Download Fitzgerald Questions and answers rated A+ 2025 and more Exams Nursing in PDF only on Docsity!
Fitzgerald Questions and answers rated
A+ 2025
Peak infectivity of hep A - correct answer ✔Before jaundice onset Continued exposure to hep B after vaccination - correct answer ✔Single dose of HBV vaccine Routine HBsAg screening should be done in - correct answer ✔Pregnant women HBV vaccine CI'd in allergy to - correct answer ✔Baker's yeast (Think Hep B = Baker's yeast) Sexually active w/HBV+ partner, not vaccinated - correct answer ✔Give HBIG and HBV series Offer HBV vaccine for un-immunized adults who: - correct answer ✔Are being tx'd for STIs Incubation length flu virus - correct answer ✔1-4 days Amantadine and rimantadine - correct answer ✔Significant resistance to select strains of influenza limits their usefulness Measles, mumps, rubella - correct answer ✔Pts born before 1957 have a high likelihood of immunity d/t hx of natural infection
MMR - correct answer ✔2 doses at least 1mo apart for young adults not immunized PCV13 - correct answer ✔Routinely used in childhood, assoc. w/greater immunogenicity PPSV23 - correct answer ✔Routinely used 65+, not licensed in children <2yo Poliovirus transmission - correct answer ✔Fecal-oral route Smallpox vaccine - correct answer ✔Live vaccinia virus Smallpox transmission - correct answer ✔Direct deposit of infective droplets Smallpox characteristics - correct answer ✔Lesions all at the same stage during the eruptive phase Tetanus series for un-immunized adult - correct answer ✔Tdap w/dose of Td at 1 and 6mos Tobacco brief intervention - correct answer ✔Ask, Advise, Assess, Assist, Arrange Varicella transmission - correct answer ✔Droplet
Giant cell arteritis concomitant therapy (w/prednisone) - correct answer ✔ASA, bisphosphonate and ca/vit d, PPI Migraine - correct answer ✔Pulsating pain Migraine supplements - correct answer ✔Butterbur, riboflavin, feverfew HA red flag - correct answer ✔Onset w/exertion, coughing, or sneezing Tension type HA - correct answer ✔"Pressing" pain Triptan MOA - correct answer ✔Selective serotonin receptor agonist Cluster HA risk fx - correct answer ✔Heavy ETOH, heavy smoking, male 1st line cluster HA tx - correct answer ✔NSAIDs, O2, triptans 1st line prophylactic TTH tx - correct answer ✔TCA Ergotamines - correct answer ✔NOT effective for TTH Bacterial meningitis CSF - correct answer ✔Glucose at 30% of serum levels
Aseptic or viral meningitis CSF - correct answer ✔Predominance of lymphocytes Physical findings in papilledema - correct answer ✔Optic disc bulging N.meningitidis - correct answer ✔Gram negative diplococcus Sx suggest menigitis caused by N.meningitidis - correct answer ✔Purpura or petechial rash Kernig sign - correct answer ✔Pt lying supine and hip flexed 90 degrees, present when extension of knee from this position elicits resistance or pain in lower back or posterior thigh N.meningitidis incubation period - correct answer ✔3-4 days N.meningitidis chemoprophylaxis - correct answer ✔Single dose of ceftriaxone, multiple doses of rifampin, single dose of meningococcal conjugate vaccine (MCV4 or Menactra) MS sx - correct answer ✔Numbness or weakness in limbs, double vision or blurred vision, cold sensitivity MS tx to attenuate disease progression - correct answer ✔Interferon beta-1b MS dx - correct answer ✔MRI, CSF analysis, evoked potential test
During type I hypersensitivity reactions, histamine causes: - correct answer ✔Vasodilation, mucous gland stimulation, tissue swelling Common site of atopic derm in infants - correct answer ✔Face Pimecrolimus (Elidel) or tacrolimus - correct answer ✔Immunomodulators; possible increased risk of cancer Bed bugs - correct answer ✔Cimux lectularius; reactions more common w/repeated exposure Cat bite - correct answer ✔Pasturella multocide; augmentin Dog bites - correct answer ✔5% result in infections Burn wound bacteria - correct answer ✔Gram-neg: P.aeruginosa, E.coli, K.pneumo Burn wound infection prevention - correct answer ✔Topical silver sulfadiazine Best tx option for cellulitis w/low MRSA risk - correct answer ✔Dicloxacillin Tzanck smear - correct answer ✔Herpesvirus
