1
AANP review Questions With Answers
Classic ECG finding in atrial flutter. - Answer - "Sawtooth" P waves
Definition of unstable angina. - Answer - Angina is new, is worsening, or occurs at rest
Antihypertensive for a diabetic patient with proteinuria. - Answer - ACEI
Beck's triad for cardiac tamponade. - Answer - Hypotension, distant heart sounds, and
JVD
Drugs that slow AV node transmission. - Answer - β-blockers, digoxin, calcium channel
blockers
Hypercholesterolemia treatment that → flushing and pruritus. - Answer - Niacin
Treatment for atrial fibrillation. - Answer - Anticoagulation, rate control, cardioversion
Treatment for ventricular fibrillation. - Answer - Immediate cardioversion
Autoimmune complication occurring 2-4 weeks post-MI. - Answer - Dressler's syndrome:
fever, pericarditis, ↑ ESR
Diagnostic test for hypertrophic cardiomyopathy. - Answer - Echocardiogram (showing
thickened left ventricular wall and outflow obstruction)
A fall in systolic BP of > 10 mmHg with inspiration. - Answer - Pulsus paradoxus (seen in
cardiac tamponade)
Classic ECG findings in pericarditis. - Answer - Low-voltage, diffuse ST-segment
elevation
Definition of hypertension. - Answer - BP > 140/90 on three separate occasions two
weeks apart
Eight surgically correctable causes of hypertension. - Answer - Renal artery stenosis,
coarctation of the aorta, pheochromocytoma, Conn's syndrome, Cushing's syndrome,
unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism
Evaluation of a pulsatile abdominal mass and bruit. - Answer - Abdominal ultrasound
and CT
Indications for surgical repair of abdominal aortic aneurysm. - Answer - > 5.5 cm, rapidly
enlarging, symptomatic, or ruptured
,2
Treatment for acute coronary syndrome. - Answer - Morphine, O2, sublingual
nitroglycerin, ASA, IV β-blockers, heparin
What is the metabolic syndrome? - Answer - Abdominal obesity, high triglycerides, low
HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states
Appropriate diagnostic test?
■ A 50-year-old male with angina can exercise to 85% of maximum predicted heart rate.
- Answer - Exercise stress treadmill with ECG
Appropriate diagnostic test?
■ A 65-year-old woman with left bundle branch block and severe osteoarthritis has
unstable angina. - Answer - Pharmacologic stress test (e.g., dobutamine echo)
Signs of active ischemia during stress testing. - Answer - -Angina
-ST-segment changes on ECG
-↓ BP
ECG findings suggesting MI. - Answer - -ST-segment elev (depression = ischemia),
-flattened T waves
-Q waves
A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are
normal. - Answer - Prinzmetal's angina
The diagnostic test for pulmonary embolism. - Answer - V/Q scan
An agent that reverses the effects of heparin. - Answer - Protamine
The coagulation parameter affected by warfarin. - Answer - PT
A young patient with a family history of sudden death collapses and dies while
exercising. - Answer - Hypertrophic cardiomyopathy
Endocarditis prophylaxis regimens. - Answer - -Oral surgery—amoxicillin;
-GI or GU procedures—ampicillin and gentamicin before and amoxicillin after
The 6 P's of ischemia due to peripheral vascular disease. - Answer - Pain, pallor,
pulselessness, paralysis, paresthesia, poikilothermia
Virchow's triad. - Answer - Stasis, hypercoagulability, endothelial damage
The most common cause of hypertension in young women. - Answer - OCPs
The most common cause of hypertension in young men. - Answer - Excessive EtOH
,3
"Stuck-on" appearance. - Answer - Seborrheic keratosis
Red plaques with silvery-white scales and sharp margins. - Answer - Psoriasis
The most common type of skin cancer; the lesion is a pearly-colored papule with a
translucent surface and telangiectasias. - Answer - Basal cell carcinoma
Honey-crusted lesions. - Answer - Impetigo
A febrile patient with a history of diabetes presents with a red, swollen, painful lower
extremity. - Answer - Cellulitis
A 55-year-old obese patient presents with dirty, velvety patches on the back of the neck.
