AANP Exam tips

AANP Exam tips

AANP Exam tips
3 month old infant with down syndrome, due to milk intolerance, mom started on goats milk; now has pale conjunctiva but otherwise healthy. Low HCT. What additional test would you order? Iron, TIBC
3 months of synthroid, TSH increased, T4 normal, what do you do? Increase Medication
3 ways to assess cognitive function in patient with signs/symptoms of memory loss…. Mini mental exam
4 month old with strabismus, mom is worried…… tell her it is normal.
4 month old wont keep anything down, what is the main thing you look at? Growth chart
6 month old closed anterior fontanel. XRAY
Abnormal cells on PAP, what do you do next? Refer for Colposcopy
Causes of tachycardia
Cranial nerves responsible for extraocular eye movements… 3,4,6
Definition of metabolic syndrome- cluster of conditions that increase risk of heart disease, stroke, diabetes.
Definitive diagnosis of acute bacterial prostatitis: urinalysis and culture!
Diagnose Trich: wet prep
Elederly presents with atrophic vaginitis, small uterus, palpable 4×5 ovary, what do you do next? Pelvic US
Elder presents with atrophic vaginitis-add estrogen cream
Epistaxis is most common in the area of the nose known as kiesselbachs triangle, where is this located? Anterior septum


Fingernail hematoma treatment… drill hole, drain blood
GERD treatment: H2 is first line
Grade 3 cells on pap, treatment? Excision
Growth Plate fracture/Salter Harris Fx
Increased risk of ectopic pregnancy…. Salpingitis
Koplick Spots… Measles
Legg-Calve Perthes disease: avascular necrosis of the proximal femoral head
Lipid level of 1500, increased risk for? Pancreatitis
Low HGB, Low HCT, High MCV indicates what? Macrocytic anemia, B12 Def
Man with high BPH, prostate feels on digital exam? Enlarged, symmetrical, smooth
Man with HTN, CAD, present femoral pulses but absent pedal…. Arterial Insufficiency
McMurrays Sign- Meniscus tears
Lachmans- ACL
Know heart murmors!!!! MrPASS MVP MsARD
Newborn with foot turned in, what do you do? Refer to orthopedist
Osgood Schlatter disease- Knee pain
Patient forgot to start Thanksgiving dinner and husband states she has trouble remembering tasks and trouble with organization. What is this indicative of? Alzheimers
Pt has Barretts Esophagus, insurance no longer covers GI who was treating condition. Pt at FNP office wanting refill prescriptions. What do you do? Refer to oncologist
Know labs for diagnosing Hepatitis
Pt presents with rash on shoulder, erythematous maculopapular rash with center clearing and scaling? Tinea Corporis
Pt presents with “bag of worms:, indicates? Varicocele
Pt with atopic dermatitis, look for what other diseases? Asthma
Pt with bleeding after menopause- endometrial biopsy
Pt with hx of PID, increased rick for? Infertility
Bacterial vaginosis does not cause PID- trich, gonorrhea, and chlamidia can cause it
Pt with HIV took high potency anti viral treatments and CD4 is >400, what does this indicate? This is good. Want higher than 350
Pt with hx of htn and stroke, now having memory loss. What does this indicate? Vascular dementia
Pregnant teacher with exposure to 5ths disease, what risk is there to the fetus? Fetal death and birth defects
Quick assessment of patients fall risk? Timed Get up and Go
Red beefy tongue? Pernicious anemia
Rotator cuff injury presentation: disturbs sleep, arm weakness, dull ache
Shingles near eye- immediate referral to ophthalmology
Signs and symptoms of Roseola? High fever, pink flat or raised rash
Treatment for chronic alcoholism: 12 step program
Treatment for Gonorrhea? Rocpehin IM and Zithromax PO
Young female want birth control, forgets to take pills, does not want to get pregnant for at least 5 years: IUD

few questions about T2DM and appropriate treatment, including insulin.

