cr?
ACE Inhibitors
46. With which first-line BP medication do we want to check the BUN/Cr?
ACE Inhibitors
47. What finding on a UA id indicative of true kidney damage?
Casts- WBC or RBC casts always need to be referred out
48. What finding on a UA id indicative of true kidney damage?
Casts- WBC or RBC casts always need to be referred out
49. When do we screen for microalbumin in the urine?
We're always going to screen when DM and HTN is first
diagnosed.
50. When do we screen for microalbumin in the urine?
We're always going to screen when DM and HTN is first
diagnosed.
51. What are the most common causes of CKD?
HTN and DM
52. What are the most common causes of CKD?
HTN and DM
53. Why is it important to perform early screening for microalbumin in the urine?
Patients who have mild kidney damage do not have symptoms,
this screening will ideally identify damage early and prevent
progression.
54. Why is it important to perform early screening for microalbumin in the urine?
Patients who have mild kidney damage do not have symptoms,
this screening will ideally identify damage early and prevent
progression.
Sarah Michelle Live Review Study Guide | Page 6
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
55. What stage of CKD do patients show true symptoms?
Stage 3 or worse
56. What stage of CKD do patients show true symptoms?
Stage 3 or worse
57. How often are we screening for micro albumin?
Bare minimum is going to be annually for patients with DM or
HTN or both.
58. How often are we screening for micro albumin?
Bare minimum is going to be annually for patients with DM or
HTN or both.
59. What is the normal range of microalbumin?
< 30
60. What is the normal range of microalbumin?
< 30
61. What is the most common symptom of all anemias?
Fatigue
62. What is the most common symptom of all anemias?
Fatigue
63. What is a normal hemoglobin level?
12-18
Women are on the lower end, and men are on the higher end
64. What is a normal hemoglobin level?
12-18
Women are on the lower end, and men are on the higher end
65. What is a normal hemoglobin to hematocrit ratio?
3 to 1
36-54%
Sarah Michelle Live Review Study Guide | Page 7
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
66. What is a normal hemoglobin to hematocrit ratio?
3 to 1
36-54%
67. What does MCV stand for?
mean corpuscular volume
68. What does MCV stand for?
mean corpuscular volume
69. What is a normal MCV?
80-100
70. What is a normal MCV?
80-100
71. What does low MCV indicate?
Microcytic anemias
72. What does low MCV indicate?
Microcytic anemias
73. What is the most common microcytic anemia?
Iron deficiency anemia
74. What is the most common microcytic anemia?
Iron deficiency anemia
75. What is the biggest risk faction for the development of IDA is int he first year of life?
The ingestion of cow's milk
76. What is the biggest risk faction for the development of IDA is int he first year of life?
The ingestion of cow's milk
77. What does high MCV levels indicate?
Microcytic anemia
78. What does high MCV levels indicate?
Microcytic anemia
Sarah Michelle Live Review Study Guide | Page 8
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
79. What are the most common microcytic anemias?
B12 and folate
80. What are the most common microcytic anemias?
B12 and folate
81. What symptoms are common with B12 deficiency anemia?
Neuro symptoms- the most common symptom is parasthesia
82. What symptoms are common with B12 deficiency anemia?
Neuro symptoms- the most common symptom is parasthesia
83. What surgery typically leads to B12 deficiency anemia?
Gastrectomy patients- who have part of their stomach removed
84. What surgery typically leads to B12 deficiency anemia?
Gastrectomy patients- who have part of their stomach removed
85. Why do gastrectomy patients typically have B12 deficiency anemia?
In order for B12 to be absorbed, it needs to be able to combine
with intrinsic factor, which is produced in the stomach. If we
remove a large portion of the stomach then we lose a lot of that
intrinsic factor.
86. Why do gastrectomy patients typically have B12 deficiency anemia?
In order for B12 to be absorbed, it needs to be able to combine
with intrinsic factor, which is produced in the stomach. If we
remove a large portion of the stomach then we lose a lot of that
intrinsic factor.
