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AANP Board Questions &Answers
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INR values below ____ increase stroke risk sixfold. - ANSWER What allergy contradicts the use of thiazide diuretics? - ANSWERSulfa Why should ACE-Is be avoided with renal stenosis? - ANSWERLeads to ARF Adverse effects of aldosterone antagonists (Aldactone) - ANSWERGalactorrhea and hyperkalemia What are beta blocker indications? - ANSWERHTN, post-MI< angina, arrhythmias, migraine prophylaxis, hyperthyroidism 1st line BP med for DM? - ANSWERACE or ARB Grapefruit juice should be avoided in what 1st line antihypertensive medication? - ANSWERCCB Alternative antibiotic treatment for patients with gram positive baterial infections that are allergic to PCN: - ANSWERmacrolides Initial treatment of COPD - ANSWERIpratropium bromide (anticholinergic) 1st line treatment for gonorrheal infections - ANSWERRocephin IM Treatment of anthrax - ANSWERCipro 500mg BID 7-10 days Treatment of traveler's diarrhea - ANSWERCipro 500mg BID 3 days What can increase the risk of tendon rupture when on a quinolone? - ANSWERage and steroids How long does ASA suppress platelet function? - ANSWERup to 7 days What is the FDA category and dose of finasteride? - ANSWER5mg PO QD and category X What drug category should not be given with warfarin? - ANSWERsulfa drugs When should routine screening for breast cancer start? - ANSWER
If a patient had only one dose of the hep B vaccine what is recommended? - ANSWERDo not restart series; Start with 2nd dose What is done if a patient has a tetanus-prone wound and an unknown vaccination status? - ANSWERAdminister immediate dose of Td and the teatnus immunoglobulin injection If a person is vaccinated with pneumovax prior to 65 what is recommended? - ANSWERGive a booster dose of pneumovax 5 years after initial dose When should Zostavax be given? - ANSWERage 60 How far apart should the varicella vaccines be given? - ANSWER4 weeks Treatment for otitis externa - ANSWERCortisporin otic drops Common bacterial pathogen of otitis externa - ANSWERPseudomonas What is cholesteatoma a complication of? - ANSWERperiorbital sinusitis What indicates an abnormal Rinne test? - ANSWERBC>AC What kind of hearing loss is found with an abnormal Rinne if BC>AC? - ANSWERconductive What kind of hearing loss is associated with lateralization to affected ear when Weber test is performed - ANSWERConductive What kind of hearing loss is associated with lateralization to unaffected ear when Weber test is performed - ANSWERsensorurial What does 20/40 vision mean? - ANSWERA person can see 20 ft whereas normal vision can see 40 Common treatment of cerumenosis - ANSWERCarbamide peroxide What route should HIV esophageal candida infections - ANSWEROral systemic Where is a scabies rash located? - ANSWERInterdigital webs and/or penis Antibiotic treatment for human, dog, or cat bite - ANSWERAugmentin A herald patch or "Christmas tree" pattern is associated with what disease? - ANSWERPItyriasis rosea What class of meds are used to treat PHN? - ANSWERTCAs
Should you lower a markedly high triglyceride level or cholesterol first? - ANSWERTriglycerides Criteria for metabolic syndrome: - ANSWERAbdominal obesity, HTN, hyperlipidemia, high triglycerides, high fasting glucose What are characteristics of fatty liver disease? - ANSWERMild elevation of ALT & AST not associated with alocohol, meds, or viral hep in overweight patients What is used to calculate PEF? - ANSWERHeight, age, gender (HAG) When treating a COPD patient with antibiotics what organism (s) must the antibiotic cover? - ANSWERH. influenzae (gram negative) No. 1 bacterium in CAP - ANSWERStrep pneumo No. 1 atypical pneumonia - ANSWERMycoplasma pneumoniae At what mm is a PPD considered positive with no risk factors? - ANSWER15mm At what mm is a PPD considered positive in HIV? - ANSWER5mm What class of medications is 1st line treatment for asthma prevention? - ANSWERInhaled corticosteroids 1st line treatment for severe asthmatic exacerbation - ANSWERadrenaline injection Why should patients have annual eye exams when on long-term steroids - ANSWERincreases the risk of cataracts and glaucoma What is the definition of subclinical hypothyroidism - ANSWERElevated TSH and normal serum free T Which antidiabetic drugs are contraindicated in heart failure or severe heart disease and why? - ANSWERGlitizones because they can cause water retention How is the psoas maneuver performed? - ANSWER Which hepatitis is associated with the highest risk of cirrhosis and liver cancer? - ANSWERHep C When is nitrofurantoin contraindicated? - ANSWERrenal insufficiency What indicates pyelonephritis on a u/a microscopic? - ANSWERWBC casts with proteinuria
