AGNP EXAMS SCRIPT 2025/2026 QUESTIONS AND
SOLUTIONS RANKED A+
✔✔Viral Hepatitis Signs (Objective) - ✔✔Jaundice
Fever
hepatosplenomegaly
tender on palpation
Elevated liver function
dark urine
clay stool
lymphocytosis
✔✔Hepatitis Diagnostics - ✔✔ALT-elevated in acute
Billirubin-elevated in acute
AST
Alk Phosphatase-gallbladder indicator
CBC/Diff
PLTs-decreased in fulminant
Lipids
TSH
INR-decreased in chronic, fulminant
CT
Ab Ultrasound
✔✔HEP A Transmission - ✔✔Oral-Fecal Route
Contaminated food/water
MSM
✔✔HEP A Incubation - ✔✔2wks-2months
✔✔HEP A Shed - ✔✔2 wks before - 1 wk after Symptoms
Shed in stool
WASH YOUR HANDS
✔✔HEP A Sequelae - ✔✔Chronic carrier-NO
Chronic active-NO
99% Recovery rate
✔✔Hep A Vaccine - ✔✔1Vaccine-ISG. PEP within 2 weeks of exposure
✔✔Hep A (Hepatitis Serologic Test) HST - ✔✔Anti-HAV
IgG
IgM (Acute phase)
Anti-HAV (+), IgM(+) = current active infection
,HAV (-), IgG (+) = Had it or vaccinated. Immune
HAV (-), IgG (-) = Never had it. NOT immune
✔✔Hep B Transmission - ✔✔Bloodborne
percutaneous
mucosal
✔✔Hep B Incubation - ✔✔2mo-6mo
✔✔Hep B Shed - ✔✔4wk-6wk prior to symptoms
✔✔Hep B Sequelae - ✔✔Chronic Carrier: 5-10%
Chronic Active: 5%
✔✔Hep B Recovery - ✔✔85-90%
✔✔Hep B Vaccine - ✔✔Hep B Vaccine and HBIg
1. Routine @ Birth. w/in 12 hours to Hep B mom births.
2. >18yo to high risk population: Healthcare workers, MSM, dialysis patients, inmates,
IV drug users
3. Post test 1-2 months after second shot
4. Two weeks prior to travel
5. PEP: 1 vaccine dose within 24H. Add HBIg for high risk.
✔✔HBsAg - ✔✔Surface Antigen
Indicates current infection. for Acute and Chronic
✔✔HBsAb - ✔✔Surface Antibody
Indicates Immunity status
either vaccine or cured exposure
✔✔Anti-HBcAb - ✔✔CALLING CARD
Indicates that HBV was ever there
✔✔IgM-anti HBc - ✔✔M= "in the Moment"
Current Acute Infection
NOT chronic; goes away after acute phase passes
✔✔HBeAg - ✔✔EARLY
early antigen
indicates high viral shed/replication stage
early in infectious stage
either acute or chronic fluctuation
If shown early in illness = acute
If shown in past 3 months = chronic
, ✔✔HBeAb - ✔✔Later chronic infection
Lower infectivity/viral shed
✔✔HCV Transmission - ✔✔Bloodboren
✔✔HCV Incubation - ✔✔2wk - 22wk
✔✔HCV Shed - ✔✔variant
✔✔HCV Recovery - ✔✔variant
✔✔HCV Sequelae - ✔✔Chronic carrier active: 75%
✔✔Anti-HCV - ✔✔4-10 weeks post infection
indicates exposure
NOT protective antibody
✔✔Hep C RNA - ✔✔2-3 weeks to show post infection
confirms you still have active infection
✔✔Diagnostics and Indicators/Risks HCV - ✔✔ALT waxes and wanes
#1 cause for liver failure/need for transplant
Risk factor for hepatocellular carcinoma
✔✔Appendicitis Presentation - ✔✔Initial: general abd pain, indigestion, anorexia
4-6hr: localizes to RLQ. severe pain.
