AANP FNP Certification Exam Study Guide ACCURATE TESTED VERSIONS OF THE EXAM FROM 2023, Exams of Nursing

Download AANP FNP Certification Exam Study Guide ACCURATE TESTED VERSIONS OF THE EXAM FROM 2023 and more Exams Nursing in PDF only on Docsity!

AANP FNP Certification Exam Study Guide

ACCURATE TESTED VERSIONS OF THE

EXAM FROM 2023TO 2024 | ACCURATE

AND VERIFIED ANSWERS | NEXT GEN

FORMAT | GUARANTEED PASS WITH 150+

QUESTIONS

Awake state with abnormal motor, sensory, autonomic or psychic behavior Movement can affect any part of body Localized or generalized Onset 3-15 years

• Ans - Simple partial or focal seizure (Jacksonian) up to 24 hours
• Ans - How long can a TIA last

1. Ischemic stroke
2. Cerebral hemorrhage
3. Subarachnoid hemorrhage (in younger adults, 5% of all strokes are d/t carotid artery dissection) – Ans - Most common forms of stroke, in order CT or MR angiography

• Ans - imaging for stenosis or occlusion in brain-supplying vessels in stroke

Inflammation of medium- to large-sized vessels, iwth sections of normal artery in between.

• Typical patients are elderly (mean = 70yrs), female (2-3:1) and white
• Head pain (usu. unilateral), jaw claudication, scalp tenderness, impaired vision, fever and fatigue
• Physical exam may reveal decreased vision and scalp tenderness over affected artery. Pulseless vessel, can be tender or nodular OLDER patients: Often atypical presentation with respiratory tract sx or mental status change, rather than classic HA, jaw, vision changes.
• ESR typically >80mm/h; CRP typically >2.
• Definitive diagnosis is temporal artery biopsy
• Tx: prednisone 60-100mg PO qday
• Ans - Giant Cell Arteritis (Temporal Arteritis) Net-like cluster
• Ans - reticular ulcerative form of impetigo
• Ans - ecthyma H. influenzae
  • Ans - Bacteria most commonly associated with burn wound infection topical silver sulfadiazine
  • Ans - Burn wound infection ppx IgE mediated. 2 types: atopic and anaphylactic

• Ans - Type 1 hypersensitivity hyphae in nail scrapings on KOH slide
• Ans - confirm onychomycosis drug use alternating with abstinent periods
  • Ans - pulse tx for onychomycosis elderly and patients with Parkinsons
• Ans - In which patient demographic is seborrheic dermatitis often found? malignant melanoma
• Ans - Which type of skin cancer is least affected by sunscreen wearing? Recommended for skin tumors w/aggressive histologic patterns or invasive features thin layers of malignant tissue are removed, and each is examined under a microscope to check for adequate extent of the resection
  • Ans - Mohs micrographic surgery 1, 2, 4
• Ans - HPV strains associated with cutaneous nongenital warts Cellulitis - Strep pyogenes or Staph. aureus - flat border Erysipelas - Strep. pyogenes - sharply demarcated and raised edges
• Ans - Cellulitis vs. Erysipelas?

Created by MRSA (Methicillin-Resistant Stapphylococcus aureaus) which can kill leukocytes and cause severe necrotizing skin infection and hemorrhagic PNA

• Ans - Panton-Valentine Leukocidin There is often a dark or black center, which appears to people to be a bite
  • Ans - Why are CA-MRSA infections often attributed to spiders? erythema chronicum migrans, flu-like symptoms. Resolve in 3-4 weeks w/o tx
• Ans - Stage 1 Lyme Disease Several months after 1st stage. cardiac defects (heart block), Bells Palsy Classic rash reappears with multiple lesions + flu-like sx
• Ans - stage 2 lyme disease chronic monoarthritis and migratory polyarthritis neuropsychiatric sx w/ memory loss, depression or neuropathy
• Ans - Stage 3 Lyme disease

1. erythematotelangiectatic: central flushing w/burn + sting.
2. Papulopustular: central flushing w/papules + pustules. Usu. middle aged women
3. Phymatous: marked skin thickenings + nodularities, esp on nose
4. Ocular: blepharitis, conjunctivities, lid inflammation, telangiectasias

