AANP PRACTICE TEST EXAM 2023/2024

AANP PRACTICE TEST EXAM 2023/2024 Treatment for Gonorrhea - CORRECT ANSWER-Rocephin (Ceftriaxone) 250mg IM and Azithromycin 1 gm po x1 or doxy 100mg BID x7 days Treatment for Chlamydia - CORRECT ANSWER-Azithromycin 1 gm po x1 or doxy 100 mg BID x 7 days or Amoxicillin 500 mg po TID x 7 days test for cure 3 weeks after completion of treatment. No doxy for preggo Treatment for Bacterial vaginosis - CORRECT ANSWER-Flagyl BID x 7 days Candidia vaginitis treatment - CORRECT ANSWER-diflucan 100mg x1 Treatment for trichomonias - CORRECT ANSWERFever, chills, N/v, photophobia, myalgia, arthralgias usually present then report development of a petechial rash on forearms, ankles, wrists, that spreads towards trunk and becomes generalized. Pt usually reports spending time in the woods. - CORRECT ANSWER-Rocky Mountain Spotted Fever What is the diagnosis and treatment for Rocky Mountain Spotted Fever? - CORRECT ANSWER-PCR essay with Rickessetti antigen tx: doxycycline What is the diagnosis and treatment for lyme disease (erythema migraines)? - CORRECT ANSWER-Dx: B. Burgdorferi via ELISA then confirm with western blot TX: doxycycline or amoxicillin if less than 7 yo Dark moles, uneven texture, different colors, irregular, > 6mm, an itch - CORRECT ANSWER-melanoma Target or bulls-eye. Abruptly, hives, blisters, peticiae, purpura, necrosis, sloughing of tissues. Extensive mucosal involvement. Prodrome of fevers with flu like symptoms. Usually triggered by medication - CORRECT ANSWER-Stevens Johnson Syndrome What medications are more likely to cause Stevens Johnson Syndrome? - CORRECT ANSWER-Allopurinol, anticonvulsants, pcn, sulfonamides, NSAIDS. Pt with HIV is at increased risk Inherited. Pruritic erythematous plaques, fine silvery-white scales with pitted fingernails. Can occur on scalp, elbows, knees, sacrum, or intergluteal folds. - CORRECT ANSWER-psoriasis What is the koebner phenomenon? - CORRECT ANSWER-new psoriatic plaques form over skin trauma What is the auspitz sign? - CORRECT ANSWER-pinpoint bleeding when plaques are removed What is the treatment for psoriasis? - CORRECT ANSWER-mild: topical steroids, tar preps if severe: anti-TNF (-mab (Humira)), methotrexate, or other immunologic therapy What is acanthros nigricans indicative of? - CORRECT ANSWER-insulin resistance What is the treatment for scabies? - CORRECT ANSWER-Permethrin cream x1, treat the whole household, wash belongings in hot water Extremely itchy. Appears on flexural folds, neck, hands. Small vesicles that rupture leaving painful, bright-red, weepy lesions that become lichenified from itching. - CORRECT ANSWER-atopic dermatitis (eczema) What is the treatment for atopic dermatitis? - CORRECT ANSWER-topical steroids, avoid hot water/soaps If more sever consider po antihistamines Dry round, pink to red lesion with a rough and scaly texture. Does not heal. Slow growing in sun exposed areas. - CORRECT ANSWER-actinic keratosis what is the treatment for actinic keratosis? - CORRECT ANSWER-cryotherapy or 5-FU cream DX: biopsy is gold standard Soft round wart light tan to black looks pasted on - CORRECT ANSWER-seborrhic keratosis benign and asymptomatic What should you watch for in a diabetic with cellulitis? - CORRECT ANSWERosteomyelitis What is a patient at risk for developing if they have cellulitis? - CORRECT ANSWERosteomyelitis or DVT What is the treatment for erysipelas? - CORRECT ANSWER-Penicillin (dicloxacillin) for 10 days What is the treatment for an abcess? - CORRECT ANSWER-Think MRSA: bactrim, doxy, or clindamycin Pearly, waxy, skin lesion, atrophic, ulcerated center that does not heal - CORRECT ANSWER-basal cell carcinoma what are the two main antibiotics for skin conditions? - CORRECT ANSWER-Keflex (cefalexin) or penicillin Intermittent claudication that feels better when they rest/lay down or dangling. Legs appear shiny, hairless, with round smooth sores on toes or bottom of feet, eschar can be present, diminished pulses. - CORRECT ANSWER-PAD