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AANP certification exam > Leik chp 2 Question Dissection & Analysis > Flashcards

Leik chp 2 Question Dissection & Analysis Flashcards

1
Q

pearly, wax-like, shiny appearance with telangiectasia is “classic” for what dermatological pathology?

A

basal cell carcinoma

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2
Q

_______ melanoma has pigment such as brown or black color with irregular borders

A

nodular

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3
Q

________ __________ is a precancer of squamous cell carcinoma and is usually located on the scalp (males), face, and the back of the hands (dorsum); They appear as a crusty/scaly growth that slowly enlarges over time

A

actinic keratosis

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4
Q

The gold standard test for skin cancer is the ______ _______.

A

skin biopsy

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5
Q 
Sudden-onset red rashes on left lower arm and hand. During the skin exam, the NP notes that there are a few blisters. When the NP touches one of the blisters, it ruptures and drains clear serous fluid. Which of the following 3 conditions should the NP consider in the differential diagnosis?
A. Contact dermatitis
B. Erysipelas
C. Psoriasis
D. Impetigo
E. Thermal burn
A

A. Contact dermatitis
D. Impetigo
E. Thermal burn

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6
Q

Fragile, easily-ruptured blisters is a classic finding for _________ _________, an acute bacterial skin infection caused by Staphylococcus or Streptococcus

A

bullous impetigo

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7
Q

__________ _________ can present with just red skin or red skin with blisters. The rash can be located anywhere on the body and it may have a pattern (like a belt) or no pattern.

A

Contact dermatitis

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8
Q

________ is a type of cellulitis caused by strep. It resembles a bright-red, warm, raised rash (plaque-like) with discrete borders usually located on the face or the shins. Blistering is not present.

A

Erysipelas

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9
Q

Rust-colored sputum is associated with _______ ______ infection.

A

Streptococcus pneumoniae

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10
Q

Patients with _________ __________ may have chest congestion but not fever, chills, or productive cough with purulent sputum.

A

acute bronchitis

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11
Q

Legionella pneumonia (Legionnaire’s disease) is uncommon in primary care. Look for history of exposure to “nebulized” water sources such as air conditioners, fountains, etc. Patients present with signs/symptoms of pneumonia that are accompanied by _____ ________.

A

GI symptoms.

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12
Q

______ _________ and _______ ________ are 8 to 13 times more likely to develop liver cancer than other groups due to higher rates of chronic Hep B infection

A

Asian Americans & Pacific Islanders

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13
Q

In alpha or beta thalassemia trait or minor, the following results are found:
normal to high serum ________ and serum ______ levels
Normal _________

A

ferritin, iron

TIBC

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14
Q

the gold-standard test to diagnose any anemia involving abnormal hemoglobin (thalassemia, sickle cell, etc.) is the _________ _________

A

hemoglobin electrophoresis

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15
Q

The _____ is a measure of the variability in size of RBCs (or anisocytosis). An elevated _______ is one of the earliest indicators of iron-deficiency anemia.

A

RDW, RDW

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16
Q

The most common anemia in the world is _______ _______ anemia.

A

iron-deficiency

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17
Q

In clinical practice, rule out _____ _____ anemia first before ordering a hemoglobin electrophoresis.

A

iron deficiency

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18
Q

bacterial vaginosis: presence of ______ _____

A

clue cells

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19
Q

What type of cell is a mature squamous epithelial cell with numerous bacteria noted on the cell surface and borders?

A

clue cell

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20
Q

bacterial vaginosis: pH is ______.

A

alkaline

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21
Q

trichomonas is a ______ or ______ ______ organism

A

protozoan; unicellular flagellated

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22
Q

normal pH of vagina is acidic. normal acidity pH is ____ to ____

A

3.5 - 4.5

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23
Q

_____ is the only vaginal condition with an alkaline pH for the exam.

A

BV

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24
Q

_____ is not considered a STD. The sex partner does not need to be treated.

A

BV

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25
Q

_______ does not cause inflammation. The microscopy slide will have very few WBCs and a large number of clue cells.

A

BV

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26
Q

The vaginal discharge in _________ infection is a white color with a thick and curdlike consistency. Frequently causes itching and redness in the vulvovagina due to inflammation.

