AANP Board 146 Questions with Answers
INR values below ____ increase stroke risk sixfold. - CORRECT ANSWER 2
What allergy contradicts the use of
... [Show More] thiazide diuretics? - CORRECT ANSWER Sulfa
Why should ACE-Is be avoided with renal stenosis? - CORRECT ANSWER Leads to ARF
Adverse effects of aldosterone antagonists (Aldactone) - CORRECT ANSWER Galactorrhea and hyperkalemia
What are beta blocker indications? - CORRECT ANSWER HTN, post-MI< angina, arrhythmias, migraine prophylaxis, hyperthyroidism
1st line BP med for DM? - CORRECT ANSWER ACE or ARB
Grapefruit juice should be avoided in what 1st line antihypertensive medication? - CORRECT ANSWER CCB
Alternative antibiotic treatment for patients with gram positive baterial infections that are allergic to PCN: - CORRECT ANSWER macrolides
Initial treatment of COPD - CORRECT ANSWER Ipratropium bromide (anticholinergic)
1st line treatment for gonorrheal infections - CORRECT ANSWER Rocephin IM
Treatment of anthrax - CORRECT ANSWER Cipro 500mg BID 7-10 days
Treatment of traveler's diarrhea - CORRECT ANSWER Cipro 500mg BID 3 days
What can increase the risk of tendon rupture when on a quinolone? - CORRECT ANSWER age and steroids
How long does ASA suppress platelet function? - CORRECT ANSWER up to 7 days
What is the FDA category and dose of finasteride? - CORRECT ANSWER 5mg PO QD and category X
What drug category should not be given with warfarin? - CORRECT ANSWER sulfa drugs
When should routine screening for breast cancer start? - CORRECT ANSWER 40
If a patient had only one dose of the hep B vaccine what is recommended? - CORRECT ANSWER Do not restart series; Start with 2nd dose
What is done if a patient has a tetanus-prone wound and an unknown vaccination status? - CORRECT ANSWER Administer immediate dose of Td and the teatnus immunoglobulin injection
If a person is vaccinated with pneumovax prior to 65 what is recommended? - CORRECT ANSWER Give a booster dose of pneumovax 5 years after initial dose
When should Zostavax be given? - CORRECT ANSWER age 60
How far apart should the varicella vaccines be given? - CORRECT ANSWER 4 weeks
Treatment for otitis externa - CORRECT ANSWER Cortisporin otic drops
Common bacterial pathogen of otitis externa - CORRECT ANSWER Pseudomonas
What is cholesteatoma a complication of? - CORRECT ANSWER periorbital sinusitis
What indicates an abnormal Rinne test? - CORRECT ANSWER BC>AC
What kind of hearing loss is found with an abnormal Rinne if BC>AC? - CORRECT ANSWER conductive
What kind of hearing loss is associated with lateralization to affected ear when Weber test is performed - CORRECT ANSWER Conductive
What kind of hearing loss is associated with lateralization to unaffected ear when Weber test is performed - CORRECT ANSWER sensorurial
What does 20/40 vision mean? - CORRECT ANSWER A person can see 20 ft whereas normal vision can see 40
Common treatment of cerumenosis - CORRECT ANSWER Carbamide peroxide
What route should HIV esophageal candida infections - CORRECT ANSWER Oral systemic
Where is a scabies rash located? - CORRECT ANSWER Interdigital webs and/or penis
Antibiotic treatment for human, dog, or cat bite - CORRECT ANSWER Augmentin
A herald patch or "Christmas tree" pattern is associated with what disease? - CORRECT ANSWER PItyriasis rosea
What class of meds are used to treat PHN? - CORRECT ANSWER TCAs
What is the treatment for rosacea? - CORRECT ANSWER Metronidazole gel
What areas of the body have thicker skin and call for higher potency steroids? - CORRECT ANSWER scalp, back, soles
How do you check for pulsus paradoxus? - CORRECT ANSWER BP cuff and stethoscope and the apical pulse
