AANP FNP flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Anion gap formula

Anion gap equals sodium minus the sum of chloride and bicarbonate; normal is about 8 to 12 mEq/L, and hypoalbuminemia lowers the calculated gap.

Corrected calcium formula

Corrected calcium equals measured calcium plus 0.8 times (4.0 minus serum albumin in g/dL); use it when albumin is abnormal because total calcium falls with hypoalbuminemia.

LDL Friedewald formula

LDL cholesterol equals total cholesterol minus HDL cholesterol minus triglycerides divided by 5; the formula is unreliable when triglycerides exceed 400 mg/dL.

Sensitivity and specificity

Sensitivity is true positives divided by all people with disease; specificity is true negatives divided by all people without disease; both are fixed test properties.

Positive likelihood ratio

Positive likelihood ratio equals sensitivity divided by (1 minus specificity); values above 10 markedly increase the post-test probability of disease.

Rinne and Weber tests

In normal hearing, Rinne shows air conduction greater than bone conduction; Weber lateralizes to the affected ear in conductive loss and to the unaffected ear in sensorineural loss.

Fixed split S2

A fixed split second heart sound persists through inspiration and expiration and suggests an atrial septal defect with right ventricular volume overload.

CAGE alcohol screening

CAGE asks about cutting down, annoyance by criticism, guilty feelings, and eye-opener morning drinking; two or more positive answers suggest an alcohol use disorder.

Wells score for DVT

Wells DVT score adds points for cancer, immobility, tenderness, swelling, calf difference, pitting edema, and collaterals, and subtracts two for an alternative diagnosis; three or more is high risk.

CURB-65 pneumonia score

CURB-65 scores confusion, urea above 7 mmol/L, respiratory rate 30 or more, low blood pressure, and age 65 or older; scores 0 to 1 usually allow outpatient care.

McIsaac sore throat score

McIsaac adds points for fever, tonsillar exudate, tender nodes, and absence of cough, then adjusts for age; scores 0 to 1 do not warrant antibiotics or testing.

HEART chest pain score

HEART scores history, electrocardiogram, age, risk factors, and troponin; 0 to 3 is low risk, 4 to 6 moderate, and 7 to 10 high risk for major cardiac events.

Ottawa ankle rules

Ankle radiography is indicated with malleolar pain plus bone tenderness at the posterior lateral or medial malleolus, or inability to bear weight for four steps.

Light's criteria

Pleural fluid is exudative if protein ratio exceeds 0.5, lactate dehydrogenase ratio exceeds 0.6, or fluid lactate dehydrogenase exceeds two-thirds the serum upper limit.

Glasgow Coma Scale

The Glasgow Coma Scale sums eye opening (1 to 4), verbal response (1 to 5), and motor response (1 to 6); a score of 8 or less generally prompts airway protection.

Alvarado appendicitis score

Alvarado scores migration of pain, anorexia, nausea, right lower quadrant tenderness, rebound, fever, leukocytosis, and left shift; scores of 7 or more suggest high probability.

Metformin renal precautions

Metformin is contraindicated when estimated glomerular filtration rate is below 30 mL/min/1.73 m2; do not start it between 30 and 45, and hold it during acute illness or contrast.

High-intensity statin doses

High-intensity statin therapy is atorvastatin 40 to 80 mg daily or rosuvastatin 20 to 40 mg daily; it lowers LDL cholesterol by at least 50 percent.

Apixaban dose reduction

Reduce apixaban to 2.5 mg twice daily when at least two of age 80 or older, weight 60 kg or less, and creatinine 1.5 mg/dL or higher are present.

Warfarin INR targets

Most atrial fibrillation and venous thromboembolism cases target INR 2.0 to 3.0; mechanical mitral valves target 2.5 to 3.5; bridging uses low-molecular-weight heparin.

Uncomplicated cystitis treatment

First-line options include nitrofurantoin for 5 days, trimethoprim-sulfamethoxazole for 3 days when resistance is under 20 percent, and fosfomycin as a single dose.

Acetaminophen maximum dose

The usual maximum acetaminophen dose is 4 grams per day in healthy adults; consider 3 grams or less with chronic alcohol use, liver disease, or low body weight.

ACE inhibitor monitoring

Check potassium and creatinine 1 to 2 weeks after starting or increasing an ACE inhibitor; a creatinine rise up to 30 percent is acceptable, but hyperkalemia requires action.

Beers criteria examples

The Beers criteria flag potentially inappropriate medications in older adults, including benzodiazepines, first-generation antihistamines, anticholinergic drugs, and long-term nonsteroidal anti-inflammatory drugs.

Colorectal cancer screening ages

Average-risk colorectal cancer screening starts at age 45 and continues to age 75; ages 76 to 85 are individualized, and routine screening stops after age 85.

Lung cancer screening criteria

Annual low-dose computed tomography is recommended for adults aged 50 to 80 with at least 20 pack-years who currently smoke or quit within 15 years.

Cervical cancer screening intervals

Cervical screening begins at age 21: cytology every 3 years, or for ages 30 to 65 co-testing every 5 years or high-risk HPV testing every 5 years.

AAA ultrasound screening

A one-time abdominal ultrasound is recommended for men aged 65 to 75 who have ever smoked; women with a smoking history may be selectively screened.

Shingles vaccine recommendation

Recombinant zoster vaccine is recommended in two doses for adults aged 50 and older and for adults 19 and older who are immunocompromised.

Pneumococcal vaccine indications

Pneumococcal vaccination is recommended for adults 65 and older and for adults 19 to 64 with risk conditions such as chronic lung disease, diabetes, or immunocompromise.

Schedule II prescription rules

Schedule II controlled substances require a written or electronic prescription, have no refills, and must be filled within a state-defined period, commonly 30 days.

HIPAA breach notification

A HIPAA breach affecting 500 or more individuals requires notification to affected persons, the Department of Health and Human Services, and the media without unreasonable delay.