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FNP Leik System ReviewChapter 4 (Preventive Health) - ANS
Chapter 4 (Preventive Health) - ANS
Sensitivity - ANS(SNOUT) Negative results rules out the disease. Sensitivity test are good at
identifying the positive markers of disease. So good that it is more prone to report false
positives. So a negative result is more definitive
Sensitivity - ANS(SNOUT) Negative results rules out the disease. Sensitivity test are good at
identifying the positive markers of disease. So good that it is more prone to report false
positives. So a negative result is more definitive
Specificity - ANS(SPIN) Positive results rules in the disease. Specificity tests are good at
identifying the negative marker of a disease. So good that is more prone to report false
negatives. So a positive result is more definitive.
Specificity - ANS(SPIN) Positive results rules in the disease. Specificity tests are good at
identifying the negative marker of a disease. So good that is more prone to report false
negatives. So a positive result is more definitive.
Primary Prevention - ANSPrevent the disease in its entirety. Examples include healthy diet,
exercise, safety (helmets/seatbelts), immunizations, and job safety
Primary Prevention - ANSPrevent the disease in its entirety. Examples include healthy diet,
exercise, safety (helmets/seatbelts), immunizations, and job safety
Secondary Prevention - ANSEarly detection of a disease. Examples include screening tests
Secondary Prevention - ANSEarly detection of a disease. Examples include screening tests
Tertiary Prevention - ANSRehabilitation of a disease. Examples include support groups,
education for pts with pre-existing disease, drug side effect safety, medical equipment safety,
any type of rehab like PT or OT
Tertiary Prevention - ANSRehabilitation of a disease. Examples include support groups,
education for pts with pre-existing disease, drug side effect safety, medical equipment safety,
any type of rehab like PT or OT
Breast Cancer Screening Guidelines (USPSTF) - ANSOnset = 50yo. Biannual. Stop at age
74yo. No SBE.
,Breast Cancer Screening Guidelines (USPSTF) - ANSOnset = 50yo. Biannual. Stop at age
74yo. No SBE.
Breast Cancer Screening Guidelines (ACA) - ANSOnset = 40yo. Annual. No stop age.
Breast Cancer Screening Guidelines (ACA) - ANSOnset = 40yo. Annual. No stop age.
Cervical cancer screening guidelines - ANSOnset=21yo (immunocompromised individuals start
at onset of sexual activity). Every 3 years Pap w/ no HPV test until 30yo. Pap and HPV test after
30 yo and can begin screening every 5 years. Stop at age 65yo. Complete hysterectomy means
no Pap unless pt has history of cervical cancer or high grade lesion.
Cervical cancer screening guidelines - ANSOnset=21yo (immunocompromised individuals start
at onset of sexual activity). Every 3 years Pap w/ no HPV test until 30yo. Pap and HPV test after
30 yo and can begin screening every 5 years. Stop at age 65yo. Complete hysterectomy means
no Pap unless pt has history of cervical cancer or high grade lesion.
Colorectal cancer - ANSOnset 50yo. 1) colonoscopy q 10 years if wnl, 2) sigmoidoscopy q 5
years if wnl, 3) annual FOBT with 3 stool samples. Stop age 75 yo.
Colorectal cancer - ANSOnset 50yo. 1) colonoscopy q 10 years if wnl, 2) sigmoidoscopy q 5
years if wnl, 3) annual FOBT with 3 stool samples. Stop age 75 yo.
Prostate cancer - ANSUSPSTF does not recommend screening with PSA but it based on
individual pt.
Prostate cancer - ANSUSPSTF does not recommend screening with PSA but it based on
individual pt.
Lipid screening - ANSOnset 18-35/45yo screen if at increased risk of heart disease. Males
>35yo and Females >45yo
Lipid screening - ANSOnset 18-35/45yo screen if at increased risk of heart disease. Males
>35yo and Females >45yo
Flu vaccine - ANSLAIV - Live virus can only be given to healthy non-pregnant 2 -49 yo w/o
recent hx of asthma (Peds). Cautioned or C/I in pts with egg, gentamicin or gelatin allergy and
kids receiving aspirin therapy (Reye's syndrome). TIV (trivalent inactivated vaccine) is approved
for >6months.
Flu vaccine - ANSLAIV - Live virus can only be given to healthy non-pregnant 2 -49 yo w/o
recent hx of asthma (Peds). Cautioned or C/I in pts with egg, gentamicin or gelatin allergy and
,kids receiving aspirin therapy (Reye's syndrome). TIV (trivalent inactivated vaccine) is approved
for >6months.
Tetanus vaccine - ANSQ 10 years. Booster for dirty wounds if last TDAP/Td is > 5 years old.
>7yo receive Td/TDAP. Avoid in egg allergy and Gullian Barre. 5 doses of DTAP aka Pediarix
(2,4,6,15 months and 5 yo) First TDAP is at age 11-12yo. Td is the booster every 10 years or if
someone has never had TDAP (came out in 2005) then they should have a one time dose of
TDAP and then continue with Td boosters.
Tetanus vaccine - ANSQ 10 years. Booster for dirty wounds if last TDAP/Td is > 5 years old.