Zostavax - correct answer ✔Live, attenuated vaccine Most common organisms in non-bullous impetigo - correct answer ✔GABHS and S.aureus Mupirocin spectrum - correct answer ✔Select gram-pos organisms; 1st line impetigo tx Ecthyema - correct answer ✔Deeply ulcerated impetigo lesion Tx of MRSA+ skin infection - correct answer ✔Bactrim Stage 2 Lyme - correct answer ✔AV block Stage 3 Lyme - correct answer ✔1yr after infection, joint pain and neuropsych sx Oncychomycosis - correct answer ✔Nail hypertrophy, brittle nails, fingernails respond better than toenails PO antifungals for oncychomycosis - correct answer ✔Itraconazole, fluconazole, terbinafine Itraconazole - correct answer ✔CYP-450 3A4 inhibitor, check LFTs Psoriasis - correct answer ✔Caused by accelerated mitosis, arises from rapid skin cell turnover leading to decreased maturation and keratinization
Imiquimod - correct answer ✔Immunomodulator Most common ABRS pathogen in adults - correct answer ✔S.pneumo 1st line ABRS tx - correct answer ✔Augmentin Adult AOM tx if GI upset w/amox - correct answer ✔Cefpodoxime Drug-resistant S.pneumo is least likely to be resistant to - correct answer ✔Respiratory fluoroquinolones M.catarrhalis - correct answer ✔High rate of beta-lactamase production H.flu - correct answer ✔Some isolates exhibit resistance via production of beta-lactamase S.pneumo - correct answer ✔Mechanism of resistance usually via altered protein-binding sites held w/in microbe's cell AOM viral causes - correct answer ✔RSV, influenza, rhinovirus Tx for strep pharyngitis in PCN allergy - correct answer ✔Azith, clarith, clinda IM PCN for strep - correct answer ✔Tx failure rates approach 20% Scarlet fever - correct answer ✔Rash often peels during recovery
Scarlet fever rash presents how long after start of symptomatic infection - correct answer ✔2 days Scarlet fever tx - correct answer ✔PCN, cefdinir, cefpodoxime M.catarrhalis pharyngitis - correct answer ✔Bothersome dry cough, lymphadenopathy, tonsillar enlargement Resp. virus pharyngitis - correct answer ✔Cough, nasal discharge, hoarsness, conjunctival inflammation, diarrhea Best tx for acute nasal congestion - correct answer ✔Decongestant nasal spray Cromolyn - correct answer ✔Mast cell stabilizer Leukotriene modifiers - correct answer ✔Inflammatory inhibitor Tx for persistent allergic conjunctivitis - correct answer ✔Topical mast cell stabilizer (cromolyn) w/topical antihistamine Cephalosporin most likely to cause allergic response in PCN allergy - correct answer ✔Cephalexin Abx w/highest rate of allergic rxn - correct answer ✔Beta-lactams
Abx for otitis externa w/facial cellulitis - correct answer ✔Fluoroquinolone Dx of malignant otitis externa - correct answer ✔CT, radionucleotide scanning, gallium scanning Primary open angle glaucoma - correct answer ✔Peripheral vision loss, excessive cupping of optic disc Glaucoma risk fx - correct answer ✔African ancestry, T2DM, advanced age Typical 1st manifestation of coronary heart disease in men - correct answer ✔MI Typical 1st manifestation of coronary heart disease in women - correct answer ✔Angina Cardiac finding most common in unstable angina - correct answer ✔S BBs - correct answer ✔Reduce myocardial O2 demand Nitrates - correct answer ✔Cause vasodilation Absolute CI to thrombolytic therapy - correct answer ✔Hx of hemorrhagic stroke
