AANP REVIEW QUESTIONS AND ANSWERS EXAM (2023/2024)

AANP REVIEW QUESTIONS AND ANSWERS EXAM (2023/2024) The macula is responsible for what type of vision? - CORRECT ANSWER-central vision Cones are responsible for what kind of vision? - CORRECT ANSWER-color Rods are responsible for what kind of vision? - CORRECT ANSWER-black and white contrast, night vision What do blurred disc margins indicate? - CORRECT ANSWER-papilledema (increased ICP) Blepharitis - CORRECT ANSWER-bilateral eyelid edges red, swollen may have fine scales Belpharitis Tx - CORRECT ANSWER-J&J baby shampoo topical bacterial ointment if suspected infection Pterygium - CORRECT ANSWER-Triangular shaped white to yellow superficial growth on nasal side bilateral tx: surgical removal if grows into pupil Pinguecula - CORRECT ANSWER-white to yellow small round superficial lesion on each side of cornea temporal and nasal areas Chalazion - CORRECT ANSWER-small painless nodule on upper or lower eye lid tx: warm compress QID; refer if not resolved in 2 weeks Senile arcus - CORRECT ANSWER-white-gray ring on edge of cornea bilateral d/t lipid deposits normal finding in elderly if <50, check lipid profile Xanthelasma - CORRECT ANSWER-soft yellow plaques on upper/lower eyelids by inner canthus and/or palpebrum cholesterol plaques; not fixed by diet removed by trichlorocetic acid, sx, lasers Hordeolum - CORRECT ANSWER-"hurts" acute onset, swollen eyelid, painful small abscess tx: warm compress QID; topical abx (can spread d/t staph [cellulitis]) Bacterial Conjunctivitis - CORRECT ANSWER-d/t H. influenza acute onset, red eye. dried crusty yellow-green discharge on awakening tx: ophthalmic flouroquinolones Viral Conjunctivits - CORRECT ANSWER-acute onset red eye; itchy; one or both eyes not a lot of drainage periauricular lymph swelling very contagious; keep out of schol x 1 week Allergic Conjunctivits - CORRECT ANSWER-bilateral itchy eyes w/ increased tearing cobble stoning Tx: ophthalmic antihistamine, Azelastine ophthalmic NSAID: Ketorolac Diabetic Retinopathy - CORRECT ANSWER-cotton wool spots microaneurysms blurred vision, floaters, scotoma Microaneursyms are due to what? - CORRECT ANSWER-neovascularization or formation of new fragile arterioles when ruptured--> bleeding--> flame hemorrhages Hypertensive Retinopathy - CORRECT ANSWER-copper wire arterioles silver wire arterioles AV nicking, flame shaped hemorrhages What is AV nicking caused by? - CORRECT ANSWER-arteriole pressing down on retinal vein Herpes Keratitis - CORRECT ANSWER-caused by HSV or shingles of trigeminal nerve (V1 branch of CN V) photophobia, blurred vision, tearing, eye pain in 1 eye if shingles will have vesicles and/or small round rashes on temple (one side) and tip of nose that follows V1 branch of CN V Flourescein stain shows fern like lesions can have scarring of cornea; refer to ophtho or ED Corneal Abrasion - CORRECT ANSWER-acute onset SEVERE eye pain, foreign body sensation, tearing Flourescein stain r/o herpes keratitis tx: topical abx w/ erythromycin ointment or sulfacetamide, ciprofloxacin or ofloxacin eye gtts NO PATCHING Contact Lens Wearer - CORRECT ANSWER-r/o infiltrate or opacity --> refer to ophtho if present topical abx therapy w/ ofloxacin, ciprofloxacin, tobramycin NO PATCHING Open-Angle Glaucoma - CORRECT ANSWER-rarely symptomatic high IOP damages optic nerve disc cupping during fundus exam tonometry tx: BB (timolol) Contraindications for BB eye drops - CORRECT ANSWER-bronchospasm, SOB, fatigue, confusion, depression, HF, bradycardia Acute Angle Closure Glaucoma - CORRECT ANSWER-acute onset severe eye pain possible n/v (think increased ICP) reports seeing halos cloudy cornea, mid-dilated pupil, non reactive pupil Age-Related Macular Degeneration - CORRECT ANSWER-painless loss of CENTRAL vision; bilateral wet, dry types sudden onset blurred vision and/or distorted vision leading cause of vision loss >50 NOT EMERGENT AMD tx - CORRECT ANSWER-Dry: antioxidant vitamins w/ zinc Wet: intravitreous injection of VEGF, laser therapy increase dietary intake of lutein and zeaxanthin (cooked kale, spinach) Cataracts - CORRECT ANSWER-affects lens of the eye; lens becomes progressively cloudy blurred vision, increased sensitivity to glare, poor night vision, halos around lights, diplopia red reflex absent --> white/gray glow seen instead Allergic Rhinitis - CORRECT ANSWER-clear muscous, itchy nose, congestion may have hx of atopy (asthma, eczema, hives, etc) nasal turbinates are bluish, pale, swollen tx: FIRST LINE is nasal steroid sprays (Nasocort, Flonase); if no relief add oral antihistamine Pts w/ nasal polyps are more likely to have sensitivity to what? - CORRECT ANSWERaspirin Kiesselbach's plexus - CORRECT ANSWER-anterior nose most common site of anterior nose bleeds Vertigo - CORRECT ANSWER-unsteadiness and feelings that room is spinning, nausea w/wo vomiting, probs w/ walking, swaying and poor balance, may have double vision, nystagmus may be present during episode tx w/ Meclizine Causes of Vertigo - CORRECT ANSWER-Meniere's, vestibular neuritis, acoustic neuroma, MS, CN 8 lesions, brainstem or cerebellar tumors or bleeding Meniere's Disease - CORRECT ANSWER-recurrent attacks of vertigo w/ n/v; may last hours feeling of fullness on one ear TRIAD: vertigo, tinnitus, and hearing loss on affected hear Tx: Diuretics, Meclizine, Scopolamine, Promethazine for nausea Acoustic Neuroma - CORRECT ANSWER-gradual onset; one sided hearing loss, tinnitus, facial numbness (if CN 5 compression) Benign tumor of CN8