FITZ EXIT EXAM
The placenta is best described as
" able to transport lipophilic substances"
What lab is diagnostic for Type II DM?
126 or higher glucose after an 8 hour fasting
how many half-lives does it take to reach a steady state?
3-5
The half life is the amount of time needed to decrease the serum concentration of a drug by
50%
A good candidate for Prozac would be
A 28 year old who skips meds occasionally and has nexplanon
What is a common finding in prostate cancer?
A painless area of induration in the posterior lobe of the prostate
An example of a medical malpractice scenario would inlcude
A pt with type II DM that is prescribed an inappropriate does of insulin and experienced a severe hypoglycemic episode.
Which class of HTN medications is most beneficial for patients who also have DM?
Ace inhibitors
A skin abnormality that is described as a rough, pink, or flesh colored lesion that is typically in sun-exposed areas
Acintic Keratosis
reduction of free androgens noted in women who use COC. helps to improve what
Acne
22 year old with no complaints Asian descent with a blood count HGB- low HCT- low RBC- high MCV normal RDW normal would likely have which anemia?
Alpha thal minor
Migraine prophylactic treatment includes the use of which med a. Amytriptiline b. ergot. c. naproxen d. clonidine
Amitryptiline
Patients with infection mono should not be given which antibiotic?
Amoxicillin
57 year old woman with RA on DMARDs has this blood count HGB- low HCT - low RBC -low MCV normal MCHC normal And RDW normal what is the likely dx.?
Anemia of chronic disease
TSH is released by the
Anterior lobe of the pituitary gland
What is the most common medication that contributes to urinary retention in an older man with BPH
Anticholinergics
When treating a recurrent Duodenal ulcer treatment which medication is appropriate?
Antimicrobials
Imitrex ( Sumatriptan) sides effects include all of the following except : A. chest pain b. Diarrhea c. pressure D. Dizziness
B.
Clue cells are consistent with which gynecological disorder?
BV
A pregnant pt comes to the clinic who is on a Daily LABA and uses 2 puffs of albuterol approximately 1 time per week -should you A. change treatment by adding a ICS B. Add Theophyline c. Change nothing D. add leukotriase inhibitor
C
First line ABT for Pylonephritis
Cipro
Cluster Headache tx options include A. NSAIDS B. Triptans c. Oxygen D. all of the above
D
What abortive migraine medication would you use in a pt with angina pectoris? A. Nortriptyline b. Ergot deriviative c. Sumartriptan d. Ibuprofen
D.
A significant hyperglycemia and ketoacidosis from lack of insulin applies to DM I or DM II?
DM I
Expected ECG changes with a hx of Acute Transmural MI 6 months ago?
Deep Q waves
Early morning waking is consistent with what mental health disorder?
Depression
An abnormal finding in a pregnant women in the 3rd trimester would be
Diastolic Murmur
A 33 year old with urethritis would be best treated with which antibiotic
Doxycycline
Writing prescriptions should include writing ones with similar names and nomenclatures and writing both the generic and trade name
FALSE
25 year old man with Acanthosis Nigricans needs which lab ordered?
FBS
48 year old woman with moderate persistant asthma with a flare what would need to be evaluated?
FEV I
A boggy gland is consistant with BPH findings
False
M. Cataralis is characterized by
Gram positive organisms
Low volume, frequent loose stools are associated with which thyroid abnormality?
HYPERthyroid
Presbyscus
Hearing loss related to aging that is progressive and usually unilateral, and high frequency loss
Mid-systolic murmur that gets louder when standing
Hypertrophic cardiomyopathy
2/6 early-to mid systolic ejection murmur best heard in lower sternal border. usually disappears with position change.
Innocent flow murmur ( pulmonic flow murmur)
A 22 yr old started a new job at a health center which would be appropriate
MMR
Ms. Ard
Mitral Stenosis, Aortic Regurgitation=Diastolic
Mr. Ass
Mitral regurgitation, aortic stenosis =Systolic murmurs
What would be an appropriate medicine to treat a pt who has been treated for ARBS with doxycycline and is still symptomatic?
Moxifloxacin
What is a common dx for a 14 year old boy who plays basketball that is complaining of knee pain and swelling
Osgood-Schlatter disease
The process of absorption, distribution, metabolism, and elimination of a drug is known as
Pharmacokinetics
Spironolactone affects which electrolytes how?
