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APEA 3P Exam: Questions With Verified Solutions
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APEA 3P Exam: Questions With Verified Solutions
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APEA 3P Exam: Questions With Verified SolutionsMost common type of skin cancer in USA Right Ans - Skin cancer
Most common type of skin cancer Right Ans - basal cell carcinoma
Basal cell carcinoma symptoms Right Ans - Appearance varies; smooth,
shiny bump, pink to pearly white
Basal cell carcinoma common locations Right Ans - cheeks, nose, face, neck,
arms, back
Basal cell carcinoma diagnosis gold standard Right Ans - biopsy. if not an
option, refer to derm
Actinic keratosis Right Ans - 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 Right Ans - Biopsy.
if not an option, refer to derm
Actinic keratosis treatment gold standard Right Ans - 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 Right Ans - chronic red scaly rough textured lesion
w/ irregular borders
crusting or bleeding may be present
Squamous cell carcinoma common locations Right Ans - rims of ears, lips,
nose, face and top of hands
Precursor lesion to squamous cell cancer Right Ans - actinic keratosis
Squamous cell carcinoma diagnosis by? Right Ans - biopsy gold standard. if
biopsy is not an option, refer to dermatology .
,Risk factors for skin cancer(melanoma and both non-melanoma) Right Ans
- 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) Right Ans - 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 Right Ans - 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 Right Ans - soft, round, wart-like growth that is light
tan to black and looks pasted on
asymptomatic &benign
Bacterial Meningitis Bacteria Right Ans - Streptococcus pneumoniae- most
common strain
Haemophilus influenzae
Neisseria meningitidis
Escherichia coli
*others
Bacterial meningitis symptoms (Classic Triad) Right Ans - 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 Right Ans - yes!
Treatment for Bacterial meningitis-patient Right Ans - 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 Right Ans - 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) Right Ans - 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 Right Ans - 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 Right Ans - 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 Right Ans - Give one dose of
menactra or menveo if never had either
Rocky mountain spotted fever (RMSF) symptoms Right Ans - 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) Right Ans - R-Rash
M-Muscle aches (myalgia)
S-Stomach aches (nausea and vomiting)
F-Fever (>102 F)
Rocky Mountain Spotted Fever (RMSF): Located: Right Ans - •Think
"Rocky"- North Carolina, Oklahoma, Arkansas, Tennessee, Missouri
Spring to Fall (April to September)
Rocky Mountain Spotted Fever (RMSF): DX Right Ans - PCR assay by
indirect immunofluorescence antibody (IFA) assay for immunoglobulin G
(IgG) for Rickettsia Rickettsii
Rocky Mountain Spotted Fever (RMSF): tx Right Ans - 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 Right Ans - 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 Right Ans - 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
Erythema Migrans (early Lyme disease): TX Right Ans - Doxycycline is
always first line for all ages
100 mg BID x 10-21 days
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