AANP 2023 Study guide

AANP 2023 Study guide Measles (Rubeola) - CORRECT ANSWER-What RNA virus is associated with cough, coryza, and conjunctivitis with photophobia, rash that starts on head or face? Ortolani maneuver - CORRECT ANSWER-technique for checking hip integrity. unequal movement suggests the hip is dislocated varicocele - CORRECT ANSWER-enlarged, dilated veins near the testicle bladder cancer - CORRECT ANSWER-cancerous tumor that arises from the cells lining the bladder; major sign is hematuria, smoking or industrial chemicals can cause Roseola infantum - CORRECT ANSWER-rash starts on the trunk and goes to the extremities Rash comes out when the fever breaks endovenous laser therapy (EVLT) - CORRECT ANSWER-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 - CORRECT ANSWER-Methylmalonic acid and Homocystein level cervical dysplasia - CORRECT ANSWER-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 - CORRECT ANSWER-general increase in red blood cells (erythremia), pruritis after a shower L5-S1 - CORRECT ANSWER-weak plantarflexion roseacea - CORRECT ANSWER-topical metronidazole Constructive pericarditis - CORRECT ANSWER-Pericardial knock Restrictive Pericarditis - CORRECT ANSWER-S3 Cluster Headache - CORRECT ANSWER-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 - CORRECT ANSWER-Ovarian cancer Deficiency of Niacin - CORRECT ANSWER-Dermatitis, diarrhea, dementia Pertussis treatment in children - CORRECT ANSWER-Azithromycin HLA-DQA or HLA-DQB - CORRECT ANSWER-gene for susceptibility for DM 1 Glyburide - CORRECT ANSWER-Most likely sulfa to cause hypoglycemia Prehn sign - CORRECT ANSWER-elevation of testicles "feels better, less pressure" Dengue fever - CORRECT ANSWER-Supportive Care Hypoparathyroidism - CORRECT ANSWER-Low serum mag Lovastatin - CORRECT ANSWER-First choice for children Vit D dosage in older adults - CORRECT ANSWER-800 units/day Allergy med that won't cause dizziness - CORRECT ANSWER-Loratadine Meriere's disease first line treatment - CORRECT ANSWER-Antihistamines of Benzo (diazepam) Rhinosinutis can cause? - CORRECT ANSWER-Orbital cellulitis Hemophilia B - CORRECT ANSWER-Prolong PTT Fibroadenoma - CORRECT ANSWER-Most common breast mass from 25-40 years old Treponema pallidum - CORRECT ANSWER-syphilis Wermer syndrome - CORRECT ANSWER-tumors on parathyroid glands Polycythemia vera - CORRECT ANSWER-condition characterized by too many erythrocytes; blood becomes too thick to flow easily through blood vessels, splenomegaly, pruritis after showering Lyme disease - CORRECT ANSWER-bullseye rash, alopecia areata - CORRECT ANSWER-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) - CORRECT ANSWER-Works by suppressing hepatic gluconeogenesis and enhancing insulin sensitivity of muscle and fat Sulfonylureas - CORRECT ANSWER-Work by stimulating insulin secretion from the pancreas Hutchinson sign - CORRECT ANSWER-zoster eruption on the tip of the nose When should screening for diabetes start? - CORRECT ANSWER-45 years old if no symptoms present Reed-Sternberg cells - CORRECT ANSWER-Hodgkin lymphoma (HL) histologic morphology Sever disease (calcaneal apophysitis) - CORRECT ANSWER-A traction-type injury, or osteochondrosis, of the calcaneal apophysis seen in young adolescents. Metformin can cause wha - CORRECT ANSWER-B12 deficiency then depression, fatigue, insomnia Cateracts - CORRECT ANSWER-clouding of the lens, yellow tinted vision Lewy body dementia - CORRECT ANSWER-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 - CORRECT ANSWER-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? - CORRECT ANSWER-Sickle cell anemia (no functioning spleen) Emphysema - CORRECT ANSWER-Structural changes that occur distal to the terminal bronchioles Pinworm treatment - CORRECT ANSWER-Albendazole or pyrantel pamoate or