FNP BOARDS AANP PEARLS-key Questions and Answers

FNP BOARDS AANP PEARLS-key Questions and Answers bulls eye rash and tx Lyme- doxy rash from extremities spreading to torso and tx and tx if pregnant Rocky Mountain spider fever. tx- doxy. If pregnant: amoxicillin fingers and toes have burrowing and tx Scabies. tx- promethean cream and wash everything with hot water Eczema is associated with what two things Asthma and allergy Itchy rash in a circle with central clearing. tx and dx and aka name ring worm aka Tinea. dx: amtifungal cream -zole Black or tan pasted on spots Seborrheic Keratosis (benign) MRSA tx Bactrim Skin infections abx penicillin/ceph skin infections but ax to PCN -mycins Mastitis treatment dicloxacillin honey crusted lesions and tx, cx Impetigo. cx: strep/strap. sand paper rash scarlet fever(from untx strep) can lead to rheumatoid fever and glomerulonephritis Christmas tree rash Pityriasis rosea Dome shaped white encapsulated rash -flush colored. indicates what and tx Molluscum Contagious, no tx- will resolve in weeks/months. HIGHLY contagious. .near genitals -- rape. Painful cluster vestibules errthytema Herpes squamous cell carcinoma dx biopsy tx for Ezema/atopic dermatitis Topical steroids Shingles. vaccine and tx shingles vaccine 50 or 18 if immunocompromised. tx. 48 hours then Acyclovir Various stages of healing lesions chicken pox aka Vericella. Vaccine 1yo Facial rash sparing nasolabial folds and tx rosacea. Tx: no sun, tx: flatly or -ozole Slapped cheek rash. tx, caution No contagious, keep away from pregnant women cause miscarriages. viral so no tx. starts with fever than lacy net like rash 3 emergent eye case retinal detachment, papilla edema, acute-closure glaucoma sudden onset of severe eye pain, firm and blurry vision. cloudy halo cornea. is and tx acute angle glaucoma. ER! PEARL: curtain pulled over vision, sudden floaters. tx retinal detachment. tx- ER *PEARL: OPTIC DISC SWELLING WITH BLURRED EDGES Papilledema. caused by HTN cupping of optic disc. peripheral vision loss. glaucoma "cant drive" s/s eye open angle glaucoma retinal hemorrhage. AV nicking. copper wiring Hypertension retinopathy cotton wool spots and retinal hemorrhaging diabetic retinopathy use eye drops with this condition or will cause ___ with eye corneal abrasion. use eye drops with bells palsy. presbyopia impaired vision as a result of aging- reading glasses condition with difficulty driving at night/glare (first sign) . blurred central vision. clouding of eye's lens cataracts b/l draining in conjunctivitis in what type b/l initially is allergies. bacterial and viral is always one side absent red reflux cataracts PEARL: grey halo around iris is high cholesterol * Koplick's spots are with 3 s/s red spots with blue center characteristic of PRODROMAL stage of Measles. Usually in mouth. 3C's with cough, conjunctivitis, and congestion Conductive vs sensorineural hearing loss Conductive -Weber: Lateralizes toward affected side (conduction louder to affected side) -Rinne: BC is AC (negative) -Caused by cereneum impaction, perf'd TM, cholesteatoma Sensorineural -Weber: Lateralizes away from affected side (conduction louder to normal side) -Rinne: AC is BC (or normal) -Caused by acoustic neuroma, meniere's disease Positive test of bone/air conduction is and what does it indicate Air conduction is louder than bone conduction and it means sensorineural hearing loss. Menieres disease s/s and tx Extreme vertigo, tinnitus. and imbalance. tx- antihistamine otitis media treatment amoxicillin 7 - 10 days; longer for younger patients and shorter for older patients