What findings are associated with hypertensive retinopathy? - CORRECT ANSWER copper and silver wire arterioles, AV nicking
What findings are associated with diabetic retinopathy? - CORRECT ANSWER Neovascularization, microaneurysms, hard exudates, cotton wool spots
What class of anti-hypertensives are used for isolated HTN in the elderly? - CORRECT ANSWER CCB
What are some "hyper" side effects of thiazide diretics - CORRECT ANSWER hyperglycemia, hyperuricemia, hypertriglyceremia
At what age is a high cholesterol no longer considered a risk factor heart disease? - CORRECT ANSWER 75
If a patient has an INR between 3-5, how should this be managed? - CORRECT ANSWER Skip 1 dose; decrease maintenance dose, check INR in 1-2 days until normal
If a patient has an INR between 5-9 how should this be managed? - CORRECT ANSWER Omit a dose and give a small dose of oral vitamin K or omit the next 2 doses. Daily INR monitoring; decrease maintenance dose
Class I NYHA heart disease classification - CORRECT ANSWER No limitation of physical activity
Class II NYHA heart disease classification - CORRECT ANSWER Ordinary physical activity results in fatigue, exertional dyspnea
Class III NYHA heart disease classification - CORRECT ANSWER Marked limitation in physical activity
Class IV NYHA heart disease classification - CORRECT ANSWER Symptoms are present at rest
Treatment class for Raynaud's - CORRECT ANSWER CCBs
What class of med lower triglycerides? - CORRECT ANSWER Niacin and fibrates
Should you lower a markedly high triglyceride level or cholesterol first? - CORRECT ANSWER Triglycerides
Criteria for metabolic syndrome: - CORRECT ANSWER Abdominal obesity, HTN, hyperlipidemia, high triglycerides, high fasting glucose
What are characteristics of fatty liver disease? - CORRECT ANSWER Mild elevation of ALT & AST not associated with alocohol, meds, or viral hep in overweight patients
What is used to calculate PEF? - CORRECT ANSWER Height, age, gender (HAG)
When treating a COPD patient with antibiotics what organism (s) must the antibiotic cover? - CORRECT ANSWER H. influenzae (gram negative)
No. 1 bacterium in CAP - CORRECT ANSWER Strep pneumo
No. 1 atypical pneumonia - CORRECT ANSWER Mycoplasma pneumoniae
At what mm is a PPD considered positive with no risk factors? - CORRECT ANSWER 15mm
At what mm is a PPD considered positive in HIV? - CORRECT ANSWER 5mm
What class of medications is 1st line treatment for asthma prevention? - CORRECT ANSWER Inhaled corticosteroids
1st line treatment for severe asthmatic exacerbation - CORRECT ANSWER adrenaline injection
Why should patients have annual eye exams when on long-term steroids - CORRECT ANSWER increases the risk of cataracts and glaucoma
What is the definition of subclinical hypothyroidism - CORRECT ANSWER Elevated TSH and normal serum free T4
Which antidiabetic drugs are contraindicated in heart failure or severe heart disease and why? - CORRECT ANSWER Glitizones because they can cause water retention
How is the psoas maneuver performed? - CORRECT ANSWER
Which hepatitis is associated with the highest risk of cirrhosis and liver cancer? - CORRECT ANSWER Hep C
When is nitrofurantoin contraindicated? - CORRECT ANSWER renal insufficiency
What indicates pyelonephritis on a u/a microscopic? - CORRECT ANSWER WBC casts with proteinuria
What is the best indicator of renal function? - CORRECT ANSWER eGFR
Treatment for temporal arteritis: - CORRECT ANSWER high-dosed prednisone for several weeks
Screening test for temporal arteritis - CORRECT ANSWER Sed rate
What HA is treated with high dosed oxygen - CORRECT ANSWER Cluster