A

candida

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27
Q

The microscopy in candidiasis will show a large number of ______, ________, and ______

A

WBCs, pseudohyphae, and spores

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28
Q

_________ is normal flora of the GI tract and in some women’s vaginas.

A

candida

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29
Q

__________ infection vaginal discharge is copious, bubbly, and green in color. It causes a lot of inflammation, resulting in itching and redness of the vulvovagina. It is considered to be a STI. The sex partner does / does not need to be treated.

A

Trichomonas

does

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30
Q

______ (____ ____) is the gold standard of diagnosis for BV, candida vaginitis, and trichomoniasis for the exam.

A

microscopy (wet smear)

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31
Q

The first-line drug for treating for treating strep throat (streptococcal pharyngitis) is still ___________.

A

Penicillin VK

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32
Q

The first-line drug for treating for treating strep throat (streptococcal pharyngitis) is still ___________ for ___ days.

A

Penicillin VK; 10

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33
Q

Adverse side effects of the thiazide diuretics: ________ and __________

A

hyperuricemia and hyperglycemia

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34
Q

According to the IDSA and the ATS guidelines, outpatient treatment of CAP in healthy patients (no comorbidities) involves the __________

A

macrolides: Azithromycin, clarithromycin, or erythromycin

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35
Q

calcium channel blockers’ side effects include _______- _______ and _______

A

swollen ankles and headache

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36
Q

beta blockers’ side effects include _______ and ________

A

fatigue and depression

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37
Q

The most common cause of cancer DEATH overall (mortality) is _______ cancer

A

lung

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38
Q

The most common cancer overall (prevalence) is ______ cancer

A

skin

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39
Q

The most common type of skin cancer is _______ cancer

A

basal cell carcinoma

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40
Q

The most common cancer in females is _______ and the most common cancer in males is ________

A

breast

prostate

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41
Q

Mortality statistics:

Disease causing the most deaths overall is

A

heart disease

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42
Q

Mortality statistics:

Cancer with the highest mortality: _______ cancer

A

lung

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43
Q

Mortality statistics:

Cancer with the highest mortality in males (_____) and females (_______)

A

lung; lung

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44
Q

Mortality statistics:
Most common cause of death in adolescents:
_____ ________ _________

A

motor vehicle crashes

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45
Q

The most common cancer overall (males and females) (prevalence) is ______ cancer

A

skin

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46
Q

The most common type of skin cancer is _______ cancer

A

basal cell cancer

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47
Q

Prevalence

The most common cancer in females is _______ and the most common cancer in males is ________

A

breast

prostate

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48
Q

prevalence:

Skin cancer with the highest mortality: ______

A

melanoma

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49
Q

Prevalence:

What is the most common type of GYN cancer?

A

uterine/endometrial

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50
Q

Second most common GYN cancer?

A

ovarian

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51
Q

_______ cancer is not considered a GYN cancer

A

breast

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52
Q

___________ tongue is a benign physiological variant

A

geographic

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53
Q

A _________ tongue has multiple fissures and irregular smoother areas on its surface that make it look like a topographic map. The patient may complain of soreness on the tongue after eating or drinking acidic foods. Remember, this is a BENIGN physiological variant.

A

geographic

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54
Q

Leukoplakia is / is not a benign variant.

A

is not

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55
Q

___________ is a slow-growing white plaque that has a firm to hard surface that is slightly raised on the tongue or inside the mouth. It is considered a ________ lesion

A

Leukoplakia

precancerous

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56
Q

The causes of leukoplakia include poorly _______ _______, ________ ______, and other types of ______

A

fitting dentures
chewing tobacco
tobacco

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57
Q

Leukoplakia: Refer the patient for a _______ b/c it can sometimes become malignant.

A

biopsy

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58
Q

Oral ________ _______ of the tongue is a ______ white patch that appears corrugated. It is usually located on the ________ aspects of the tongue or other areas inside the mouth and is associated with _____ and _____

A

hairy leukoplakia
painless
lateral
HIV and AIDS

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59
Q

Oral hairy leukoplakia is caused by ______-____ virus infection of the tongue. It is / is not considered a premalignant lesion.

A

Epstein-Barr

is not

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60
Q

Always rule out ovarian cancer in a postmenopausal woman who has a _________ _______

A

palpable ovary

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61
Q

When ruling out ovarian cancer in a postmenopausal woman with a palpable ovary, the first step is to order a _______ and _________ ultrasound with ______, and refer to _________.

