AANP-FNP exam 81 Questions with Answers
Hegar's sign - CORRECT ANSWER Softening of lower uterine segment
Chadwick's sign - CORRECT ANSWER Bluish
... [Show More] color of cervix and vagina at 6-8 weeks
Goodell's sign - CORRECT ANSWER Softening of cervix at 4+ weeks
Lipids in chronic inactivity - CORRECT ANSWER Low HDL
Lipids in under- or untreated hypothyroidism - CORRECT ANSWER Elevated total cholesterol, TG, and LDL
Lipids in chronic renal insufficiency - CORRECT ANSWER Elevated total cholesterol and TG
Lipids in alcohol abuse - CORRECT ANSWER Elevated TG, HDL, and LDL
Vaccines with live attenuated viruses - CORRECT ANSWER MMR, varicella, flu-mist(intranasal), Zostavax
Drugs of choice for abdominal infection - CORRECT ANSWER Beta lactams + metronidazole (most common); fluoroquinolones
Drugs of choice for urinary tract infection - CORRECT ANSWER Fluoroquinolones (except moxi), TMP-SMX, fluconazole, b-lactams, nitrofurantoin, fosfomycin if pt has many allergies
Drugs of choice for pulmonary infections - CORRECT ANSWER Macrolides, resp fluoroquinolones, b-lactams, doxycycline (MRSA, atypical coverage)
Drugs of choice for skin and soft tissue infections - CORRECT ANSWER MRSA: TMP-SMZ, doxycycline, clindamycin; b-lactams
Drugs of choice for MRSA - CORRECT ANSWER Vancomycin, daptomycin , linezolid, TMP-SMZ, doxycycline, ceftaroline
Macrolide drugs - CORRECT ANSWER Erythromycin, clarithromycin, azithromycin
Macrolide AEs - CORRECT ANSWER GI, QT prolongation
Tetracycline uses - CORRECT ANSWER MRSA, rocky mtn spotted fever, atypicals (mycoplasma pneumonia, chlamydia), spirochetes (Lyme), h.pylori
Tetracycline AEs - CORRECT ANSWER GI, teeth, hepatic dysfunction, photosensitivity
Fluoroquinolone drugs - CORRECT ANSWER Ciprofloxacin, levofloxacin, moxifloxacin
Fluoroquinolone uses - CORRECT ANSWER UTI (cipro or levo), atypicals (mycoplasma, legionella)
Fluoroquinolones and dairy or vitamins - CORRECT ANSWER Take 2 hrs before or 4 hours after (decrease concentrations)
Metronidazole (Flagyl) uses - CORRECT ANSWER C. Diff, vaginitis
Metronidazole AEs - CORRECT ANSWER GI, peripheral neuropathy, disulfiram reaction
Nitrofurantoin uses - CORRECT ANSWER UTI -not pyelonephritis due to no systemic absorption
Nitrofurantoin AEs, contraindications - CORRECT ANSWER Pulmonary fibrosis, contraindicated in CrCl <60 (excludes many elderly)
Aminoglycoside drugs - CORRECT ANSWER Gentamycin, tobramycin
Aminoglycoside uses - CORRECT ANSWER Atypical coverage, resistant infections, tobramycin for CF only
Aminoglycoside AEs - CORRECT ANSWER Ototoxicity (irreversible), nephrotoxicity (reversible)
Aminoglycoside monitoring - CORRECT ANSWER Renal dose adjust, hearing test, drug level monitoring
Antifungals (azoles) - CORRECT ANSWER Fluconazole, itraconazole
Itraconazole interactions - CORRECT ANSWER Acid suppressive therapies
Fluconazole dose adjust - CORRECT ANSWER Renal
Antifungal AEs - CORRECT ANSWER GI, QTc prolongation (fluconazole)
Antifungal drug interactions - CORRECT ANSWER QT prolongation meds, warfarin
Anti-infectives not for pregnant - CORRECT ANSWER Tetracyclines, TMP-SMZ
TMP-SMZ coverage - CORRECT ANSWER G+, G-, MRSA, Protozoa (toxoplasma gondii), fungus (pneumocystis jirovecii), poor anaerobic activity
TMP-SMZ AEs - CORRECT ANSWER Sulfa allergy, photosensitivity, hematologic (anemia, leukopenia, thrombocytopenia)
TMP-SMZ on renal function - CORRECT ANSWER Dose adjust in renal impairment, false elevation in serum Cr
TMP-SMZ drug interactions - CORRECT ANSWER Warfarin
Gram + only coverage - CORRECT ANSWER Clindamycin, linezolid, vancomycin, daptomycin
Gram - only - CORRECT ANSWER Monobactams (aztreonam), penicillin VK
Gram +/- - CORRECT ANSWER PCN (aminopcn, ext. spectrum), carbapenams, aminoglycosides, TMP-SMZ, fluoroquinolones, fosfomycin
Head growth in first year of life - CORRECT ANSWER Total 12cm
Head growth 0-3mo - CORRECT ANSWER 6cm
Head growth 4-6mo - CORRECT ANSWER 3cm
Head growth 6-12mo - CORRECT ANSWER 3cm
Head growth 2-7yo - CORRECT ANSWER 0.5cm/yr
Head growth 8-12yo - CORRECT ANSWER 0.3cm/yr
Tumor grading: T0 - CORRECT ANSWER No evidence of primary tumor