What HA is treated with high-dosed anticonvulsants? - CORRECT ANSWER Trigeminal neuralgia
What HA is accompanied by tearing and nasal congestion? - CORRECT ANSWER Cluster
What is the diagnostic test of thalassemia and sickle cell anemia? - CORRECT ANSWER Hemoglobin electrophoresis
What two tests indicate that a patient has pernicious anemia if they are elevated? - CORRECT ANSWER parietal antibody test and/or intrinsic factor antibody test
What lab value indicates RBC size? - CORRECT ANSWER MCV
What anemia manifests with neurologic symptoms? - CORRECT ANSWER B12
Where are Heberden's nodes located? - CORRECT ANSWER Distal interphalangeal joint (DIP)
How is uveitis treated? - CORRECT ANSWER High-dose steroids; refer to opthalmology
How does a Baker's cyst present? - CORRECT ANSWER Located behind the knee (popliteal fossa) as a ball-like mass
1st line treatment for ankolysing spondilytis? - CORRECT ANSWER NSAIDS
What medical conditions do antipsychotics increase the risk of (5)? - CORRECT ANSWER obesity, DMII, hyperlipidemia, metabolic syndrome, and hypothyroidism
What foods are high in tyramine? - CORRECT ANSWER fermented-beer, wine, aged cheese, fava beans
What is the FDA black box warning for SSRIs? - CORRECT ANSWER May increase the risk of suicidal thoughts/behaviors in children, adolescents, and young adults
What causes Korsakoff's syndrome? - CORRECT ANSWER Chronic thiamine deficiency
Can a patient smoke while on Zyban? - CORRECT ANSWER yes
What SSRI should be weaned? - CORRECT ANSWER Paroxetine
How is the effectiveness of Proscar determined? - CORRECT ANSWER Obtain a PSA value and multiply it by 2. Should be below baseline
What BC pills are indicated for acne rx? - CORRECT ANSWER Ortho-Tri-Cyclin, Yaz, and Desogen
Characteristics of clue cells - CORRECT ANSWER squamous epithelial cells that have blurred edges due to a large number of bacteria (increased WBC count)
What is Fitz-Hugh-Curtis syndrome? - CORRECT ANSWER Chlamydial and/or gonoccal infection of the liver capsule resulting in scarring
What is Jarisch-Herxheimer reaction? - CORRECT ANSWER Acute febrile reaction that can occur 24 hrs after rx of an STI such as chlamydia, gonorrhea, or syphillis
What is the treatment for genital warts? - CORRECT ANSWER Imiquimod
How long should a reproductive age female wait to get pregnant after receiving the varicella vaccine? - CORRECT ANSWER 3 months
Which ethnic group should be screened for Tay-Sach's disease during pregnancy? - CORRECT ANSWER Askenazi (european) Jews
Cryptorchidism increases the risk of: - CORRECT ANSWER testicular cancer
Which of these crosses the midline? Caput succedaneum or cephalohematoma - CORRECT ANSWER caput succedaneum
What does a strong Moro relfex in an infant >6 months indicate? - CORRECT ANSWER brain damage
What are the screening tests for degenerative hip dysplasia? - CORRECT ANSWER Ortolani and Barlow
How do you assess for coartication of the aorta? - CORRECT ANSWER compare radial and femoral pulses
How many doses of HPV vaccine are there? - CORRECT ANSWER 3
What is the youngest age a child can receive Gardasil? - CORRECT ANSWER 9
Physical presentation of fragile X syndrome: - CORRECT ANSWER long face with prominent forehead, jaw, and large ears. Large body with flat feet
How does an anorexic patient present? - CORRECT ANSWER lanugo, peripheral edema, amonorrhea, weight loss >10 % body weight
Most common cause of blindness in the US - CORRECT ANSWER macular degeneration
1st line treatment for essential tremors - CORRECT ANSWER beta blockers
What occurs at Kiesselbach's plexus? - CORRECT ANSWER Anterior nosebleed
