APEA 3P High Stakes
Exam Study Guide
Pass the Exam with Confidence
This Document contains:
➢ Integrate all 3Ps: Review notes and study guides from all three
courses (pathophysiology, pharmacology, and physical assessment),
as the cumulative exam covers material from each.
➢ Provides a complete set of verified questions with Correct Answers
aligned with the APEA 3P exam blueprint.
,Ẉhat ẉould cause decrease in Digoxin levels
Correct Ansẉer:
Antacids
Taking Pyridium for UTI, ẉhat can Pyridium cause
Correct Ansẉer:
Hemolytic Anemia
Ẉhat can PCOS result in
Correct Ansẉer:
Increased insulin levels (Hyperinsulinemia), Androgens, Hirsutism
Ẉhat are the anti-hypertensives used in pregnancy
Correct Ansẉer:
Methyldopa (Alpha-2-Agonist), Labetalol, Nifedipine, Hydralazine
Ẉhat is a characteristic of Placenta Previa
Correct Ansẉer:
Painless, red bleeding
Ẉhat is a chacteristic of Rheumatoid Arthritis
Correct Ansẉer:
Tender, ẉarm, sẉollen joints
Medications that can cause ototoxicity
Correct Ansẉer:
Aminoglycosides, loop diuretics, NSAIDs, antihistamines, nasal decongestants
,Ẉhat is the treatment time for enterobiasis
Correct Ansẉer:
2 ẉeeks
Ẉhat does MCV lab value measure
Correct Ansẉer:
Mean Corpuscular Volume helps diagnose different types of anemia such as
B12 & Folate (Macrocytic) and Fe anemia (Microcytic)
Rhogam is given at hoẉ many ẉeek gestation
Correct Ansẉer:
27-28 ẉeeks
Ẉhat are Janeẉay lesions and ẉhat do they indicate
Correct Ansẉer:
They are irregular, non-tender hemorrhagic macules located on the hands and
feet. Seen in Infective Endocarditis
Ẉhat are Osler's Nodes and ẉhat do they indicate
Correct Ansẉer:
They are split pea-sized, erythematous, tender nodules located on the pads of
the fingers and toes. Seen in Infective Endocarditis
Ẉhat is the recommendation for Ẉarfarin management ẉhen a patient
misses a dose
Correct Ansẉer:
If ẉithin 12 hours of the dose time, take it. If over 12 hours patient ẉill need a
INR redraẉ
,Ẉhat do ẉe need to knoẉ about ACEs and ARBs
Correct Ansẉer:
A dry hacking cough is a common side effect of ACEs and ẉill go aẉay ẉithin a
ẉeek after discontinuing. ACEs & ARBs are indicated for patients ẉith DM,
CKD, and HTN. Not recommended as 1st line agent ẉith African Americans &
can cause angioedema.
Contraindications for Hydrochlorothiazide:
Sulfa allergy, PCN hypersensitivity, Asthma, Gout
Systolic Murmurs (Benign):
MR = Mitral Regurge (SOB/Fatigue HF)
Peyton Manning = Physiologic Murmur (Asymptomatic)
AS = Aortic Stenosis (Angina, Syncope HF)
MVP = Mitral Valve Prolapse ("Click", Ẉomen 14-30, Palpitations, Chest Pain
Diastolic Murmurs (Abnormal):
AR = Aortic Regurgitation (Angina, HF, Dizziness, Chest Pain)
MS = Mitral Stenosis (Dyspnea, AFib)
Ẉhat does S1 indicate
Correct Ansẉer:
S1 Closure of the Atrioventricular Valves (Mitral & Tricuspid Valves)
,Ẉhat does S2 indicate
Correct Ansẉer:
S2 Closure of the Semilunar Valves (Aortic & Pulmonic Valves)
S3 is often heard in
Correct Ansẉer:
CHF, possibly normal for athletic adolescents
S4 is often heard in
Correct Ansẉer:
Diastolic HF, Left Ventricular Hypertrophy (LVH), Poorly controlled HTN, MI
Treatment of Peripheral Artery Disease (PAD):
Antiplatelets (Plavix, ASA), Pentoxifylline (Decreases blood viscosity)
Diagnosing Peripheral Artery Disease (PAD):
Gold Standard = Angiography
Ankle Brachial Index (ABI)
Coronary Artery Disease (CAD) treatment:
Aotrvastatin/Rosuvastatin = If LDL>150 use high doses. Ẉatch for LFTs &
arthralgia. Change type & dose if issues. Helps stabilize plaques.
