AANPCB A-GNP cheat sheet

Colorectal cancer screening: average-risk adults ages 45–75; individualize screening for ages 76–85 based on health and prior screening.

Cervical cancer screening: ages 21–29 cytology every 3 years; ages 30–65 cytology every 3 years, HPV testing every 5 years, or co-testing every 5 years.

Breast cancer screening: biennial mammography is recommended for women ages 40–74.

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

Osteoporosis screening: DXA for women age 65 and older and for postmenopausal women younger than 65 with elevated fracture risk.

Diabetes screening: adults ages 35–70 with overweight or obesity; repeat at least every 3 years when results are normal.

Statin initiation: adults ages 40–75 with at least 1 ASCVD risk factor and estimated 10-year risk of 10% or higher.

Immunization: recombinant zoster vaccine 2 doses 2–6 months apart at age 50 and older; Tdap/Td booster every 10 years.

Alcohol screening: AUDIT-C or a single-item screen; a positive screen triggers brief intervention and further assessment.

Anion gap = Na − (Cl + HCO3); normal is approximately 8–12 mEq/L; hypoalbuminemia lowers the measured gap.

Corrected sodium = measured sodium + 1.6 mEq/L for each 100 mg/dL that glucose exceeds 100 mg/dL.

Primary hypothyroidism: elevated TSH with low free T4; subclinical hypothyroidism: elevated TSH with normal free T4.

Iron deficiency: low ferritin, low serum iron, high TIBC, and low transferrin saturation; ferritin rises with inflammation.

MoCA score below 26 is generally abnormal; add 1 point when education is less than 12 years.

Timed Up and Go longer than 12 seconds indicates increased fall risk.

Melanoma ABCDE: Asymmetry, Border irregularity, Color variation, Diameter greater than 6 mm, and Evolving lesion.

Chest pain red flags include exertional pressure, diaphoresis, dyspnea, syncope, radiation to arm or jaw, and vascular risk factors.

Headache red flags include thunderclap onset, fever with neck stiffness, focal deficit, papilledema, new headache after age 50, cancer, or immunosuppression.

CURB-65 assigns 1 point each for confusion, urea above 7 mmol/L, respiratory rate 30 or higher, low blood pressure, and age 65 or older.

Uncomplicated cystitis: nitrofurantoin for 5 days or trimethoprim-sulfamethoxazole for 3 days when local E. coli resistance is below 20%; fluoroquinolones are not first-line.

Bacterial sinusitis is suggested by symptoms longer than 10 days, severe symptoms with fever for 3–4 days, or worsening after initial improvement.

Centor/McIsaac criteria: tonsillar exudate, tender anterior cervical nodes, fever, and absence of cough.

COPD exacerbation antibiotics: increased sputum purulence plus increased dyspnea or sputum volume, or need for ventilatory support.

Nonpurulent cellulitis: beta-lactam coverage; purulent abscess: incision and drainage with MRSA coverage when indicated.

Acute gout: NSAID, colchicine, or glucocorticoid; urate-lowering therapy need not be delayed during a flare when otherwise indicated.

Wells score for DVT includes active cancer, paralysis or immobilization, bed rest or surgery, deep vein tenderness, leg swelling, calf swelling, pitting edema, collaterals, and prior DVT.

PERC rule: age below 50, heart rate below 100, oxygen saturation 95% or higher, no hemoptysis, no estrogen use, no prior DVT/PE, and no unilateral leg swelling.

ACC/AHA stage 1 hypertension: systolic 130–139 mm Hg or diastolic 80–89 mm Hg; target is below 130/80 mm Hg for most adults.

Type 2 diabetes: A1c below 7% for most nonpregnant adults; less stringent goals with limited life expectancy, hypoglycemia risk, or advanced complications.

ASCVD risk: 10-year risk of 20% or higher supports high-intensity statin; 7.5–19.9% supports moderate-intensity statin with risk discussion.

HFrEF: ejection fraction 40% or lower; four pillars are ARNI/ACEi/ARB, beta blocker, mineralocorticoid receptor antagonist, and SGLT2 inhibitor.

HFpEF: ejection fraction 50% or higher; SGLT2 inhibitors reduce heart failure hospitalization; treat congestion and comorbidities.

CKD: eGFR categories G1–G5 and albuminuria categories A1 (<30), A2 (30–300), and A3 (>300 mg/g).

COPD: post-bronchodilator FEV1/FVC below 0.70 confirms airflow obstruction; GOLD ABE groups guide inhaled therapy.

Depression: PHQ-9 cutoffs 5/10/15/20 represent mild, moderate, moderately severe, and severe depression; score 10 or higher often triggers treatment.

Asthma: ACT score 19 or lower indicates uncontrolled asthma; step up controller therapy and assess adherence and inhaler technique.

Falls: ask annually; Timed Up and Go longer than 12 seconds or recurrent falls prompts multifactorial assessment of medications, vision, gait, orthostasis, and home hazards.

Delirium: CAM-positive requires acute onset with fluctuating course, inattention, plus disorganized thinking or altered level of consciousness.

Dementia: screen with Mini-Cog or MoCA; evaluate reversible causes with TSH, B12, CBC, CMP, and medication review.

Urinary incontinence: stress is leakage with cough or sneeze; urge is sudden urgency; overflow is incomplete emptying; functional is barriers to toileting.

Polypharmacy: Beers criteria flag anticholinergics, benzodiazepines, sulfonylureas, proton pump inhibitors beyond 8 weeks, and NSAIDs in older adults.

Pressure injury staging: stage 1 is intact skin with nonblanchable erythema; stage 2 is partial-thickness loss; stage 3 extends to fat; stage 4 exposes bone, tendon, or muscle.

Frailty phenotype includes gait speed below 0.8 m/s, unintentional weight loss, exhaustion, low grip strength, and low physical activity.

Elder abuse: direct screening questions; suspected abuse is reported to adult protective services per state law, with safety and capacity assessment.

Constipation: Rome criteria require at least 2 of straining, lumpy or hard stool, incomplete evacuation, fewer than 3 stools per week, manual maneuvers, or laxative need.