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