FNP Board Review: Comprehensive Lecture Notes

Comprehensive practice flashcards covering pharmacology, eye-ENT, dermatology, cardiovascular, respiratory, endocrine, and neurological topics for FNP board review.

First-pass metabolism

A phenomenon of drug metabolism where the concentration of an active drug is reduced, specifically when administered orally, before it reaches the systemic circulation; the liver is the major site for this effect.

Cytochrome P450 (CYP450) Inducers

Proteins that increase drug metabolism and clearance, thereby decreasing the concentration of the drug in the body; examples include carbamazepine, phenobarbital, and phenytoin.

Cytochrome P450 (CYP450) Inhibitors

Proteins that slow down drug clearance and increase drug concentration, raising the risk for overdose; examples include cimetidine, erythromycin, and grapefruit juice.

Digoxin Therapeutic Range

A narrow range defined as $0.5-2.0\,ng/mL$.

Presbyopia

Also known as 'aging sight,' this occurs when the lens loses its normal accommodating power and can no longer focus on objects at arm's length or closer.

Retinoblastoma

A cancer in the back of the eye (retina) that clinically presents as leukocoria, also known as a white pupillary reflex.

Arcus senilis

A white, gray, or blue opaque ring in the corneal margin or the periphery of the iris in older adults associated with hypercholesterolemia.

Subconjunctival Hemorrhage

Blood underneath the conjunctiva caused by broken arterioles from coughing, sneezing, or trauma; it typically resolves spontaneously within $1$ to $3$ weeks.

Chalazion

A small, painless, lump or swelling on the eyelid that feels like a bead or pea.

Papilledema

An eye condition characterized by a swollen optic disc with blurred edges caused by increased intracranial pressure ($ICP$).

Cupping

A funduscopic finding in glaucoma patients where the cup-to-disc ratio is increased to greater than $0.5$ or is asymmetrical between eyes.

AV Nicking

A clinical finding associated with Hypertension where an artery crosses and indents a vein, visible during a funduscopic exam.

Retinal detachment

An ocular emergency characterized by the sudden onset of floaters or the sensation of a 'curtain closing' over the field of vision.

Macular degeneration

The leading cause of central vision loss in elderly patients.

Pterygium

A yellow, triangular thickening on the nasal side of the eye.

Otitis Externa

Commonly caused by $Pseudomonas\,aeruginosa$, this infection is typically treated with Ciprofloxacin/hydrocortisone drops.

Presbycusis

A sensorineural hearing loss that occurs at higher frequencies, typically presenting bilaterally in elderly patients.

Kiesselbach's plexus

The vascular area located in the anterior region of the nasal septum where most anterior nosebleeds originate.

Rhinitis medicamentosa

Rebound congestion caused by the daily use of topical decongestants like Oxymetazoline ($Afrin$) for more than $3$ days.

Aphthous stomatitis

Also known as a canker sore, it is a painful yellow ulcer with a red base inside the mouth that usually resolves within $7-10$ days.

Pathological jaundice

Jaundice that occurs within the first $24$ hours after birth, requiring an immediate check of bilirubin levels.

Milia

Tiny white dots appearing on the cheeks and nose of a newborn.

Measles (Rubeola)

A viral infection characterized by Koplik's spots (white lesions with a red halo in the pharynx) and a maculopapular rash with cephalocaudal distribution.

Fifth's Disease (Erythema Infectiosum)

A condition caused by Parvovirus $B-19$ that presents as bright red 'slapped' cheeks in children.

Pityriasis Rosea

A skin condition characterized by a herald patch followed by a 'Christmas tree' distribution rash on the trunk.

Impetigo

A skin infection characterized by honey-colored crusts after vesicles or pustules rupture; limited lesions are treated with topical mupirocin.

Tinea Corporis

A pruritic, annular-shaped 'ringworm' rash with raised borders and central clearing, treated with topical azole antifungals.

Rocky Mountain Spotted Fever

A tick-borne illness presenting with high fever, chills, and a rash on the palms and soles, treated with Doxycycline.