albendazole PO Primary achalasia - CORRECT ANSWER-loss of peristalysis in distal esophagus and failure of LES relaxation with swallowing Polymyositis treatment - CORRECT ANSWER-1. steroids 2. followed by methotrexate (methotrexate for long-term immunosuppressant therapy) CLL (chronic lymphocytic leukemia) - CORRECT ANSWER--Chronic with lengthy survival -Primarily a diagnosis of the elderly -Usually B cells -WBC more mature and not functioning properly Vitamin D deficiency - CORRECT ANSWER-Less than 12 mg/ml Acute urticaria - CORRECT ANSWER-fenofenadine, cetirizine, loratadine, first line (second-generation H1 antihistamines) ankylosing spondylitis - CORRECT ANSWER-can cause uveitis tinea cruris - CORRECT ANSWER-Jock itch, terbinafine or butenafine first line (topical) Diagnosing asthma - CORRECT ANSWER-spirometry Hypoparathyroidism - CORRECT ANSWER-hypocalcemia and hyperphosphatemia Screening for gestational diabetes - CORRECT ANSWER-Between 24-28 weeks Indication for PM? - CORRECT ANSWER-Asymptomatic Mobitz II second-degree AV block-risk of progressing to 3rd degree HB Horner syndrome - CORRECT ANSWER-ptosis, miosis, anhidrosis Binocular diplopia, horizontal diplopia on gaze towards affected side? what cranial nerve and muscle? - CORRECT ANSWER-Abducens nerve, lateral rectus muscle First line treatment for pertussis? - CORRECT ANSWER-Azithromycin Lichen planus - CORRECT ANSWER-Pruritic, purple, polygonal planar papules and plaques (6 P's), treatment-topical steroids (topical fluocinonide) Expected clinical finding with high triglycerides? - CORRECT ANSWER-Eruptive xanthomas Rotterdam criteria - CORRECT ANSWER-Diagnosis of PCOS (2 out of 3) - amenorrhea/anovulatory cycles, signs of hyperandrogenism (hirsutism, acne, alopecia, virilization, infertility), polycystic ovaries on US Marfan syndrome - CORRECT ANSWER-Aortic regurgitation Shigella - CORRECT ANSWER-Treatment-azithromycin De Quervain thyroiditis - CORRECT ANSWER-caused by neutrophilic inflammation of the thyroid gland. It is typically viral in origin, and is preceded by an upper respiratory infection Acromegaly - CORRECT ANSWER--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 - CORRECT ANSWER-avoid antimalarial drugs, sulfonamides (sulfamethoxazole), nitrofurans (nitrofurantoin), methylene blue, vitamin K, and phenazopyridine Eosinophilic esophagitis - CORRECT ANSWER-dysphagia to solid foods Retropharyngeal abscess is a deep neck space infection - CORRECT ANSWER-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 - CORRECT ANSWER-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 - CORRECT ANSWER-macules, patches, scales, or thin plaques, that may be hypo- or hyperpigmented or may be slightly erythematous -Ketoconazole 2% shampoo Celiac disease - CORRECT ANSWER--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 - CORRECT ANSWER-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 - CORRECT ANSWER-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 - CORRECT ANSWER-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 - CORRECT ANSWER-widely split and fixed S2 is very common in large left-to-right shunts Still's murmurs - CORRECT ANSWER-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) - CORRECT ANSWER-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 - CORRECT ANSWER-low diastolic blood pressure Hyperaldosteronism - CORRECT ANSWER--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? - CORRECT ANSWERPosterolateral Which of the following lab findings would you expect to find in a patient with betathalassemia? - CORRECT ANSWER-Codocytes Ankylosing spondylitis - CORRECT ANSWER--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 - CORRECT ANSWER--chronic wet cough for more than 4 weeks, the absence of other signs or symptoms that indicate another cause, normal