Know the reason for doing a PSA

When to give a pregnant woman with negative rubella titer the rubella vaccine

Treatment for gonorrhea, and syphilis, including during pregnancy

What meds you can’t take while ingesting grapefruit juice

Bells palsy s/S

S/s of serotonin syndrome

Kawasaki disease presentation

Lab test for “slapped face”

Treatment for shin splints

What to do with thyroid meds based on lab values

What heart sound would be expected in CHF

What antihypertensive meds to avoid in GERD

Who gets hep C screening

Definition of AIDS

No hepatitis a or b on mine

The cheapest treatment of shingles -acyclovir

T2DM has foot laceration, what would u monitor them for- osteomylitis

Acute GAD treatment-ssri

Know which murmurs are diastolic and where they’re located

What pts would need to go to ED with pneumonia… CURB65

Presentation of allergic conjunctivitis- bilateral eye symptoms

Treatment of mild persistent asthma

Parents have heterozygous disorder, what % of children are homozygous-25%

Weber and Rinne

No CN questions for me

Darcosytosis s/s

Cotton wool on fundoscopic exam means??

Chronic use of afrin causes…medicamentosa

Vascular dementia most commonly occurs with people who had stroke and htn

S/s of strep a pharyngitis
Some of the questions I still remember from this morning exam:

Signs and symptoms of definitive HF

Description of Molluscum contagiosum

Management of fall with extended arm but no fracture seen on the xray

2 questions about Hepatitis


Evaluation of fall for the elderly

Know your labs for anemia, hypo & hyperthyroidism, hyperparathyroidism

Systolic murmurs

Carotid bruits

Primary amenorrhea

Acquired hypothyroidism

Drugs for OM and alternatives

Drugs for gono and chlamydia and alternatives

Autosomal recessive and dominant

AV nicking

Pediatric asthma management

Infant dehydration assessment


Grades of HF, bruits and thrills

A lot of questions about Weber and Rinnes test


12 weeks just above SP


Wilms tumor

Antipsychotic drug that causes hyperglycemia

Management of TG if niacin does not work

When to prescribe insulin… that’s all I remember. And I’m sure all of you know these stuff?
but some variations like titration of levothyxine based on labs as well as coumadi at least 4 or 5 questions . Grapefruit affects what meds? On the review class from Barkley, some comments about the least expensive treatment for severe shingles. His questions are not the same format as AANP. TB diagnosis and PPD readings. No cranial nerves. Xray interpretation of knee fx. No pictures. What kind of pain on MI, ekg interpretation. Read in detail about the 3 recent posts about the new test, they helped me a lot . Good luck
genetics, a few on sexually transmitted disease and the medications (mostly gonorrhea), I had several questions about the elderly and medications that were safe and meds that were not. I had several questions on Derm, Basal cell carcinoma and seborrheic keratosis, I had a lot of questions of what labs to order, and they gave the situation of the patient. I had several questions on monon, anemia ,and sinusitis. I had PNA when to send to ER, Glaucoma, Hep B, 2 murmurs, one asthma, One on Marijuana s/s, 2 on BV, one on Alzheimer’s, one on hypothyroidism, one on symptoms of a person with Myasthenia Gravis, menopause, woman had bleeding what to do, Glaucoma, also shingles around the eyes, treatment of Bells Palsy, also how to diagnose Temperal arthritis, OA and RA.
anemias and RA vs OA, two murmurs, 2-3 Hepatitis serological, picking which Abx is appropriate for a named infection, PTSD, lots of frail elderly, STIs, PUD, GERD, Adolescents, who’s at risk for suicide, Myesthenia Gravis, Parkinson’s, appropriate tests for poss diagnoses, HTN meds, proteinuria, gastroenteritis dx, tests for appendicitis, expected labs changes in cholecystitis, dx hepatitis from pt symptoms.

hep b and C, hypercalcemia, fibromyalgia, Alzheimer’s, fifth disease, MCL, Pagets.
I had a couple of questions on genetics, a few on sexually transmitted disease and the medications (mostly gonorrhea), I had several questions about the elderly and medications that were safe and meds that were not. I had several questions on Rocky Mountain spotted fever. I had a lot of questions of what labs to order, and they gave the situation of the patient. I had several questions on mononucleosis, anemia ,and sinusitis. I want to thank everyone for all the questions that were posted, they helped a lot.
Here’s some additional details on my AANP FNP exam from Jan 12, 2018. I suspect my exam was the “new version” (it was expected to be updated this January).

