EXAM 2023/2024 AANP STUDY GUDE TEST EXAM

EXAM 2023/2024 AANP STUDY GUDE TEST EXAM Migranes - CORRECT ANSWER-- Symptoms: Throbbing pain behind one eye Photophobia, phonophobia, N/V - At-Risk Patients: Adult females - Aggravating Factors: Red wine, MSG, aspartame, menstruation, stress Trigeminal neuralgia - CORRECT ANSWER-- Symptoms: Type 1: Intense, sharp, shock-like, stabbing pain; Type 2: constant, aching, burning pain - At-Risk Patients: Older adults and elderly - Aggravating Factors: Cold food, cold hair, chewing, talking, touch Cluster HA - CORRECT ANSWER-- Symptoms: "Icepick" piercing pain behind one eye/temple Tearing, rhinorrhea, ptosis, miosis Homer's syndrome - At-Risk Patients: Middle-aged females - Aggravating Factors: Occurs at same time, daily, in clusters Weeks to months Tension HA - CORRECT ANSWER-- Symptoms: b/1 "band-like" pain; dull, may last a day; may have spasms of trapezius muscles - At-Risk Patients: Adults - Aggravating Factors: Stress Migrane - CORRECT ANSWER-- Acute tx: Ice pack, rest, dark room Sumatriptan or Toradol Prochlorperazine for - Prophylaxis/Other: TCA, BBs, Effexor, Topamax {not if hx of kidney stones) Pharmacokinetics - CORRECT ANSWER-Movement of drugs through body Pharmacodynamics - CORRECT ANSWER-Physiologic and biochemical effects of drugs Pharmacogenomics - CORRECT ANSWER-Study of how genes affect response to meds Half-life - CORRECT ANSWER-Amount of time it takes for drug concentration to decrease 50% First-Pass Effect - CORRECT ANSWER-Oral drug enters portal circulation - in liver, CYP450 metabolizes drug, then it is released to body; can bypass first-pass effect via IV, gels/creams/patches, buccal When asked about drug interactions, think of these - CORRECT ANSWER-· Macrolides · Antifungals · Cimetidine · Citalopram · Protease inhibitors · Grapefruit juice (Interacts with statins, erythromycin, CCBs, antivirals, amiodarone, benzos, cisapride, carbamazepine, buspirone) Safety Issues with Common Meds Drug: Thiazolidinediones e.g. pioglitazone - CORRECT ANSWER-Safety Issue: Black box: exacerbate CHF, do not use if NYHA Class Ill or IV HF Contraindications: Ml, stroke, bladder CA, TlDM, eye/liver Safety Issues with Common Meds Drug: H2 antagonists e.g. ranitidine, famotidine - CORRECT ANSWER-Safety Issue: Mental status changes w/ kidney disease Avoid if creatinine clearance 50 ml/min Safety Issues with Common Meds Drug: PPls e.g. omeprazole, pantoprazole - CORRECT ANSWER-Safety Issue: Risk of fractures, PNA, CDiff, hypomagnesemia, B12 and iron malabsorption, atrophic gastritis, kidney disease Interactions: warfarin, diazepam, carbamazepine, phenytoin, ketoconazole Safety Issues with Common Meds Drug: Warfarin - CORRECT ANSWER-Safety Issue: Interacts with "G" herbs - garlic, ginger, ginkgo, ginseng D/C 7 days before surgery Aortic regurgitation presentation - CORRECT ANSWER-Long asymptomatic period followed by exercise intolerance then dyspnea at rest. The left ventricle fails unless the aortic valve is replaced AV nicking is most commonly seen? - CORRECT ANSWER-Retinal exam of patients with hypertension Carotid artery bruits can indicate? - CORRECT ANSWER-Generalized atherosclerosis The USPSTF recommends a 1-time abdominal aortic aneurysm screening with ultrasonography is done in men - CORRECT ANSWER-Age 65 to 75 who have ever smoked Hypertension is the most common cause of? - CORRECT ANSWER-Hemorrhagic stroke Patients with acute coronary syndrome typically have? - CORRECT ANSWER-Plaque erosion caused by accumulation of hyaluronan and neutrophils The ductus arteriosus is a blood vessel that connects? - CORRECT