AANP 2023 Study Questions and Answers 100% correct, Graded A+

AANP 2023 Study Questions and Answers 100% correct, Graded A+ Measles (Rubeola) What RNA virus is associated with cough, coryza, and conjunctivitis with photophobia, rash that starts on head or face? Ortolani maneuver technique for checking hip integrity. unequal movement suggests the hip is dislocated varicocele enlarged, dilated veins near the testicle bladder cancer cancerous tumor that arises from the cells lining the bladder; major sign is hematuria, smoking or industrial chemicals can cause Roseola infantum rash starts on the trunk and goes to the extremities Rash comes out when the fever breaks endovenous laser therapy (EVLT) treatment of large varicose veins in the legs in which a laser fiber is inserted directly into the affected vein to heat the lining within the vein, causing it to collapse, shrink, and eventually disappear; also called endovenous laser ablation (EVLA) B12 deficiency Methylmalonic acid and Homocystein level cervical dysplasia the presence of precancerous changes in the cells that make up the inner lining of the cervix, white, sharply demarcated lesion of cervix polycythemia vera general increase in red blood cells (erythremia), pruritis after a shower L5-S1 weak plantarflexion roseacea topical metronidazole Constructive pericarditis Pericardial knock Restrictive Pericarditis S3 Cluster Headache Unilateral severe orbital, supraorbital, or temporal pain. More common in males. Restlessness, tearing of eyes, nasal congestion, rhinnorrhea, fullness of ear, tx-O2 100% CA 125 Ovarian cancer Deficiency of Niacin Dermatitis, diarrhea, dementia Pertussis treatment in children Azithromycin HLA-DQA or HLA-DQB gene for susceptibility for DM 1 Glyburide Most likely sulfa to cause hypoglycemia Prehn sign elevation of testicles "feels better, less pressure" Dengue fever Supportive Care Hypoparathyroidism Low serum mag Lovastatin First choice for children Vit D dosage in older adults 800 units/day Allergy med that won't cause dizziness Loratadine Meriere's disease first line treatment Antihistamines of Benzo (diazepam) Rhinosinutis can cause? Orbital cellulitis Hemophilia B Prolong PTT Fibroadenoma Most common breast mass from 25-40 years old Treponema pallidum syphilis Wermer syndrome tumors on parathyroid glands Polycythemia vera condition characterized by too many erythrocytes; blood becomes too thick to flow easily through blood vessels, splenomegaly, pruritis after showering Lyme disease bullseye rash, alopecia areata Autoimmune disorder that causes the affected hair follicles to be mistakenly attacked by a person's own immune system; usually begins with one or more small, round, smooth bald patches on the frontal bone of the scalp. Biguanides (Metformin) Works by suppressing hepatic gluconeogenesis and enhancing insulin sensitivity of muscle and fat Sulfonylureas Work by stimulating insulin secretion from the pancreas Hutchinson sign zoster eruption on the tip of the nose When should screening for diabetes start? 45 years old if no symptoms present Reed-Sternberg cells Hodgkin lymphoma (HL) histologic morphology Sever disease (calcaneal apophysitis) A traction-type injury, or osteochondrosis, of the calcaneal apophysis seen in young adolescents. Metformin can cause wha B12 deficiency then depression, fatigue, insomnia Cateracts clouding of the lens, yellow tinted vision Lewy body dementia A form of dementia characterized by an increase in Lewy body cells in the brain. Symptoms include visual hallucinations, momentary loss of attention, falling, and fainting, but also parkinsonian motor features such as bradykinesia, resting tremor, rigidity, and gait difficulty Ramsey Hunt Syndrome Reactivation of cranial nerve VII, facial paralysis, ear pain, vesicular eruption in the auricle and ear canal Why would you give meningococcal vaccine before 11th birthda? Sickle cell anemia (no functioning spleen) Emphysema Structural changes that occur distal to the terminal bronchioles Pinworm treatment Albendazole or pyrantel pamoate or albendazole PO Primary achalasia loss of peristalysis in distal esophagus and failure of LES relaxation with swallowing Polymyositis treatment 1. steroids 2. followed by methotrexate (methotrexate for long-term immunosuppressant therapy) CLL (chronic lymphocytic leukemia) -Chronic with lengthy survival -Primarily a diagnosis of the elderly -Usually B cells -WBC more mature and not functioning properly Vitamin D deficiency Less than 12 mg/ml Acute urticaria fenofenadine, cetirizine, loratadine, first line (second-generation H1 