AANP review QUESTIONS AND ANSWERS 100% CORRECT
Classic ECG finding in atrial flutter. Correct Answer: "Sawtooth" P waves
Definition of unstable
... [Show More] angina. Correct Answer: Angina is new, is worsening, or occurs at rest
Antihypertensive for a diabetic patient with proteinuria. Correct Answer: ACEI
Beck's triad for cardiac tamponade. Correct Answer: Hypotension, distant heart sounds, and JVD
Drugs that slow AV node transmission. Correct Answer: β-blockers, digoxin, calcium channel blockers
Hypercholesterolemia treatment that → flushing and pruritus. Correct Answer: Niacin
Treatment for atrial fibrillation. Correct Answer: Anticoagulation, rate control, cardioversion
Treatment for ventricular fibrillation. Correct Answer: Immediate cardioversion
Autoimmune complication occurring 2-4 weeks post-MI. Correct Answer: Dressler's syndrome: fever, pericarditis, ↑ ESR
Diagnostic test for hypertrophic cardiomyopathy. Correct Answer: Echocardiogram (showing thickened left ventricular wall and outflow obstruction)
A fall in systolic BP of > 10 mmHg with inspiration. Correct Answer: Pulsus paradoxus (seen in cardiac tamponade)
Classic ECG findings in pericarditis. Correct Answer: Low-voltage, diffuse ST-segment elevation
Definition of hypertension. Correct Answer: BP > 140/90 on three separate occasions two weeks apart
Eight surgically correctable causes of hypertension. Correct Answer: Renal artery stenosis, coarctation of the aorta, pheochromocytoma, Conn's syndrome, Cushing's syndrome, unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism
Evaluation of a pulsatile abdominal mass and bruit. Correct Answer: Abdominal ultrasound and CT
Indications for surgical repair of abdominal aortic aneurysm. Correct Answer: > 5.5 cm, rapidly enlarging, symptomatic, or ruptured
Treatment for acute coronary syndrome. Correct Answer: Morphine, O2, sublingual nitroglycerin, ASA, IV β-blockers, heparin
What is the metabolic syndrome? Correct Answer: Abdominal obesity, high triglycerides, low HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states
Appropriate diagnostic test?
■ A 50-year-old male with angina can exercise to 85% of maximum predicted heart rate. Correct Answer: Exercise stress treadmill with ECG
Appropriate diagnostic test?
■ A 65-year-old woman with left bundle branch block and severe osteoarthritis has unstable angina. Correct Answer: Pharmacologic stress test (e.g., dobutamine echo)
Signs of active ischemia during stress testing. Correct Answer: -Angina
-ST-segment changes on ECG
-↓ BP
ECG findings suggesting MI. Correct Answer: -ST-segment elev (depression = ischemia), -flattened T waves
-Q waves
A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are normal. Correct Answer: Prinzmetal's angina
The diagnostic test for pulmonary embolism. Correct Answer: V/Q scan
An agent that reverses the effects of heparin. Correct Answer: Protamine
The coagulation parameter affected by warfarin. Correct Answer: PT
A young patient with a family history of sudden death collapses and dies while exercising. Correct Answer: Hypertrophic cardiomyopathy
Endocarditis prophylaxis regimens. Correct Answer: -Oral surgery—amoxicillin;
-GI or GU procedures—ampicillin and gentamicin before and amoxicillin after
The 6 P's of ischemia due to peripheral vascular disease. Correct Answer: Pain, pallor, pulselessness, paralysis, paresthesia, poikilothermia
Virchow's triad. Correct Answer: Stasis, hypercoagulability, endothelial damage
The most common cause of hypertension in young women. Correct Answer: OCPs
The most common cause of hypertension in young men. Correct Answer: Excessive EtOH
"Stuck-on" appearance. Correct Answer: Seborrheic keratosis
Red plaques with silvery-white scales and sharp margins. Correct Answer: Psoriasis
The most common type of skin cancer; the lesion is a pearly-colored papule with a translucent surface and telangiectasias. Correct Answer: Basal cell carcinoma
Honey-crusted lesions. Correct Answer: Impetigo
A febrile patient with a history of diabetes presents with a red, swollen, painful lower extremity. Correct Answer: Cellulitis
