AANP Exam REVIEW - Answered
TB Testing Principles - The PPD is 5 tuberculin units in 0.1 ml is administered
intradermally on the volar aspect of the lower arm and read 48 hours after the test
is given. The PPD result must have induration and measure 10 mm or greater to be
positive in a low-risk patient. Greater than 5 mm is considered positive in high risk
population such as those with known exposure to TB.
Any HIV person needs annual testing for TB.
A positive result warrants chest x ray.
Diagnosis confirmation with sputum culture.
TB Risk factors - Compromised immune system, high-risk populations (minorities,
foreign-born people, prisoners, nursing home residents, indigents, migrant workers
and healthcare providers), steroid therapy and blood disorders.
AFP (Alpha Feta Protein) - Produced in the fetal and maternal liver, higher levels
are commonly seen in multiple gestations due to the growing fetuses and
enlargement of the livers.
Calcium Channel Blockers - Act by blocking the calcium channels in the heart
muscle and the blood vessels, thereby keeping more calcium in the bones.
Lachman Maneuver - Test performed to assess for knee instability. Knee instability
indicates a tear of the anterior cruciate ligament.
Tanner Staging - After stage III, expect menses.
Stage IV is secondary breast mound
Stage III for males is lengthening of penis.
Stage IV is increased breadth and width.
S2 - Caused by closure of the semilunar valves
,Medicare Part B: - 1. outpatient physician visits, lab, and x-ray
2. durable medical equipment
3. mammograms/colonoscopy yearly after age 50
4. rehab
Atopic Dermatitis - Skin condition in which the lesions occur in a linear fashion.
they may have many different stages including erythematous papules and vesicles,
with weeping, drainage, and/or crusting. Lesions are commonly found on the scalp,
face, forearms, wrists, elbows, and backs of knees. commonly pruritic. Also known
as eczema.
A positive Coombs test on an Rh-negative pregnant women means. - The mother's
antibodies can attack the fetus's Rh-positive red blood cells and cause destruction
of these cells, which can cause severe anemia and complications in the fetus.
Today this is preventable with the administration of anti- RhD immunoglobulin to
an Rh-negative mother at 28 weeks gestation and after birth if the newborn is Rh
positive.
RhoGAM - Give to mothers with Rh negative blood when the fetus has Rh positive
blood. RhoGAM protects the mother from developing antibodies by destroying the
Rh-positive fetal RBCs in the mother's blood system.
Fitz-Hugh-Curtis - a complication of having pelvic inflammatory disease that was
caused by a vaginal infection, such as gonorrhea or chlamydia. This causes
inflammation and infection in the pelvic cavity. Left untreated, this infection can
cause adhesions that stretch from the peritoneum to the liver.
Preeclampsia - Hypertension
Edema
Proteinuria
Presumptive Signs of Pregnancy - These are the signs that are experienced by the
patient such as amenorrhea, breast tenderness, nausea, vomiting, fatigue, increased
urinary frequency, etc.
,Probable Signs of Pregnancy - These are the signs that are detected by the
examiner such as enlarge uterus, Hegar's sign, and Chadwick's sign.
Positive Signs of Pregnancy - These are the signs that are direct evidence of
pregnancy such as audible FHT or cardiac activity on ultrasound.
Chadwick's Sign - Bluish discoloration of the cervix and vagina.
Placenta abruptio - Bright red vaginal bleeding, board-like uterus on palpation, and
pain.
Placenta previa - Painless vaginal bleeding
Jarish-Herxheimer reaction - Immune mediated reaction precipitated by the
destruction of a large number of spirochetes due to the antibiotic injection
BV - Large amount of bacteria coating the squamous cells (Clue Cells) and very
few leukocytes or RBCs.
Proventil (Beta Agonist) vs steroids and luekotriene - Proventil is a short acting
bronchodilator and is used for immediate relief of shortness of breath. It acts
quickly to dilate the tubes of the lungs where as steroids and leukotriene inhibitors
help the inflamed channels of the lungs to remain open and clear over time. They
are much slower acting than SABAs.
Hepatitis C - When a patient tests positive for anti-HCV, labs should be ordered
and include hepatitis C PCR (polymerase chain reaction) to further evaluate the
patient
When anti-hep C is positive then a HCV RNA should be performed.
Which of the following viral infections is associated with occasional abnormal
forms of lymphocytes during an acute infection? - A. CMV
, B. Epstein Barr -A test for an acute infection of the EBV will show abnormal
lymphocytes
Will also demonstrate positive EBV titers, elevated liver enzymes, and elevated
BUN and creatinine
C. HPV
D. Coxsackie Virus
Cafe au lait spots are associated with: - Neurofibromatosis or von Recklinhausen's
disease. They are caused by an increase in melanin content, often with the presence
of giant melanosomes. They have irregular borders and vary from light to dark
brown.
Treatment for erythema migrans or Lyme Disease - Doxycycline 100 mg BID x 21
days
Risk factors for Coronary Heart Disease - Hypertension
Hypercholesterolemia
Women 55 years and older
Fundoscopic exam - A normal exam includes sharp disc margins, yellow-orange
appearing macula and vein to artery ratio of 3:2
Snellen Chart - If a patient's vision results are 20/30 then the patient can see at 20 ft
what a person with normal vision can see at 30 feet.
Somogi Phenomenon - Nocturnal hypoglycemia (2 a.m. to 3 a.m.) stimulates the
liver to produce glucagon to raise the blood sugar. The fasting blood glucose levels
will be elevated from this glucagon production.
Initial evaluation for intermittent claudication would include: - Checking the ankle
and brachial blood pressure before and after exercise
Peak expiratory flow is determined using - Height, gender, and age.
