AANP board certification exam 100% VERIFIED SOLUTIONS LATEST UPDATE 2024

AANP board certification exam 100% VERIFIED SOLUTIONS LATEST UPDATE 2024 how long will a cough last for acute bronchitis? up to three weeks is completely normal how do you treat acute bronchitis? 95% cases are viral-- tessalon pearls to help with cough. * prednisone is never the answer ** explain the following views of chest xrays: AP, PA, PA and lateral which one do you want for pneumonia patient? AP- shows the heart predominantly because its from front to back PA- shows the lungs predominantly because its back to front lateral shows fluid line what is the gold standard for diagnosing community acquired pneumonia chest xray- PA/lateral, repeat post treatment in 6 weeks (repeat not really done anymore) treatment guidelines for CAP- healthy adult no comorbidities MAD LUNG amoxicillin 1 gram TID (best choice) doxycycline 100 mg twice daily macrolide (mycin) in areas with low macrolide resistance so not the best choice treatment guidelines for CAP- adult with comorbidities monotherapy: respiratory quinolone (levofloxacin 750 mg daily) combination therapy: augmentin or cephalosporin PLUS macrolide or doxy what are common respiratory fluroquinolones? Think FLOXACIN-- moxifloxacin, gemifloxacin, levofloxacin what are common macrolides for CAP think "MYCIN" -- azithromycin, clarithromycin what are common tetracyclines for CAP doxycycline what are common beta lactams for CAP amoxicillin, augmentin (amox with clav), cefpodoxime, cefuroxime how would you treat a pregnant 29 year old with pneumonia? Amoxicillin 1 g TID-- cant give levaquine (flouroquinolones no in pregnancy due to fetal ligament destruction, doxycycline no in pregnancy stains tooth bones in fetus) how long do you give antibiotics to patient with pneumonia? 5-10 days, you always want to continue antibiotics for 3 more days after clinically stable (no fever) When do you get a chest xray for pneumonia? it is the gold standard for diagnosis, you do not need to do resolution chest xray unless things are lingering or you suspect something else. When do you give pneumococcal vaccine? adults > 65 years old you give PPSV23 or you can give both PCV 13 and PPSV23 but must be 1 year apart adults > 65 with immunocompromising condition give both pcv 13 and ppsv23 adults 19-64 at increased risk of pneumococcal disease (asthma, copd, smokers, cv dz) - give PPSV23 only adults 19-64 with asplenia, cochlear implants, csf leak-- give pCV13 NOW then PPSV23 in 8 weeks , then PPSV23 in 5 years. What is the diagnostic criterion for COPD FEV1/FVC ratio of < 0.70 What are characteristics of COPD midlife onset, symptoms slowly progressive, exposure to lung irritant, DOE is progressive, chronic cough and chronic sputum production what are characteristics of asthma onset early in life, symptoms vary widely from day to day, symptoms worse at nighttime/early AM, allergic rhinitis, eczema, family history, obesity what are characteristics of heart failure (when evaluating diff dx of COPD) chest xray with dilated heart, pulmonary edema what are characteristics of tuberculosis when ruling out for COPD patient onset all ages, chest xray with lung infiltrate, microbiologic confirmation what are the characteristics of bronchiectasis LOTS OF PURULENT SPUTUM, chest xray shows bronchial wall thickening and bronchial dilation What intervention has the greatest influence on slowing progression of a COPD patient? smoking cessation!! what are first line smoking cessation drugs? (3) varenicline (chantix), nicotine patch, buproprion extended release (zyban) what is second line smoking cessation drug? sertraline (zoloft) what smoking cessation dr