2024 SANNERS NR511 REVIEW
FINAL EXAM WITH ANSWERS
macrocytic anemia - CORRECT-ANSWERSincreased MCV
-vitamin b12, iron deficiency, pernicious anemia
BPH - CORRECT-ANSWERSafter 6 months of therapy w/ finasteride, PSA
should decrease by 50%, if does not decrease suspect and evaluate for
prostate cancer
-surgery 4-6 weeks after, safe to resume sex
-finasteride and dutasteride used for tx
erectile dysfunction - CORRECT-ANSWERS*first perform a medical history*
-causes: antiandrogens, beta blockers, reserpine, anticholinergics,
antidepressants, antipsychotics, CNS decreased, alcohol, tobacco
bacterial prostatitis - CORRECT-ANSWERSrecurrent bacterial infection of the
prostate and urinary tract, affects men aged 50 to 80
-s&s: bladder obstruction, hesitancy, dribbling, painful ejaculation
-most commonly from E Coli, young adult males get it from gonorrhea or
bacteria
*prostatic massage is contraindicated*
acute: always with UTI, fever, chills
prostate cancer - CORRECT-ANSWERSassociated with human
cytomegalovirus
-latent s&s: bone pain, weight loss, anemia, SOB, lymphedema,
lymphadenopathy
-a man with a first degree relative is twice as likely to develop disease,
increased meat, fat, and smoking as risks
-tx: zoladex (goserelin acetate) and lypron (leuprolide acetate) block release
of FSH and LH, administer IM
carpal tunnel syndrome - CORRECT-ANSWERS*inflammation of median
nerve*
-characterized by: wrist achiness that radiates to the base of the hand, may
be awakened at night with pain and numbness
-initial tx: wrist splints and NSAIDs
shoulder pain - CORRECT-ANSWERS-older patients (>55) more likely to have
rotator cuff tears or degenerative arthritis
, -fractures and dislocations related to falls
-<30 years typically dislocation injury
-impingement syndrome in middle age
shoulder dislocation - CORRECT-ANSWERSassessment: pain with shrugging
shoulders
-due to excessive pressure on shoulders
herniated discs - CORRECT-ANSWERS*L4-L5 most common area (weakness
in great toe)*
straight leg test: pt in supine, elevate affected leg, if elicits pain in back and
sciatic pain (positive test for herniated disc)
-pt is unable t walk on toes or heels without pain
-cessation of smoking, weight reduction, good posture, adherence to
exercise regimen
knee pain - CORRECT-ANSWERSpatellofemoral dysfunction: encompasses a
continuum of disorder due to overuse
-management is conservative with NSAIDs and quad-strengthening
exercises
-McMurray test is used to evaluate individuals for tears in the meniscus
phalen's test - CORRECT-ANSWERSinvolves flexing the wrist for 60 seconds,
leads to pain or paresthesia in the median nerve (carpal tunnel)
anterior drawer test - CORRECT-ANSWERSused in initial clinical assessment
of suspected rupture of crucial ligaments of knee
low back pain - CORRECT-ANSWERSassess the cause, trauma?
-patient history important
-diff dx: ovarian cyst, ankylosing spondylitis and infection
lumbar spinal stenosis - CORRECT-ANSWERSoften radicular complaints in the
legs
-progressing from proximal to distal direction and walking or prolonged
standing causes pain and weakness in legs and butt
-short term relief often reported w/ leaning forward (counters, grocery cart,
etc)
spinal fracture - CORRECT-ANSWERScan present as low back pain
-consider red flags from patient history that alerts you, which may include a
fall history, prolonged steroid use, osteopenia, osteoporosis
vertebral fractures - CORRECT-ANSWERSosteoporosis is most commonly the
cause