[Edit: I have no idea if/when the test is updated – lots of people posted conflicting information about it; you can search the group for posts on the subject to see the whole gamut.]
NOTE: I will not give out any questions or any specifics. This is just a vague description of some of the topics covered. ?
I feel like I had multiple musculoskeletal questions – from RA to pediatric conditions to tendonitis to grade 3 muscle strains.
I had a lot of endocrine on my exam too – particularly hypothyroid, hyperthyroid, Hypoparathyroidism vs hyperparathyroidism – the type of questions ranged from from s/s, to meds, to scan, test and lab results.
Quite a few derm questions, from lichen planus to tinea to BCC to shingles. One question about what in-office procedure is best for a specified derm finding.
Only 1-2 questions were right off the PSI predictor. Only a few were like the questions from this group or from Leik. Difficulty level of the AANP exam felt more in line with the difficulty of the APEA practice exam.
2 murmurs. One hepatitis serology. 2 asthma. 1 or 2 anemia questions.

EKG finding description for bradyarrythmia

Otitis externa and media

Varus vs. valgus in knee exam

Presentation of HTN 2* to renal dx

Tendonitis progressing into tear s/s

Palpable ovary in elderly female

Palpable abdominal mass in a child



Calcium dosage

Meds that may worsen GERD s/s


Acute renal conditions


Pain meds for geriatric pt

Venous and arterial insufficiency

Top cause of mortality in a specific population group

Post menopausal abnormal gyne findings and how to respond


Newborn/infant GI disorders
Fair amount of derm and Peds derm dx and treatment, Peds ortho dx and reg ortho dx and tests, elderly women’s health issues, some pregnancy. 2 murmurs, one asthma, one asked about prolonged PR on EKG strip what kind of block!!, UAs, thyroid and parathyroid, one anemia, one hep serology, one asthma tx, infant emergent conditions.
passed AANP yesterday!! yayy! This group was so much help! Thank you for everyone posting tips and questions! I strongly recommend going through the tips that people have been giving in the past few weeks. My test had many of the topics they gave! Some of the questions I had no clue at all, but most of them I could come down to two answers and choose from there. It was very nerve wracking and I am so happy to be done! One thing that really helped me every day for a couple weeks for my test was I reread this bible verse over and over and told myself it was okay if I failed! It put less pressure on me Here are some of the topics I specifically remember! (also read the old psi test because I had a couple from there on the test)

I started studying hard about 3-4 weeks before the test and I studied most week days at least 5-8 hrs because I felt very behind and like I needed it. I went to a fitzgerald live review a couple of months ago, I watched and took notes on all of the hollier videos (which really helped me get an initial knowledge for the topics) then I read the leik book (which had almost every topic that was on my exam!) then I made note cards and spent the last week reviewing those and the topics that were given by the people in this group. Probably overkill but I’m glad I did it! On my scratch paper I wrote: Deuteronomy 31:6, heart murmurs, cranial nerve picture, S/S of anticholinergics (SAD CUB) and SSRI (BAD SSRI), weber and Rinne and hepatitis panel.

– Dacrocytsis

-ruptured tympanic membrane


-thyroid and parathyroid

-Treatment for gonorrhea and chlamydia while pregnant

-I had about 3 cranial nerves which I wasn’t expecting

-2-3 Rinne and Weber

-aquired hypothyroidism

-know what fundoscopic exam will look like from HTN and DM-I got one about AV nicking

-Fundal height at 12 weeks

-Wilms tumor

-Carotid bruits

-Primary amenorrhea

-Apthous stomatitis- a little kid with sores in his mouth

-Hypertension medications – like which one you would give or not give for specific patient- which one causes GERD CCB.