A

pelvic and intravaginal

oncologist

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62
Q

The strongest risk factors for ovarian cancer (or breast cancer) is _______ ________ such as BRCA1 or BRCA2 mutations and _______ ________ _______

A

genetic predisposition

positive family history

63
Q

Patients with Barretts esophagus are treated with high-dose PPIs ______ ______

A

for life

64
Q

The first-line treatment of mild, uncomplicated GERD is ______ _______

A

lifestyle changes

65
Q

lifestyle changes in treatment of mild, uncomplicated GERD are avoid eating ___ to ____ hours before bedtime, _______ changes, ______ loss if _______

A

3 to 4
dietary
weight; overweight

66
Q

Girls (and boys) Tanner stage I:

A

prepubertal pattern

67
Q

Girls Tanner stage II:

A

breast bud and areola start to develop

68
Q

Girls Tanner stage III:

A

breast continues to grow with nipples/areola (one mound/no separation)

69
Q

Girls Tanner stage IV:

A

Nipples and areola become elevated from the breast (a secondary mound)

70
Q

Girls (and boys) Tanner stage V:

A

Adult pattern

71
Q

Boys Tanner stage II:

A

Testes and scrotum start to enlarge (skin starts to darken/more rugae

72
Q

Boys Tanner stage III:

A

Penis grows longer (length) and testes/scrotum continues to become larger

73
Q

Boys Tanner Stage IV:

A

Penis becomes wider and continues growing in length (testes are larger with darker scrotal skin and more rugae)

74
Q

Remember, NEVER ________ a patient and/or family member. This will help rule out an incorrect answer

A

reassure

75
Q

_________ ________ physical exam findings will show disk-like breast tissue that is mobile under each nipple/areola, the breast may be tender, and the breast can be assymetrical (one larger than the other)

A

Physiological gynecomastia

76
Q

Overweight to obese males are at highest risk for ________

A

gynecomastia

77
Q

Foods with high _______ content (aged cheeses, red wine, chocolate) can cause dangerous food-drug interactions with MAO inhibitors (Marplan, Nardil, Parnate)

A

tyramine

78
Q

Foods and supplements containing stimulants, such as ________ and ________, are best avoided by patients with HTN, arrhythmias, high risk for MI, hyperthyroidism, albuterol use, and amphetamine use

A

caffeine and ephedra

79
Q

Gluten/celiac disease: avoid _______, _______, and ______

A

wheat, rye, barley

80
Q

Magnesium decreases BP, dilates blood vessels, and is found in nuts such as _____, _____, _____, some beans, ________ _______, also found in laxatives, antacids, milk of magnesia

A

almonds, peanuts, cashews

whole wheat

81
Q

Potassium helps decrease BP and is found in most fruits, esp ______, _______, _______, ______ and in some vegetables (brussel sprouts, potatoes)

A

apricot, banana, orange, prune

82
Q

folate decreases _______ levels and fetal neural tube defects, and is found in _________ ______ fortified with folate, ______ _____ vegetables, and liver

A

homocysteine
breakfast cereals
green leafy

83
Q

Iron is found in beef, ______, _______ beans, and ______-_____ ______

A

liver, black

black-eyed peas

84
Q

Vitamin K (should control intake if on anticoagulants) is found in _____ ______ vegetables, broccoli, and

A

green leafy

cabbage

85
Q

high sodium content (increases water retention, can increase BP) is found in _____ ______, pickles, ________ foods, canned foods, hot dogs, chips

A

cold cuts

preserved

86
Q

Celiac disease: lifetime avoidance of _____, _____, and ______

A

wheat, barley, rye

87
Q

Gluten free: ______,

_______, ______. Most people with celiac disease can eat ______.

A

rice, corn, potatoes (are gluten free)

oats

88
Q

Hypertension: Maintain an adequate intake of _________, _______, and _______.

