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APEA 3P Exam/PMHNP 3P exam prep With complete Questions and answers Latest 2024/25
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APEA 3P Exam/PMHNP 3P exam prep With complete Questions and answers Latest 2024/25
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APEA 3P Exam/PMHNP 3P exam prep Withcomplete Questions and answers Latest 2024/25
Most common type of skin cancer in USA - Skin cancer
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ii Most common type of skin cancer - basal cell carcinoma
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basal cell carcinoma symptoms - Appearance varies; smooth, shiny bump, pink to pearly
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white
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ii Basal cell carcinoma common locations - cheeks, nose, face, neck, arms, back
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ii basal cell carcinoma diagnosis gold standard - biopsy. if not an option, refer to derm
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Actinic keratosis - Precursor to squamous cell carcinoma
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numerous dry, round and pink to red lesions w/ rough and scaly texture ii ii ii ii ii ii ii ii ii ii ii ii
--> does not heal, slow growing in sun exposed areas
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Actinic keratosis diagnosis gold standard - Biopsy.
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if not an option, refer to derm
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Actinic keratosis treatment gold standard - small- cryotherapy
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large- number 5-FU (5-flouracil aka efudex). 5-FU medication Causes skin to ooze, crust,
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scab and be red
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**5-flouracil/ efudex-wear sunscreen!!** ii ii
squamous cell cancer - chronic red scaly rough textured lesion w/ irregular borders
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crusting or bleeding may be present ii ii ii ii ii
Squamous cell carcinoma common locations - rims of ears, lips, nose, face and top of
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hands
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ii precursor lesion to squamous cell cancer - actinic keratosis ii ii ii ii ii ii ii ii ii ii
squamous cell carcinoma diagnosis by? - biopsy gold standard. if biopsy is not an option,
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refer to dermatology .
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Risk factors for skin cancer(melanoma and both non-melanoma) - Blistering sunburn as a
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child, history of sunburns, light skin, chronic exposure to UV light (sunlight/tanning beds),
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moles, family hx for skin cancer
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Melanoma symptoms (ABCDE) - asymmetry (shape/uneven texture)
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border (irregular/notched/blurred) ii
color (variegated colors from black, blue, dark to light brown)
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diameter (size >6mm size of pencil eraser or larger) ii ii ii ii ii ii ii ii
,evolving (changes in color/size/shape) ii ii ii
may be itchy ii ii
Acral lengtiginous melanoma - Most common type of melanoma in dark skinned
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individuals (blacks & asians)
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--> look for longitudinal brown to black bands under the nailbed. a changing spot or mole in
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the palms, or the soles of the feet
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seborrheic keratosis - soft, round, wart-like growth that is light tan to black and looks
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pasted on
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asymptomatic &benign ii
Bacterial Meningitis Bacteria - Streptococcus pneumoniae- most common strain
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Haemophilus influenzae ii
Neisseria meningitidis ii
Escherichia coli ii
*others
Bacterial meningitis symptoms (Classic Triad) - High fever
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Nuchal rigidity ii
rapid change in mental status w/ headache
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Triad=neck up ii
erythematous spot-like rash (petechiae) ecchymosis to purple-colored lesions (purpura) ii ii ii ii ii ii ii ii
which are non-blanchable
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ii Is bacterial meningitis a reportable disease - yes!
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Treatment for Bacterial meningitis-patient - IV Abx ASAP, resp/droplet iso for first 24-48
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hrs, hydrate (low maintenance after initial fluid correction), Maintain ventilation and reduce
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increased intra cranial pressure if present (dexamethosone(to reduce inflammation,
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mannitol to diurese the brain), low stim environment, tx complications that may arrive and
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support family
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Treatment for bacterial meningitis-close encounter - Close contacts should be treated w/
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rifampin 600 mg q 12 hours x 2 days
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**Rifampin changes urine color to reddish orange and can stain contacts ii ii ii ii ii ii ii ii ii ii
**AVOID RIFAMPIN IN PREGNANCY ii ii ii
Brudzinkski sign (meningeal irritation) - Tests for meningeal irritation
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Patient supine, raise BACK of head and flex chin towards chest
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+ result if pt automatically beds both hips
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--Brudzinski and back of head start with B as well as bends-- ii ii ii ii ii ii ii ii ii ii ii
ii Kernig's sign - Tests for meningeal irritation ii ii ii ii ii ii ii ii
, patient supine. flex patients hips and knees in a right angle, then slowly straighten/extend
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the legs up
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+ result if when the patient complains of pain during extension of leg
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MCV4 (meningococcal vaccine) Age 11-19 - Give one dose of menactra or menveo
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primary dose given age 12 or younger give a booster at age 16-18
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MCV4 (meningococcal vaccine) Age 19-21 - Give one dose of menactra or menveo if
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never had either
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Rocky mountain spotted fever (RMSF) symptoms - Fever
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chills
N/V
myalgia
arthralgia
2-5 days later develop petechial rash on forearms, ankles, and wrists that spreads towards
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trunk and becomes generalised. sometimes rash develops on palms and soles
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**RASH DEVELOPS INWARDS** ii ii
ii RMSF pneumonic (RMSF) - R-Rash ii ii ii ii ii ii ii
ii M-Muscle aches (myalgia) ii ii ii
ii S-Stomach aches (nausea and vomiting) ii ii ii ii ii
ii F-Fever (>102 F) ii ii
Rocky Mountain Spotted Fever (RMSF): Located: - •Think "Rocky"- North Carolina,
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Oklahoma, Arkansas, Tennessee, Missouri
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Spring to Fall (April to September)
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Rocky Mountain Spotted Fever (RMSF): DX - PCR assay by indirect
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immunofluorescence antibody (IFA) assay for immunoglobulin G (IgG) for Rickettsia
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Rickettsii
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Rocky Mountain Spotted Fever (RMSF): tx - Doxycycline is always first line for all ages
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100 mg every 12 hours x 7-10 days
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Can be fatal if not treated within the first 5 days
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Erythema Migrans (early Lyme disease): Symptoms - Usually appears in 7-14 days after
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being bitten by a deer tick; range 3-30 days
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Target bull's-eye Rash is hot to touch with rough texture. Expanding red rash with central
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clearing • Common locations are belt line, axillary area, behind the knees, and groin area •
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Positive for flu like symptoms. Lesions and rash resolve within a few weeks with or without
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treatment
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Erythema Migrans (early Lyme disease): DX - Dx: • First step is enzyme immunoassay
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(EIA) also knows as ELISA if negative no further testing needed. If positive confirm with
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Western Blot test (aka indirect immunofluorescence assay (IFA) for Borrelia Burgdorferi
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