-Fibromyalgia diagnosis-11/18

-Gold standard for temporal lobe arthritis- biopsy, give sterids, associated with Temporal arteritis

-I had one hepatitis question- IGm was positive

-Cause for ectopic pregnancy

That’s all I can remember specifically! Good luck everyone!
Question that I  was able to remember

•       Basal Cell Cancer: Question description and the fact that it doesn’t have any tx  (Hints: Waxy, pearly, telangiectasia, ulcer center lesion

•       Actinic Keratosis: Question about description (Scaly red to yellow located in sun exposed area

•       Melanoma question: Know ABCDE

•       Subungal Hematoma tx: Make a hole and drain the blood

•       Tx for moderate acne- I got one about Retin A

•       Know Systolic and Diastolic Murmur (MR. ASS & MS. ARD). Mr. ASS question was asked about heart murmur with high pitch holosystolic and the other one is mid systolic.  Got one about a low rumbling diastolic murmur

•       Question about Grade III/VI Murmur: (Loud murmur easily heard)

•       Coarctation of Aorta: Know that systolic BP on lower extremities is supposed to be higher compare to upper extremities. In COA case its vise versa. Look for weak radial and bounding femoral pulse

•       Know the difference between Peripheral Arterial Disease and Chronic Venous Insufficiency. There was question about PAD and the answer was exercise by walking (Tx)- chronic venous insufficiency you elevate it

•       Question about JVD causes? HF right side to be specific

•       Know Bacterial endocarditis (There was a pt. with gradual onset of fever, hemorrhages on nail beds, painful raised red nodules) Osler’s nodes

•       RML CXR

•       Chronic bronchitis description and treatment

•       Hiv pt. PPD + (5mm)

•       Croup/Epiglottitis: Question about what condition would make you order Lateral X-ray of the neck. Options include: Drooling, Unable to do ROM of the neck / stiff neck.

•       Hyper and Hypothyroidism

•       Question about AV nicking (Arterioles pressing on vein of the eye): Its HTN retinopathy

•       Question causes of IOP-Papilledema

•       Rovsing sign
Mcmurray sign

•       Pt. with GERD and Barrett’s esophagus: Refer to Oncologist

•       Question about pencil like stool: Options include problem with ascending colon, descending colon. Descending colon
Question about  a thin narrow stool and possible causes include colon cancer, diarrhea, IBS. Refer for GI colonoscopy

•       Question about Hepatitis B active Immunology.

•       Know your urinalysis result

•       Question about Pt. complaining of headache after trauma: (Options include post concussion headache, subarachnoid hemorrhage and Subdural hemorrhage). I think the answer is subdural hemorrhage

•       Question about Migraine headache: Know the description and duration of headaches as well- nausea vomitting

•       Question about CN 3,4,6 (EOM)

•       Anemia question, Vitamin B12 deficiency-beefy red tongue, tingling

•       A lot of Musculoskeletal questions: (Anteriorly ligament which is for ACL; Apprehension test positive, lateral epicondylitis Tx, Morton’s Neuroma description as someone with high heels and has a mass or nodule on the 4th/5th toe)

•       Osgood Schlatter Disease: Hint tibia tuberosity

•       Question about an 88/yr. old patient in for follow up secondary. She’s been treated with Tylenol for Joint arthritis. Her SED rate was checked after 6 weeks of treatment and it was 28. Normal range is from something to 25. How would you treat the pt. (Do nothing, Increase Tylenol, change to NSAID, and pt. is expected to have a high SED rate due to age). I think it should be changed to NSAID cuz SED rate is a sign of inflammation,

•       Question about medial Tibia Stress

•       ADHD is a behavior disease

•       Which medication causes low sperm count for a patient (SSRI)

•       Question about grandiosity (Bipolar)

•       Question about contraceptive pills

•       Question about, Trichomonas test wet mount was mentioned on the exam

•       Question about a pt. pap’s smear noted with Low Grade Squamous Intraepithelial Lesions and High Grade Squamous Epithelia Lesion noted on the report, what should NP do? (Options are referring for colposcopy, repeat in 12 month and can’t remember other options. My review book stated to order HPV test if not done. Refer for colposcopy.