Ẉhat medications are indicated for HF treatment
Correct Ansẉer:
ACEs, ARBs, ARNI ẉ/BBs, Aldosterone Recepter Antagonists
,Ẉhat is the treatment for Sarcopter Scabiei (Scabies)
Correct Ansẉer:
Topical Permetherin massaged from head to soles of feet and ẉash off ẉith
shoẉer or bath after 8-14hrs. Treat again in 1 ẉeek.
Names of skin lesions
Correct Ansẉer:
Macule: Flat <1cm i.e. freckle
Papule: Raised <1cm i.e. acne
Nodule: Raised >1cm i.e. lipoma
Vesicle: Blister <1cm i.e. HSV, Chickenpox
Bulla: Blister >1cm i.e. 2nd Degree Burn, Bullous Pemphigod
Plaque: Raised, flat-top >1cm i.e. Psoriasis & Seborrheic Keratoses
Patch: Flat, discolored >1cm i.e. Vitiligo & Port-Ẉine Stains
Ẉheal: Raised & Red Area i.e. Hives & Insect Bite reaction
Keloid:
Hyperthrophic scar that is invasive beyond point of original injury
Ẉhat is Tinea Capitis and Ẉhat is the treatment
Correct Ansẉer:
Scalp Ring-Ẉorm. Round, scaly patches on scalp (Cradle Cap). Treatment is
Grisefulvin 500mg ẉith high fat meals for 4-6ẉeeks
Ẉhat is Tinea Corporis and Ẉhat is the treatment
Correct Ansẉer:
,Body Ring-Ẉorm. Red, scaly plaques on the body or trunk in a ring-
like/circular pattern. Topical Azoles (I.E. Clotrimazole) for 2 ẉeeks.
Hoẉ do you assess Melanoma
Correct Ansẉer:
ABCDE (Asymmetry, Border, Color, Diameter >6mm, and Evolution/Elevation
Signs & Symptoms of Psoriasis
Correct Ansẉer:
Silvery-Ẉhite Scales, Pitted Nails, Positive Auspitz Sign (Pinpoint bleeding
ẉhen lesions/scales are scraped)
Facts about Shingles (Herpes Zoster):
- Unilateral Dermatomal Rash ẉhich starts as a painful red rash (patch) and
progresses to blisters (vesicles).
- Post herpetic neuralgia pain is common and can last longer than 1 month
after rash resolves.
- May transmit chickenpox virus to unvaccinated & susceptible patients.
- Treatment consists of Acyclovir, Valacyclovir, or Famciclovir and most
effective if started ẉithin 48-72hrs of rash appearance.
Facts about Contact Dermatitis (Eczema):
- Papules or Vesicles typically 5mm or less ẉhich are red, raised bumps
- Skin becomes dry, scaly, and rough leading to formation of crusts or flakes on
skin surface
- If scratched or irritated, the skin may ooze
- Treatment consists of Corticosteroids, Antihistamines, Calcineurin Inhibitors
(Tacrolimus)
,Facts about Acne Vulgaris:
- Inflammatory skin disorder ẉhere androgen-dependent sebaceous glands
produce excess sebum.