• Ans - 4 subtypes of rosacea adenovirus

• Ans - most common virus causing conjunctivitis malignancy risks are higher, osteomyelitis or mastoiditis
  • Ans - risks associated w/OE in patient with DM, HIV or chemotx myopia, cataract extraction, ocular trauma, FH or other eye hx, lattice degeneration, diabetic retinopathy
• Ans - Risk factors for retinal detachment AA, DM, family hx, eye trauma/uveitis history, advancing age
• Ans - risk factors for primary open-angle glaucoma q 1-2 years
• Ans - How frequently should patients at high r/o open-angle glaucoma be checked? Alterations in the ear:
• change in endolymphatic pressure
• breakage in the membrane separating the endolymph and perilymph fluids
• sudden change in vestibular nerve firing rate cause changes in hearing, vertigo, tinnitus and pressure sensation in ear
  • Ans - Meniere's pathophysiology aminoglycosides high-dose salicylate use chemo exposure to loud noise

• Ans - risk factors for Meniere's
• nystagmus or rhythmic oscillation toward affected ear
• Weber test lateralizes to UNaffected ear
• Rinne is normal
• decreased hearing
• Positive Romberg and Fukuda marching step
• Ans - Exam findings in menieres positive Dix-Hallpike: nystagmus while moving a patient from sitting to supine with the head angled at 45 degrees
• Ans - exam findings in BPV squamous cell carcinoma
  • Ans - Most common form of oral cancer G+ bacteria, enterobacteriae, proteus spp.
• Ans - Common pathogens causing OE less pain but more itch
• Ans - typical presentation of fungal OE typical respiratory viruses: RSV, flu, rhinovirus,
• Ans - Which viruses are implicated in AOM cefpodoxime
• Ans - reasonable cephalosporin alternative to amoxicillin for AOM

g - high rate of beta-lactamase production

• Ans - M. catarrhalis some resistance via production of beta-lactamase - Ans - H. influenzae M. catarhallis H. influenzae - Ans - Which pathogens become resistant by producing beta-lactamase? S. pneumoniae (can be overcome by high-dose amoxicillin) - Ans - Which pathogens become resistant d/t altered protein binding sites? ipsilateral anterior cervical chain enlarged and painful - Ans - Presentation of enlarged lymph nodes with AOM S. pyogenes - Ans - which pathogen causes rheumatic fever
• rheumatic fever: Abx tx helps minimize risk.
• glomerulonephritis: 1-3 weeks after original infection. Risk NOT minimized by abx tx.
• scarlet fever: sandpaper rash, usu. on 2nd day of illness. starts on trunk and spreads to arms & legs. - Ans - Possible complications of s. pyogenes pharyngitis 3 weeks - Ans - incubation period for m. pneumoniae 3 - 5 days - Ans - incubation period for s. pyogenes

orbital edema/cellulitis - Ans - possible life-threatening complication of ABRS S. pneumoniae - Ans - Most common causative organism in ABRS 30 - 50 days - Ans - incubation period for mono (EBV) 3 - 5 day prodrome flu-like sx w/o fever Acute sx 5-15 days: fatigue, pharyngitis, tonsillar enlargement, fever, HA, lymphadenopathy - Ans - presentation of mononucleosis No - the patient is more likely to have + test later in the illness but not always during the 1st 2- 3 weeks - Ans - Is the mono spot test always accurate Spleen is 1" x 3" x 5". weighs ~ 7 oz., is b/w ribs 9 & 11. - Ans - Rule of odds: spleen <140/ Use ACEi or ARB - Ans - JNC 8 goal for >18 with CKD 150 / 90 Goal: < 150/90 - Ans - JNC8 indication for starting HTN tx in otherwise healthy pop > or = 60 140/ Goal: <140/90 - Ans - JNC8 indication for starting HTN tx in otherwise healthy pop <60yo microalbuminuria (connection also with smoking) is not only an independent preductor doubling risk, but also increases risk associated with OTHER risk factors - Ans - Microalbuminuria (or GFR <60) and CV risk

mid systolic click with late systolic murmur - Ans - MVP murmur pectus excavatum, scoliosis or other thoracic abnormality - Ans - common physical findings with MVP Marfan syndrome - Ans - Risk factors for MVP Encourage a regular aerobic exercise routine but stress the importance of high levels of fluid intake! - Ans - MVP and exercise blood culture TEE can see vegitation - Ans - most helpful test for looking for bacterial endocarditis an inflammatory disease that occurs mainly in children and affects the heart valves and joints (it can follow after diseases such as strep throat and scarlet fever) - Ans - rheumatic fever (rheumatic heart disease) a cardiomyopathy of unknown cause, in which the left ventricle is hypertrophied and the cavity is small; it is marked by obstruction to left ventricular outflow. Autosomal-dominant inheritance - Ans - idiopathic hypertrophic subaortic stenosis (IHSS) Low pulse pressure - Ans - Unique characteristic of late aortic stenosis