Scabies

Pruritic linear burrows located between the phalanges, typically causing intense itching at night and treated with Permethrin.

Auspitz sign

The clinical finding of bleeding upon the removal of a scale, which is diagnostic for Psoriasis.

Basal cell carcinoma

The most frequent cancer in the USA, characterized by a pearly, waxy, or ulcerated skin lesion with telangiectasis.

Malignant melanoma

An asymmetrical skin lesion with irregular borders and multiple colors (black, brown, blue, or pink).

Intermittent claudication

The most typical symptom of Peripheral Arterial Disease ($PAD$), involving calf pain during walking that is relieved by rest.

Ankle Brachial Index ($ABI$)

A diagnostic test for $PAD$ that compares BP in the ankle and arm; a value of $< 0.9$ is positive for disease.

Deep Vein Thrombosis ($DVT$)

Characterized by calf pain, erythema, localized heat, and a positive Homans’ sign, often following immobilization or long-distance travel.

S3 Heart Sound

A heart sound associated with ventricular volume overload, commonly heard in heart failure and pregnancy.

S4 Heart Sound

A heart sound associated with a stiff ventricle, commonly heard in cases of uncontrolled hypertension or left ventricular hypertrophy.

Aortic Stenosis

A systolic harsh murmur heard at the right second intercostal space that radiates to the neck.

Mitral Regurgitation

A high-pitched pansystolic blowing murmur heard best at the apex that radiates to the axilla.

Bacterial Endocarditis

A serious infection presenting with fever, splinter hemorrhages, Osler's nodes, and Janeway lesions.

Prinzmetal’s angina

Chest pain and $ST$ elevation that occurs at rest without physical activity.

Peritonsillar abscess

An emergency condition characterized by a 'hot potato voice,' fever, and uvular deviation.

Mononucleosis

Caused by the Epstein-Barr virus, symptoms include sore throat, fever, and posterior cervical adenopathy; physical activity is limited for $4-6$ weeks to prevent splenic rupture.

Graves’ disease

The autoimmune process most frequently associated with hyperthyroidism.

Addison’s disease

Adrenal insufficiency presenting with hyperpigmentation, salt cravings, hyperkalemia, and hyponatremia; diagnosis involves a morning cortisol test.

Metabolic Syndrome

A cluster including large waist circumference ($W \ge 35,\,M \ge 40$), Triglycerides $\ge 150\,mg/dL$, $HDL < 50\,mg/dL$, and $BP \ge 130/85\,mmHg$.

Pyloric Stenosis

An infant condition defined by forceful/projectile vomiting and a possible olive-shaped mass in the RUQ, typically diagnosed at $2$ months of age.

Intussusception

Characterized by a sausage-shaped mass in the right upper quadrant and 'currant jelly' or bloody stools.

Rovsing Sign

A diagnostic maneuver for appendicitis where palpation in the left lower quadrant causes pain in the right lower quadrant.

Wilms’ tumor

A nephroblastoma appearing as a non-tender, smooth unilateral flank mass that does not cross the midline in pediatric patients.

Trigeminal neuralgia

Severe, sharp, unilateral facial pain triggered by talking or chewing, typically treated with Carbamazepine.

Meniere's disease

An inner ear condition presenting with vertigo, tinnitus, and sensorineural hearing loss.

Polymyalgia Rheumatica ($PMR$)

A condition in the elderly causing severe neck, shoulder, and hip stiffness, often associated with Temporal Arteritis and elevated $ESR$.

Lachman’s test

Specialized physical exam maneuver used to diagnose an Anterior Cruciate Ligament ($ACL$) injury.

Osgood-Schlatter disease

Inflammation and swelling of the tibial tuberosity in active adolescents.

Korsakoff Syndrome

A syndrome caused by Thiamine ($B1$) deficiency, frequently occurring in chronic alcoholism.

Serotonin Syndrome

A dangerous condition caused by mixing $SSRIs$ with other serotonergic agents (like St. John’s Wort or Triptans), presenting with fever, confusion, and hyperreflexia.

Varicocele

A scrotal mass often described as a 'bag of worms' due to the feeling of enlarged blood vessels.