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APEA 3P NEUROLOGY EXAM WITH 100% VERIFIED SOLUTIONS (LATEST UPDATE)
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APEA 3P NEUROLOGY EXAMWITH 100% VERIFIED
SOLUTIONS (LATEST UPDATE)
Most common type of skin cancer in usa
Skin cancer
Most common type of skin cancer
Basal cell carcinoma
Basal cell carcinoma symptoms
Appearance varies; smooth, shiny bump, pink to pearly white
Basal cell carcinoma common loca<ons
Cheeks, nose, face, neck, arms, back
Basal cell carcinoma diagnosis gold standard
Biopsy. If not an op<on, refer to derm
Ac<nic keratosis
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
Ac<nic keratosis diagnosis gold standard
Biopsy.
If not an op<on, refer to derm
Ac<nic keratosis treatment gold standard
Small- cryotherapy
large- number 5-fu (5-flouracil aka efudex). 5-fu medica<on causes skin to ooze,
crust, scab and be red
*5-flouracil/ efudex-wear sunscreen!!*
,Squamous cell cancer
Chronic red scaly rough textured lesion w/ irregular borders
crus<ng or bleeding may be present
Squamous cell carcinoma common loca<ons
Rims of ears, lips, nose, face and top of hands
Precursor lesion to squamous cell cancer
Ac<nic keratosis
Squamous cell carcinoma diagnosis by?
Biopsy gold standard. If biopsy is not an op<on, refer to dermatology .
Risk factors for skin cancer(melanoma and both non-melanoma)
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)
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 leng<ginous melanoma
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
SoR, round, wart-like growth that is light tan to black and looks pasted on
asymptoma<c &benign
Bacterial meningi<s bacteria
,Streptococcus pneumoniae- most common strain
haemophilus influenzae
neisseria meningi<dis
escherichia coli
*others
Bacterial meningi<s symptoms (classic triad)
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 meningi<s a reportable disease
Yes!
Treatment for bacterial meningi<s-pa<ent
Iv abx asap, resp/droplet iso for first 24-48 hrs, hydrate (low maintenance aRer
ini<al fluid correc<on), maintain ven<la<on and reduce increased intra cranial
pressure if present (dexamethosone(to reduce inflamma<on, mannitol to
diurese the brain), low s<m environment, tx complica<ons that may arrive and
support family
Treatment for bacterial meningi<s-close encounter
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 irrita<on)
, Tests for meningeal irrita<on
pa<ent supine, raise back of head and flex chin towards chest
+ result if pt automa<cally beds both hips
--brudzinski and back of head start with b as well as bends--
Kernig's sign
Tests for meningeal irrita<on
pa<ent supine. Flex pa<ents hips and knees in a right angle, then slowly
straighten/extend the legs up
+ result if when the pa<ent complains of pain during extension of leg
Mcv4 (meningococcal vaccine) age 11-19
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
Give one dose of menactra or menveo if never had either
Rocky mountain spoded fever (rmsf) symptoms
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. Some<mes rash develops on
palms and soles
*rash develops inwards*
Rmsf pneumonic (rmsf)
R-rash
m-muscle aches (myalgia)
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