• occurs more often in boys
• standing hx of excessive SOB w/activity
• usu. bicuspid valve or tricuspid w/fused leaflets - Ans - Aortic stenosis in children Grade 1-4 harsh crescendo-decrescendo systolic - Ans - AS murmur pattern

Aortic sclerosis. Asymptomatic Found in >50% of adults >50 - Ans - 50 over 50 murmur low pitched late diastolic, like thunder rumble Often with opening snap Enhanced by left lateral decubitus, squat, cough, Valsalva Almost always rheumatic in origian - Ans - mitral stenosis characteristics narrow split S2 + mitral regurgitation murmur - Ans - murmur of pulmonary HTN high-pitched blowing systolic like long "haaaaa" heard best at R lower scapular border Decreased with standing + valsalva found in ischemic heart disease and often there is also some degree of mitral stenosis - Ans - murmur of mitral regurgitation rupture of chordae usually occurs in presence of connective tissue dz - Ans - greatest threat with MVP painful nodules on finger and toe pads....seen in endocarditis caused by strep viridans - Ans - Osler's nodes those at highest risk, incl. w/ hx of infective endocarditis, with prosthetic valves or with congenital heart disease unrepaired or repaired with prosthetics or repaired with residual defects - Ans - who needs infective endocarditis ppx S4 - Ans - unstable angina cardiac finding

deep Q waves - Ans - ECG changes in pt with hx of transmural MI inverted T waves - Ans - ECG changes in presence of acute myocardial ischemia Umbrella term for STEMI, NSTEMI, unstable angina - Ans - acute coronary syndrome normal in 50% otherwise transient ST inversion or elevation, or T wave inversion - Ans - ECG finding in pt with unstable angina ECG stress testing CT for coronary artery calcification - Ans - Testing for unstable angina prodrome: unusual fatigue acute: SOB & weakness - Ans - Most common prodromal and acute symptoms of ACS in women L BBB - Ans - Which heart condition can mask acute STEMI? slightly depressed, cupped ST segment - Ans - ECG finding in digoxin pt AV heart block - Ans - ECG finding in dig toxicity anorexia - Ans - #1 dig toxicity sx horizontal opaque lines extending to the pulmonary periphery associated with pulmonary edema / HF - Ans - Kerley B lines

No functional limitations or symptoms with ordinary activity - Ans - NYHA Stage I Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in symptoms of HF - Ans - NYHA stage II Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity causes symptoms of HF. - Ans - NYHA Stage III Unable to carry on any physical activity without symptoms of HF, or symptoms of HF at rest - Ans - NYHA Stage IV At high risk for HF but without structural heart disease or symptoms of HF - Ans - ACCF/AHA Stage A Structural heart disease but without signs or symptoms of HF - Ans - ACCF/AHA Stage B Structural heart disease with prior or current symptoms of HF - Ans - ACCF/AHA Stage C Refractory HF requiring specialized interventions - Ans - ACCF/AHA Stage D min 5 L in adults - Ans - How much fluid needs to accumulate before peripheral edema will onset

1. reduction of preload
2. reduction of Peripheral vascular resistance
3. inhibition of renin / sympathetic NS - Ans - Goal of HF tx CT scan - Ans - Best imaging for suspected appendiceal rupture, or appendicitis

transitional cell intermediate in development between a myelocyte and a mature granular leukocyte. Its presence with severe bacterial infection is ominous - Ans - Metamyelocyte rebound tenderness - Ans - Blumberg's sign depends on anatomical positioning of appendix; can be in epigastrum, flank, or groin as well as typical abdominal sites - Ans - presentation of pain in appendicits defined as absolute neutrophil count of >7000/mm3 - Ans - neutrophilia ~ 4% - Ans - What percent of WBCs are usually bands pancreatitis sepsis - Ans - most common complication of cholecystitis inflammation of the gallbladder; usually associated with gallstones - Ans - cholecystitis Referred pain to right shoulder and back with biliary colic / Cholelithiasis - Ans - Collins sign biliary colic w/ Collins sign RUQ or epigastric pain & tenderness N/V