87. What diabetes medication used long term can also lead to B12 deficiency?
Metformin
88. What diabetes medication used long term can also lead to B12 deficiency?
Metformin
89. What is an abnormal lead level?
>5, ideally no lead should be within the body
Sarah Michelle Live Review Study Guide | Page 9
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
90. What is an abnormal lead level?
>5, ideally no lead should be within the body
91. What kind of symptoms may lead intoxication lead to?
Cognitive delays and behavioral problems
92. What kind of symptoms may lead intoxication lead to?
Cognitive delays and behavioral problems
93. What are the 3 microcytic anemias?
• LIT
• Lead
• Iron
• Thalassemia
94. What are the 3 microcytic anemias?
• LIT
• Lead
• Iron
• Thalassemia
95. What are the 2 macrocytic anemias?
FAB
Folate and B12
96. What are the 2 macrocytic anemias?
FAB
Folate and B12
97. What are the components of a lipid profile?
• Total cholesterol
• HDl
• LDL
• Triglycerides
Sarah Michelle Live Review Study Guide | Page 10
Sarah Michelle
Live Review Study Guide
2000 Questions & Answers
NP Exam Preparation
Main Features:
• Focused NP exam review
• Questions and Answers
• Extensive collection of Review questions and answers
• Helpful for identifying knowledge gaps
• Covers high-yield concepts
• Supports structured study and final revision
Sarah Michelle Live Review Study Guide | Page 1
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
1. What is the screening tool for the thyroid?
TSH Level
2. What is the screening tool for the thyroid?
TSH Level
3. What is the normal range for TSH?
0.5-5.0
4. What is the normal range for TSH?
0.5-5.0
5. When do you order a full thyroid profile?
If thyroid screening of TSH comes back abnormal, then we will
reorder TSH and T3, T4.
6. When do you order a full thyroid profile?
If thyroid screening of TSH comes back abnormal, then we will
reorder TSH and T3, T4.
7. What disorder demonstrates a low TSH level and high T3 and T4 levels?
Hyperthyroidism
8. What disorder demonstrates a low TSH level and high T3 and T4 levels?
Hyperthyroidism
9. What disorder demonstrates a high TSH level and low T3 and T4 levels?
Hypothyroidism
10. What disorder demonstrates a high TSH level and low T3 and T4 levels?
Hypothyroidism
11. What medication is used to treat hypothyroidism?
Levothyroxine (Synthroid)
Sarah Michelle Live Review Study Guide | Page 2
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
12. What medication is used to treat hypothyroidism?
Levothyroxine (Synthroid)
13. What dose of Synthroid do you want to start your patient on?
If patient is elderly or if they have a significant cardiac history
then we are going to start at a lower dose of 12.5-25 mcg po
daily.
In a normal healthy patient, we will start at 25-50 mcg po daily.
14. What dose of Synthroid do you want to start your patient on?
If patient is elderly or if they have a significant cardiac history
then we are going to start at a lower dose of 12.5-25 mcg po
daily.
In a normal healthy patient, we will start at 25-50 mcg po daily.
15. After initiation of medication for treatment of hypothyroidism, when do you recheck
TSH level?
6-8 weeks
16. After initiation of medication for treatment of hypothyroidism, when do you recheck
TSH level?
6-8 weeks
17. When TSH level is stabilized, how often do you recheck their level?
Every 6-12 months
18. When TSH level is stabilized, how often do you recheck their level?
Every 6-12 months
19. What is the go to medication for treatment of hyperthyroidism?
Tapazole and PTU
20. What is the go to medication for treatment of hyperthyroidism?
Tapazole and PTU
21. How do you manage treatment for hyperthyroidism in a pregnant patient?
We need to use PTU instead if they are in their first trimester.
After first trimester, then they can be switched to tapazole.