antihistamines) ankylosing spondylitis can cause uveitis tinea cruris Jock itch, terbinafine or butenafine first line (topical) Diagnosing asthma spirometry Hypoparathyroidism hypocalcemia and hyperphosphatemia Screening for gestational diabetes Between 24-28 weeks Indication for PM? Asymptomatic Mobitz II second-degree AV block-risk of progressing to 3rd degree HB Horner syndrome ptosis, miosis, anhidrosis Binocular diplopia, horizontal diplopia on gaze towards affected side? what cranial nerve and muscle? Abducens nerve, lateral rectus muscle First line treatment for pertussis? Azithromycin Lichen planus Pruritic, purple, polygonal planar papules and plaques (6 P's), treatment-topical steroids (topical fluocinonide) Expected clinical finding with high triglycerides? Eruptive xanthomas Rotterdam criteria Diagnosis of PCOS (2 out of 3) - amenorrhea/anovulatory cycles, signs of hyperandrogenism (hirsutism, acne, alopecia, virilization, infertility), polycystic ovaries on US Marfan syndrome Aortic regurgitation Shigella Treatment-azithromycin De Quervain thyroiditis caused by neutrophilic inflammation of the thyroid gland. It is typically viral in origin, and is preceded by an upper respiratory infection Acromegaly -abnormal enlargement of the extremities -insidious onset, with a time to diagnosis on the order of 6-10 years. The classic facial findings, which include enlargement of the supraorbital ridges, mandible and a widened nose glucose-6-phosphate dehydrogenase (G6PD) deficiency avoid antimalarial drugs, sulfonamides (sulfamethoxazole), nitrofurans (nitrofurantoin), methylene blue, vitamin K, and phenazopyridine Eosinophilic esophagitis dysphagia to solid foods Retropharyngeal abscess is a deep neck space infection sore throat, difficulty swallowing, or difficulty breathing with possible signs of fever and systemic toxicity. Examination of the oral pharynx may demonstrate midline or unilateral swelling or bulging of the posterior pharyngeal wall -CT scan of the neck with intravenous contrast Vascular dementia seen in patients with risk factors such as hyperlipidemia, hypertension and diabetes. Patients with vascular dementia have patchy cognitive impairment, often with focal neurologic signs and symptoms. Onset may be abrupt, with a stepwise decline. Patients who have had a stroke are at increased risk for vascular dementia Tinea versicolor, also called pityriasis versicolor macules, patches, scales, or thin plaques, that may be hypo- or hyperpigmented or may be slightly erythematous -Ketoconazole 2% shampoo Celiac disease -autoimmune disorder of the gastrointestinal tract caused by exposure to dietary gluten in genetically susceptible individuals -dermatitis herpetiformis, a pruritic vesicular rash on extensor bony surfaces, is pathognomonic for celiac disease. -IgA tissue transglutaminase is currently the test of choice for serologic diagnosis and for monitoring of celiac disease Pemphigus vulgaris Nikolsky's sign (separation of epidermis caused by rubbing of the skin) -severe, rare autoimmune disease that causes blistering of the mucosa, skin, or both herpetic whitlow viral infection of the distal finger, typically between the fascial planes surrounding the nail. This infection is caused by the herpes simplex virus -symptomatic management cluster headache The classic presentation of a cluster headache is severe orbital, temporal, or supraorbital pain that is accompanied by autonomic symptoms such as ipsilateral ptosis, miosis, nasal congestion, rhinorrhea, lacrimation, or conjunctival injection. Restlessness and agitation often accompany the headache with patients pacing or rocking back and forth. Typical headache attacks last for between 15-180 minutes and occur between 1-8 times throughout the day atrial septal defect widely split and fixed S2 is very common in large left-to-right shunts Still's murmurs typically a grade 1 or grade 2 systolic murmur, most often loudest in the lower left sternal border or apex. The murmur may be noted when the patient is supine, compared to when the patient is sitting. Fever or anxiety may result in a louder murmur Polymyalgia rheumatica (PMR) acute proximal muscle pain and stiffness. Age of onset is > 50 years. Areas commonly affected are the muscles of the shoulder and pelvic girdle. -Treatment is corticosteroids, usually prednisone 10-20 mg per day. Aortic regurgitation low diastolic blood pressure Hyperaldosteronism -excessive output of aldosterone from the adrenal gland, leading to increased sodium and water retention and loss of potassium, hypertension common -Treatment is with