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