• Murphy's sign 25% jaundice leukocytosis >12, elevated hepatic enzymes - Ans - Common signs of cholelithiasis/cholecystitis

more sensitive and specific at revealing obstructed cystic duct - Ans - benefits of HIDA scan conservative: clear liquid diet + analgesia abx possible cholecystectomy should be considered - Ans - tx for acute cholecystitis none - Ans - most common symptoms in colon cancer 2 samples from 3 consecutive specimens - Ans - recommended home testing for colon cancer screen q5y:

• flexible sigmoidoscopy
• double contrast barium enema
• CT colonography - Ans - alternative screening tests to annual colonoscopy L side abdominal cramping increased flatus alternating constipation / diarrhea - Ans - common sx of diverticulosis CT scan - Ans - typical diagnostic modality for diverticulitis 2 - Ans - resting stomach normal pH g- spiral-shaped w/ sheathed flagella - Ans - describe h.pylori

no - Ans - are coffee drinking and occasional ETOH use risk factors for PUD? stool antigen testing. Pt should d/c PPI for 2 weeks before h.pylori testing! - Ans - most cost-effective means of testing for h.pylori endoscopy w/ biopsy and urease testing of biopsied sample - Ans - gold standard for h.pylori testing upper endoscopy Perform upper endoscopy for all adults >50yo who present with new onset sx, to r/o gastric cancer - Ans - what imaging should be performed when suspect ulcer but not sure of location awakening at 1-2am w/symptoms - Ans - unique duodenal ulcer sx junction of esophagus and stomach - Ans - where is esophageal adenocarcinoma usually located upper esophagus - Ans - where is esophageal squamous cell cancer usually located dysphagia odynophagia GI bleed unexplained weight loss persistent chest pain Fe-deficient anemia - Ans - red flag sx with GERD

bypass, NOT restrictive - Ans - best bariatric surgery for pts with GERD painful, ineffective defecation - Ans - tenesmus area with little or no radionuclide concentration - Ans - cold spot goiter w/ nodules , neck pain, tightness - Ans - Hashimoto's goiter diffuse thyroid enlargement, hot gland with heterogenous uptake - Ans - Graves' goiter

1. With clinical ASCVD
2. Without ASCVD but with LDL >
3. Diabetic aged 40-75, LDL 70- 189
4. Non-diabetic, LDL 70-189, ASCVD risk 7.5% or higher - Ans - Statin intensity therapy groups 75 or younger: high-intensity statin if a candidate

75: mod intensity statin - Ans - Statin tx for tx group 1 High-intensity, if a candidate - Ans - Statin tx for tx group 2 (LDL >190) moderate intensity. If ASCVD risk > 7.5%, high-intensity - Ans - Statin tx for tx group 3 (age 40-75, DM + LDL 70-189) moderate to high intensity statin - Ans - Statin tx for tx group 4 (Aged 40-75, ASCVD risk >7.5%) e.g. cortisol

• maintain glucose control

• suppress the immune response
• help the body's stress response - Ans - role of glucocorticoids e.g. aldosterone
• regulate Na and K balance - Ans - role of mineralocortioids Na+, K+ out of balance low cortisol levels check ACTH levels, results will depend on etiology - Ans - lab abnormalities with addisons DISEASE = caused specifically by the pituitary increased ACTH secretion Syndrome = s/sx related to incr cortisol. - Ans - Cushing's syndrome vs. Cushing's disease ~ 28 days - Ans - HAV avg incubation time allergy to Baker's yeast - Ans - HBV vaccine c/i

50% - Ans - What percent of HCV patients develop chronic hep c? tumor of the liver. Monitor HBV and HCV patients retularly for alpha-fetoprotein to monitor for

tumor - Ans - hepatoma Significantly elevated AST and ALT - Ans - Hep A lab values nausea, anorexia, fever, malaise, abdom pain, jaundice. My include clay colored stools, dark urine, and joint pain. Aversion to smoke often reported.