•       Question about NP palpating right ovaries on a 1-year postmenopausal woman. Options include (To refer for endocerviacal test, for ovarian cancer something, couldn’t remember other options). Answer is to r/o ovarian cancer

•       Another question about who is at high risk for ovarian cancer (Options include Family history, previous abortion and cant remember the rest)

•       High risk for ectopic pregnancy: (Options include: Infertile, and cant remember the rest of the options)

•       Question about chlamydia

•       Question about CURBS: Which of the options does not require hospitalization for pneumonia (Options are all except 1; all include one that’s not part of it) Review CURBS: It’s a criteria for pneumonia hospital admission

•       Question about genital wart tx

•       Question about treating HIV pt. with antiviral and CD4 count still less than 200. What should NP tell the pt. (Different option but the best option is to tell the pt. that he is qualified to be diagnosed with AIDS according to CDC

•       Most common cause of death in children (Options are poisoning, Motor vehicle accident, drowning, and cant remember the fourth one)

•       Tanner stage questions

•       Sensorineural (Presbyacus)

•       Know types of Alzheimer’s: Question about a pt. expericieng memory loss, and increase in confusion and she has a history of stroke, HTN, What type of Alzheimer. Options include (Dementia with lewy bodies, Vascular dementia, frontotemporal dementia). I think the answer is vascular dementia.

•       Question about Romberg test and how its done

•       Question about sensitivity

•       Question about Coombs test r/o bilirubin

•       Hyperbiliribubin question risk

     Preeclampsia tx  (bed rest, laying on her side and

•       Question about a pregnant female at slightly above symphysis pubic   and Fundal height is 32cm (above the umbilical. What should be done (I picked to have Ultrasound done to)

•       Question about molloscum contagiosum- umbilicated,

•       Question about pyloric stenosis (Hint is non bilious vomiting, olive like firm mass palpated on right upper quadrant)

•       Review your skin issues for adult and kids.

Question about Rubeola (Koplick)- measles

•       Question about horizontal nystagmus that stops when eye is close to midline in a college student (options include messinere, BBPV, normal and cant remember the forth one)

•       Question about someone eating, painful lump noted on the jaw that comes and go. Options include (Cancer of Wharton, sialolithiasis). The answer is sialolithiasis

•       Question about ADHD (options include are solely a behavior disorder, panic, personality disorder)

•       Question about a pt. complaining about upper arm tremor that seems to be hereditary. What’s the treatment? options include (Xanax, lorazepam, metoprolol and cant rember the last one)

•       Which among the list can cause increase in respiration. Options include (low oxygen, high oxygen, hypercapnia, hypocapnia)

•       Question about osteoporosis risk factors. Options include (low estrogen level, obesity, sedimentary lifestyle, cant remember the last one)
Osteoporosis exercise- walking (weight bearing exercise)

•       Tx to prevent fracture in a pt. with low vitamin d hydroxyl, high TSH and low Hct (Option include Calcium carbonate 600mg, vitamin d 800 IU, cant remember the remaining 2 options)

•       Questions about carotid bruit signs can signifies what. Options include (Pulmonary HTN, carotid problem, cant remember the remaining two options0

•       Ovarian CA risk. options are (multipara, family history and cant remember the rest).

•       Question about ectopic risk factor. Options include (abnormality, exposure to some chemicals, previous abortion)

•       Common causes of GERD. Options are (Histamine blocker, BB, CCB, cant remember the last one)

•       Zeprexa (What lab and intervention to put in place) such as weigh check, DM,)

•       Question about what’s the common bug in children with diarrhea.