A

calcium, magnesium, and potassium

89
Q

Migraine headaches and MAOIs (Marplan, Nardil, and Parnate): avoid high _______ foods:
______ ______
_____ ______, fava beans, draft beer, anything fermented

A

tyramine
aged cheeses
red wine

90
Q

Vitamin K decreases the effectives of ________

A

warfarin

91
Q

ED treatment meds for anaphylaxis:

A 
epi IM
100% O2 by face mask
antihistamine such as Benadryl
H2 antagonist such as ranitidine
bronchodilator such as Albuterol
systemic glucocorticosteroids such as prednisone
92
Q

Patients with an atopic history (asthma, eczema, allergic rhinitis) with _______ ______ are at a higher risk for ______ and ________ allergies

A

nasal polyps

ASA and NSAID

93
Q

Anaphylaxis is classified as a ____ ____, _____- _____ reaction

A

type I; IgE-dependent

94
Q

Biphasic anaphylaxis occurs in up to 23% of cases (symptoms may recur within ___ to ___ hours after initial episode). This is why these patients are discharged with a Rx for ________ _____ ______ and a long-acting _________ from the ED.

A

8 to 10
Medrol Dose Pack
antihistamine

95
Q

The most common triggers for anaphylaxis in children are _______. In adults, they are ______ _____ and ________.

A

foods
insect stings
medications

96
Q

Those between the ages of _____ and ____ are “young gerontologicals”.

A

65 and 84

97
Q

Those age _____ and older are “frail elderly”

A

85

98
Q

______ are the first-line treatment for unipolar/major depression. They carry an FDA warning that they increase suicidality in children and young adults up to age 23.

A

SSRIs

99
Q

________ (antidepressants) have many anticholinergic effects such as dry mouth, sedation, arrhythmias, confusion, and urinary retention

A

TCAs

100
Q

________ (antidepressant class) have many anticholinergic effects such as dry mouth, sedation, arrhythmias, confusion, and urinary retention

A

TCAs

101
Q

_________ (antidepressant class) have major food and drug interactions and are not first-line drugs

A

MAOIs

102
Q

The differential diagnosis for an early morning cough includes _________ _______,
________ _________
__________
_______

A

postnasal drip
allergic rhinitis
sinusitis
GERD

103
Q 
Which of the following is most likely to be found in patients with a long-standing case of iron-deficiency anemia?
A Pica
B Fatigue
C Pallor
D Irritability
A 
A Pica
(also spoon-shaped nails is associated with iron-deficiency anemia)
104
Q

____________: a skin rash that has both color, are circumscribed, and are small spots on the skin. They are not raised or depressed

A

Macular

105
Q

__________: a skin rash with small raised lesions varying from red to bright pink

A

papular

106
Q

___________: A skin rash that has both color and texture, small raised skin lesions

A

maculopapular

107
Q

A maculopapular rash in a lace-like pattern is ______ ________.

A

Fifth disease

108
Q

Maculopapular rashes with papules, vesicles, and crusts are ______ ______ and _______ _______

A

varicella zoster

herpes simplex

109
Q

Maculopapular rashes that are oval shaped with a herald patch are __________ _________

A

pityriasis rosea

110
Q

vesicular rashes on an erythematous base are _______ ______ and _______ _______

A

herpes simplex

genital herpes

111
Q

Assume that a patient has _______ if excoriated pruritic rashes are located in the finger webs and the penis until proven otherwise.

A

scabies

112
Q

High risk people for ______ are health care providers, those with large populations like school workers, nursing homes, group homes, prisons

A

scabies

113
Q

True/false:

With scabies, All family members and close contacts must be treated at the same time as the patient.

A

true

114
Q

The rash of _________ has a sandpaper-like texture and is accompanied by a sore throat, strawberry tongue, and skin desquamation (peeling) of the palms and soles. It is / is not pruritic.

A

scarlatina

is not

115
Q

The rash of ________ initially appears as papules that develop into bullae. These rupture easily, becoming superficial, bright-red, weeping rashes with honey-colored exudate that becomes crusted as it dries. The rashes are very itchy and are located on areas that are easily traumatized (face, arms, legs).

