AANP EXAM 2023/2024 STUDY GUIDE

AANP EXAM 2023/2024 STUDY GUIDE Tanner Stage I: Girls - CORRECT ANSWER-prepubertal Tanner Stage II: Girls - CORRECT ANSWER-Breast bud Tanner Stage III: Girls - CORRECT ANSWER-Breast and nipple growth, one mound, no separation Tanner Stage IV: Girls - CORRECT ANSWER-Nipple/areola elevated from breast, secondary mound Tanner Stage V: Girls - CORRECT ANSWER-Adult Tanner Stage I: Boys - CORRECT ANSWER-prepubertal Tanner Stage II: Boys - CORRECT ANSWER-testes/scrotum enlarges, scrotum darkens, more ruggae Tanner Stage III: Boys - CORRECT ANSWER-penis grows longer, scrotum continues to grow Tanner Stage IV: Boys - CORRECT ANSWER-penis becomes wider, continues getting longer, scrotum larger, darker, more ruggae Tanner Stage V: Boys - CORRECT ANSWER-adult kiesselbach's plexus - CORRECT ANSWER-blood vessels on anterior septum where 90% of nosebleeds originate Finkelstein's test - CORRECT ANSWER-used to dx DeQuervain's tenosynovitis, thumb in fist, bend wrist towards little finger. positive c pain in wrist on thumb side anterior drawer test - CORRECT ANSWER-used to check for ACL injury, pull tibia forward from femur c both hands on tibia c pt laying and knee flexed at 90 deg, positive c >5mm translation or increase laxity compared to unaffected side lachman maneuver - CORRECT ANSWER-tests ACL integrity, pt on back knee flexed 20-30 deg, one hand stabilize femur, other applies pressure to back of knee, positive c mushy end point pivot test - CORRECT ANSWER-tests ACL integrity, pt on back, knee fully extended, rotate foot internally. Apply valgus stress while flexing knee. Positive= translation of tibia on femur McMurray test - CORRECT ANSWER-checks for meniscus injury, pt supine, knee flexed. medial: apply valgus force, externally rotate the foot and passively extend knee. lateral: apply varus force, internally rotate foot and passively extend knee. Positive= audible or palpable snap in knee during extension diabetic retinopathy - CORRECT ANSWER-cotton wool spots, hard exudates, neovascularization, microaneurysms hypertensive retinopathy - CORRECT ANSWER-AV nicking, silver and/or copper wire arterioles Tinel's sign - CORRECT ANSWER-Detects irritated nerves, most often c carpal tunnel. Tap on median nerve. Positive= tingling down thumb, index, and middle finger Phalen's maneuver - CORRECT ANSWER-Detects carpal tunnel syndrome. allow wrists to fall into maximum flexion, hold for 60 seconds. Positive= tingling down thumb, index, and middle finger Kernig's sign - CORRECT ANSWER-sign of meningitis. Pt supine, hip flexed at 90, attempt to straighten leg. Positive= inability to straighten leg Maculopapular rash in lace like pattern - CORRECT ANSWER-Fifth's disease Maculopapular rash with papules, vesicles, and crusts - CORRECT ANSWER-Varicella Maculopapular rashes that are oval shaped with herald patch or Christmas tree - CORRECT ANSWER-pityriasis rosea vesicular rashes on an erythematous base - CORRECT ANSWER-herpes simplex scarlet fever (scarletina) - CORRECT ANSWER-caused by group A strep, rash is fine, red, and rough textured. non-puritic. accompanied by sore throat, stawberry tongue, and peeling of hands and feet. tx c abx for strep (Penicillin) S3 - CORRECT ANSWER-Heard best over pulmonic area (2nd L intercostal space), indicates heart failure, ventricular overload psoas sign (ilipsoas muscle sign) - CORRECT ANSWER-used c acute abdomen, appendicitis. Pt lays on left side, hyperextends right thigh. Positive= abd pain obturator sign - CORRECT ANSWER-used c acute abdomen, appendicitis. Pt supine, flex knee and hip to 90 deg, internally rotate hip. Positive= abd pain (c R leg for appendix) Rovsing's sign - CORRECT ANSWER-used c acute abdomen, appendicitis. Palpate LLQ, Positive= pain in RLQ McBurney's point - CORRECT ANSWER-2/3rds of distance from umbilicus to the R anterior superior iliac spine. Deep tenderness at this point may be indicative of appendicitis Hirschsprung (Hirschberg) test - CORRECT ANSWER-aka corneal light reflex. Checks for strabismus. Rocky Mountain spotted fever - CORRECT ANSWER-S central US. Red rash on wrists and ankles that spreads centrally that appears 3rd day after fever (103-105). Can cause death if not tx in 1st 8 days of symptoms Cholesteatoma - CORRECT ANSWER-Cauliflower like growth in ear c foul smelling discharge. Can eat through tm, bone, & nerves. Refer to EENT Koplik's spots - CORRECT ANSWER-Small red papules with white center inside cheeks by lower molars. Indicates measles, before rash. hordeolum - CORRECT ANSWER-stye. infection on hair follicle of eye lash. tx c abx eye drops and warm packs. Pinguecula - CORRECT ANSWER-yellow triangular thickening of the bulbar conjunctiva. on inner and outer margins of cornea. Caused by UV light damage. Pterygium - CORRECT ANSWER-yellow triangular thickening of the bulbar conjunctiva, extends to the cornea. Caused by UV light damage. Chalazion - CORRECT ANSWER-chronic inflammation of meibomian (sweat) gland of eyelid. small painless movable bead-like nodule. Should resolve within weeks. Rinne test - CORRECT ANSWER-tests for conductive hearing loss. normal= AC>BC Webber test - CORRECT ANSWER-tuning fork on middle of head. Abnormal= lateralization to affected ear meningococcemia prophylaxis - CORRECT ANSWER-Rifampin for close contacts