•       What test needed to differentiate lesion/cyst found on a breast (Options include Screening mammogram, Ultrasound, Need aspiration)

•       Increase in triglyceride can cause pancreatitis

•       Weber/Rinne Test know this by heart multiple questions about it –WUS and WAC
Lung sound on a pt with emphysema- I put hyperresonance?
Things I remembered that I marked:

– Assessment for dullness on patient with ascites

-INR goal on patient with DVT less than a month ago 2-3
If INR not therapeutic increase the dose

-know pneumoconiosis (so you know which one you can eliminate)

-Varus/Valgus test

-know the difference of measles (Rubeola)vs german measles(Rubella)

-patient with IOP of 32mmHg, what do you expect during fundoscopic exam-Cupping

-1st line tx for Chronic bronchitis

-significant risk factor for ovarian CA

-meds for patient with BPH and urge incontinence-flomax

-causes of hyperbilirubinemia in newborn

-treatment for genital herpes-cheapest option acyclovir oral

-mild persitent asthma meds

-CN responsible for EOM (3,4&6)

-metabolic syndrome criteria

-seasonal disorder definition

-intussusception symptoms

-fundal heights and what to do if there is discrepancy with the expected measurement

-glucagon counteracts hypoglycemia

-Janeway lesions and Osler’s nodes for bacterial endocarditis

-causes of carotid bruit

-III/VI murmur presentation

-organism responsible for IBS

-otitis externa treatment

-meds for patients with osteoporosis (know your Ca and Vit D dosage)

-Psych med that causes high glucose

-Meds for GAD-ssri
Know presentation of PTSD

-hallmark finding in retinoblastoma

-molloscum contagiosum description

-signs of dehydration in infants (post fontanel)

-meds for staph aureus infection (skin) with pus

-hyperparathyroidism=high calcium level

-tx for hyperthyroidism

-breast changes in elderly

-antihypertensive med that causes GERD

-difference of RA vs OA based on symptoms

-systolic vs diastolic murmurs

-recent guidelines on screening mammography

-symptoms of serotonin syndrome

-causes of arrhythmia in elderly-hyperthyroidism

-Weber/Rinne test

-How to diagnose fibromyalgia

-lab test for fifth disease-B19

-one anemia screening question

-pt has AOM but has hives on Amoxicillin and N/V with erythromycin, what meds to give? (Process of elimination..) azithromycin
-treatment for chylamdia in pregnant women

-know CURB 65criteria.

-sensorineural hearing loss  what is it called in elderly-presbycusus

– basal cell description

– squamous cell description

-Signs in strep throat

-when do you see av nicking

– what does IOP look like of fundascope

-treatment for allergic rhinitis

-treatment for pt who comes in with “something in my eye”. What would NP do first? Check visual acuity

-papilledema what it looks like on fundascope .

-TB in duration for Immuno compromised pt.

-what does melanoma look like

-what would np do when pt. comes in with rash on palms .

-what test would you order to evaluate breast cyst

-know treatment for COPD

-know tx. For mild persistent asthma

-what is first approach for pt. With high lipids

-causes of GERD

-know how to treat thyroid  disease. They give you labs and you decide what to do  with meds

-jvd what does it indicate

-treatment for subungal  hematoma

-pyloric stenosis

-causes of Peptic ulcer disease and presentation

-when you give pregnant woman MMR- postpartum

-H/A. Know signs, duration I had 2 questions on  different type and 1 question  of treatment

-sensitivity def.

-tx for gonorrhea

-anemia’s. Know s/s and labs – ex what would pt present w/ an elevated MCV MCH

-know test you perform for knee injuries. Lachman Test and anterior drawer.
-neuro:Romberg tear, post  concussion

-breast changed in elderly

-know thx for calcium and vit. D

-Know murmurs where they Are located, radiate ,

-know murmur grades

-labs you would consider for pt w/5th disease

-tx. for GAD

-contraindications for taking ACEI
Ace inhibitor can cause renal stenosis- stop the ACE
-when you administer live vaccines-12months