ANSWER-The aorta and the pulmonary artery in fetus so that blood flow skips the lungs In patients with ductus arteriosus, the murmur is best heard where? - CORRECT ANSWER-At the left clavicle and is both systolic and diastolic Cardiovascular: Diabetics, females and elderly The tricuspid valve separates what? - CORRECT ANSWER-The right atrium and right ventricle Pulmonic stenosis - CORRECT ANSWER-A mid to late systolic murmur How many licks does it take to get to the Tootsie Roll center of a Tootsie Pop? - CORRECT ANSWER-No idea. Aortic regurgitation and mitral valve stenosis are? - CORRECT ANSWER-Diastole only murmurs EKG shows ST elevation, T wave changes (such as inversion), ST depressional and Q waves during episodes of angina. - CORRECT ANSWER-Diastole is the minimum arterial pressure exerted during relaxation and dilation of the ventricle. The 4 heart defects of Tetralogy of Fallot are? - CORRECT ANSWER-- Ventricular Septal Defect - Right Ventricular Hypertrophy - Overriding Aorta - Pulmonary Stenosis Audible S3 in an older adult patient is usually a sign of? - CORRECT ANSWER-Left ventricular hypertrophy from heart failure or cardiomyopathy Atherosclerotic peripheral arterial disease presents with symptomatic limb ischernia upon exertion. - CORRECT ANSWER-Mitral regurgitation is a harsh murmur heard loudest at the apex with radiation toward the left axilla. A widened pulse pressure greater than or equal to 60 in an older adult is a risk factor for? - CORRECT ANSWER-Cardiovascular disease, stroke, or renal disease The atrium forcefully contracting against a stiffened ventricle causes S4. - CORRECT ANSWER-Pericarditis often causes sharp chest pain. In coarctation of the aorta, blood pressure is higher in the arms than in the legs due to? - CORRECT ANSWER-Narrowing in the aorta. It is common to hear a split S2 heart sound over the pulmonic area of the heart with inspiration. As long as it disappears with expiration, with no other abnormal symptoms, this is a normal finding. - CORRECT ANSWER-Go Brandy! Go Brandy! Go Brandy GO! Common side effects of NSAIDs are? - CORRECT ANSWER-- Renal impairment - Acute renal failure - Gastritis Oral Iron should be taken on empty stomach with something acidic and high in calcium such as orange juice. - CORRECT ANSWER-Skin manifestations of a Penicillin allergy is hives. Headache, nausea, insomnia, restlessness and agitation are symptoms that a patient may experience when they are started on SSRI but these symptoms usually resolve in 2 weeks. - CORRECT ANSWER-ACEI induced cough usually begins around 2 weeks after starting medication The drug of choice for male patients with a UTI is? - CORRECT ANSWER-Bactrim for 7-10 days If no response to SSRis another antidepressant can be tried in 8-12 weeks. - CORRECT ANSWER-NSAIDs should be used cautiously in patients with hypertension because they cause sodium retention and increase blood pressure. Side effects of ADHD medication (Strattera) include? - CORRECT ANSWERHypertension and tachycardia Theophylline is a methylxanthines medication that causes bronchodilation. It is used to treat wheezing, sob, asthma, bronchitis, emphysema and lung disease. - CORRECT ANSWER-Beta blockers are contraindicated in patients with Variant (prinzmetal) angina because they may induce coronary vasospasm. Ropinirole (Requip) is a dopamine agonist used to treat? - CORRECT ANSWERParkinson's disease and restless leg syndrome Medications known to cause urinary retention are? - CORRECT ANSWER-- Antihistamines - TCAs - Antispasmodics - Bronchodilators - Antipsychotics - Carbidopa/levodopa