✔✔McBurney's Point - ✔✔-between umbilicus and anterior superior iliac spine
-Textbook appendicitis indicator
✔✔Obturator - ✔✔Right hip and knee flexed, pain with hip rotation indicates +
appendicitis
✔✔Psoas - ✔✔raise leg straight to resistance
✔✔Rovsing's Sign - ✔✔"Roving" around
RLQ pain with palpation of LLQ
✔✔Appendicitis Diagnostics - ✔✔CBC/diff (Leukocytosis)
HcG (pregnancy)
Pelvic Exam (PID)
US/CT scan
SOLUTIONS RANKED A+
✔✔Viral Hepatitis Signs (Objective) - ✔✔Jaundice
Fever
hepatosplenomegaly
tender on palpation
Elevated liver function
dark urine
clay stool
lymphocytosis
✔✔Hepatitis Diagnostics - ✔✔ALT-elevated in acute
Billirubin-elevated in acute
AST
Alk Phosphatase-gallbladder indicator
CBC/Diff
PLTs-decreased in fulminant
Lipids
TSH
INR-decreased in chronic, fulminant
CT
Ab Ultrasound
✔✔HEP A Transmission - ✔✔Oral-Fecal Route
Contaminated food/water
MSM
✔✔HEP A Incubation - ✔✔2wks-2months
✔✔HEP A Shed - ✔✔2 wks before - 1 wk after Symptoms
Shed in stool
WASH YOUR HANDS
✔✔HEP A Sequelae - ✔✔Chronic carrier-NO
Chronic active-NO
99% Recovery rate
✔✔Hep A Vaccine - ✔✔1Vaccine-ISG. PEP within 2 weeks of exposure
✔✔Hep A (Hepatitis Serologic Test) HST - ✔✔Anti-HAV
IgG
IgM (Acute phase)
Anti-HAV (+), IgM(+) = current active infection
,HAV (-), IgG (+) = Had it or vaccinated. Immune
HAV (-), IgG (-) = Never had it. NOT immune
✔✔Hep B Transmission - ✔✔Bloodborne
percutaneous
mucosal
✔✔Hep B Incubation - ✔✔2mo-6mo
✔✔Hep B Shed - ✔✔4wk-6wk prior to symptoms
✔✔Hep B Sequelae - ✔✔Chronic Carrier: 5-10%
Chronic Active: 5%
✔✔Hep B Recovery - ✔✔85-90%
✔✔Hep B Vaccine - ✔✔Hep B Vaccine and HBIg
1. Routine @ Birth. w/in 12 hours to Hep B mom births.
2. >18yo to high risk population: Healthcare workers, MSM, dialysis patients, inmates,
IV drug users
3. Post test 1-2 months after second shot
4. Two weeks prior to travel
5. PEP: 1 vaccine dose within 24H. Add HBIg for high risk.
✔✔HBsAg - ✔✔Surface Antigen
Indicates current infection. for Acute and Chronic
✔✔HBsAb - ✔✔Surface Antibody
Indicates Immunity status
either vaccine or cured exposure
✔✔Anti-HBcAb - ✔✔CALLING CARD
Indicates that HBV was ever there
✔✔IgM-anti HBc - ✔✔M= "in the Moment"
Current Acute Infection
NOT chronic; goes away after acute phase passes
✔✔HBeAg - ✔✔EARLY
early antigen
indicates high viral shed/replication stage
early in infectious stage
either acute or chronic fluctuation
If shown early in illness = acute
If shown in past 3 months = chronic
, ✔✔HBeAb - ✔✔Later chronic infection
Lower infectivity/viral shed
✔✔HCV Transmission - ✔✔Bloodboren
✔✔HCV Incubation - ✔✔2wk - 22wk
✔✔HCV Shed - ✔✔variant
✔✔HCV Recovery - ✔✔variant
✔✔HCV Sequelae - ✔✔Chronic carrier active: 75%
✔✔Anti-HCV - ✔✔4-10 weeks post infection
indicates exposure
NOT protective antibody
✔✔Hep C RNA - ✔✔2-3 weeks to show post infection
confirms you still have active infection
✔✔Diagnostics and Indicators/Risks HCV - ✔✔ALT waxes and wanes
#1 cause for liver failure/need for transplant
Risk factor for hepatocellular carcinoma
✔✔Appendicitis Presentation - ✔✔Initial: general abd pain, indigestion, anorexia
4-6hr: localizes to RLQ. severe pain.
✔✔McBurney's Point - ✔✔-between umbilicus and anterior superior iliac spine
-Textbook appendicitis indicator
✔✔Obturator - ✔✔Right hip and knee flexed, pain with hip rotation indicates +
appendicitis
✔✔Psoas - ✔✔raise leg straight to resistance
✔✔Rovsing's Sign - ✔✔"Roving" around
RLQ pain with palpation of LLQ
✔✔Appendicitis Diagnostics - ✔✔CBC/diff (Leukocytosis)
HcG (pregnancy)
Pelvic Exam (PID)
US/CT scan