Sarah Michelle Live Review Study Guide | Page 3
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
22. How do you manage treatment for hyperthyroidism in a pregnant patient?
We need to use PTU instead if they are in their first trimester.
After first trimester, then they can be switched to tapazole.
23. What medication class is used to treat symptoms of hyperthyroidism?
Beta-blockers- these help manage tachycardia and palpitations
24. What medication class is used to treat symptoms of hyperthyroidism?
Beta-blockers- these help manage tachycardia and palpitations
25. What are 2 other treatments for the hyperthyroidism?
Thyroidectomy and radioactive iodine
26. What are 2 other treatments for the hyperthyroidism?
Thyroidectomy and radioactive iodine
27. What labs are used to measure and evaluate kidney function?
GFR, BUN, Creatinine
28. What labs are used to measure and evaluate kidney function?
GFR, BUN, Creatinine
29. What lab value is most accurate description of kidney function?
GFR- this is going to tell us how the kidneys are filtering the
blood and how well they are removing waste.
30. What lab value is most accurate description of kidney function?
GFR- this is going to tell us how the kidneys are filtering the
blood and how well they are removing waste.
31. What is a normal GFR value?
>90
32. What is a normal GFR value?
>90
33. What GFR value indicates an absolute need to start a patient on dialysis?
<15- this means that patient is in CKD stage 5
Sarah Michelle Live Review Study Guide | Page 4
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
34. What GFR value indicates an absolute need to start a patient on dialysis?
<15- this means that patient is in CKD stage 5
35. What is the second most important lab value to measure kidney function?
Creatinine
36. What is the second most important lab value to measure kidney function?
Creatinine
37. What is creatinine?
A waste product in the blood. If your kidneys are functioning
properly, then this waste product is removed by your kidneys.
When kidney function decreases, your creatinine level starts to
rise.
38. What is creatinine?
A waste product in the blood. If your kidneys are functioning
properly, then this waste product is removed by your kidneys.
When kidney function decreases, your creatinine level starts to
rise.
39. What is a normal creatine value?
Around 1
40. What is a normal creatine value?
Around 1
41. Why is BUN least telling for kidney function?
Blood urea nitrogen is a normal waste product when your body
breaks down urea. However, this is not specific to the kidneys. It
can also indicate liver issues.
42. Why is BUN least telling for kidney function?
Blood urea nitrogen is a normal waste product when your body
breaks down urea. However, this is not specific to the kidneys. It
can also indicate liver issues.
43. What is a normal BUN level?
10-20
Sarah Michelle Live Review Study Guide | Page 5
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
44. What is a normal BUN level?
10-20
45. With which first-line BP medication do we want to check the BUN/Cr?
ACE Inhibitors
46. With which first-line BP medication do we want to check the BUN/Cr?
ACE Inhibitors
47. What finding on a UA id indicative of true kidney damage?
Casts- WBC or RBC casts always need to be referred out
48. What finding on a UA id indicative of true kidney damage?
Casts- WBC or RBC casts always need to be referred out
49. When do we screen for microalbumin in the urine?
We're always going to screen when DM and HTN is first
diagnosed.
50. When do we screen for microalbumin in the urine?
We're always going to screen when DM and HTN is first
diagnosed.
51. What are the most common causes of CKD?
HTN and DM
52. What are the most common causes of CKD?
HTN and DM
53. Why is it important to perform early screening for microalbumin in the urine?
Patients who have mild kidney damage do not have symptoms,
this screening will ideally identify damage early and prevent
progression.
54. Why is it important to perform early screening for microalbumin in the urine?
Patients who have mild kidney damage do not have symptoms,
this screening will ideally identify damage early and prevent
progression.
Sarah Michelle Live Review Study Guide | Page 6
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
55. What stage of CKD do patients show true symptoms?
Stage 3 or worse
56. What stage of CKD do patients show true symptoms?
Stage 3 or worse
57. How often are we screening for micro albumin?
Bare minimum is going to be annually for patients with DM or
HTN or both.