Potassium sparing and calcium excreting
Most common pathogen in COPD exacerbation
Respiratory viruses
The most common causative bacterial agent in adults with ARBS is
S. Pneumonia
Which heart sound occurs in late diastole and is at the end of s2
S3
Which heart sound occurs in late diastole and occurs before s1
S4
Triptans mechanism of action is
SSRI
In acute coronary syndrome this EKG change is expected.
St segment deviation
What would be the most common pathogen for an 18 year old with a sore throat, swollen glands, for 3 days 101 temp, exudative pharyngitis, tender anterior cervical lympadenopathy, NO pain in upper right and left abd.
Strep pyrogenes
On EKG in Myocardial Ischemia what finding is likely?
T-wave inversion
What is the best way to enhance iron absorption
Take on an empty stomach
Beneficance
The obligation to help people in need
Veracity
The obligation to remain truthful
All children should receive the Hep B vaccine
True
Beta Blockers are contraindicated in the presence of HTN and Asthma
True
Emergency Contraceptives are about 89% effective.
True
Exam findings in Graves disease include Eye lid retraction
True
Hospital stays are NOT considered an incident to office visit
True
Periods of Anorexia occur with Bulemia
True
Physiologic or Benign murmurs usually get softer when standing or moving from supine to sitting
True
Synthroid should be taken on an empty stomach
True
UTI prevention teaching would be questionable if the patient states she will take her medication and empty her bladder every time she feels the urge.
True
What is a classic finding in otitis media?
Tympanic membrane immobility
Weight loss management in a 55 year old woman with DM II that is discouraged about losing weight.
What barriers do you see to losing weight?
Creatine Clearance is best described as
a product related to skeletal muscle metabolism
55 yr old male with asymptomatic erythematous pharynx with high lipids and mostly normal hemogram is most consistent with
alcohol abuse
Creatinine Clearance usually
approximates GFR
risk for Asthma related deaths are caused by all the following except A. 3 er visits b. use of several medications c. rural residence d. low income
c
Obesity and diabetes is considered what type of relationship ?
causal
A child with a PCN allergy who requires an ABT you could consider
cefixame
Leggionairres disease is most likely contracted by
contaminated water-AC worker
A pt treated after and I and D that is in for follow- up and has some redness that is around the site treatment would include
continuing to monitor
How can steroid treatment be enhanced
covering with an occlusive dressing
Most common UTI pathogen in children
e- coli
Subclinical hypothyroidism can be identified by
elevated TSH and normal T4
In Acute Cholecystitis lab changes would not include
elevated creatinine
Untreated primary open-angle glaucoma exam findings include
excessive cupping on fundoscopic exam
Ectopic pregnancies occur in the
fallopian tubes
The most effective HTN med with DM and persistant proteinuria would include
fiosinpril ( ace inhibitor)
The most common sign of bladder cancer
gross hematuria
What is a common behavior consistent with bipolar I disorder
impulsive behavior
Teaching for a pt that is being treating for scabies
itching can last a few weeks even after successful treatment
A Platelet count of 20-50000 indicates what bleeding risk
moderate with possible aggravation from post traumatic bleeding
Untreated primary open-angle glaucoma complaint by patient is
peripheral vision loss
Most of the body's iron is obtained from
recycled iron content from aged RBCs
NP legally can be reimbursed by a 3rd party payer (medicaid/medicare) if:
services include a medical eval and dec. making, the NP has legal authority to receive it, they are enrolled with the payer, the service is covered by the pts health plan or insurance
high-moderate steroid ointment in a child most commonly can cause
skin atrophy
Breaching the standard of care would include
the provider failing to adhere to current practice standards
18 year old says tx for acne is not working after tx with doxy for 3 weeks what do you tell him
therapy typically takes -8 weeks
Women using HT that experience vaginal atrophy and frequent UTIs can benefit from
topical estrogen
A certified letter would be an appropriate way to inform a pt of an abnormal pap smear
true
A duty of care results from the establishment of a provider- patient relationship
true
A level 3 office visit does not require a new prescription or medication refill
true
Dysthymia is characterized by anhedonia and sustained depression and would be most exemplified by a women who has been depressed for 2 years with fatigue and anhedonia.
true
Treatment with ABT for COPD exacerbation is debatable even in severe disease unless pneumonia is present
true
A 22 year old with suspected Reiters syndrome would need which lab
urethral cultures
A urticarial lesion is usually described as a
wheal
Which patient is least likely to be affected by medication induced hepatoxicity
young man