- Answer - Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Dermatomal distribution. - Answer - Varicella zoster
Flat-topped papules. - Answer - Lichen planus
Iris-like target lesions. - Answer - Erythema multiforme
A lesion characteristically occurring in a linear pattern in areas where skin comes into
contact with clothing or jewelry. - Answer - Contact dermatitis
Presents with a herald patch, Christmas-tree pattern. - Answer - Pityriasis rosea
A 16-year-old presents with an annular patch of alopecia with broken-off, stubby hairs. -
Answer - Alopecia areata (autoimmune process)
Pinkish, scaling, flat lesions on the chest and back. KOH prep has a "spaghetti-and-
meatballs" appearance. - Answer - Pityriasis versicolor
Four characteristics of a nevus suggestive of melanoma. - Answer - Asymmetry, border
irregularity, color variation, large diameter
Premalignant lesion from sun exposure that can → squamous cell carcinoma. - Answer
- Actinic keratosis
"Dewdrop on a rose petal." - Answer - Lesions of 1° varicella
"Cradle cap." - Answer - Seborrheic dermatitis. Treat with antifungals
Associated with Propionibacterium acnes and changes in androgen levels. - Answer -
Acne vulgaris
, 4
A painful, recurrent vesicular eruption of mucocutaneous surfaces. - Answer - Herpes
simplex
Inflammation and epithelial thinning of the anogenital area, predominantly in
postmenopausal women. - Answer - Lichen sclerosus
nodular
opaque
sun-exposed area
ulcerating
non-distinct borders
*associated with a risk of metastasis* - Answer - Squamous cell carcinoma
The most common cause of hypothyroidism. - Answer - Hashimoto's thyroiditis
Lab findings in Hashimoto's thyroiditis. - Answer - High TSH, low T4, antimicrosomal
antibodies
Exophthalmos, pretibial myxedema, and ↓ TSH. - Answer - Graves' disease
The most common cause of Cushing's syndrome. - Answer - Iatrogenic steroid
administration. The second most common cause is Cushing's disease
A patient presents with signs of hypocalcemia, high phosphorus, and low PTH. - Answer
- Hypoparathyroidism
"Stones, bones, groans, psychiatric overtones." - Answer - Signs and symptoms of
hypercalcemia
A patient complains of headache, weakness, and polyuria; exam reveals hypertension
and tetany. Labs reveals hypernatremia, hypokalemia, and metabolic alkalosis. -
Answer - 1° hyperaldosteronism (due to Conn's syndrome or bilateral adrenal
hyperplasia)
A patient presents with tachycardia, wild swings in BP, headache, diaphoresis, altered
mental status, and a sense of panic. - Answer - Pheochromocytoma
Should α- or β-antagonists be used first in treating pheochromocytoma? - Answer - α-
antagonists (phentolamine and phenoxybenzamine)
A patient with a history of lithium use presents with copious amounts of dilute urine. -
Answer - Nephrogenic diabetes insipidus (DI)
An antidiabetic agent associated with lactic acidosis. - Answer - Metformin
AANP review Questions With Answers
Classic ECG finding in atrial flutter. - Answer - "Sawtooth" P waves
Definition of unstable angina. - Answer - Angina is new, is worsening, or occurs at rest
Antihypertensive for a diabetic patient with proteinuria. - Answer - ACEI
Beck's triad for cardiac tamponade. - Answer - Hypotension, distant heart sounds, and
JVD
Drugs that slow AV node transmission. - Answer - β-blockers, digoxin, calcium channel
blockers
Hypercholesterolemia treatment that → flushing and pruritus. - Answer - Niacin
Treatment for atrial fibrillation. - Answer - Anticoagulation, rate control, cardioversion
Treatment for ventricular fibrillation. - Answer - Immediate cardioversion
Autoimmune complication occurring 2-4 weeks post-MI. - Answer - Dressler's syndrome:
fever, pericarditis, ↑ ESR
Diagnostic test for hypertrophic cardiomyopathy. - Answer - Echocardiogram (showing
thickened left ventricular wall and outflow obstruction)
A fall in systolic BP of > 10 mmHg with inspiration. - Answer - Pulsus paradoxus (seen in
cardiac tamponade)
Classic ECG findings in pericarditis. - Answer - Low-voltage, diffuse ST-segment
elevation
Definition of hypertension. - Answer - BP > 140/90 on three separate occasions two
weeks apart
Eight surgically correctable causes of hypertension. - Answer - Renal artery stenosis,
coarctation of the aorta, pheochromocytoma, Conn's syndrome, Cushing's syndrome,
unilateral renal parenchymal disease, hyperthyroidism, hyperparathyroidism
Evaluation of a pulsatile abdominal mass and bruit. - Answer - Abdominal ultrasound
and CT
Indications for surgical repair of abdominal aortic aneurysm. - Answer - > 5.5 cm, rapidly
enlarging, symptomatic, or ruptured
,2
Treatment for acute coronary syndrome. - Answer - Morphine, O2, sublingual
nitroglycerin, ASA, IV β-blockers, heparin
What is the metabolic syndrome? - Answer - Abdominal obesity, high triglycerides, low
HDL, hypertension, insulin resistance, prothrombotic or proinflammatory states
Appropriate diagnostic test?
■ A 50-year-old male with angina can exercise to 85% of maximum predicted heart rate.
- Answer - Exercise stress treadmill with ECG
Appropriate diagnostic test?