LDL goal for 64yo w/DM and ACS 2yrs ago - correct answer ✔< BB in HF - correct answer ✔Reduce effects of circulating catecholamines ECG finding w/digoxin - correct answer ✔Slightly depressed, cupped ST segments ECG finding in dig. toxicity - correct answer ✔AV block Sx most likely in dig toxicity - correct answer ✔Anorexia Kerley B lines - correct answer ✔On x-ray in HF Risk for dig toxicity w/concomitant use of - correct answer ✔Amiodarone, clarithromycin, cyclosporine PNA in HF - correct answer ✔Increases R-sided heart workload Inotropic - correct answer ✔Force of cardiac contraction Dromotropic - correct answer ✔Cardiac conduction Common finding in MVP - correct answer ✔Pectus excavatum (Marfans) MVP - correct answer ✔Encourage regular aerobic exercise
Non-DHP CCBs CI'd in - correct answer ✔Severe L ventricular dysfunction DHP CCBs - correct answer ✔-pine Non-DHP CCB - correct answer ✔Diltiazem Drugs for HTN and angina pectoris B - correct answer ✔BB and CCB Drugs for HTN and CAD - correct answer ✔TZD, BB, ACEI, CCB Asthma - correct answer ✔Chronic airway inflammation w/superimposed bronchospasm CXR finding in acute severe asthma attack - correct answer ✔Hyperinflation Leukotriene receptor antagonists - correct answer ✔Controllers to limit inflammatory responses NAEPP risk fx for asthma death - correct answer ✔Hospitalization or ER visit in past month, current or recent withdrawal from systemic steroids, difficulty perceiving airflow obstruction or its severity Levalbuterol - correct answer ✔Greater bronchodilation w/lower dose ICS in children - correct answer ✔Potential for delayed growth
Cough in acute bronchitis - correct answer ✔Can last up to 3wks Bacterial pathogens in acute bronchitis - correct answer ✔M.pneumo, C.pneumo, pertussis Limitations of CT screening for lung ca. in smokers - correct answer ✔Low sensitivity LABAs in asthma - correct answer ✔Assoc. w/small increase in risk of asthma death; should only be added when ICS isn't adequate LAMA MOA - correct answer ✔Inhibition of muscarinic cholinergic receptors --> bronchodilation COPD definition - correct answer ✔FEV1/FVC ratio <.7 after properly timed SABA use SABA - correct answer ✔Used for all GOLD stages in COPD Pathogen most implicated in COPD exacerbation caused by respiratory tract infection - correct answer ✔Resp. tract viruses Role of abx in COPD exacerbated - correct answer ✔Debated, even in severe exacerbations CURB 65 - correct answer ✔Confusion, BUN >19, RR >30, BP <90/60, Age 65+
Contributors to resistant pathogens - correct answer ✔Longer tx time, higher antimicrobial dosage, broad spectrum use CT lung cancer screening - correct answer ✔30+ pack yr hx age 55-74yo Acute appendicitis - correct answer ✔Elevated bands Appendicitis in elderly - correct answer ✔Presentation can differ d/t anatomical location of appendix Psoas - correct answer ✔Passive extension of hip Obturator - correct answer ✔Passive flexion and internal rotation of hip Appendicitis imaging w/suspected rupture - correct answer ✔CT Ominous WBC finding - correct answer ✔Metamyelocyte Peak age appendicitis - correct answer ✔10-30yo Clinical sx of appendiceal rupture - correct answer ✔Fever >102, palpable abdominal mass, marked leukocytosis w/WBC >20k Blumberg's - correct answer ✔Abd. palpation that yields rebound tenderness Most common anal fissure location - correct answer ✔Posterior midline
Most common complaint w/anal fissure - correct answer ✔Anal pain for 1- 2hrs after BM Long-term high dose mineral oil can lead to - correct answer ✔Vit. A deficiency Celiac disease aka - correct answer ✔Celiac sprue, sprue, small bowel malabsorption syndrome Most accurate markers for celiac - correct answer ✔IgA endomysial and IgA tTG antibodies Most common diverticulosis area - correct answer ✔Sigmoid colon Tx to avoid development of acute diverticulitis - correct answer ✔Fiber supplements #3 cause of cancer death in men and women - correct answer ✔Colorectal Esophageal columnar epithelial metaplasia - correct answer ✔Risk for esophageal adenocarcinoma PPI - correct answer ✔Increase pH of stomach Estrogen-progestin hormonal therapy - correct answer ✔Can cause reflux