Tumor grading: T1 - CORRECT ANSWER 2 cm or less in greatest dimension
Tumor grading: T2 - CORRECT ANSWER >2-5cm
Tumor grading: T3 - CORRECT ANSWER >5cm
Chvostek sign - CORRECT ANSWER Hypocalcemia, spasm when tap facial nerve
Trousseau sign - CORRECT ANSWER Hypocalcemia, spasm when compress brachial artery w/ BP cuff
Myocardial ischemia EKG changes - CORRECT ANSWER Inverted T wave, T wave depression
Myocardial injury EKG changes, - CORRECT ANSWER ST segment elevation, tall peaked t wave
Myocardial infarction EKG changes - CORRECT ANSWER Q wave
1st gen antihistamines - CORRECT ANSWER Diphenhydramine, chlorpheniramine
2nd gen antihistamines - CORRECT ANSWER Loratadine, desloratadine, cetirizine, fexofenadine, levocetirazine
Ishihara chart - CORRECT ANSWER Test for color blindness
Scarlet fever presentation - CORRECT ANSWER Sandpaper-like rash, exudative pharyngitis, localized anterior cervical lymphadenopathy, rash 2 days after pharyngitis then peels later
Roseola (HHV-6) presentation - CORRECT ANSWER Rash lasts hours to 3 days, follows 3-7 day high fever, sometimes febrile seizures, tx supportive
Rubella (German measles, rubella virus) - CORRECT ANSWER Mild sx, posterior and postauricular cervical lymphadenopathy, arthralgia 5-10 days before rash, teratogenic, contagious 1 week before and 2 weeks after rash
Measles (rubeola) - CORRECT ANSWER Acute presentation, generalized lymphadenopathy, photophobia, koplik spots, pharyngitis mild w/o exudate, rash 3-4 days after sx, contagious 1 wk before and 2-3 weeks after rash, permanent neuro impairment and/or death possible, tx supportive
Hand foot mouth dz (coxsackievirus a16) - CORRECT ANSWER Fever, malaise, sore mouth, anorexia, lesions, fecal-oral or droplet, highly contagious 2-6 wks, tx supportive
Fifth disease (human parvovirus b19) - CORRECT ANSWER Rash starts on face (slapped cheek) spreads to trunk, extremities, contagious before rash but not during or after. Droplet. Leukopenia. Hydrops fetalis in pregnant. Tx supportive.
Infectious mononucleosis (Epstein-Barr) - CORRECT ANSWER Diffuse lymphadenopathy, hepatic and splenic tenderness/ enlargement, incubation 20-50 days, systemic corticosteroids if resp distress from swollen airway, monospot/leukopenia w/ atypical lymphocytes diagnostic. Avoid contact sports at least one month.
Kawasaki disease - CORRECT ANSWER Acute phase: fever >= 104 >= 5 days, polymorphous exanthem on trunk/flexor region/perineum, erythema of oral cavity (strawberry tongue), chapped lips, bilateral conjunctivitis w/o discharge, edema/erythema of hands and feet w peeling skin. Children 1-8yr. Tx IV immunoglobulin, pop aspirin, consult
Lyme stage 1 (early localized disease) - CORRECT ANSWER Mild flu-like illness, singular annular lesion (erythema migrans), sx resolve 3-4 wks w/o tx
Lyme stage 2 (early disseminated) - CORRECT ANSWER Months after initial infx, classic rash may reappear w/ multiple lesions. Arthralgias, myalgia, HA, fatigue. Less common: heart block, neuro findings (Bell's palsy)
Lyme stage 3 (late persistent) - CORRECT ANSWER 1 year after initial infection, msk s/s persist w/ joint pain, frank arthritis, joint damage. Neuropsychiatric findings - memory problems, depression, neuropathy.
Lyme organism - CORRECT ANSWER B. burgdorferri (tick-transmitted spirochete)
Lyme testing - CORRECT ANSWER ELISA confirmed with western blot
Lyme tx - CORRECT ANSWER Doxycycline (children >8yo), amoxicillin, cefuroxime - adults and children
Chancroid tx - CORRECT ANSWER Azithromycin or ceftriaxone, alt. ciprofloxacin or erythromycin
Genital herpes (HSV 2) tx - CORRECT ANSWER Acyclovir
Lymphogranuloma vereneum (c. trachomatis) tx - CORRECT ANSWER Doxycycline, or erythromycin
Nongonococcal urethritis/cervicitis (c. Trachomatis) tx - CORRECT ANSWER Azithromycin or doxycycline
Gonococcal urethritis/cervicitis tx - CORRECT ANSWER Cefixime or ceftriaxone, add azithromycin or doxy if chlamydia not ruled out
Bacterial vaginosis tx - CORRECT ANSWER Metronidazole
Pelvic inflammatory disease tx - CORRECT ANSWER Ceftriaxone+doxycycline +/- metronidazole
Trichomoniasis tx - CORRECT ANSWER Metronidazole [Show Less]