Family Nurse Practitioner

There are two certification options. American Academy of Nurse Practitioners (AANP) is a board examination. Upon passing, the credentials awarded are FNP-C (C-denotes certified) 2,3 Questions: 150 questions (135 are scored; 15 are pretest and not scored) 2 Exam Breakdown Assessment (~36%) Diagnosis (~24%) Plan (~23%) Evaluation (~17%) Exam Breakdown by Patient Age: Prenatal (~3%) read more…

Rocky Mountain spotted fever (RMSF) Patient with a history of recently being in the woods hiking or camping Complaining of abrupt onset of severe headache, photophobia, vomiting, diarrhea, and myalgia PE will show maculopapular eruption on the palms and soles Most commonly caused by Rickettsia rickettsia Treatment is ALWAYS doxycycline, even in children Sample question: A 19-year-old woman presents with four days of read more…

Anticholinergic Toxidrome PE will show hyperthermia, tachycardia, mydriasis, and dry skin Treatment is supportive care alone or in combination with antidotal therapy with physostigmine Comments: Classes of medications with anticholinergic properties include antihistamines, tricyclic antidepressants, and sleep aids Mnemonic: “Mad as a hatter” (AMS), “blind as a bat” (mydraisis), “red as a beet” (flushed skin), “hot as a hare”(anhydrosis), and “dry as read more…

de Quervain Tenosynovitis Patient will be complaining of radial wrist pain PE will show pain on ulnar wrist deviation with thumb in fist (Finkelstein’s test) Treatment is thumb spica splint, NSAIDs Sample question: A 20-year-old man who is employed in construction presents with pain to his thumb and wrist for 4 months. He states that the pain worsens while he is read more…

Kawasaki Disease Patient is a child With a history of high fever for 5 days Conjunctivitis, rash, adenopathy, strawberry tongue, hand/feet edema, fever Treatment is IVIG + aspirin Comments: #1 cause of pediatric acquired heart disease, risk for coronary artery aneurysm Mnemonic: CRASH and burn: Conjunctivitis, Rash, Adenopathy, Strawberry tongue, Hand/feet edema, Fever Sample question: A 4-year-old girl is brought to read more…

Wernicke Encephalopathy Patient will be a chronic alcoholic Complaining of ataxia and confusion PE will show nystagmus Most commonly caused by thiamine (B1) deficiency Treatment is aggressive thiamine repletion Comments: replace thiamine BEFORE glucose Sample question: A 53-year-old woman with chronic alcohol use presents with confusion and blurred vision. Her vital signs are normal. Physical examination reveals a wide-based gait, inability to abduct her read more…

Achalasia Patient will complain of dysphagia to solids and liquids PE will show absent peristalsis in lower esophagus Barium swallow shows “bird beak” appearance Diagnosis is made by esophageal manometry increased LES pressure Sample question: A 60-year-old man comes to the clinic complaining of difficulty swallowing, heartburn, chest pain, and mild weight loss. He has difficulty swallowing solids and liquids and read more…

Tetralogy of Fallot Patient with a history of episodes of cyanosis (tet spells) and squatting for relief PE will show pulmonic stenosis, right ventricular hypertrophy, overriding aorta, VSD CXR will show “boot-shaped” heart Comments: Most common cyanotic congenital heart disease Mnemonic: PROVe: Pulmonic stenosis, Right ventricular hypertrophy, Overriding aorta, VSD Sample question: A 1-year-old girl presents to the emergency room after her mother noticed that she became blue while crying. The patient subsequently read more…

Many of our savvy customers realize intuitively that there is a treasure trove of performance data accumulating in the background with each new question answered by each of our users (40,933,037 total questions answered, as of today).

