AANP exam review Questions and Answers 2023

AANP exam review Questions and Answers 2023 A mother complains that her 3 mth old infant becomes constipated easily. Using suppositories makes her fussy and have diarrhea stools. What is your recommendation? Encourage adding 1-2 tsp Karo syrup to bottle BID. Corn syrup will act as osmotic agent to increase water concentration of fecal material, stimulating peristalsis which causes a BM. A father brings his AA to the NP because he has an umbilical hernia and wants to know if that is normal at 3 y/o. The hernia is easily reducible and has not increased in size. How do you respond? This is a normal finding in your child and will probably resolve by 5 y/o. In the AA population it may remain until age 7. UH is common is most populations up to 2 y/o. Functions of aging Iron, folic acid, and Vit B-12 decreased absorption /p 80 y/o. Loss of muscle mass in both genders but more common in men. Increase of adipose tissue. Total body water decreases (increased risk for dehydration) and metabolism and O2 consumption decreases (decreased O2 demand). Benefits of hormone replacement therapy: Decreases LDL; raises HDL. Unknown if it helps to prevent CAD. Exercise advice for 42 y/o newly diagnosed DM. Snack prior to exercise; Exercise most days of the week, but not if BS 300 mg/dl (may worsen hyperglycemia due to insufficient insulin availability); improves CV fitness and increases insulin secretion and glucose utilization. Increases risk for hearing loss in child include: intrauterine infection ; LBW 1500 grams; family history of hearing loss; use of ototoxic drugs; head trauma; viral meningitis; and hyperbilirubinemia. Cri du chat AKA 5p- (5p minus) syndrome, is a chromosomal condition that results when a piece of chromosome 5 is missing. Symptoms: Cry that is high-pitched and sounds like a cat Downward slant to the eyes Low birth weight and slow growth Low-set or abnormally shaped ears Mental retardation (intellectual disability) Partial webbing or fusing of fingers or toes Single line in the palm of the hand Skin tags just in front of the ear Slow or incomplete development of motor skills Small head (microcephaly) Small jaw (micrognathia) Wide-set eyes Physical exam reveals for Cri-Du-Chat Syndrome: PE may show: Inguinal hernia Diastasis recti (separatation of the muscles in the belly area) Low muscle tone Epicanthal folds, an extra fold of skin over the inner corner of the eye Problems with the folding of the outer ears Genetic tests can show a missing part of chromosome 5. Skull x-ray may reveal any problems with the shape of the base of the skull. Hypothyroidism in infants: Symptoms Most affected infants have few or no symptoms. This is because their thyroid hormone level is only slightly low. Infants with severe hypothyroidism often have a unique appearance, including: Dull look Puffy face Thick tongue that sticks out This appearance usually develops as the disease gets worse. Choking episodes Constipation Dry, brittle hair Jaundice Lack of muscle tone (floppy infant) Low hairline Poor feeding Short height Sleepiness Sluggishness Exams and test for infant hypothyroidism: A physical exam may show: Decreased muscle tone Failure to grow Hoarse-sounding cry or voice Short arms and legs Very large soft spots on the skull (fontanelles) Wide hands with short fingers Widely separated skull bones Blood tests are done to check thyroid function. Other tests may include: Thyroid scan X-ray of the long bones Medications that predispose to HYPOglycemia: Beta-blockers Medications that predispose to HYPERglycemia: Glucocorticosteriods; thiazide diuretics, phentoin Trophic changes caused by chronic ARTERIAL insufficiency include: loss of lean muscle mass and adipose tissue; thin dry skin; decreased of absent hair growth; dry "punched out" ulcers primarily over the PIP and DIP joints and medial malleolus. Trophic changes caused by chronic VENOUS insufficiency include: weeping ulcers with irregular borders particularly near the lateral malleolus and edema DX HIB in 2 Y/O child. What is the tx plan for the household? Rifampin to all household contacts, including adults, for households with children under 4 y/o who have not been immunized. Secondary amenorrhea is caused by: Anorexia nervosa; female athletes due to high frequency and extremes of exercise; pregnancy; receiving Depo Provera q 3 months for family planning. Alpha thalassemia: Persons from Southeast Asia, the Middle East, China, and in those of African descent. Beta thalassemias: Persons of Mediterranean origin. To a lesser extent, Chinese, other Asians, and African Americans can be affected. Thalassemia labs: (microcytic, hypochromic) Total RBC may be mildly elevated Ferritin normal to high Serum Iron normal to high TIBC normal to borderline MCHC normal Hgb electrophoresis abnormal if beta and normal if Iron Deficiency Anemia labs: (microcytic, hypochromic) (Most common anemia in world) Low H/H Low RBC Low MCV 80 MCHC decreased Ferritin low Serum Iron decreased TIBC high Hgb electrophoresis normal RDW elevated