Skin rash occasional - Ans - acute hepatitis presentation IgM and IgG - Ans - Test to confirm HAV <40yo: vaccine

40yo: IG within 2 weeks of exposure - Ans - post-exposure ppx for HAV <10 - Ans - At what level of HBsAb should a booster dose be administered? presence of anti-HCV, an antibody that persists in the presence of HCV but is not protective, is diagnostic Viral load is elevated in acute infection - Ans - Dx of HCV leukopenia w/ lymphocytosis, w/ atypical lymphocytes. Bilirubin in the urine Elevated hepatic enzymes - Ans - Lab findings common to all forms of viral hepatitis 8 - 38 units/L

• enzyme found mainly in heart muscle and liver, moderate amounts found; skeletal muscles, kidneys, pancreas
• Rises with cellular injury, liver injury (hepatitis, necrosis), pancreatitis, musculoskeletal trauma May be slightly increased with statin use Elevates quickly and clears quickly (12-24h) after liver injury, more quickly than ALT - Ans - AST (aspartate aminotransferase) Elevated AST Normal ALT Mild macrocytosis - Ans - Likely lab values for long-term alcohol abuse

More specific to the liver Longer 1/2t than AST (37-57h) Most likely to be elevated with hepatitis, less likely to be elevated with ETOH abuse - Ans - ALT total bilirubin >2.5mg - Ans - Clinical jaundice levels Conjugated (direct) is loosely bound to albumin and therefore water soluble. When present in excess, it is excreted in urine...therefore DARK URINE IS ONLY SEEN WITH CONJUGATED BILIRUBIN! Unconjugated bilirubin is tightly bound to albumin and therefore not water soluble. It cannot be excreted in urine even fi blood levels are high; it is toxic - the unbound form can cross the BBB and cause neurologic deficits The liver turns unconjugated bili into conjugated bili - Ans - Conjugated vs unconjugated bilirubin biliary tract disease (incl gallstones) excessive ETOH use elevated triglyceride levels idiopathic causes - Ans - most common risks for pancreatitis abdom pain, weight loss, anorexia, N/V Pain worse with walking and lying supine, improved w/sitting and leaning forward weakness, sweating, anxiety if severe. Fever, tachycardia, hypotension, pallor, cool, clammy skin and/or mild jaundice Acute renal failure often seen - Ans - Typical presentation of pancreatitis Amylase and lipase are 3x ULN

Gut perforation and infarction have been ruled out CT scan confirms - Ans - pancreatitis dx, clinched Minimum 2 of 3:

• severe abdominal pain
• amylase and/or lipase 3x ULN
• characteristic abdominal imaging (CT) - Ans - Criteria for dx of pancreatitis Ranson criteria: Looks at age, lab values, + series of changes which if occur w/in 1st 48 hours are indicative of a worsening prognosis.

4 points indicates higher mortality rate - Ans - Scale used to determine severity of pancreatitis Anemia of chronic dz Elevated total bilirubin Elevated Alk phos Uncommon: elevation in amylase unless pancreatitis also present - Ans - Typical presentation of pancreatic CA In pancreatitis: Amylase rises first, decreases w/in 7 days of resolution Lipase appears 4-8h after sx, peaks @ 24h, decreases w/in 14 days of resolution - Ans - amylase vs lipase

• renal failure
• perforated duodenal ulcer
• bowel obstruction
• bowel infarction - Ans - nonpancreatic causes of elevated lipase

• salivary glands
• ovarian cysts
• ovarian tumors
• tubo-ovarian abscess
• ruptured ectopic
• lung CA - Ans - nonpancreatic causes of elevated amylase no median sulcus enlarged size rubbery sensation of incomplete emptying - Ans - BPH prostate exam
• urinary flow test
• postvoid residual volume
• transrectal US
• prostate biopsy Always r/o UTI w/ UA and culture, and r/o prostate CA - Ans - Tests available to confirm that enlarged prostate is causing sx Obstruction of ureters causing backpressure in glomerulus which decreases GFR. (decreased GFR means azotemia and oliguria) Urea nitrogen & Cr elevation, retention and outflow tract obstruction - Ans - postrenal azotemia Due to decreased blood flow to kidneys; common cause of acute renal failure. Findings will include elevated BUN and Cr - Ans - prerenal azotemia

