AANP exam 77 Questions with Answers Tanner Stage I: Girls - CORRECT ANSWER prepubertal Tanner Stage II: Girls - CORRECT ANSWER Breast bud Tanner Stage III: Girls - CORRECT ANSWER Breast and... nipple growth, one mound, no separation Tanner Stage IV: Girls - CORRECT ANSWER Nipple/areola elevated from breast, secondary mound Tanner Stage V: Girls - CORRECT ANSWER Adult Tanner Stage I: Boys - CORRECT ANSWER prepubertal Tanner Stage II: Boys - CORRECT ANSWER testes/scrotum enlarges, scrotum darkens, more ruggae Tanner Stage III: Boys - CORRECT ANSWER penis grows longer, scrotum continues to grow Tanner Stage IV: Boys - CORRECT ANSWER penis becomes wider, continues getting longer, scrotum larger, darker, more ruggae Tanner Stage V: Boys - CORRECT ANSWER adult kiesselbach's plexus - CORRECT ANSWER blood vessels on anterior septum where 90% of nosebleeds originate Finkelstein's test - CORRECT ANSWER used to dx DeQuervain's tenosynovitis, thumb in fist, bend wrist towards little finger. positive c pain in wrist on thumb side anterior drawer test - CORRECT ANSWER used to check for ACL injury, pull tibia forward from femur c both hands on tibia c pt laying and knee flexed at 90 deg, positive c >5mm translation or increase laxity compared to unaffected side lachman maneuver - CORRECT ANSWER tests ACL integrity, pt on back knee flexed 20-30 deg, one hand stabilize femur, other applies pressure to back of knee, positive c mushy end point pivot test - CORRECT ANSWER tests ACL integrity, pt on back, knee fully extended, rotate foot internally. Apply valgus stress while flexing knee. Positive= translation of tibia on femur McMurray test - CORRECT ANSWER checks for meniscus injury, pt supine, knee flexed. medial: apply valgus force, externally rotate the foot and passively extend knee. lateral: apply varus force, internally rotate foot and passively extend knee. Positive= audible or palpable snap in knee during extension diabetic retinopathy - CORRECT ANSWER cotton wool spots, hard exudates, neovascularization, microaneurysms hypertensive retinopathy - CORRECT ANSWER AV nicking, silver and/or copper wire arterioles Tinel's sign - CORRECT ANSWER Detects irritated nerves, most often c carpal tunnel. Tap on median nerve. Positive= tingling down thumb, index, and middle finger Phalen's maneuver - CORRECT ANSWER Detects carpal tunnel syndrome. allow wrists to fall into maximum flexion, hold for 60 seconds. Positive= tingling down thumb, index, and middle finger Kernig's sign - CORRECT ANSWER sign of meningitis. Pt supine, hip flexed at 90, attempt to straighten leg. Positive= inability to straighten leg Maculopapular rash in lace like pattern - CORRECT ANSWER Fifth's disease Maculopapular rash with papules, vesicles, and crusts - CORRECT ANSWER Varicella Maculopapular rashes that are oval shaped with herald patch or Christmas tree - CORRECT ANSWER pityriasis rosea vesicular rashes on an erythematous base - CORRECT ANSWER herpes simplex scarlet fever (scarletina) - CORRECT ANSWER caused by group A strep, rash is fine, red, and rough textured. non-puritic. accompanied by sore throat, stawberry tongue, and peeling of hands and feet. tx c abx for strep (Penicillin) S3 - CORRECT ANSWER Heard best over pulmonic area (2nd L intercostal space), indicates heart failure, ventricular overload psoas sign (ilipsoas muscle sign) - CORRECT ANSWER used c acute abdomen, appendicitis. Pt lays on left side, hyperextends right thigh. Positive= abd pain obturator sign - CORRECT ANSWER used c acute abdomen, appendicitis. Pt supine, flex knee and hip to 90 deg, internally rotate hip. Positive= abd pain (c R leg for appendix) Rovsing's sign - CORRECT ANSWER used c acute abdomen, appendicitis. Palpate LLQ, Positive= pain in RLQ McBurney's point - CORRECT ANSWER 2/3rds of distance from umbilicus to the R anterior superior iliac spine. Deep tenderness at this point may be indicative of appendicitis Hirschsprung (Hirschberg) test - CORRECT ANSWER aka corneal light reflex. Checks for strabismus. Rocky Mountain spotted fever - CORRECT ANSWER S central US. Red rash on wrists and ankles that spreads centrally that appears 3rd day after fever (103-105). Can cause death if not tx in 1st 8 days of symptoms Cholesteatoma - CORRECT ANSWER Cauliflower like growth in ear c foul smelling discharge. Can eat through tm, bone, & nerves. Refer to EENT Koplik's spots - CORRECT ANSWER Small red papules with white center inside cheeks by lower molars. Indicates measles, before rash. hordeolum - CORRECT ANSWER stye. infection on hair follicle of eye lash. tx c abx eye drops and warm