10/22/24, 10:00 PM AANP EXAM, PRACTICE EXAM AND STUDY GUIDE NEWEST 2024 ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAI…
AANP EXAM, PRACTICE EXAM AND STUDY
GUIDE NEWEST 2024 ACTUAL EXAM 200
QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES
Terms in this set (201)
-autoimmune- decreased Ach receptor and
antibodies against sites
-weakness and rapid fatigue of muscles under
Myasthenia Gravis voluntary control
Symptoms/Patho -dropping eyelid, impaired voice, difficulty
swallowing, arm/leg weakness
-worsening throughout day as Ach drops- more
symptomatic at dinner
-Tensilon Test (anticholinesterase allowing for Ach)
looking for improved muscle responses in 5 minutes*
Myasthenia Gravis Tests - also check RA and ANA for coexisting autoimmune
disease
-EMGs
Myasthenia Gravis -slowly progressive- can lead to fatal aspiration
Complications
-Anticholinesterase drugs: Neostigmine QID*
-Prednisone high dose then taper
Myasthenia Gravis
-Thymectomy (thymus may be abnormal)
Treatment
-Plasmapheresis (get rid of antibodites against Ach
receptors)
,10/22/24, 10:00 PM AANP EXAM, PRACTICE EXAM AND STUDY GUIDE NEWEST 2024 ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAI…
-Aminoglycosides (gentomycin, tobramycin,
Never give this class of
neomycin)- they exacerbate disease leading to
meds in Myasthenia Gravis
difficulty swallowing and aspiration
What Hz tuning fork to use 512
for Weber Test
-Acromeagly-excess growth hormone
-Cushings- stim adrenal to increase cortisol
-Diabetes Insipidous- decreased antidiuretic hormone
Disease caused by
(vasopressin)
Pituitary Adenoma
(caution: in pts being treated for hypothyroid with no
response to high synthroid doses order CT to r/o
pituitary adenoma)
One pupil bigger then other
Anasacoria -can occur with M.S. and other coniditions-needs
investigated
-ocular symptoms*
#1 symptom presentation
-bursts of light and dark, anasacoria
in MS
-pallor of optic disc on microscopic exam
MRI- progressive demylinization of white matter*;
Diagnostics for MS
Autoimmune
-remission and attacks- symptoms aggravated by
physical and emotional stress
-sensory and vision abnormalities (anasacoria)
-symptoms on opposite side of body then brain
demylinzation
-intention tremor
Symptoms of MS -onset 20-30years
-balance and speech affected
-hyperreflexia +4
-babinski may be present on one foot (stroke lateral
foot upward and watch big toe)
-Lhermitte's sign
-incontinence- may have frequent UTI (>3 a year)
, 10/22/24, 10:00 PM AANP EXAM, PRACTICE EXAM AND STUDY GUIDE NEWEST 2024 ACTUAL EXAM 200 QUESTIONS AND CORRECT DETAI…
-diagnostic of MS
Lhermitte's sign* -lay supine and flex neck- this causes electric shock
down both arms
Acute (both cause weight gain):
-Glucocorticoids
-Baclofen for spasticity
MS Treatments
Reduce relapses:
-SQ Betaseron (Interferon beta 1b) QOD
-IM Avonex (Interferon beta 1a) Qweek
Acute prob involving PROXIMAL limb SYMMETRICAL
weakness that often begins in the legs and ASCENDs
quickly; unknown cause; Areflexia and facial paralysis
and respiratory paralysis may results; Maximum deficit
Guillian Barre BY 7 days; Tx: plasmapharesis or IgG
Polyneuropathy MONO IS A RISK FOR GB so watch for it in pt's you
are treating for mono- MUST document achilles reflex
when you make the diagnosis of mono to get
baseline; GB will have ascending loss of reflexes
-can start as tingling in the feet
Achilles DTR* S1, L5
Patellar DTR* L3, L4
Brachioradialis* C5, C6
Biceps* C5, C6
Triceps* C7, C8
Prolonged recovery of the Hypothyroid
achilles reflex supports
the diagnosis of*
-Nose, hands, bones getting larger d/t pituitary
Acromeagly adenoma- excessive growth hormone
-provider could be mistreating for hypothyroid
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