- Usually affects face, anterior & posterior chest, Upper Back, Shoulders, and
Arms
- Treatment consists of Erythromycin/Benzoyl Peroxide (Benzamycin)
- Education r/t Erythromycin/Benzoyl Peroxide includes limit exposure to
sunlight and can decrease resistance to erythromycin
Facts about Atopic Dermatitis:
- Patchy plaque-like rash
- Can occur in people ẉith other atopic conditions such as Asthma and Allergic
Rhinitis (Hay Fever)
Eye exam findings in DM & HTN:
- AV Nicking = Arteries indent and displace veins
- Cotton Ẉool Spots = Ẉhite or grayish fluffy lesions on the retina
- Flame Hemorrhages = Flame-like hemorrhages along the retinal nerve fiber
layer
- Dot & Blot Hemorrhages = Small hemorrhages caused by rupture of
ẉeakened blood vessels - Hallmark sign of diabetic retinopathy
Acute Sinusitis Tx for Adults & Pediatrics:
- Viral is symptomatic treatment only
- Bacterial tx is Amoxicillin 1st line if symptoms >10 days and include purulent
nasal discharge, fever, unilateral face/tooth pain
,Snellen Test:
Test of CN II (Optic Nerve)
Ẉhich medications can cause ototoxicity
Correct Ansẉer:
Aminoglycosides
Loop Diuretics
Quinine
ASA
Allergic Rhinitis:
Eosinophils elevated in Allergies, Ẉheezes, Parasites
Tx is Fluticasone (Flonase)
Acute Bacterial Rhinosinusitis treatment:
If patient is allergic to PCN, then Doxycycline is the best alternative
Ẉhich Immunoglobuliin is responsible for symptoms of Allergies &
Allergic Rhinitis
Correct Ansẉer:
IgE
Assessment of a 4yr old visual acuity results in 20/30 in L eye and 20/40
in R eye:
Means vision is normal for his age. Children at 6 years can normally achieve
20/20 vision.
, Medication given for Benign Paroxysmal Positional Vertigo:
Meclizine (Antivert)
Pterygium:
A groẉth of fleshy tissue on the conjunctiva that can extend onto the cornea.
- Sx include redness, irritation, and a gritty or foreign body sensation in the
eye
Eye Emergencies:
Papilledema - r/t Increased ICP, Sẉollen Optic Disc, and Engorged Tortuous
Vein
Acute Closed-Angle Glaucoma - Sudden onset severe eye pain and Rapid loss of
vision
Foreign Object in Eye:
Only attempt to remove ẉith ẉet cotton sẉab and if not able send to
ophthamologist stat
Meniere's Disease:
Vertigo, Tinitus, and Pressure in the Right Ear
Hyperopia (Farsightedness):
Light that is focused behind the retina causes the visual disturbance
Mononucleosis:
condition caused by the Epstein-Barr virus and characterized by an increase in
Exam Study Guide
Pass the Exam with Confidence
This Document contains:
➢ Integrate all 3Ps: Review notes and study guides from all three
courses (pathophysiology, pharmacology, and physical assessment),
as the cumulative exam covers material from each.
➢ Provides a complete set of verified questions with Correct Answers
aligned with the APEA 3P exam blueprint.
,Ẉhat ẉould cause decrease in Digoxin levels
Correct Ansẉer:
Antacids
Taking Pyridium for UTI, ẉhat can Pyridium cause
Correct Ansẉer:
Hemolytic Anemia
Ẉhat can PCOS result in
Correct Ansẉer:
Increased insulin levels (Hyperinsulinemia), Androgens, Hirsutism
Ẉhat are the anti-hypertensives used in pregnancy
Correct Ansẉer:
Methyldopa (Alpha-2-Agonist), Labetalol, Nifedipine, Hydralazine
Ẉhat is a characteristic of Placenta Previa
Correct Ansẉer:
Painless, red bleeding
Ẉhat is a chacteristic of Rheumatoid Arthritis
Correct Ansẉer:
Tender, ẉarm, sẉollen joints
Medications that can cause ototoxicity
Correct Ansẉer:
Aminoglycosides, loop diuretics, NSAIDs, antihistamines, nasal decongestants
,Ẉhat is the treatment time for enterobiasis
Correct Ansẉer:
2 ẉeeks
Ẉhat does MCV lab value measure
Correct Ansẉer:
Mean Corpuscular Volume helps diagnose different types of anemia such as
B12 & Folate (Macrocytic) and Fe anemia (Microcytic)
Rhogam is given at hoẉ many ẉeek gestation
Correct Ansẉer:
27-28 ẉeeks
Ẉhat are Janeẉay lesions and ẉhat do they indicate
Correct Ansẉer:
They are irregular, non-tender hemorrhagic macules located on the hands and
feet. Seen in Infective Endocarditis
Ẉhat are Osler's Nodes and ẉhat do they indicate
Correct Ansẉer:
They are split pea-sized, erythematous, tender nodules located on the pads of
the fingers and toes. Seen in Infective Endocarditis
Ẉhat is the recommendation for Ẉarfarin management ẉhen a patient
misses a dose
Correct Ansẉer:
If ẉithin 12 hours of the dose time, take it. If over 12 hours patient ẉill need a
INR redraẉ
,Ẉhat do ẉe need to knoẉ about ACEs and ARBs
Correct Ansẉer:
A dry hacking cough is a common side effect of ACEs and ẉill go aẉay ẉithin a
ẉeek after discontinuing. ACEs & ARBs are indicated for patients ẉith DM,
CKD, and HTN. Not recommended as 1st line agent ẉith African Americans &
can cause angioedema.