What ligament is damaged in a positive anterior drawer test? - CORRECT ANSWER anterior cruciate ligament
What is tonus palatinus? - CORRECT ANSWER A chronic bony growth located midline in hard palate
Which drugs increase hyperbilirubinemia in the 3rd trimester? - CORRECT ANSWER Nitrofurantoin and sulfa drugs
Most common gynecological cancer - CORRECT ANSWER Uterine
Examples of gluten - CORRECT ANSWER wheat, rye, barley, oats
Examples of plant sterols and steols - CORRECT ANSWER wheat germ, sesame oil, corn oil, peanuts
Examples of monounsaturated fats - CORRECT ANSWER olive oil, canola oil, almonds, walnuts, sunflowers
Examples of foods with magnesium - CORRECT ANSWER almonds, peanuts, cashews, some beans, whole wheat
Example of foods with iron - CORRECT ANSWER liver, beef, black beans
Signs and symptoms of RMSF - CORRECT ANSWER petechiae rash on hands/feet, headache, myalgia, conjunctival injection, nausea/vomiting, arthralgia
Diagnostic screening for herpes keratitis - CORRECT ANSWER Fluorescein lamp
Signs of acute angle-closure glaucoma - CORRECT ANSWER Sudden onset of severe eye pain with headache, n/v, halos, decreased vision, cupping of the optic nerve
A maculopapular rash that is oval-shaped with herald patch (disease) - CORRECT ANSWER pityriosis rosea
Where is the best location to auscultate the S3 heart sound? - CORRECT ANSWER pulmonic area
Drugs that have a narrow therapeutic index - CORRECT ANSWER Warfarin, digoxin, lithium, levothyroxine, theophylline, tegretol, dilatin
What is the black box wearing of aldosterone antagonists? - CORRECT ANSWER increases benign and malignant tumors
When are beta blockers contraindicated? - CORRECT ANSWER asthma, COPD, chronic bronchitis, emphysema, bradycardia, and AV-block
What bacteria do 1st generation cephalosporins act on? - CORRECT ANSWER gram positive
What bacteria do 2nd generation cephalosporins act on? - CORRECT ANSWER gram negative and gram positive
What bacteria do 3rd generation cephalosporins act on? - CORRECT ANSWER Both gram positive and negative, however, poor gram positive coverage
What is 1st line treatment of MRSA? - CORRECT ANSWER Bactrim DS or clindamycin
Which abx should not be used with mono? - CORRECT ANSWER ampicillin or amoxicillin
What bacteria do sulfonamides act on? - CORRECT ANSWER gram negative
When is LAIV contraindicated? - CORRECT ANSWER Pregnancy, asthma, COPD, renal failure, DM, immunosuppression,
What is larger in the eyes-veins or arteries? - CORRECT ANSWER veins
What diagnostic tool is used to assess for fluid in the middle ear? - CORRECT ANSWER Tympanogram
Appearance of nasal turbinates in allergic rhinitis - CORRECT ANSWER Bluish, pale, boggy
Description of Koplik spots - CORRECT ANSWER small sized papules with blue-white center inside the cheek
What is a pinguecula? - CORRECT ANSWER A yellow-triangular thickening of the bulbar conjunctiva
What disease is a sandpaper-textured pink rash found in: - CORRECT ANSWER Scarlet fever
Description of basal cell carcinoma - CORRECT ANSWER pearly or waxy skin lesion with atrophic or ulcerated center that does not heal
What drug classes are higher risk for Steven Johnson's syndrome - CORRECT ANSWER dilantin, PCN, sulfas, barbituates
Is a thyroid cancer nodule hot or cold? - CORRECT ANSWER Cold
What is pheochromocytoma? - CORRECT ANSWER Random episodes of severe HTN assc with abrupt onset of severe headache, tachycardia, and anxiety
What hormone stimulates the ovaries to ovulate? - CORRECT ANSWER LH
Treatment of hyperthyroidism - CORRECT ANSWER Prophylthiouracil (PTU) or Methimazole (Tapazole) [Show Less]