what ABI indicates PAD? - CORRECT ANSWER-ABI < 0.9 What is the main risk factor for PAD? - CORRECT ANSWER-smoking Edema, redness/purple/dark skin, varicose veins present often, sores with irregular borders on ankles, yellow slough or ruddy skin, pulses present - CORRECT ANSWERVenous insufficiency (PVD) What are pt with PVD at risk for? - CORRECT ANSWER-DVT What is the treatement for mastitis? - CORRECT ANSWER-(inflammed breast tissue) TX: keflex (cefalexin) or penicillin, use warm compresses, continue to breast feed. What is the treatement for acne vulgaris? - CORRECT ANSWER-- topicals - add an po antibiotic (tetracycline) - refer to derm for accutane What is the treatement for localized impetigo - CORRECT ANSWER-topical mupirocin (bactroban) severe: keflex (cefalexin) What needs to be monitored while taking accutane? - CORRECT ANSWER-LFTs, 2 forms of contraceptives, monthly pregnancy testing, only prescribe one month supply chronic and small acne-like papules around nose mouth and chin. - CORRECT ANSWER-Acne Rosacea What is the treatment for acne rosacea? - CORRECT ANSWER-topical metrogel (metronidazole), azelex (azeleic acid), or tetracycline. Small flat topped, red to purple bumps that may have white scales/flakes. Whispy grey white streaks called wichhams striae often found on the inner wrists, forearms, and ankles. Can cause hair loss if found on scalp. - CORRECT ANSWER-lichen planus What are some causes of lichen planus? - CORRECT ANSWER-Hep C, medications, or contact with chemicals What is the treatment of spider bite? - CORRECT ANSWER-ice packs to inactivate the toxin, antibiotic ointmnet at first, treat like cellulitis What is the treatment for a cat bite? - CORRECT ANSWER-Augmentin What should you consider when a patient presents with pityoris rosea? - CORRECT ANSWER-Test for syphilis: screen with RPR then VDRL What is the rule of 9's? - CORRECT ANSWER-Head and neck - 9% Each arm - 9% Each leg - 18% Anterior trunk - 18% Posterior trunk - 18% Affects CN V, abrupt onset of pain, fluorescein dye shows "fern like" pattern - CORRECT ANSWER-herpes keratitis Acute/severe halos, cupping optic nerve, cloudy cornea, mid-dilated oval pupil - CORRECT ANSWER-acute angle closure glaucoma ER STAT CN2 is affected, gradual changes in peripheral vision then second central vision - CORRECT ANSWER-primary open angle glaucoma Opaque appearance on eye exam. Elderly pt complains of issues with nigh vision - CORRECT ANSWER-cataracts Painless loss of central vision. Straight lines appear curved. Periphery is intact. - CORRECT ANSWER-macular degeneration (give asmler grid) Floaters, curtain pulled down over vision, flashes of light, painless - CORRECT ANSWER-retinal detachment swelling of optic disc with blurred edges - CORRECT ANSWER-papilledema (think incresaed ICP) What are the signs of hypertensive retinopathy? - CORRECT ANSWER-- copper/silver wire arterioles - AV nicking - retinal hemorrhages What are the signs of diabetic retinopathy? - CORRECT ANSWER-- Cotton wool spots - micro-aneurysms - can also have retinal hemorrhages Clusters of small, red papules with white centers in the buccal mucosa often close to lower molars - CORRECT ANSWER-koplik spots Koplik spots, 3 c's, morbiliform rash - CORRECT ANSWER-measles (rubeola) BC>AC, lateralization to bad ear - CORRECT ANSWER-conductive hearing loss Test of CN VIII done with tuning fork on midline of head - CORRECT ANSWER-Weber test Test that measures AC and BC - CORRECT ANSWER-Rinne test Painful, swollen, red warm abscess of the eyelid - CORRECT ANSWER-hordeolum TX: hot compresses, erythromycin or penicillin drops What is the treatment for otitis media: - CORRECT ANSWER-- amoxicillin - or cephalosporin (omnicef) or fluroquinolone (levaquin) - if allergic to pcn azithromycin or clarithromycin if recurrent amoxicillin-clavulate What is the treatment for otitis externa? - CORRECT ANSWER-coritcosporin drops or cipro What is the treatment for anthrax? - CORRECT ANSWER-Doxycycline or ciprofloxacin/levaquin