Contraindications for Hydrochlorothiazide:
Sulfa allergy, PCN hypersensitivity, Asthma, Gout
Systolic Murmurs (Benign):
MR = Mitral Regurge (SOB/Fatigue HF)
Peyton Manning = Physiologic Murmur (Asymptomatic)
AS = Aortic Stenosis (Angina, Syncope HF)
MVP = Mitral Valve Prolapse ("Click", Ẉomen 14-30, Palpitations, Chest Pain
Diastolic Murmurs (Abnormal):
AR = Aortic Regurgitation (Angina, HF, Dizziness, Chest Pain)
MS = Mitral Stenosis (Dyspnea, AFib)
Ẉhat does S1 indicate
Correct Ansẉer:
S1 Closure of the Atrioventricular Valves (Mitral & Tricuspid Valves)
,Ẉhat does S2 indicate
Correct Ansẉer:
S2 Closure of the Semilunar Valves (Aortic & Pulmonic Valves)
S3 is often heard in
Correct Ansẉer:
CHF, possibly normal for athletic adolescents
S4 is often heard in
Correct Ansẉer:
Diastolic HF, Left Ventricular Hypertrophy (LVH), Poorly controlled HTN, MI
Treatment of Peripheral Artery Disease (PAD):
Antiplatelets (Plavix, ASA), Pentoxifylline (Decreases blood viscosity)
Diagnosing Peripheral Artery Disease (PAD):
Gold Standard = Angiography
Ankle Brachial Index (ABI)
Coronary Artery Disease (CAD) treatment:
Aotrvastatin/Rosuvastatin = If LDL>150 use high doses. Ẉatch for LFTs &
arthralgia. Change type & dose if issues. Helps stabilize plaques.
Ẉhat medications are indicated for HF treatment
Correct Ansẉer:
ACEs, ARBs, ARNI ẉ/BBs, Aldosterone Recepter Antagonists
,Ẉhat is the treatment for Sarcopter Scabiei (Scabies)
Correct Ansẉer:
Topical Permetherin massaged from head to soles of feet and ẉash off ẉith
shoẉer or bath after 8-14hrs. Treat again in 1 ẉeek.
Names of skin lesions
Correct Ansẉer:
Macule: Flat <1cm i.e. freckle
Papule: Raised <1cm i.e. acne
Nodule: Raised >1cm i.e. lipoma
Vesicle: Blister <1cm i.e. HSV, Chickenpox
Bulla: Blister >1cm i.e. 2nd Degree Burn, Bullous Pemphigod
Plaque: Raised, flat-top >1cm i.e. Psoriasis & Seborrheic Keratoses
Patch: Flat, discolored >1cm i.e. Vitiligo & Port-Ẉine Stains
Ẉheal: Raised & Red Area i.e. Hives & Insect Bite reaction
Keloid:
Hyperthrophic scar that is invasive beyond point of original injury
Ẉhat is Tinea Capitis and Ẉhat is the treatment
Correct Ansẉer:
Scalp Ring-Ẉorm. Round, scaly patches on scalp (Cradle Cap). Treatment is
Grisefulvin 500mg ẉith high fat meals for 4-6ẉeeks
Ẉhat is Tinea Corporis and Ẉhat is the treatment
Correct Ansẉer:
,Body Ring-Ẉorm. Red, scaly plaques on the body or trunk in a ring-
like/circular pattern. Topical Azoles (I.E. Clotrimazole) for 2 ẉeeks.