Chlamydia Cervicitis Diagnosis is made by nucleic acid amplification testing (NAAT) Most commonly caused by Chlamydia trachomatis Treatment is azithromycin Comments: Most commonly reported sexually transmitted disease in the United States Empirically treat for concomitant gonorrhea The United States Preventive Services Task Force recommends routine screening for sexually active women < 24 years of age, and in women > read more…

Cushing’s Syndrome Patient will be complaining of amenorrhea, central obesity, depressive symptoms, and easy bruising PE will show purple striae, “moon face” (facial adiposity), “buffalo hump” (increased adipose tissue in the neck and upper back), and hypertension Diagnosis is made by 24-hr urine cortisol and testing ACTH levels Most commonly caused by hypercortisolism from ACTH-secreting pituitary tumor Comments: If cause is pituitary tumor, then read more…

Hypercalcemia Patient will be complaining of bone pain (Bones), kidney stones (Stones), abdominal pain (Groans), lethargy, psychosis (Psychiatric overtones) Labs will show ↓ QT interval Most commonly caused by: Malignancy (most common inpatient cause) Primary hyperparathyroidism (most common outpatient cause) Treatment is IV fluids Sample question: A 67-year-old woman who was recently diagnosed with breast cancer presents read more…

Pertussis (Whooping Cough) Patient with a history of nasal congestion, cough, and low-grade fever “Rapid fire,” repetitive coughing followed by an inspiratory “whoop” and post-tussive emesis Most commonly caused by Bordetella pertussis Treatment is a macrolide – azithromycin Sample question:  A 2-year-old boy who is new to your practice is brought to the clinic because of coughing. For the past two weeks, he has had rhinorrhea read more…

Acanthosis Nigricans Patient will be obese or diabetic PE will show thickened, velvety, darkly pigmented plaques on the neck or axillae Comments: Screen for diabetes in those not yet diagnosed Sample question: A 19-year-old woman presents to her primary care provider’s office for a rash on the back of her neck that has grown and gotten darker over read more…

Ankylosing Spondylitis Patient will be a male Complaining of low back pain that’s worse in the morning and improves with exercise X-ray will show multiple vertebral fusions (bamboo spine) Labs will show increased ESR Most commonly caused by presence of HLA-B27 Treatment is NSAIDs, physical therapy Comments: diseases associated with HLA-B27 PAIR: Psoriatic arthritis, Ankylosing spondylitis, Inflammatory bowel disease, Reactive arthritis Sample question: A 51-year-old man presents with low back read more…

von Willebrand Disease Patient with a history of a parent with similar symptoms Mucosal hemorrhage or bleeding that is difficult to control Labs will show decreased factor VIII, prolonged bleeding time Treatment is desmopressin (DDAVP) Comments: Most common inherited bleeding disorder, autosomal dominant Sample question: A 9-year-old child is being evaluated for frequent epistaxis and easy bruising tendencies. Bleeding time is prolonged, PT, PTT, read more…

Hypothyroidism Patient will be complaining of generalized weakness, fatigue, facial swelling, constipation, cold intolerance, and weight gain PE will show periorbital edema, dry skin, and coarse brittle hair Labs will show high TSH and low free T4, antithyroid peroxidase, and antithyroglobulin autoantibodies Most commonly caused by Hashimoto’s thyroiditis Treatment is levothyroxine Comments: Takes about 6 weeks to see treatment effects. Monitor TSH Hashimoto’s: Risk factor for non-Hodgkin lymphoma Sample Question: A 55-year-old woman presents to your office with complaints of fatigue, read more…

Hyphema Patient with a history of blunt or penetrating trauma Complaining of blurry vision PE will show unequal pupils, injected conjunctiva/sclera and blood in anterior chamber Treatment is eye protection and rest with the head of the bed at 30-45 degrees all the times A 13-year-old boy is brought to the urgent care clinic by his mother. He read more…

Meniere Disease Patient will be complaining of episodic low-frequency hearing loss, tinnitus with aural (ear) fullness, and vertigo lasting one to eight hours Diagnosis is made clinically Most commonly caused by too much inner ear endolymph and increased pressure within the inner ear Treatment is low salt diet, diuretics (HCTZ + triamterene) Example: A patient complains of read more…