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AANP Review Questions and Answers 2025 (Verified Answers)
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A 64 year old with HTN and DM presents with productive cough, fever, body aches. What diagnosis is most likely? a. Acute bronchitis b. Chronic bronchitis c. Pneumonia d. Pertussis - ANSWER-c. Pneumonia 1st clue: 64 year old 2nd clue: multiple comorbidities 3rd clue: cough, fever what was the stem of the question? Indications for a chest xray with acute cough - ANSWER-abnormal vital signs (increased RR or HR, temp >38c, 100.4F rales, consolidation
or equal 75 years of age with cough*** ***Pneumonia in older patient: tachypnea, decreased O2 sat, OR change in mental status or behavior A 75 year old patient wo smokes and has COPD presents with a worsening cough, weight loss, fatigue, and an enlarged right supraclavicular node. Which finding is most indicative of a right lung tumor?
3 weeks - ANSWER-3. 1-3 weeks The patient with bronchitis will have evidence of upper AND lower airway symptoms.
COUGH, COUGH, COUGH, usually worse at night! What is the management of bronchitis? - ANSWER-Treat symptoms! Time is the only thing for bronchitis ABX usually prescribed, but usually not necessary Differential Diagnosis for Acute Bronchitis - ANSWER-PND Asthma PNA Pertussis TB Supraclavicular nodes: associated with high rates of malignancy. What organs are on the right vs left?
If both are choices are present (PFT and Spirometry), choose PFT. Otherwise spirometry. What is the diagnostic criteria for COPD? - ANSWER-Airflow obstruction <70% (FEV1/FVC ratio) What are some meds for COPD? - ANSWER-Beta agonist - SABA (about 4 hrs duration) & LABA (12 hrs duration) BRONCHODILATION Anticholinergics - ipratropium. works great in combo with beta agonists PREVENT BRONCHOCONSTRICTION Theophylline - resp stimulant. causes nervousness, like caffiene, xanthines, need theo levels. watch out for TOXIC effects (drug-drug). metabolized in liver. if pt develops lower resp infections, erythro and clarithro metabolized in liver and can cause theo levels to rise. Inhaled/systemic corticosteroids - addresses inflammatory component Strategy for prescribing meds for COPD - ANSWER-Bronchodilators and anticholinergics: improve lung function, decrease dyspnea and exacerbations Steroids: decrease exacerbations, modestly slow progression of symptoms. A patient who has COPD is using an albuterol inhaler multiple times daily. What med is unsafe in combination with inhaled albuterol?
SOB or chest tightness What is asthma? - ANSWER-A chronic, reversible (as opposed to COPD: irreversible), airway obstruction, inflammation and airway hyper-responsiveness. Triggers for asthma - ANSWER-Exercise Cold air Exposure to irritants, dust, molds, furry animals, etc Infection What choice below characterizes exercise induced asthma?
peripheral smear TIBC (transferrin) - ANSWER-Serum iron - iron floating around Serum ferritin - iron in storage retic count - ability of bone marrow to produce RBC's. Reticulocyte is an immature RBC. If anemic, the retic count should go up. Peripheral smear - visual description of the RBC TIBC - total iron binding capacity. Reciprocal relationship. Capacity of RBC to bind to iron. Palm of hand is RBC, fingers are binding site. TIBC elevated in IDA (iron def anem). Iron Deficiency Anemia - ANSWER-Microcytic, hypochromic (small and pale) causes (men): occult malignancy ASA use blood loss - usually through GI tract impaired RBC production causes (female) occult malignancy menorrhagia poor iron absorption impaired RBC production A patient has HGB=9.1, HCT=27%. Which findings are consistent with iron deficiency anemia? Norms: MCV:80-100, MCH:28-
Neck stiffness Neuro deficits Papilledema - swelling of optic disc, almost always bilateral Unilateral papilledema is a classic finding in which condition?