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ACNP Review - Questions With Detailed Solutions
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ACNP Review - Questions With Detailed Solutions
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ACNP Review - Questions With Detailed SolutionsContraindications to HRT in post-menopausal women Right Ans -
Unexplained vaginal bleeding
Acute liver disease
Chronic impaired liver function
Thrombotic disease
Neuro-opthamologic vascular disease
Endometrial or breast cancer
Caution in: seizure disorders or dyslipidemia
Cardiovascular disease or risk factors for heart disease
Generally recommended not to start HRT after menopause (51)
CN I Right Ans - Olfactory (Smell)
CN II Right Ans - Optic (Vision)
CN III Right Ans - Oculmotor (eyelid and eye movement)
CN IV Right Ans - Trochlear (eye movement - down and laterally)
CN V Right Ans - Trigeminal
CN VI Right Ans - Abducens (lateral eye movement)
CN VII Right Ans - Facial (facial expression, tears, saliva, taste)
CN VIII Right Ans - Vestibulocochlear (hearing, balance)
CN IX Right Ans - Glossopharyngeal (oral sensation, taste, salivation)
CN X Right Ans - Vagus (aortic blood pressure, slows heart rate, stimulates
digestive organs, taste)
CN XI Right Ans - Accessory (shoulder elevation, head turning, swallowing)
CN XII Right Ans - Hypoglossal (tongue movement)
,A.D.P.I.E. Right Ans - Assessment, Diagnosis, Plan, Implementation,
Evaluate
Leading Cause of Death Age 15-34 Right Ans - Unintentional injury, suicide,
homicide
Leading Cause of Death 35-44 Right Ans - Unintentional injury, malignancy,
heart disease
Leading Cause of Death 45-64 Right Ans - Malignancy, Heart disease,
unintentional injury
Leading Cause of Death 65+ Right Ans - Heart Disease, malignancy, chronic
lower respiratory disease
Overall leading causes of death Right Ans - Heart disease, malignancy,
chronic lower respiratory disease
Sensitivity Right Ans - When Negative, helps rule Out the disease
Specificity Right Ans - When Positive, helps rule IN the disease
Breast CA screening guidelines Right Ans - ACS: Mammography annually at
45-54, then biennially for as long as good health and life expectancy >10 years
USPSTF: biennially age 50-74
Colorectal CA screening guideline Right Ans - Fecal occult blood test
annually, starting at age 50
Flexible sigmoidoscopy every 5 years OR Colonoscopy every 10 years
Lung CA screening guideline Right Ans - Low dose CT for individuals 55-74
in fairly good health with >30 pack-year history, current smokers, or <15
years since quitting
Cervical CA screening guideline Right Ans - Begin at age 21, Pap every 3
years 21-29, Pap and HPV every 5 years 30-65 or Pap alone every 3 years.
Prostate screening guideline Right Ans - USPSTF recommends against PSA
,Neutrophils Right Ans - Destroy Bacteria. NL 57-67%
Lymphocytes Right Ans - Destroy Viruses. NL 22-33%
Eosinophils Right Ans - Combats allergens, parasites. NL 1-3%
Bands Right Ans - Immature neutrophils, increase in big infections. NL 3-
5%
Post Op causes of fever Right Ans - Bacteria (drainage, not just redness,
eval lines/drains, abx w evidence of neutrophilia/drainage/positive cultures)
Volume contraction (dehydration, hypovolemia, increased BUN/Creat, URINE
OUTPUT <30 mL/hr or 05.-1 mL/kg/hr)
Atelectasis (CXR, cough, SOB, incentive spirometer, OOB)
Contraindications to fever Right Ans - Myocardial disease (increases O2
requirement 15%)
Pregnancy
Elderly (caution, already volume down, decreased caloric reserves etc)
Active Immunity Right Ans - Protection onset within 1 month, lifelong
duration
Most common bacterial STI Right Ans - Chlamydia
Most common STI Right Ans - HPV
HIV Treatment Right Ans - ELISA >99.9% sensitivity
Western Blot 99.9% specificity
Offer antiretrovirals at time of diagnosis, begin when CD4 count <350 or if
clinically immunocompromised
Passive Immunity Right Ans - Onset of protection within hours of dose,
duration is usually time limited: 6-9 months
Influenza vaccine start and interval Right Ans - Start at age 6 months, then
annually should receive inactivated influenza vaccine. High dose IIV is
available for adults age 65 and older.
, LAIV should not be used: Right Ans - In age less than 2 years, more than 49.
Pregnant women, immunocompromised individuals, egg allergy
Egg allergy and Flu Vaccine Right Ans - People with only hives following
exposure to egg should get the vaccine. Recombinant vaccine should be used,
especially in people ages 18 and older with history of angioedema reaction to
eggs. People able to eat lightly cooked eggs are unlikely to have a reaction.
Flu vaccine contraindication Right Ans - History of severe allergic reaction
to flu vaccine.
Tdap Vaccine Right Ans - Pregnant women should get one every
pregnancy, persons aged >11 years with unknown or incomplete
immunization, and then every 10 years.
Varicella Vaccine Right Ans - Emphasized for health care personnel, family
members of immunocompromised patients, those at high risk for exposure or
transmission. Pregnant women who are not immune should receive first dose
at completion of pregnancy and second dose 4-8 weeks later.
HPV vaccine Right Ans - 3 dose series recommended for males, females,
men who have sex with men, and immunocompromised patients age 11-26.
Not recommended for pregnant women.
Zoster Vaccine Right Ans - Recommended for all adults aged >60 years,
regardless of history of zoster. Contraindicated in severe immunodeficiency or
pregnancy.
MMR Vaccine Right Ans - Adults born before 1957 generally considered to
be immune. All adults born after 1957 should have documentation of 1 or
more MMR vaccine unless medical contraindication
Measles component Right Ans - 2nd dose MMR recommended (minimum
28 days after 1st) for students in postsecondary educational institutions,
health care workers, and international travelers.
Hep B vaccine Right Ans - For sexually active persons not in a long term
mutually monogamous relationship (more than 1 sex partner in the last 6
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