AANP FNP cheat sheet

BMI = weight (kg) / height (m)^2; overweight is 25.0–29.9 kg/m^2 and obesity is 30 kg/m^2 or higher.

Devine ideal body weight: men = 50 kg + 2.3 kg per inch above 5 ft; women = 45.5 kg + 2.3 kg per inch above 5 ft.

Anion gap = Na − (Cl + HCO3); normal is 8–12 mEq/L; add 2.5 to the gap for every 1 g/dL fall in albumin below 4 g/dL.

Corrected calcium = measured Ca + 0.8 × (4.0 − albumin g/dL); ionized calcium is unaffected by albumin.

Friedewald LDL = total cholesterol − HDL − triglycerides/5; valid only when triglycerides are below 400 mg/dL.

Sensitivity = TP/(TP+FN); specificity = TN/(TN+FP); positive LR = sensitivity/(1 − specificity); negative LR = (1 − sensitivity)/specificity.

Rinne: air conduction > bone conduction is normal or sensorineural; bone conduction > air conduction is conductive loss. Weber lateralizes to the affected ear in conductive loss and to the better ear in sensorineural loss.

S2 splitting: fixed split suggests atrial septal defect; paradoxical split suggests aortic stenosis, left bundle branch block, or a pacemaker.

Wells DVT score: cancer, paralysis/immobility, bedridden >3 days or surgery <4 weeks, deep vein tenderness, entire leg swelling, calf swelling >3 cm, pitting edema, and collateral veins each +1; alternative diagnosis −2; ≥3 is high risk.

Wells PE score: clinical DVT signs +3, alternative diagnosis less likely +3, heart rate >100 +1.5, immobilization/surgery +1.5, prior DVT/PE +1.5, hemoptysis +1, cancer +1; >6 high, 2–6 moderate, <2 low.

CURB-65: confusion, urea >7 mmol/L (BUN >19 mg/dL), respiratory rate ≥30, systolic BP <90 or diastolic ≤60, age ≥65; 0–1 outpatient, 2 short admission, ≥3 severe.

McIsaac: fever, tonsillar exudate, tender anterior cervical nodes, absence of cough each +1; age 3–14 +1, 15–44 0, ≥45 −1; 0–1 no test or antibiotics, 2–3 rapid antigen test, ≥4 empiric therapy.

HEART score: history, ECG, age, risk factors, and troponin each 0–2; 0–3 low, 4–6 moderate, 7–10 high risk.

Ottawa ankle rules: radiograph if malleolar pain plus bone tenderness at the posterior edge or tip of the lateral or medial malleolus, or inability to bear weight four steps immediately and in the emergency department.

Light's criteria: exudate if pleural protein/serum protein >0.5, pleural LDH/serum LDH >0.6, or pleural LDH >2/3 the serum upper limit of normal.

Glasgow Coma Scale: eye 1–4, verbal 1–5, motor 1–6; total ≤8 generally indicates need for intubation.

Alvarado score: migration, anorexia, nausea/vomiting, RLQ tenderness, rebound, fever, leukocytosis, left shift; ≥7 suggests appendicitis.

Metformin: contraindicated at eGFR <30 mL/min/1.73 m^2; do not initiate at eGFR 30–45; hold with iodinated contrast or acute illness when eGFR is low.

High-intensity statin: atorvastatin 40–80 mg or rosuvastatin 20–40 mg daily; moderate-intensity includes atorvastatin 10–20 mg, rosuvastatin 5–10 mg, simvastatin 20–40 mg.

Apixaban dose: 5 mg twice daily; reduce to 2.5 mg twice daily if two of age ≥80, weight ≤60 kg, creatinine ≥1.5 mg/dL.

Warfarin INR: 2.0–3.0 for most atrial fibrillation and VTE; 2.5–3.5 for mechanical mitral valve; bridge with LMWH when risk is high.

Uncomplicated cystitis: nitrofurantoin 5 days; TMP-SMX 3 days if local E. coli resistance <20%; fosfomycin single dose.

Acetaminophen maximum: 4 g/day in healthy adults; 3 g/day or less with chronic alcohol use, liver disease, or low body weight.

ACE inhibitor/ARB: check potassium and creatinine 1–2 weeks after initiation or dose increase; a creatinine rise ≤30% is acceptable.

Beers criteria: avoid benzodiazepines, first-generation antihistamines, anticholinergics, and long-term NSAIDs in older adults when safer alternatives exist.

Hypertension: stage 1 is 130–139/80–89 mm Hg; first-line agents include thiazide diuretics, ACE inhibitors/ARBs, and dihydropyridine calcium channel blockers.

USPSTF colorectal cancer screening: average risk ages 45–75; ages 76–85 individualized; stop after 85.

USPSTF breast cancer screening: mammography every 2 years for women aged 40–74.

Cervical cancer screening: ages 21–65 cytology every 3 years; ages 30–65 co-testing or high-risk HPV every 5 years.

Lung cancer screening: annual low-dose CT for ages 50–80 with ≥20 pack-year history and current smoking or quit within 15 years.

AAA screening: one-time ultrasound for men aged 65–75 who have ever smoked.

Hepatitis C screening: all adults aged 18–79 at least once; HIV screening: ages 15–65 at least once.

Adult immunizations: influenza annually; Tdap every 10 years; recombinant zoster ≥50 years in 2 doses; pneumococcal ≥65 years; RSV ≥75 years or 60–74 with risk.

Schedule II controlled substances: no refills; electronic or written prescription; PDMP review per state law; DEA registration required.

HIPAA breach: if ≥500 individuals affected, notify affected persons, HHS, and media without unreasonable delay; smaller breaches notify HHS annually.