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ACNP BOARDS: Questions And Accurate Answers (A+)
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ACNP BOARDS: Questions And Accurate Answers (A+)
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ACNP BOARDS: Questions And Accurate Answers (A+)Hypertonic Hyponatremia Right Ans - (serum osmolality > 290 mosm/kg)
Hypertonic Hyponatremia causes Right Ans - Hyperglycemia: Usually from
HHNK Osmolality is high and the Na is low
Somogyi Effect: Right Ans - Nocturnal hypoglycemia develops stimulating a
surge of counter regulatory hormones which raise blood sugar.
0300 glucose decreases
0700 glucose increases
Somogyi Effect Treatment Right Ans - Reduce or omit the at-bedtime dose
of insulin
Dawn Phenomenon Right Ans - Results when tissue becomes desensitized
to insulin nocturnally.
Blood glucose becomes progressively elevated throughout the night.
0300 elevated glucose
0700 elevated glucose
Dawn Phenomenon Treatment: Right Ans - Add or increase the at-bedtime
dose of insulin
Diabetes Mellitus (Type 1 DM) Right Ans - Most common in adolescents but
may occur in adulthood
Diabetes Mellitus (Type 1 DM) Right Ans - Previously known as insulin
dependent or juvenile diabetes
Diabetes Mellitus (Type 1 DM) Right Ans - Islet cell antibodies found in
approximately 90 % of patients within 1st year of diagnosis
Diabetes Mellitus (Type 2 DM) Right Ans - Previously known as non-IDDM
or adult onset DM
Diabetes Mellitus (Type 2 DM) Right Ans - Most common type of diabetes ?
90 % diabetes in the United States
,Diabetes Mellitus (Lype 2 DM) Right Ans - Circulating insulin is inadequate
to meet the patient's insulin needs
Diabetes Mellitus (Type 2 DM) Right Ans - Caused by either tissue
insensitivity to insulin or an insulin secretory defect resistance and/or
impaired resulting in insulin production
Diabetes Mellitus (Lype 2 DM) Right Ans - Associated with obesity &
Syndrome X: obesity, hypertension, abnormal lipid profiles (low HDLs and
high triglycerides)
What is Metabolic syndrome: Right Ans - Waist circumference: > 40 inches
(101.6 cm) in men and >35 inches (88.9 cm) in women
BP > 130/85
Triglycerides >150
FBG> 100
HDL: <40 in men and< 50 in womer
Diabetes Mellitus (Type 1 DM) S/S: Right Ans - Polyuria
Polydipsia
Polyphagia
Nocturnal enuresis
Weight loss
Weakness/fatigue
Diabetes Mellitus (Type 1) Labs / Diagnostics Right Ans - -Random plasma
glucose 200 mg / dL Serum fasting blood sugar 2126 mg/dL Ketonemia,
ketonuria, both
BUN/creatinine elevated (dehydration)
Inpaired glucose tomerance:
FBG >100 and < 125
Component of physical for adolescents? Right Ans - Htwgt, skin exam, oral
exam, hearing. abuse/neglect/depression, BP (120/80)
Time of Visit for Adolescents? Right Ans - 3 Visits (11-14, 15-17, & 18-21
yoa)
,When to start HPV vac with Females? Right Ans - Gardasil age 1-26;
Gardasil 9 age 9-26; Cervarix- age e 10-25. 3 series on zero, 2 & 6 months
schedule
When to screen for syphilis (all ages)? Right Ans - When sexually active;
PRN or w/ Pap smear
When to start testicular/breast exam for males? Right Ans - Start at
adolescent (11 yoa); monthly
When to screen for HIV (all ages)? Right Ans - Sexual activity or IV drug
user; ALWAYS assess knowledge of prevention, contraception, a nd
protection, etc
When to screen for meningococcal (menomune, Menactra, Menveo) and
Vaccinate? Right Ans - Everyone 11-18 yoa; Revaccinate once for high risk
(college freshman in dorms) after 5 years from last.
When to give the Influenza vaccine to adolescents and older? Right Ans -
Annually
When to give Td vaccine? Right Ans - Age 7 and up; Q10 years; Substitute 1
dose w/ Tdap (Adacel): Not indicated after 65 yoa
When to give the pneumococcal vaccine? Right Ans - PPSV23: Age 19-64
who is smoker, asthma, COPD, DM, or alcoholic.
When to do PPD screening? Right Ans - Once during adolescents and Q2
years if at risk or exposure to TB
How often to do physical exam for ages 20-59 ? Right Ans - Q5-6 years
How offen to do physical exam for 60 & older? Right Ans - Q 2 years
When to start pap smear with GC & Chlamydia screen and Cytology? How
often? Right Ans - Age 21; Q3 years; Discontinue> 65 w/3 consecutive
normal cytology or no a bnormal test in past 10 years
, When to start HPV Co-test (Cytology +HPV)? How often? Right Ans - 30 to
65 yoa: Q5years
When to start self-breast Exams for Females? Clinical Breast Exams? Right
Ans - Self-Breast - age 21; Clinical - Adolescent, Q3years; Age 40 and up
annually.
When to evaluate BP? Right Ans - Age 20, Q visit or Q2 years
When to start screen total cholesterol and HDL Full fasting panel? Right
Ans - Age 20, Q5 years unless cholesterol > 200
How often should dental cleaning and checkups be performed? Right Ans -
Q 6-12 months
When to start mammography ? Right Ans - ACS: Ages 45-54 anually>55 yoa
Q2 years USPSTF:Q2 years; Ages 50-74 ACOG: Annually, Ages 50-74
When to start prostate screening (digital rectal exam and PSA? Right Ans -
Age 40 with family hx of prostate cancer or African American; or Age 50 for
everyone else
.First ECG should be done at what age? Right Ans - Age 40 for baseline or
cardiac risk factors; then PRN as indicated
When should colorectal cancer screening start? Right Ans - Age 50
What does a colorectal cancer screening consist of? Right Ans - Annual
Fecal Occult Blood test (FOBT) Flexible Sigmoidoscopy (Q5years), Total colon
exam by colonoscopy (Q10 years) or double contrast barium enema (DCBE)
Q5 10 years.
When should a Glaucoma screening (Tonometry) start? How often? Right
Ans - Age 40; Annually
When should Herpes Zoster (Zostavax) be given? How often? Right Ans -
Age 60; Once
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