-tx for mild acne

-when would you see Kolpik

-s/s of otitis externa

– cataracts – how would pt describe s/s

– Kawasaki disease.  How does pt present desquamation

– Know ABCDE of melanoma

– Lyme disease

– RMSF-presentations in hands and feet

– Coaction of  aorta. What would pt exam look like

– JVD when do you see it and what does it mean

– Description of MI  how would patient describe feeling-persistnat does let up

– Addison’s. What would pt.    presentation look like – needs steroids, HINT pt craving salt

– Romberg  Test. How do you do it

– Dx of essential tremors.  What would you prescribe for pt to relieve or decrease tremors

– HIV know DC4 count

– Tx of pt with urge incontinence what med would you prescribe

– Tx for allergic rhinitis-flonase

– Osteoarthritis how joints present (on hand) bochard and herberden

– Exercise that would help osteoporosis-walking

– Dx of fibromyalgia

– serotonin syndrome what are s/s

– Tx for veriocele

– Coombs Test

– Know Fundus Checks

– Morton’s. Neuroma

– Korsakoff wernicke
-Mastitis tx
I had breast-feeding, Child growth stages, STD, hyper and hypo thyroidism, skin types and treatments, screening for breast cancer, colon cancer, birth control, hepatitis, heart murmur, several questions on medications for BP and DM type 1 and 2, temporal arteritis, anemia, and skin treatments for adolescents.
lot of geriatrics- HF, COPD meds, kidney issues & meds to avoid, DM- the question about DM pt with foot laceration – what is he at risk for was on there. Thyroid & parathyroid question, HTN, hyperlipidemia, neuro – Parkinson’s , LUTS, (bph, prostatitis) women/pregnancy- AFP testing, fundus height, mastitis treatment- obvious answer of dicloxacillin was not listed as an option, so I used Hollier’s trick- which bug are you treating then the answer became obvious- more than 5. One eye thing.  Lots of pedi – resp, msk, rash – viral exanthems, one murmur question.  Lots of adolescents- Early & late adolescents questions. STD male & female – HIV/AIDS, gonorrhea, syphillis. One anemia- pernicious, cluster & migraine h/a.  Reason for JVDistention.
heart murmurs, cranial nerve picture, S/S of anticholinergics (SAD CUB) and SSRI (BAD SSRI), weber and Rinne and hepatitis panel.

– Dacrocytsis

-ruptured tympanic membrane


-thyroid and parathyroid

-Treatment for gonorrhea and chlamydia while pregnant

-I had about 3 cranial nerves which I wasn’t expecting

-2-3 Rinne and Weber

-aquired hypothyroidism

-know what fundoscopic exam will look like from HTN and DM

-Fundal height at 12 weeks

-Wilms tumor

-Carotid bruits

-Primary amenorrhea

-Apthous stomatitis

-Hypertension medications – like which one you would give or not give for specific patient