packs. Pinguecula - CORRECT ANSWER yellow triangular thickening of the bulbar conjunctiva. on inner and outer margins of cornea. Caused by UV light damage. Pterygium - CORRECT ANSWER yellow triangular thickening of the bulbar conjunctiva, extends to the cornea. Caused by UV light damage. Chalazion - CORRECT ANSWER chronic inflammation of meibomian (sweat) gland of eyelid. small painless movable bead-like nodule. Should resolve within weeks. Rinne test - CORRECT ANSWER tests for conductive hearing loss. normal= AC>BC Webber test - CORRECT ANSWER tuning fork on middle of head. Abnormal= lateralization to affected ear meningococcemia prophylaxis - CORRECT ANSWER Rifampin for close contacts basal cell carcinoma - CORRECT ANSWER pearly or waxy lesion with atrophic or ucerated center that does not heal. acral lentiginous melanoma - CORRECT ANSWER dark brown to black lesions on nail bed, palmar, and plantar surfaces. subungal (nail bed) are longitudinal brown/black bands. Most common melanoma in African Americans and Asians. actinic keratosis - CORRECT ANSWER numerous dry, round, red colored lesions with rough texture that do not heal in older adults. on sun exposed areas. May lead to squamous cell carcinoma. seborrheic keratosis - CORRECT ANSWER soft, round wart-like growths on trunk, tan to black. benign. Koebner phenomenon - CORRECT ANSWER seen c psoriasis. New plaques over areas of skin trauma. Auspitz sign - CORRECT ANSWER seen c psoriasis. pin point bleeding under where plaque was removed. Amsler grid - CORRECT ANSWER Used to assess for macular degeneration presbycusis - CORRECT ANSWER age related hearing loss. bilateral, symmetrical, high frequencies. Hemic murmur - CORRECT ANSWER murmur heard in persons with no valvular lesions, heard with anemia erysipelas - CORRECT ANSWER st. anthony's fire. tender, erythemous plaques with sharply demarcated boarder. Type of skin infection, usually caused by group B strep. Vibrio vulnificus - CORRECT ANSWER micro organism that can cause rapidly expanding cellulitis or sepsis, found in brackish or salt water. Somogyi effect - CORRECT ANSWER increased morning fasting blood sugar d/t too much insulin or hypoglycemia at night keratoacanthoma - CORRECT ANSWER rapid growing, domed shaped with surrounding erythema. Maybe self limiting or lead to squamous cell carcinoma. Top CAP micro organisms - CORRECT ANSWER 1) Strep. pneumoniae 2) Haemophilus pneumonia PPD + c >5mm - CORRECT ANSWER HIV+, exposure to infective TB, immunocompromised, children <5 c close contact or symptoms, +CXR changes PPD + c >10mm - CORRECT ANSWER homeless, IV drug user, healthcare worker, employee/resident of high incidence area, recent immigrant from high incidence country, children < 4 yrs, any child exposed to high risk adults Physiologic split S2 - CORRECT ANSWER <30 yrs. Best heard over pulmonic area on inspiration Split S2 - CORRECT ANSWER atrial septal defect S4 - CORRECT ANSWER uncontrolled HTN, recurrent MI blue dot sign - CORRECT ANSWER torsion of the appendix testis, most common in school aged boys, blue colored round mass on testes surface Prehn's sign - CORRECT ANSWER Positive= relief of pain c scrotal elevation. indicative of epididymitis heberden's nodes - CORRECT ANSWER bony nodules on DIP, seen c OA Bouchard's nodes - CORRECT ANSWER bony nodules on PIP, seen c OA swan neck deformity - CORRECT ANSWER flexion of DIP joint with hyperextension of the PIP joint, seen c RA Boutonniere deformity - CORRECT ANSWER Hyperextension of the DIP with flexion of PIP, seen c RA Cullen's sign - CORRECT ANSWER blue discoloration around umbilicus, seen c acute pancreatitis, ruptured ectopic pregnancy Grey-Turner's sign - CORRECT ANSWER blue discoloration on the flanks, seen c acute pancreatitis spurling maneuver - CORRECT ANSWER tilt head towards radicular pain, press down. positive=pain radiating down that side. indicates cervical rediculopathy straight leg raise test - CORRECT ANSWER tests for lumbar root compression drop arm test - CORRECT ANSWER tests for rotator cuff markel sign - CORRECT ANSWER aka heel jar test. up on heels, drop suddenly. sign of paritoneal irritation blumberg sign - CORRECT ANSWER aka rebound tenderness Murphy's maneuver - CORRECT ANSWER press deeply on RUQ under costal margin during inspiration. mid-inspiratory arrest = positive. Indicative of cholecystitis. Osler nodes - CORRECT ANSWER painful violet nodes on fingers and feet, sign of infective endocarditis Janeway lesions - CORRECT ANSWER tender red spots on the palms/soles [Show More]
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