Hemophylis ducrei - Ans - pathogen causing chancroid Painful, soft ulcer w/ necrotic base Dense, matted lymphadenopathy on ipsilateral side of lesion Affected nodes often rupture - Ans - Findings in chancroid an infection of the lymphatic system caused by three strains of the bacterium Chlamydia trachomatis, transmitted sexually. Sx appear 1-4 weeks after infection Vesicular or ulcerative lesion on external genitalia, painless progresses to cause inguinal lymphadenitis or buboes, which can fuse and drain causing multiple sinus tracts - Ans - Lymphogranuloma venereum (LGV) <35yo: usu. G&C. Tx w/ IM Rocephin + PO doxycycline

35yo: usu. g- organism, 2ndary to prostatitis. Tx w/ ciprofloxin and obtain culture MSM: usu. enteric organism. Tx w/levofloxacin - Ans - acute epididymitis causes & tx g- diplococci, n. gonorrhoeae produces beta-lactamase - Ans - gonorrhea pathogen fluoroquinolones, d/t resistnce - Ans - Which med should NOT be used for gonorrhea Azithromycin 2g PO + PO gemifloxacin single dose - Ans - alternative tx to gonorrhea urine culture - Ans - Best dx test to identify pathogen in bacterial prostatitis

gram - rods - Ans - Most common pathogens in bacterial prostatitis

10 - Ans - Concerning levels of PSA < 4 in older men < 2.5 in younger men - Ans - PSA norms Average risk: Discuss @ 50yo High risk: Discuss @ 45yo Very high risk (multiple 1st degree relatives): Discuss @ 40yo - Ans - Screening recommendations for PSA/prostate CA If PSA is <2.5: q2y If PSA is >2.5: q1y - Ans - PSA rescreening protocol fixation of the testes in the scrotum - Ans - orchiopexy Surgical repair- option-Left spermatic vein ligation-Performed if the varicocele is painful or causing infertility-Open surgery W/o surgery, scrotal support can be helpful w/ discomfort - Ans - Tx of variocele a characteristic soft, gummy lesion caused by bacteria that invade organs throughout the body; found in the tertiary stage of syphilis Other sx of tertiary syphilis: aortic insufficiency or aneurysm, seizures - Ans - Gumma 16 & 18 - Ans - HPV strains causing anorectal carcinoma

6 & 11 - Ans - HPV strains causing condyloma acuminatum Positive virological test, negative serological = primary infection Positive both = recurrent infection - Ans - Lab tsting for HSV- 2 Any condition that causes nerve injury or impairs blood flow, e.g. DM, kidney disease, chronic ETOH use, vascular dz, tobacco use, neuropathy, urological surgery

• Ans - Conditions which can cause ED in men Ab/Ag test (window period 2-6 weeks post-infection) - Ans - Which HIV dx test is recommended for a patient who is less likely to return for testing Intact hepatic function: long 1/2T: chlordiazepoxide, diazepam Hepatic dysfunction: short 1/2T: lorazepam, oxazepam Alternative to benzos: carbamazepine Start w/ high dose long acting, taper down by 5mg daily - Ans - Specifics on benzo use for ETOH withdrawal
• B vitamins: thiamine, pyridoxine, folic acid, B12
• Vitamin C
• Mg - Ans - typical nutritional deficiencies in ETOH abuse
• elevated AST
• normal or slightly elevated ALT
• mild macrocytosis - Ans - Which lab values lead us to suspect long-standing ETOH abuse?

Likely only mildly, unless liver damage is presetn - Ans - Will ALT increase w/ ETOH abuse? ~ 3 months - Ans - How long does it take for labs to return to normal after ETOH sobriety? modify the intoxicating effects of ETOH - Ans - naltrexone MOA ETOH abuse reduce alcohol craving - Ans - acamprosate MOA ETOH abuse induce unpleasant effects if ETOH is ingested - Ans - disulfiram MOA ETOH abuse cerebral and coronary - Ans - which vessels does cocaine preferentially constrict Interferes w/ regulation of body temp. Can lead to hyperthermia, organ damage and death - Ans

• Effects of MDMA in high doses Weight reduction, muscle wasting Abdominal distension with hepatomegaly Oral and gum disease Coarse dry skin Hypotension, bradycardia, hypothermia Cheilosis - Ans - Clinical manifestations of anorexia nervosa bursal aspiration - Ans - 1st line tx for prepatellar bursitis no it is usually normal ROM - Ans - with bursitis is ROM usually abnormal? NSAIDs, rest, ice, eliminating the offending activity.