AANP EXAM, PRACTICE EXAM AND STUDY GUIDE NEWEST 2024 ACTUAL EXAM 450 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES

Erythropoetin - CORRECT ANSWER 90 % renal, 10% hepatic, need supplementation when GFR is less than 49 Reticulocytes - CORRECT ANSWER In health, make up 1-2 % of total RBCs, increased in response to anema. Absence of reticulocytosis or presence of reticulocytopenia shows inadequate bone marrow response. Hemoglobin - CORRECT ANSWER normal is 12 for females and 15 for males. Ratio to hematocrit is 1:3 MCV - CORRECT ANSWER determines red blood cell size - normal is 80-96 MCH - CORRECT ANSWER reflects hgb content and color, normal is 31-37 RDW - CORRECT ANSWER variation of RBC size - normal is 11.5-15% Normocytic, normochromic , normal RDW - CORRECT ANSWER acute blood loss, anemia of chronic disease Microcytic, hypochromic anemia, elevated RDW - CORRECT ANSWER Iron deficiency anemia Microcytic, hypochromic, normal RDW - CORRECT ANSWER alpha or beta thalassemia minor Macrocytic, normochromic, elevated RDW - CORRECT ANSWER Vitamin B12 deficiency, folate deficiency, pernicious anemia Macrocytosis without anemia - CORRECT ANSWER use of medications like tegretol, AZT, depakote, dilantin, alcohol Heart murmur seen in b12 deficiency - CORRECT ANSWER Hemic murmur Most common pathogen in CAP, ABRS, AOM - CORRECT ANSWER S. pneumoniae Common pathogen in ABRS, AOM, CAP particularly with recurrent infections and tobacco use - CORRECT ANSWER H. influenzae, more than 30% now pcn resistant via beta lactamase production First line treatment for Acute Bacterial Rhinosinusitis - CORRECT ANSWER Augmentin 500/125 TID or 875/125 BID Second line treatment for Acute Bacterial Rhinosinusitis - CORRECT ANSWER Augmentin 2000/125 BID or doxy 100 mg BID or 200 mg QD Treatment for ABRS if allergic to PCN, Cephalosporins - CORRECT ANSWER Doxy, Levofloxacin, Moxifloxacin Treatment for ABRS if antibiotic resistance of failed initial therapy - CORRECT ANSWER Doxy, levofloxacin, moxifloxacin Presbycusis - CORRECT ANSWER slowly progressive hearing loss that is symmetric and high frequency 1st line controller therapy in allergic rhinitis - CORRECT ANSWER Intranasal corticosteriods like Flonase, Nasonex, Nasacort, Omnaris. Side effects are that nasal irritation and bleeding may occur. Optimal efficacy may take 1-2 weeks. 1st line rescue treatment in allergic rhinitis - CORRECT ANSWER Nasal antihistamines, esp if there is nasal congestion. sedation could occur. Drugs like astelin, Astepro, and patanase 1st generation oral antihistamines - CORRECT ANSWER significant potential to cause sedation and anticholinergic effects so not a first line therapy. Ex. benadryl, chlor trimeton, dimetapp, vistaril. 2nd generation oral antihistamines - CORRECT ANSWER These are preferred over because no anticholinergic effects but not as helpful with nasal congestion. Ex. claritin, clarinex, zyrtec, allergra Oral decongestants - CORRECT ANSWER alpha adrenergic agonist so vasoconstrictive. Take caution with the elderly, young children, HTN, bladder neck obstruction, glaucoma, and hyperthyroidism. Ex. sudafed Nasal decongestants - CORRECT ANSWER Alpha adrenergic agonist so vasoconstrictive. Can cause rebound congestion/medicamentosa so limit use to 5-7 days. Intranasal anticholinergics - CORRECT ANSWER reduce runny nose because of drying action. No effect on other nasal symptoms. Dryness can occur. Ex.. Atrovent