A

impetigo

116
Q

Cutaneous ______ _______ (creeping eruption) rashes are shaped like red raised wavy lines (snake-like) that are alone or a few may be grouped. They are very itchy and may become excoriated from scratching (appears maculopapular)

A

larva migrans

117
Q

The preferred treatment for larva migrans is systemic treatment with either ______ daily for __ to ___ days or _________ for 3 days

A

ivermectin 1 to 2

albendazole

118
Q

____________ is the preferred first-line antibiotic for both AOM and _______ _______ in children (for pts with no risk factors for resistant organisms like as in recent abx use)

A

amoxicillin

acute sinusitis

119
Q

____________ is the preferred first-line antibiotic for both AOM and _______ _______ in children (for pts with no risk factors for resistant organisms like as in recent abx use - past THREE months)

A

amoxicillin

acute sinusitis

120
Q

If pt with AOM or sinusitis is a treatment failure or was on an abx in the past 3 months, give second-line abx like _____ or _______ BID

A

Augmentin BID

Omnicef BID

121
Q

For pts who are PCN-allergic and have AOM or acute sinusitis, an alternative is _________ and ________

A

azithromycin (Z-pack)

clarithromycin BID

122
Q 
Which of the following is the best location to auscultate a S3 heart sound?
Aortic
Pulmonic
Tricuspid
Mitral
A

mitral

123
Q

Skin __________, not the red color, is the best indicator of a positive Mantoux reaction

A

induration

124
Q

What is the gold standard test for pulmonary TB?

A

sputum culture

125
Q

Is TB a reportable disease?

Noncompliant patients can be ___________

A

yes

quarantined

126
Q

For pts on isoniazid, a baseline ______ level and follow-up testing are recommended.

A

LFT

127
Q

degenerative joint disease is AKA ____

A

osteoarthritis

128
Q

atopic dermatitis is AKA _______

A

eczema

129
Q

lupus is AKA ____ ____ _____

A

systemic lupus erythematosus

130
Q

enterobiasis is AKA _____

A

pinworms

131
Q

vitamin B1 is AKA _____

A

thiamine

132
Q

scarlet fever is AKA ______

A

scarlatina

133
Q

otitis externa is AKA _______ _____-

A

swimmer’s ear

134
Q

condyloma acuminata is AKA _______ ______

A

genital warts

135
Q

trigeminal neuralgia is AKA ______ ______

A

tic douloureux

136
Q

temporal arteritis is AKA ___- _______ ______

A

giant cell arteritis

137
Q

Iliopsoas muscle sign is AKA ____ sign

A

psoas

138
Q

Light reflex is AKA ________ _____

A

Hirschberg (corneal reflex) test

139
Q

sentinel nodes are AKA ____ _______

A

Virchow’s nodes

140
Q

erythema migrans is AKA ____ ____

A

Lyme disease

141
Q

sinusitis is AKA ________

A

rhinosinusitis

142
Q

major depression is AKA ________ ________

A

unipolar depression

143
Q

All _______ patients should be screened for suicidal/homicidal ideation. Incorrect answers are statements that are judgmental, reassuring, vague, disrespectful, or do not address the issue of suicide in a direct manner.

A

depressed

144
Q

When interviewing a ________, do it privately and with parents present

A

teen

145
Q

SSRIs are the 1st line treatment for
D______
O_____

P_______
A_______
P______
S_______

A

depression
OCD

panic disorder
anxiety
PTSD
social anxiety disorder

146
Q

TCAs are also used for prophylactic treatment of _______, _______ _______, and __________ pain

A

migraines
chronic pain
neuropathic

147
Q

Do NOT give suicidal patients a Rx for ______ b/c of the high risk of hoarding the drug and overdosing, which can be fatal

A

TCAs

148
Q

Anticonvulsants (Tegretol) are used for _____ _____ and ______ ______

A

chronic pain

trigeminal neuralgia

149
Q

Abuse:
If a history is being taken, pick the ___-____ question first. Interview both the possible abuser and patient together, then interview the patient separately.

A

open-ended

150
Q 
CAGE:
C \_\_\_\_\_\_
A \_\_\_\_\_\_
G \_\_\_\_\_\_
E \_\_\_\_\_\_
A

cut down
annoyed
guilty
early

151
Q

The most common bacterial pathogen in otitis externa is __________ (bright green pus)

A

Pseudomonas

152
Q

Differential diagnoses to consider for chronic cough are:
C_________ ________
A___ ______
T__

G_____
A________
L____ _______

A

Chronic bronchitis
Ace Inhibitors
TB

GERD
Asthma
Lung Cancer

153
Q

Tay-Sachs (a rare and fatal genetic disorder) is most common among ______ ______

A

Ashkenazi Jews

AANP certification exam (10 decks)

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