otitis media with effusion treatment ■ Oral DECONGESTANTS (pseudoephedrine or phenylalanine). ■ STEROID NASAL SPRAY BID to TID × few weeks or saline nasal spray (OCEAN spray) PRN. ■ Allergic rhinitis, STEROID nasal sprays with long-acting oral antihistamine (ZYRTEC). otitis external treatment - Antibiotic/Steroid combination drops - NSAIDs - pain control Xanthelasma treatment high lipid levels s/s. fat deposits on eye lids mono sports recommendation once spleen is not enlarged on US: 4-6 weeks Pearl: Pulsating abdominal mass abdominal aortic aneurysm. DO NOT PALPATE. ER! statins look out for what s/s to stop. can cause if dark urine or muscle pain = STOP. can cause Rhabdomylosis. BP meds safe in pregnancy New little mama- Nifedipine, Labetalol, Methyldopa S3 heart failure or pregnancy s4 hypertrophy of the ventricle or HTN s3 normal in athletics, pregnancy and children Heart murmurs locations and name All people take money. Aortic right ICS 2nd pulmonary ICS left 2nd. Tricuspid 4/5th ICS. Mitral 5th ICS no p wave is what heart condition A-fib PAD vs PVD PAD: black/cool/hairless. relieved at rest. PVD: relieved with elevation. brown skin. wear compression stockings Thiazides increase glucose. triglycerides, uria Splinter hemorrhages s/s of Endocarditis Osler noders- painful red lesions on hands/feet or Janeway lesions of small red muscles on palm/soles is sign of Endocarditis Check what before starting statins liver enzymes DVT order what test D-dimer Raynauds dx and tx cold blue fingers. tx: CCB avoid what BP meds with GERD CCB--pines If BPH and HTN then give what medication -Terazosin If Diabetic and HTN then give what BP med ACE or ARB avoid NSAID In cardiovascular pts/HTN Pulsus paradoxus. what it is and what it indicates Drop in BP during inspiration 10. Indicates a heart/respiratory dx Avoid these classes in Pregnancy ACE (--pril) or ARB (--sartan) class to avoid BP meds if CHF no CCB IF metabolic syndrome then avoid what class thiazide meds avoid this BP med in kidney dx thiazide avoid this BP med in gout dx thiazide COPD avoid what BP class avoid -lol BB Asthma avoid what BP class avoid -lol BB Abdominal bruit heard with Renal stenosis/hypertension Palpable murmur is what grade grade 4 warfarin INR 2-3 TR BP indicates meds for 60yo+ If BP is 150/90 ASCVD score to starrt meds if 10% African American with HTN give CCB or thiazide Medication for high triglyceride Finofibrate triglyceride 500, what s/s = acute pancreatitis: Cullens sign (belly blue) and turners sign (back) EKG showing hypokalemia inverted T wave and U wave shown Addisons electrolyte to watch for can cause hyperkalemia BP med that cause high K ACE, ARBS, k-sparing diuretics (Like spironolactone) electrolytes with hypoparathyroidism and what EKG low ca, low mg. tornadoes de pointes with low mg Digoxin toxicity s/s *PEARL green/yellow vision/halo Digoxin Therapeutic range 0.5-2 Lithium Therapeutic range 0.6-1.2 Digoxin monitor what at home HR. hold if 60. DVT meds eliquis, Pradaxa, Xarelto, (and warfarin) what INR for warfarin would you give vitamin K If INR is 10 avoid if this with lovenox avoid in spinal anesthesia lasix vs spirolacatone Lasix lowers K, spiralacatone (doesn't touch K) Upper lobe infiltrates means. vs lower lobes? Lower lobes- pneumonia Upper lobe- TB TB induration mm for positive, for immunocompromised/immigrants etc normal: 15 10 if immigrants 5 if immunocompromised or health care workers tx for pneumonia. tx if abx 3 months Macrobid, amoxicillin, or doxy. if 3 months then --floxacin pearl dx for cough at nighttime Asthma FEV1 diagnosis for asthma if FEV1 80%