2023 AANP EXAM STUDY NOTES /LATEST
VERSION /WELL DETAILED
1.Migranes: - Symptoms: Throbbing pain behind one eye Photophobia,
phonopho- bia, N/V
- At-Risk Patients: Adult females
- Aggravating Factors: Red wine, MSG, aspartame, menstruation, stress
2.Trigeminal neuralgia: - Symptoms: Type 1: Intense, sharp, shock-like,
stabbing pain; Type 2: constant, aching, burning pain
- At-Risk Patients: Older adults and elderly
- Aggravating Factors: Cold food, cold hair, chewing, talking, touch
3.Cluster HA: - Symptoms: "Icepick" piercing pain behind one eye/temple
Tearing, rhinorrhea, ptosis, miosis
Homer's syndrome
- At-Risk Patients: Middle-aged females
,- Aggravating Factors: Occurs at same time, daily, in
clusters Weeks to months
4.Tension HA: - Symptoms: b/1 "band-like" pain; dull, may last a day;
may have spasms of trapezius muscles
- At-Risk Patients: Adults
- Aggravating Factors: Stress
5.Migrane: - Acute tx: Ice pack, rest, dark room Sumatriptan or Toradol
Prochlor- perazine for
- Prophylaxis/Other: TCA, BBs, Effexor, Topamax {not if hx of kidney
stones)
6.Pharmacokinetics: Movement of drugs through body
7.Pharmacodynamics: Physiologic and biochemical effects of drugs
8.Pharmacogenomics: Study of how genes affect response to meds
9.Half-life: Amount of time it takes for drug concentration to decrease 50%
10.First-Pass Effect: Oral drug enters portal circulation - in liver, CYP450
me- tabolizes drug, then it is released to body; can bypass first-pass
effect via IV, gels/creams/patches, buccal
,11.When asked about drug interactions, think of these: · Macrolide
· Antifungals
· Cimetidine
· Citalopram
· Protease inhibitors
· Grapefruit juice (Interacts with statins, erythromycin, CCBs, antivirals,
amiodarone, benzos, cisapride, carbamazepine, buspirone)
12.Safety Issues with Common Meds
Drug: Thiazolidinediones e.g. pioglitazone: Safety Issue: Black
box: exacerbate CHF, do not use if NYHA Class Ill or IV HF
Contraindications: Ml, stroke, bladder CA, TlDM, eye/liver
13.Safety Issues with Common Meds
Drug: H2 antagonists e.g. ranitidine, famotidine: Safety Issue:
Mental status changes w/ kidney disease Avoid if creatinine clearance
50 ml/min
, 14.Safety Issues with Common Meds
Drug: PPls e.g. omeprazole, pantoprazole: Safety Issue:
Risk of fractures, PNA, CDiff, hypomagnesemia, B12 and iron
malabsorption, at- rophic gastritis, kidney disease Interactions:
warfarin, diazepam, carbamazepine, phenytoin, ketoconazole
15.Safety Issues with Common Meds
Drug: Warfarin: Safety Issue:
Interacts with "G" herbs - garlic, ginger, ginkgo, ginseng D/C 7 day
before surgery
16.Aortic regurgitation presentation: Long asymptomatic period followed by
ex- ercise intolerance then dyspnea at rest. The left ventricle fails
unless the aortic valve is replaced
17.AV nicking is most commonly seen?: Retinal exam of patients with
hyperten- sion
18.Carotid artery bruits can indicate?: Generalized atherosclerosis
19.The USPSTF recommends a 1-time abdominal aortic aneurysm screening with
ultrasonography is done in men: Age 65 to 75 who have ever smoked
VERSION /WELL DETAILED
1.Migranes: - Symptoms: Throbbing pain behind one eye Photophobia,
phonopho- bia, N/V
- At-Risk Patients: Adult females
- Aggravating Factors: Red wine, MSG, aspartame, menstruation, stress
2.Trigeminal neuralgia: - Symptoms: Type 1: Intense, sharp, shock-like,
stabbing pain; Type 2: constant, aching, burning pain
- At-Risk Patients: Older adults and elderly
- Aggravating Factors: Cold food, cold hair, chewing, talking, touch
3.Cluster HA: - Symptoms: "Icepick" piercing pain behind one eye/temple
Tearing, rhinorrhea, ptosis, miosis
Homer's syndrome
- At-Risk Patients: Middle-aged females
,- Aggravating Factors: Occurs at same time, daily, in
clusters Weeks to months
4.Tension HA: - Symptoms: b/1 "band-like" pain; dull, may last a day;
may have spasms of trapezius muscles
- At-Risk Patients: Adults
- Aggravating Factors: Stress
5.Migrane: - Acute tx: Ice pack, rest, dark room Sumatriptan or Toradol
Prochlor- perazine for
- Prophylaxis/Other: TCA, BBs, Effexor, Topamax {not if hx of kidney
stones)
6.Pharmacokinetics: Movement of drugs through body
7.Pharmacodynamics: Physiologic and biochemical effects of drugs
8.Pharmacogenomics: Study of how genes affect response to meds
9.Half-life: Amount of time it takes for drug concentration to decrease 50%
10.First-Pass Effect: Oral drug enters portal circulation - in liver, CYP450
me- tabolizes drug, then it is released to body; can bypass first-pass
effect via IV, gels/creams/patches, buccal
,11.When asked about drug interactions, think of these: · Macrolide
· Antifungals
· Cimetidine
· Citalopram
· Protease inhibitors
· Grapefruit juice (Interacts with statins, erythromycin, CCBs, antivirals,
amiodarone, benzos, cisapride, carbamazepine, buspirone)
12.Safety Issues with Common Meds
Drug: Thiazolidinediones e.g. pioglitazone: Safety Issue: Black
box: exacerbate CHF, do not use if NYHA Class Ill or IV HF
Contraindications: Ml, stroke, bladder CA, TlDM, eye/liver
13.Safety Issues with Common Meds
Drug: H2 antagonists e.g. ranitidine, famotidine: Safety Issue:
Mental status changes w/ kidney disease Avoid if creatinine clearance
50 ml/min
, 14.Safety Issues with Common Meds
Drug: PPls e.g. omeprazole, pantoprazole: Safety Issue:
Risk of fractures, PNA, CDiff, hypomagnesemia, B12 and iron
malabsorption, at- rophic gastritis, kidney disease Interactions:
warfarin, diazepam, carbamazepine, phenytoin, ketoconazole
15.Safety Issues with Common Meds
Drug: Warfarin: Safety Issue:
Interacts with "G" herbs - garlic, ginger, ginkgo, ginseng D/C 7 day
before surgery
16.Aortic regurgitation presentation: Long asymptomatic period followed by
ex- ercise intolerance then dyspnea at rest. The left ventricle fails
unless the aortic valve is replaced
17.AV nicking is most commonly seen?: Retinal exam of patients with
hyperten- sion
18.Carotid artery bruits can indicate?: Generalized atherosclerosis
19.The USPSTF recommends a 1-time abdominal aortic aneurysm screening with
ultrasonography is done in men: Age 65 to 75 who have ever smoked