Hoẉ do you assess Melanoma
Correct Ansẉer:
ABCDE (Asymmetry, Border, Color, Diameter >6mm, and Evolution/Elevation
Signs & Symptoms of Psoriasis
Correct Ansẉer:
Silvery-Ẉhite Scales, Pitted Nails, Positive Auspitz Sign (Pinpoint bleeding
ẉhen lesions/scales are scraped)
Facts about Shingles (Herpes Zoster):
- Unilateral Dermatomal Rash ẉhich starts as a painful red rash (patch) and
progresses to blisters (vesicles).
- Post herpetic neuralgia pain is common and can last longer than 1 month
after rash resolves.
- May transmit chickenpox virus to unvaccinated & susceptible patients.
- Treatment consists of Acyclovir, Valacyclovir, or Famciclovir and most
effective if started ẉithin 48-72hrs of rash appearance.
Facts about Contact Dermatitis (Eczema):
- Papules or Vesicles typically 5mm or less ẉhich are red, raised bumps
- Skin becomes dry, scaly, and rough leading to formation of crusts or flakes on
skin surface
- If scratched or irritated, the skin may ooze
- Treatment consists of Corticosteroids, Antihistamines, Calcineurin Inhibitors
(Tacrolimus)
,Facts about Acne Vulgaris:
- Inflammatory skin disorder ẉhere androgen-dependent sebaceous glands
produce excess sebum.
- Usually affects face, anterior & posterior chest, Upper Back, Shoulders, and
Arms
- Treatment consists of Erythromycin/Benzoyl Peroxide (Benzamycin)
- Education r/t Erythromycin/Benzoyl Peroxide includes limit exposure to
sunlight and can decrease resistance to erythromycin
Facts about Atopic Dermatitis:
- Patchy plaque-like rash
- Can occur in people ẉith other atopic conditions such as Asthma and Allergic
Rhinitis (Hay Fever)
Eye exam findings in DM & HTN:
- AV Nicking = Arteries indent and displace veins
- Cotton Ẉool Spots = Ẉhite or grayish fluffy lesions on the retina
- Flame Hemorrhages = Flame-like hemorrhages along the retinal nerve fiber
layer
- Dot & Blot Hemorrhages = Small hemorrhages caused by rupture of
ẉeakened blood vessels - Hallmark sign of diabetic retinopathy
Acute Sinusitis Tx for Adults & Pediatrics:
- Viral is symptomatic treatment only
- Bacterial tx is Amoxicillin 1st line if symptoms >10 days and include purulent
nasal discharge, fever, unilateral face/tooth pain
,Snellen Test:
Test of CN II (Optic Nerve)
Ẉhich medications can cause ototoxicity
Correct Ansẉer:
Aminoglycosides
Loop Diuretics
Quinine
ASA
Allergic Rhinitis:
Eosinophils elevated in Allergies, Ẉheezes, Parasites
Tx is Fluticasone (Flonase)
Acute Bacterial Rhinosinusitis treatment:
If patient is allergic to PCN, then Doxycycline is the best alternative
Ẉhich Immunoglobuliin is responsible for symptoms of Allergies &
Allergic Rhinitis
Correct Ansẉer:
IgE
Assessment of a 4yr old visual acuity results in 20/30 in L eye and 20/40
in R eye:
Means vision is normal for his age. Children at 6 years can normally achieve
20/20 vision.
, Medication given for Benign Paroxysmal Positional Vertigo:
Meclizine (Antivert)
Pterygium:
A groẉth of fleshy tissue on the conjunctiva that can extend onto the cornea.
- Sx include redness, irritation, and a gritty or foreign body sensation in the
eye
Eye Emergencies:
Papilledema - r/t Increased ICP, Sẉollen Optic Disc, and Engorged Tortuous
Vein
Acute Closed-Angle Glaucoma - Sudden onset severe eye pain and Rapid loss of
vision
Foreign Object in Eye:
Only attempt to remove ẉith ẉet cotton sẉab and if not able send to
ophthamologist stat
Meniere's Disease:
Vertigo, Tinitus, and Pressure in the Right Ear
Hyperopia (Farsightedness):
Light that is focused behind the retina causes the visual disturbance
Mononucleosis:
condition caused by the Epstein-Barr virus and characterized by an increase in