A 55-year-old obese patient presents with dirty, velvety patches on the back of the neck. Correct Answer: Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Dermatomal distribution. Correct Answer: Varicella zoster
Flat-topped papules. Correct Answer: Lichen planus
Iris-like target lesions. Correct Answer: Erythema multiforme
A lesion characteristically occurring in a linear pattern in areas where skin comes into contact with clothing or jewelry. Correct Answer: Contact dermatitis
Presents with a herald patch, Christmas-tree pattern. Correct Answer: Pityriasis rosea
A 16-year-old presents with an annular patch of alopecia with broken-off, stubby hairs. Correct Answer: Alopecia areata (autoimmune process)
Pinkish, scaling, flat lesions on the chest and back. KOH prep has a "spaghetti-and-meatballs" appearance. Correct Answer: Pityriasis versicolor
Four characteristics of a nevus suggestive of melanoma. Correct Answer: Asymmetry, border irregularity, color variation, large diameter
Premalignant lesion from sun exposure that can → squamous cell carcinoma. Correct Answer: Actinic keratosis
"Dewdrop on a rose petal." Correct Answer: Lesions of 1° varicella
"Cradle cap." Correct Answer: Seborrheic dermatitis. Treat with antifungals
Associated with Propionibacterium acnes and changes in androgen levels. Correct Answer: Acne vulgaris
A painful, recurrent vesicular eruption of mucocutaneous surfaces. Correct Answer: Herpes simplex
Inflammation and epithelial thinning of the anogenital area, predominantly in postmenopausal women. Correct Answer: Lichen sclerosus
nodular
opaque
sun-exposed area
ulcerating
non-distinct borders
*associated with a risk of metastasis* Correct Answer: Squamous cell carcinoma
The most common cause of hypothyroidism. Correct Answer: Hashimoto's thyroiditis
Lab findings in Hashimoto's thyroiditis. Correct Answer: High TSH, low T4, antimicrosomal antibodies
Exophthalmos, pretibial myxedema, and ↓ TSH. Correct Answer: Graves' disease
The most common cause of Cushing's syndrome. Correct Answer: Iatrogenic steroid administration. The second most common cause is Cushing's disease
A patient presents with signs of hypocalcemia, high phosphorus, and low PTH. Correct Answer: Hypoparathyroidism
"Stones, bones, groans, psychiatric overtones." Correct Answer: Signs and symptoms of hypercalcemia
A patient complains of headache, weakness, and polyuria; exam reveals hypertension and tetany. Labs reveals hypernatremia, hypokalemia, and metabolic alkalosis. Correct Answer: 1° hyperaldosteronism (due to Conn's syndrome or bilateral adrenal hyperplasia)
A patient presents with tachycardia, wild swings in BP, headache, diaphoresis, altered mental status, and a sense of panic. Correct Answer: Pheochromocytoma
Should α- or β-antagonists be used first in treating pheochromocytoma? Correct Answer: α-antagonists (phentolamine and phenoxybenzamine)
A patient with a history of lithium use presents with copious amounts of dilute urine. Correct Answer: Nephrogenic diabetes insipidus (DI)
An antidiabetic agent associated with lactic acidosis. Correct Answer: Metformin
A patient presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment? Correct Answer: 1° adrenal insufficiency (Addison's disease). Treat with replacement glucocorticoids, mineralocorticoids, and IV fluids
Goal hemoglobin A1c for a patient with DM. Correct Answer: < 7.0
Treatment of DKA. Correct Answer: Fluids, insulin, and aggressive replacement of electrolytes (e.g., K+)
Why are β-blockers contraindicated in diabetics? Correct Answer: They can mask symptoms of hypoglycemia
Sensitive tests have few false negatives and are used to rule _____ a disease. Correct Answer: Out
PPD reactivity is used as a screening test because most people with TB (except those who are anergic) will have a +PPD. Highly sensitive or specific? Correct Answer: Highly sensitive for TB
Describe a test that consistently gives identical results, but the results are wrong. Correct Answer: High reliability, low validity
indications for early colorectal cancer screening? Correct Answer: -IBD
-familial adenomatous polyposis (FAP)/hereditary nonpolyposis colorectal cancer (HNPCC)
-first-degree relatives with adenomatous polyps (< 60 years of age) or colorectal cancer [Show Less]