AANP review Questions and ANSWERS
Classic ECG finding in atrial flutter. Correct Answer: "Sawtooth" P waves
Definition of unstable angina. Correct Answer: Angina is new, is worsening, or occurs at rest
Antihypertensive for a diabetic patient with proteinuria. Correct Answer: ACEI
Bec...
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
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
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
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
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