AGACNP BARKLEY REVIEW:
COMBINED QUESTIONS AND ANSWERS
WITH SOLUTIONS 2024
WhatTcausesTfever? *ABCDEFGHIMN*
*Auto-immune*T-TSLE,TGCA
*Blood*T-THeme/OncT-TLeukemia/Lymphoma
*Cancer*T
*Drugs*T-TAmphotericinTB,TBeta-lactamTabx,Tprocainamide
*Endo*T-Thyperthyroidism,Tpheochromocytoma
*FamilialTmediterraneanTfever*
*GI*T-Tintra-abdominalTabscess,TIBD
*Heart*-TMI,Tendocarditis
*Infection*T-Tbacterial,Tviral,Tfungal,Tparasites,Tetc.
*Misc*T-THematoma
*Neuro*T-Ttumor,TICH,TMST-TinterfereTw/TthermoregulatoryTprocess
WhatTisTmalignantThyperthermia? *highTfeverTd/tTsuccinylcholine*
usuTgivenTinTORTtoTrelaxTlaryngealTmuscle
contraindicatedTtoTsuccs?Thyperkalemia
*Tx:TdantroleneT-TreversalTforTsuccs*
WhatTisTtheTtreatmentTforTfever? 1.TantimicrobialsTonlyTwhenTaTmicrobeTisTpresent
2.Tantipyretics
3.TtxTunderlyingTcondition
WhatTareTtheTcausesTofTnon-infectiousTpost-opTfever? 1.Tpost-opTatelectasis
2.TincreasedTbasicTmetabolicTrate
3.Tdehydration
,4.TdrugTreactions:TAmphotericinTB,Ttrimethoprim-sulfamethazole,Tbeta-
lactamT(abx),Tprocainamide,Tisoniazid,Talpha-methyldopa,Tquinidine,Tetc.
WhatTwouldTpromptTyouTtoTthinkTthatTaTpost-opTfeverTisTinfectious?
1.TusuTaccompaniedTbyTsubjectiveTcomplaintsT&TaTWBCTelevationTwithT*leftTshift*T(i.e.,Tbandemia)
2.TWBCT>30kTisTusuTnotTd/tTinfectionT
3.T*surgicalTincisions*
4.T*pointTofTentryTforTanyTcatheter,TcultureTit*
5.TUTI
6.TlungsT
7.Tsinusitis
8.TabscessT(e.g.,Tintra-abd)
normalTWBCT-T5-10k
sinusitisT-T12k
cellulitisT-T17k
septicTshockT-T20-22k
leukemiaT-T30k
whatTisTtheTinitialTtxTforTpost-opTfeverTinTtheTabsenceTofTinformationTofTinfection?
HydrationT+TmeasuresTtoTexpandTlungs
whatTisTtheTtreatmentTforTinfectiousTpost-opTfever? -IVFT+TAPAPT
-txTunderlyingTsourceT
-gramTstain,TC&S,TallTinvasiveTlinesTorTcatheters,TasTindicated
**beforeTcultures,TdoTnotTgiveTAPAPTorTIVF.TDoTnotTsuppressTanti-
inflammatoryTresponseTbecTyouTwantTtoTcultureTatTmaximumTinflammationTresponse,TthenTbroadTspectru
mTabx,TIVF,T&TAPAP,TthenTnarrowTonceTcultureTcomesTback.
whatTareTtheTcomponentsTofTheadacheTevaluation? 1.TchronologyT-TmostTimptThxTitem
,2.Tlocation,Tduration,TqualityT
3.TassociatedTactivityT-Ti.e.Texertion,Tsleep,Ttension,Trelaxation
4.TtimingTofTmenstrualTcycle
5.TpresenceTofTassocTsymptoms
6.TpresenceTofT"triggers"
WhatTisTtheTlab/diagnosticTtestTandTtreatmentTforTtensionTheadache? -
TnoTlab/diagnosticTtestTspecificTforTtensionTh/a
-TtxTisTOTCTanalgesicsT&Trelaxation
WhatTisTtheTpathophysiologyTbehindTmigraineTheadaches? -
TmigraineTheadachesTareTrelatedTtoTdilationT&TexcessiveTpulsationTofTbranchesTofTtheTexternalTcarotidTarte
ry
-TtypicallyTlastsT2-72ThoursTfollowingTtheTtrigeminalTnerveTpathway
WhatTareTtheTphysicalTexamTfindingsTyouTmayTfindTinTaTmigraineTheadache? -
manyTtimesTappearTnormal,T+/-TneuroTdeficits,TorTappearTill
-neuroTdeficitsT-TvisualTdisturbances,Taphasia,Tnumbness/tingling,TN/V,Tphotophobia/phonophobia
*carefulTneuroTexamTforTfocalTdeficitsTorTfindingsTsupportiveTofTtumor
WhatTlabs/diagnosticTtestsTdoTyouTorderTinTptsTw/TnewTmigraineTh/a? CBC,TBMP
VDRLT-Tr/oTsyphilis
ESRT-TelevatedTinTGCA
headTCTT-Tr/oTtumorT&Tbleed,TespTinTyoungTptTw/Tha
otherTstudiesTasTindicatedTbyTH&P
WhatTisTtheTmanagementTforTaTmigraineTheadache? 1.TAvoidanceTofTtriggerTfactorsT(veryTimpt)
2.Trelaxation/stressTmgt
3.TPPXTdailyTifTattacksToccureT>2-3x/month
-amitryptyline(Elavil)
, -divalproex(Depakote)
-propanolol(Inderal)
-Imipramine(Tofranil)
-clonodine(Catapres)
-verapamil(Calan)
-topiramate(Topamax)
-gabapentin(Neurontin)
-methysergide(Sansert)
-magnesium
***notTanTinclusiveTlist**
WhatTisTtheTmanagementTforTanTacuteTattackTofTmigraineTheadache? 1.TrestTinTdark,TquietTroom
2.TsimpleTanalgesicT(ASA)TtakenTrightTawayTmayTprovideTsomeTrelief
3.TSumatriptan(Imitrex)T6mgTSQTatTonset,TmayTrepeatTinT1hrT(totalTofT3x/day)
4.TSumatriptanT25mgTPOTatTonsetTofTheadache
ClusterTheadachesTaffectTmostlyT__________? middle-agedTmen,TveryTpainfulTsyndromes
WhatTareTtheTcauses/incidenceTofTclusterTheadaches? -T*middle-agedTmen*
-ToftenTnoTFMHxTofTheadacheTorTmigraine
-TmayTbeT*precipitatedTbyTalcoholTingestion*
-TcharacterizedTbyT*severe,Tunilateral,TperiorbitalTpain*ToccurringTdailyTforTseveralTweeks
-TusuT*occursTatTnight,TawakeningTtheTptTfromTsleep*
-TusuT*lastsT<2Thours*
-TusuTpainTfreeTforTweeksTorTmonthsTb/wTattacks
-T*ipsilateralTnasalTcongestion,Trhinorrhea,T&TeyeTrednessTmayToccur*
WhatTareTtheTphysicalTexamTfindingsTinTclusterTheadache? -
TusuallyTnormalTexam,TmayTseeT*eyeTredness,Trhinorrhea,TipsilateralTnasalTcongestion*