■ A 65-year-old woman with left bundle branch block and severe osteoarthritis has
unstable angina. - Answer - Pharmacologic stress test (e.g., dobutamine echo)
Signs of active ischemia during stress testing. - Answer - -Angina
-ST-segment changes on ECG
-↓ BP
ECG findings suggesting MI. - Answer - -ST-segment elev (depression = ischemia),
-flattened T waves
-Q waves
A young patient has angina at rest with ST-segment elevation. Cardiac enzymes are
normal. - Answer - Prinzmetal's angina
The diagnostic test for pulmonary embolism. - Answer - V/Q scan
An agent that reverses the effects of heparin. - Answer - Protamine
The coagulation parameter affected by warfarin. - Answer - PT
A young patient with a family history of sudden death collapses and dies while
exercising. - Answer - Hypertrophic cardiomyopathy
Endocarditis prophylaxis regimens. - Answer - -Oral surgery—amoxicillin;
-GI or GU procedures—ampicillin and gentamicin before and amoxicillin after
The 6 P's of ischemia due to peripheral vascular disease. - Answer - Pain, pallor,
pulselessness, paralysis, paresthesia, poikilothermia
Virchow's triad. - Answer - Stasis, hypercoagulability, endothelial damage
The most common cause of hypertension in young women. - Answer - OCPs
The most common cause of hypertension in young men. - Answer - Excessive EtOH
,3
"Stuck-on" appearance. - Answer - Seborrheic keratosis
Red plaques with silvery-white scales and sharp margins. - Answer - Psoriasis
The most common type of skin cancer; the lesion is a pearly-colored papule with a
translucent surface and telangiectasias. - Answer - Basal cell carcinoma
Honey-crusted lesions. - Answer - Impetigo
A febrile patient with a history of diabetes presents with a red, swollen, painful lower
extremity. - Answer - Cellulitis
A 55-year-old obese patient presents with dirty, velvety patches on the back of the neck.
- Answer - Acanthosis nigricans. Check fasting blood sugar to rule out diabetes
Dermatomal distribution. - Answer - Varicella zoster
Flat-topped papules. - Answer - Lichen planus
Iris-like target lesions. - Answer - Erythema multiforme
A lesion characteristically occurring in a linear pattern in areas where skin comes into
contact with clothing or jewelry. - Answer - Contact dermatitis
Presents with a herald patch, Christmas-tree pattern. - Answer - Pityriasis rosea
A 16-year-old presents with an annular patch of alopecia with broken-off, stubby hairs. -
Answer - Alopecia areata (autoimmune process)
Pinkish, scaling, flat lesions on the chest and back. KOH prep has a "spaghetti-and-
meatballs" appearance. - Answer - Pityriasis versicolor
Four characteristics of a nevus suggestive of melanoma. - Answer - Asymmetry, border
irregularity, color variation, large diameter
Premalignant lesion from sun exposure that can → squamous cell carcinoma. - Answer
- Actinic keratosis
"Dewdrop on a rose petal." - Answer - Lesions of 1° varicella
"Cradle cap." - Answer - Seborrheic dermatitis. Treat with antifungals
Associated with Propionibacterium acnes and changes in androgen levels. - Answer -
Acne vulgaris
, 4
A painful, recurrent vesicular eruption of mucocutaneous surfaces. - Answer - Herpes
simplex
Inflammation and epithelial thinning of the anogenital area, predominantly in
postmenopausal women. - Answer - Lichen sclerosus
nodular
opaque
sun-exposed area
ulcerating
non-distinct borders
*associated with a risk of metastasis* - Answer - Squamous cell carcinoma
The most common cause of hypothyroidism. - Answer - Hashimoto's thyroiditis
Lab findings in Hashimoto's thyroiditis. - Answer - High TSH, low T4, antimicrosomal
antibodies
Exophthalmos, pretibial myxedema, and ↓ TSH. - Answer - Graves' disease
The most common cause of Cushing's syndrome. - Answer - Iatrogenic steroid
administration. The second most common cause is Cushing's disease
A patient presents with signs of hypocalcemia, high phosphorus, and low PTH. - Answer
- Hypoparathyroidism
"Stones, bones, groans, psychiatric overtones." - Answer - Signs and symptoms of
hypercalcemia
A patient complains of headache, weakness, and polyuria; exam reveals hypertension
and tetany. Labs reveals hypernatremia, hypokalemia, and metabolic alkalosis. -
Answer - 1° hyperaldosteronism (due to Conn's syndrome or bilateral adrenal
hyperplasia)
A patient presents with tachycardia, wild swings in BP, headache, diaphoresis, altered
mental status, and a sense of panic. - Answer - Pheochromocytoma
Should α- or β-antagonists be used first in treating pheochromocytoma? - Answer - α-
antagonists (phentolamine and phenoxybenzamine)
A patient with a history of lithium use presents with copious amounts of dilute urine. -
Answer - Nephrogenic diabetes insipidus (DI)
An antidiabetic agent associated with lactic acidosis. - Answer - Metformin
