Nurse Practitioner

Sample question: A 2-year-old boy is brought by his parents to the clinic because of opacity and hyperpigmentation of both eyes. His skin is noted to be dry and scaly, especially on the arms, legs, shoulders, and buttocks. He also gets sick frequently. Physical examination reveals an afebrile and weak-looking child. There is a note read more…

Polycystic Ovarian Syndrome (PCOS) Patient will be an obese female Complaining of amenorrhea, obesity, hirsutism PE will show bilateral ovarian enlargement, acanthosis nigricans Labs will show high LH:FSH, androgen excess Most commonly caused by insulin resistance Treatment is combination OCPs, lifestyle changes, metformin Sample question: A 26-year-old obese woman with a 2-year history of increased acne, abnormal hair growth, and menstrual abnormalities presents to her obstetrician for read more…

Ulcerative Colitis Patient will be 15–30 years old Complaining of bloody diarrhea, crampy abdominal pain, and tenesmus Colonoscopy will show continuous mucosal inflammation always involving the rectum Treatment is sulfasalazine, surgery is curative Complications: Toxic megacolon, ↑ colon cancer risk Sample question: A 32-year-old man presents to clinic with worsening colicky stomach pains, and bloody, mucous streaked diarrhea. He reports he has no fever, nausea or vomiting. read more…

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…

Subdural Hematoma Patient will be elderly or alcoholic With a history of a fall or traumatic head injury Complaining of headache, mental status changes, seizures, or focal deficits Diagnosis is made by non-contrast CT, crescent-shaped hematoma Most commonly caused by rupture of the bridging veins Treatment is neurosurgical consultation Sample question: A 68-year-old man presents to the ED after a fall down 12 stairs. read more…