high-dose spironolactone or eplerenone (aldosterone antagonist) to normalize potassium levels What is the most common type of elbow dislocation? Posterolateral Which of the following lab findings would you expect to find in a patient with beta-thalassemia? Codocytes Ankylosing spondylitis -It typically has a slow onset, with the pain being worse in the morning that improves with activity. -notable fusion of the sacroiliac joints and eventual ossification of the annulus fibrosus, which results in the classic "bamboo spine" appearance on X-ray. Protracted bacterial bronchitis -chronic wet cough for more than 4 weeks, the absence of other signs or symptoms that indicate another cause, normal chest radiographs, minimal systemic effects, minimal improvement with bronchodilators, and resolution of the cough within 2 weeks of starting an antibiotic Rheumatoid arthritis symmetric polyarthritis of small joints. Rheumatoid arthritis is more common in women than men with a peak onset of 40-50 years in women and 60-80 years in men. Clinical manifestations include early morning stiffness and pain of the affected joints that persists beyond 30 minutes. The stiffness recurs after periods of inactivity or after strenuous activity. -The laboratory workup for rheumatoid arthritis includes ESR and CRP levels, presence of antibodies to cyclic citrullinated peptide (anti-CCP) bodies, rheumatoid factor, a CBC, kidney function, and hepatic enzymes Lynch syndrome hereditary nonpolyposis colorectal cancer (HNPCC), is the most common cause of hereditary colon cancer. Men and women with Lynch syndrome are more likely to get colon cancer or other cancers, such as stomach, liver, kidney, and brain cancer, before the age of 50 Multiple myeloma Men are slightly more affected than women. Multiple myeloma should be suspected in any patient presenting with one or more of the following: bone pain resulting from lytic lesions, hypercalcemia, kidney injury, or anemia. Elevated serum protein levels can also be seen in patients with multiple myeloma. -protein electrophoresis and free light chain assay Acute mastoiditis Streptococcus pneumoniae is the most common cause of mastoiditis. Mastoiditis presents with fever, headache, and otalgia. Patients will often have a preceding history of acute otitis media which has not resolved after 2 or more weeks. Physical examination reveals postauricular erythema and tenderness, as well as protrusion of the auricle. In addition, the tympanic membrane is erythematous, bulging, and has decreased mobility. A 65-year-old man presents for follow-up after an upper endoscopy. He has a 10-year history of cirrhosis. The upper endoscopy revealed small esophageal varices with red signs. There was no active bleeding seen and no band ligation was performed. Based on his history of cirrhosis and findings on endoscopy, what would be the most appropriate next step in the management of this patient? Start nadolol- or other non-selective beta blocker-reduces portal venous inflow Proprioceptive sensitivity loss high-stepping and stamping gait, increased risk of falls niacin (vitamin B3) deficiency -dementia, dermatitis, and diarrhea -Isoniazid (INH) biochemically competes with niacin and inhibits the conversion of tryptophan to niacin, resulting in niacin deficiency. venous hum Common innocent murmur. It is low-pitched and is best heard in the right or left supraclavicular or infraclavicular areas. The low-pitch quality allows for the murmur to be best heard with the bell of the stethoscope. A 53-year-old man presents with weight loss, anorexia, abdominal pain, jaundice and early satiety. Which of the following is the most appropriate initial diagnostic test to diagnose and stage pancreatic cancer? CT scan What is the most common form of psoriasis? Psoriasis vulgaris primary hyperparathyroidism asymptomatic hypercalcemia, which is typically detected as an incidental finding on routine blood testing. Manifestations of hypercalcemia include paresthesias, muscle cramps, fatigue, and depression. Cardiovascular symptoms may include hypertension, palpitations, prolonged PR interval, shortened QT interval, bradydysrhythmias, and heart block systolic murmur at the apex. The murmur is associated with a midsystolic click -Mitral valve prolapse occurs due to a mitral valve leaflet abnormality. The associated murmur is systolic with a mid- to late-systolic click, heard best at the apex of the heart. Symptoms can include palpitations, depression, anxiety, fatigue, or syncope -procedural antibiotic prophylaxis is indicated to avoid infective endocarditis