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Fitzgerald ACNP Review: Questions & Complete Answers
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Fitzgerald ACNP Review: Questions & Complete Answers
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Fitzgerald ACNP Review: Questions & CompleteAnswers
Sensitivity vs Specificity Right Ans - Sensitivity: likelihood that someone
who has the disease will positive. (SnNout, Neg helps you rule OUT)
Specificity: likelihood that someone who doesn't have the disease will test
negative (SpPin, Pos helps you rule IN)
Ranking of study types Right Ans - Systematic reviews
RCT
Cohort studies
Case-Control
Case series/case reports
Expert opinion
Stages of change Right Ans - Precontemplation- not interested
Contemplation
Preparation
Action
Maintenance/relapse
Exercise recommendations Right Ans - Either 150 minutes weekly of
moderate activity, or 75 minutes weekly of vigorous activity, plus muscle
strengthening twice weekly.
Breast cancer screening recs Right Ans - Very weak/no evidence for self-
exam/clinical exam.
There are multiple guidelines. Either annual or biennial mammography
starting sometime between 40 and 50, and ending with the costs outweigh the
benefits d/t life expectancy/health status.
Colorectal cancer screening recs Right Ans - Annual FOBT (or FIT, fecal
immunochemical test) starting at 50 years.
AND/OR some sort of imaging (flexible sigmoidoscopy, double contrast
barium enema, or CT colongraphy) every 5 years.
,AND/OR colonoscopy every 10 years.
If any of the non-colonoscopy tests are positive, they need a colonoscopy.
Lung cancer screening recs Right Ans - People 55-74 with a >30 pack-year
smoking history, who are either current smokers or quit in the last 15 years,
can get a low-dose computed tomography (LDCT) screening annually.
Cervical Cancer screening recs Right Ans - No screening before 21.
Pap smear every 3 years from 21 to 29.
From ages 30-65, co-test (Pap + HPV test) every 5 years or Pap alone every 3
years.
Stop screening at 65 unless they have specific risk factors or previous positive
tests.
Prostate Cancer screening recs Right Ans - USPSTF recommends against
use of PSA as a screening test- should only be used when patients have
symptoms that suggest prostate cancer.
BRCA screening recs Right Ans - Women with family history should be
tested with a BCRA-specific family history screening tool, and if positive,
should get genetic counseling and then gene testing.
5 W's of postop fever Right Ans - Wind (atelectasis).
Water (UTI).
Wound (wound infection).
Walking (DVT)
Wonder drug (drug fever).
Also, volume contraction.
Basics of I&D Right Ans - Deep penetration at the crown of the abscess
Explore the wound to break up loculations
Copious irrigation with normal saline
,Difference between UTI and pyelo Right Ans - UTI is only urinary
symptoms- dysuria, frequency, and urgency. If they have fever, n/v, or CVA
tenderness, suspect pyelo.
Treatment for pyelo or complicated UTI Right Ans - Urine C&S, blood
cultures, and CBC.
Admit to hospital for IV abx if they have n/v or +blood cultures.
Send home with 10-14 day course (typically a fluoroquinolone) if not. Admit
them if it doesn't resolve.
Complicated UTI inclues men, pregnant women, anyone who has a foley or has
recently had antibiotics.
Treatment for uncomplicated uti Right Ans - 3 days of bactrim (TMP-SMX).
OR
5 days of macrobid (nitrofurantoin).
If they fail that, they get 10-14 days of PO abx (typically a fluoroquinolone). If
they fail that, admit them.
Outpatient ABX for non-MRSA (non-purulent) cellulitis Right Ans - A 10
day course of one of the following
Cephalexin
Penicillin VK
Clindamycin
Inpatient ABX for non-MRSA (non-purulent) cellulitis Right Ans - Cefazolin
IV
Clindamycin IV
Vancomycin IV (if they have a PCN allergy)
Treat until afebrile, then switch to PO penicillin V-K for 10 days
Outpatient ABX for MRSA (purulent) cellulitis Right Ans - 5-10 days of one
of the following:
, Clindamycin
TMP-SMX
Doxycycline
Inpatient treatment of MRSA cellulitis Right Ans - Vancomycin IV
Linezolid PO or IV
Definition and treatment of mild c diff Right Ans - Mild = WBC <15k and no
increase in Cr
Treatment: PO metronidazole for 10-14 days
Definition and treatment of moderate c diff Right Ans - WBC >15K
>50% increase in serum creatinine
Treatment: Vancomycin PO for 10-14 days
Treatment of severe c diff Right Ans - Flagyl IV + PO vancomycin
Gonorrhea Right Ans - Purulent drainage in men, typically asymptomatic in
women. Major cause of infertility.
Test either via swab or urine sample. Always test and treat simultaneously for
gonorrhea and chlamydia.
Treatment: one-time IM injection of Ceftriaxone. Also treat for chlamydia (1
PO dose of azithromycin)
Chlamydia Right Ans - Most common bacterial STI
Typically asymptomatic, may cause purulent drainage. Major cause of
infertility.
Test by either swab or urine sample. Always test and treat simultaneously for
gonorrhea and chlamydia.
Treatment: 1 PO dose of azithromycin. Also treat for gonorrhea (one-time IM
injection of Ceftriaxone)
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