>7yo receive Td/TDAP. Avoid in egg allergy and Gullian Barre. 5 doses of DTAP aka Pediarix
(2,4,6,15 months and 5 yo) First TDAP is at age 11-12yo. Td is the booster every 10 years or if
someone has never had TDAP (came out in 2005) then they should have a one time dose of
TDAP and then continue with Td boosters.
Pneumococcal vaccine - ANSPCV 23 given one time at age 65 yo in healthy adults and for
persons who are 2 years and older and at high risk for pneumococcal disease (e.g., those with
sickle cell disease, HIV infection, or other immunocompromising conditions). PPSV23 is also
recommended for use in adults 19 through 64 years of age who smoke cigarettes or who have
asthma. One time booster given 5 years after first dose (So non-healthy pts will receive 2 doses
of PSV23 over their lifetime). PCV 13 is for <5 yo. When both PCV13 and PPSV23 are
indicated, PCV13 should be administered first; PCV13 and PPSV23 should not be administered
during the same visit. When indicated, PCV13 and PPSV23 should be administered to adults
whose pneumococcal vaccination history is incomplete or unknown.
Pneumococcal vaccine - ANSPCV 23 given one time at age 65 yo in healthy adults and for
persons who are 2 years and older and at high risk for pneumococcal disease (e.g., those with
sickle cell disease, HIV infection, or other immunocompromising conditions). PPSV23 is also
recommended for use in adults 19 through 64 years of age who smoke cigarettes or who have
asthma. One time booster given 5 years after first dose (So non-healthy pts will receive 2 doses
of PSV23 over their lifetime). PCV 13 is for <5 yo. When both PCV13 and PPSV23 are
indicated, PCV13 should be administered first; PCV13 and PPSV23 should not be administered
during the same visit. When indicated, PCV13 and PPSV23 should be administered to adults
whose pneumococcal vaccination history is incomplete or unknown.
Varicella Vaccine - ANS60 yo. May be given to pts who have previously had shingles. May be
given earlier at age 50yo. Live virus so c/I include pregnancy and immunocompromised.
Varicella Vaccine - ANS60 yo. May be given to pts who have previously had shingles. May be
given earlier at age 50yo. Live virus so c/I include pregnancy and immunocompromised.
Chapter 5 (EENT) - ANS
Chapter 5 (EENT) - ANS
, Herpes Keratitis - ANSInflammation of the cornea. C/O abrupt severe eye pain, photophobia
and blurred vision. Diagnose with fluorescein dye and black lamp. Look for fernlike lines
(corneal abrasions appear more linear). Infection permanently damages corneal epithelium
which may result in blindness.
Herpes Keratitis - ANSInflammation of the cornea. C/O abrupt severe eye pain, photophobia
and blurred vision. Diagnose with fluorescein dye and black lamp. Look for fernlike lines
(corneal abrasions appear more linear). Infection permanently damages corneal epithelium
which may result in blindness.
Acute angle closure - ANSGlaucoma (Increased ICP r/t blocked drainage duct). Elderly pt c/o
abrupt onset of severe eye pain, HA, N/V, halos around eyes, and decreased vision. Exam
reveals mid-dilated pupil that is oval shaped, cloudy cornea, and fundoscopic exam shows
cupping of the optic nerve. Tx = keep pt supine, trx to ED for acetazolamide, B blockers, and
topical steroids. Sx may be required
Acute angle closure - ANSGlaucoma (Increased ICP r/t blocked drainage duct). Elderly pt c/o
abrupt onset of severe eye pain, HA, N/V, halos around eyes, and decreased vision. Exam
reveals mid-dilated pupil that is oval shaped, cloudy cornea, and fundoscopic exam shows
cupping of the optic nerve. Tx = keep pt supine, trx to ED for acetazolamide, B blockers, and
topical steroids. Sx may be required
Cholesteatoma - ANSCauliflower like growth in the middle ear. Pt c/o foul smelling discharge
and hearing loss. On exam, no TM or ossicles visible. PMhx of chronic OM. The mass is not
cancerous but it can erode in to the bones of the face and damage CN7. Tx = ENT referral for
sx, abx. Mass is usually made of epithelium and cholesterol. AKA pearl tumor.
Cholesteatoma - ANSCauliflower like growth in the middle ear. Pt c/o foul smelling discharge
and hearing loss. On exam, no TM or ossicles visible. PMhx of chronic OM. The mass is not
cancerous but it can erode in to the bones of the face and damage CN7. Tx = ENT referral for
sx, abx. Mass is usually made of epithelium and cholesterol. AKA pearl tumor.
Battle's sign - ANSBruise behind the ear over the mastoid process. Hx of trauma, and indicates
a fracture of the basilar skull. Golden serous discharge from ear or nose. Refer to ED for abx
and imaging (CSF will be + for glucose. Mucous will be - for glucose).
Battle's sign - ANSBruise behind the ear over the mastoid process. Hx of trauma, and indicates
a fracture of the basilar skull. Golden serous discharge from ear or nose. Refer to ED for abx
and imaging (CSF will be + for glucose. Mucous will be - for glucose).
Cavernous sinus thrombosis - ANSBlood clot in w/I cavernous sinus. This cavity houses internal
carotid artery and CN III, IV, V and VI). PmHx of sinus or facial infection. Pt c/o severe HA, high
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