-Fibromyalgia diagnosis

-Gold standard for temporal lobe arthritis

-I had one hepatitis question

-Cause for ectopic pregnancy
Board Review Combined
RMSF- Inc. fever, chills, N/v, photophobia, myalgia, arthralgias THEN 2-5 days later you develop a petechial rash on forearms, ankles, wrists, that spreads towards trunk and becomes generalized. Think rocky NC/OK/AK/TN/MO. DX: PCR essay with Rickessetti Antigen TREATMENT- doxycycline.  EXAM
Erythema Migraines- (stage 1 Lyme) Target bulls-eye, usually appears in 7-14 days POST being bitten by a deer tick. Rash is hot to touch with rough texture, flu like symptoms. DX: B. Burgdorferi via ELISA, then confirm with western blot. Increased ESR. TREATMENT: Less than 7 Amoxicillin or cefuroxime axetil. Older than 7 Doxycycline. EXAM
Melanoma- Dark Moles, uneven texture, different colors, irregular, >6mm, could be itchy. EXAM
Stevens Johnson Syndrome- Classic is target or bulls-eye. Abruptly, hives, blisters, petechiae, purpura, necrosis, sloughing of tissues. Extensive mucosal involvement. Prodrome of fevers with flu like symptoms. Triggers: Allopurinol, anticonvulsants, pcn, sulfonamides, NSAIDS. HIV ppl have higher risk for this syndrome.
Psoriasis– Inherited. Pruritic erythematous plaques, fine silvery-white scales with pitted fingernails. Scalp, elbows, knees, sacrum, intergluteal folds.
(Koebner phenomenon- new psoriatic plaques form over skin trauma)
(Auspitz sign- pinpoint bleeding when plaques are removed).
TREATMENT: Topical steroids, Tar preps (mild). For (severe) do anti-TNF, or immunologic.
Acanthros Nigricans- velvet hyperpigmented patches most common on back of neck or skin folds- DM resistance.
Scabies- itching bedtime. Primethrin cream treat everyone wash sheets and everything else in hot water.
Atopic Dermatitis (eczema)- Inherited. Extremely itchy. On flexural folds, neck, hands. Inc. IgE. “small vesicles that rupture leaving painful, bright-red, weepy lesions” they become lichenified from itching. First line: Topical steroids. Avoid hot water/soaps. PO antihistamines. EXAM
Tinea Corporis- “ring like itchy rash, slowly enlarge central clearing”-Treatment: most respond to topical antifungals, if severe do oral Lamisil.  EXAM AZOLE ending
Actinic Keratosis- Precursor to squamous cell carcinoma. “numerous dry round and pink to red lesions” with a rough and scaly texture. Does not heal. Slow growing in sun exposed areas. Diagnosis: BIOPSY Golden Standard. Treatment: Sm. (cryotherapy), Lrg. (5-FU cream)- which causes ur skin to ooze, crust, scab, redness. EXAM
Seborrheic Keratosis- soft round wart light tan to black pasted on. Asymptomatic and benign.
Erysipelas- Group A strep, Upper dermis, clear demarcated, cheeks, shins.
TREATMENT- Dicloxacillin QID x10d. Cephalexin, Clinda. PCN ALLERGY? Do Azithro x5d.
MRSA TREATMENT: Bactrim, doxy, mino, clinda. If sulfa allergy do not use Bactrim.
Basal Cell Carcinoma- pearly, waxy, skin lesions, atrophic, ulcerated center that does not heal.
Molloscum Contagiosum- white plug, dome shaped. Highly contagious. EXAM
Varicella Zoster Virus- “contagious 48 h. before, until all lesions crusted over” low grade fever, generalized lymphadenopathy, intense itching, erythematous macules, papules develop over macules, then vesicles erupt. “initially on trunk, then scalp and face” TREATMENT supportive, antihistamines, acyclovir 20mg/kg 5xd. If given first 24 hours works best.  EXAM
Acne Vulgaris (common acne)- ON EXAM
mild (topicals only) *open/closed comedone w/ or w/o sm. papules. Retin-A, acne worsens 4-6 weeks if no improvement in 8-12 weeks increase dose or add erythromycin, benzoyl peroxide.
Moderate (topicals plus antibiotics)- papules, pustules w/ comedones. Continue with topicals combined with topical antibiotics. Then add ORAL antibiotics tetra, mino, doxy.
Severe- with painful indurated nodule, cysts, abscesses, pustules. Accutane- check LFTs, 2 forms of contraceptives, monthly prego testing, only prescribe 1 month supply.
Acne Rosacea- chronic small acne like papules/pustules around nose mouth chin. TREATMENT- Metrogel, Azelex. Low dose tetracycline. EXAM
Impetigo-Gram positive. Itchy pink-red lesions, evolve into vesiculopustules that rupture. If bullous-large blisters. Severe- Keflex, dicloxacillin. PCN Allergic-Azithro, clinda. If NO BULLAE- Bactroban. EXAM
Scarlet fever (Scarlantina)- “sandpaper textured-pink rash with sore throat” strawberry tongue, rash starts on head and neck, spreads to trunk. The skin THEN desquamates. EXAM


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