58. How often are we screening for micro albumin?
Bare minimum is going to be annually for patients with DM or
HTN or both.
59. What is the normal range of microalbumin?
< 30
60. What is the normal range of microalbumin?
< 30
61. What is the most common symptom of all anemias?
Fatigue
62. What is the most common symptom of all anemias?
Fatigue
63. What is a normal hemoglobin level?
12-18
Women are on the lower end, and men are on the higher end
64. What is a normal hemoglobin level?
12-18
Women are on the lower end, and men are on the higher end
65. What is a normal hemoglobin to hematocrit ratio?
3 to 1
36-54%
Sarah Michelle Live Review Study Guide | Page 7
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
66. What is a normal hemoglobin to hematocrit ratio?
3 to 1
36-54%
67. What does MCV stand for?
mean corpuscular volume
68. What does MCV stand for?
mean corpuscular volume
69. What is a normal MCV?
80-100
70. What is a normal MCV?
80-100
71. What does low MCV indicate?
Microcytic anemias
72. What does low MCV indicate?
Microcytic anemias
73. What is the most common microcytic anemia?
Iron deficiency anemia
74. What is the most common microcytic anemia?
Iron deficiency anemia
75. What is the biggest risk faction for the development of IDA is int he first year of life?
The ingestion of cow's milk
76. What is the biggest risk faction for the development of IDA is int he first year of life?
The ingestion of cow's milk
77. What does high MCV levels indicate?
Microcytic anemia
78. What does high MCV levels indicate?
Microcytic anemia
Sarah Michelle Live Review Study Guide | Page 8
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
79. What are the most common microcytic anemias?
B12 and folate
80. What are the most common microcytic anemias?
B12 and folate
81. What symptoms are common with B12 deficiency anemia?
Neuro symptoms- the most common symptom is parasthesia
82. What symptoms are common with B12 deficiency anemia?
Neuro symptoms- the most common symptom is parasthesia
83. What surgery typically leads to B12 deficiency anemia?
Gastrectomy patients- who have part of their stomach removed
84. What surgery typically leads to B12 deficiency anemia?
Gastrectomy patients- who have part of their stomach removed
85. Why do gastrectomy patients typically have B12 deficiency anemia?
In order for B12 to be absorbed, it needs to be able to combine
with intrinsic factor, which is produced in the stomach. If we
remove a large portion of the stomach then we lose a lot of that
intrinsic factor.
86. Why do gastrectomy patients typically have B12 deficiency anemia?
In order for B12 to be absorbed, it needs to be able to combine
with intrinsic factor, which is produced in the stomach. If we
remove a large portion of the stomach then we lose a lot of that
intrinsic factor.
87. What diabetes medication used long term can also lead to B12 deficiency?
Metformin
88. What diabetes medication used long term can also lead to B12 deficiency?
Metformin
89. What is an abnormal lead level?
>5, ideally no lead should be within the body
Sarah Michelle Live Review Study Guide | Page 9
, SARAH MICHELLE LIVE REVIEW STUDY GUIDE
90. What is an abnormal lead level?
>5, ideally no lead should be within the body
91. What kind of symptoms may lead intoxication lead to?
Cognitive delays and behavioral problems
92. What kind of symptoms may lead intoxication lead to?
Cognitive delays and behavioral problems
93. What are the 3 microcytic anemias?
• LIT
• Lead
• Iron
• Thalassemia
94. What are the 3 microcytic anemias?
• LIT
• Lead
• Iron
• Thalassemia
95. What are the 2 macrocytic anemias?
FAB
Folate and B12
96. What are the 2 macrocytic anemias?
FAB
Folate and B12
97. What are the components of a lipid profile?
• Total cholesterol
• HDl
• LDL
• Triglycerides
Sarah Michelle Live Review Study Guide | Page 10