What is the best indicator of renal function? - ANSWEReGFR Treatment for temporal arteritis: - ANSWERhigh-dosed prednisone for several weeks Screening test for temporal arteritis - ANSWERSed rate What HA is treated with high dosed oxygen - ANSWERCluster What HA is treated with high-dosed anticonvulsants? - ANSWERTrigeminal neuralgia What HA is accompanied by tearing and nasal congestion? - ANSWERCluster What is the diagnostic test of thalassemia and sickle cell anemia? - ANSWERHemoglobin electrophoresis What two tests indicate that a patient has pernicious anemia if they are elevated? - ANSWERparietal antibody test and/or intrinsic factor antibody test What lab value indicates RBC size? - ANSWERMCV What anemia manifests with neurologic symptoms? - ANSWERB Where are Heberden's nodes located? - ANSWERDistal interphalangeal joint (DIP) How is uveitis treated? - ANSWERHigh-dose steroids; refer to opthalmology How does a Baker's cyst present? - ANSWERLocated behind the knee (popliteal fossa) as a ball-like mass 1st line treatment for ankolysing spondilytis? - ANSWERNSAIDS What medical conditions do antipsychotics increase the risk of (5)? - ANSWERobesity, DMII, hyperlipidemia, metabolic syndrome, and hypothyroidism What foods are high in tyramine? - ANSWERfermented-beer, wine, aged cheese, fava beans What is the FDA black box warning for SSRIs? - ANSWERMay increase the risk of suicidal thoughts/behaviors in children, adolescents, and young adults What causes Korsakoff's syndrome? - ANSWERChronic thiamine deficiency Can a patient smoke while on Zyban? - ANSWERyes What SSRI should be weaned? - ANSWERParoxetine
Most common cause of blindness in the US - ANSWERmacular degeneration 1st line treatment for essential tremors - ANSWERbeta blockers What occurs at Kiesselbach's plexus? - ANSWERAnterior nosebleed What ligament is damaged in a positive anterior drawer test? - ANSWERanterior cruciate ligament What is tonus palatinus? - ANSWERA chronic bony growth located midline in hard palate Which drugs increase hyperbilirubinemia in the 3rd trimester? - ANSWERNitrofurantoin and sulfa drugs Most common gynecological cancer - ANSWERUterine Examples of gluten - ANSWERwheat, rye, barley, oats Examples of plant sterols and steols - ANSWERwheat germ, sesame oil, corn oil, peanuts Examples of monounsaturated fats - ANSWERolive oil, canola oil, almonds, walnuts, sunflowers Examples of foods with magnesium - ANSWERalmonds, peanuts, cashews, some beans, whole wheat Example of foods with iron - ANSWERliver, beef, black beans Signs and symptoms of RMSF - ANSWERpetechiae rash on hands/feet, headache, myalgia, conjunctival injection, nausea/vomiting, arthralgia Diagnostic screening for herpes keratitis - ANSWERFluorescein lamp Signs of acute angle-closure glaucoma - ANSWERSudden 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) - ANSWERpityriosis rosea Where is the best location to auscultate the S3 heart sound? - ANSWERpulmonic area Drugs that have a narrow therapeutic index - ANSWERWarfarin, digoxin, lithium, levothyroxine, theophylline, tegretol, dilatin
What is the black box wearing of aldosterone antagonists? - ANSWERincreases benign and malignant tumors When are beta blockers contraindicated? - ANSWERasthma, COPD, chronic bronchitis, emphysema, bradycardia, and AV-block What bacteria do 1st generation cephalosporins act on? - ANSWERgram positive What bacteria do 2nd generation cephalosporins act on? - ANSWERgram negative and gram positive What bacteria do 3rd generation cephalosporins act on? - ANSWERBoth gram positive and negative, however, poor gram positive coverage What is 1st line treatment of MRSA? - ANSWERBactrim DS or clindamycin Which abx should not be used with mono? - ANSWERampicillin or amoxicillin What bacteria do sulfonamides act on? - ANSWERgram negative When is LAIV contraindicated? - ANSWERPregnancy, asthma, COPD, renal failure, DM, immunosuppression, What is larger in the eyes-veins or arteries? - ANSWERveins What diagnostic tool is used to assess for fluid in the middle ear? - ANSWERTympanogram Appearance of nasal turbinates in allergic rhinitis - ANSWERBluish, pale, boggy Description of Koplik spots - ANSWERsmall sized papules with blue-white center inside the cheek What is a pinguecula? - ANSWERA yellow-triangular thickening of the bulbar conjunctiva What disease is a sandpaper-textured pink rash found in: - ANSWERScarlet fever Description of basal cell carcinoma - ANSWERpearly or waxy skin lesion with atrophic or ulcerated center that does not heal What drug classes are higher risk for Steven Johnson's syndrome - ANSWERdilantin, PCN, sulfas, barbituates Is a thyroid cancer nodule hot or cold? - ANSWERCold
