APEA 3P Exam verified with correct
answers 2026/2027 version
Most common type of skin cancer in USA- correct answer>>>Skin cancer
Actinic keratosis- correct answer>>>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 answer>>>Biopsy.
if not an option, refer to derm
Actinic keratosis treatment gold standard- correct answer>>>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 answer>>>chronic red scaly rough textured lesion w/
irregular borders
crusting or bleeding may be present
Squamous cell carcinoma common locations- correct answer>>>rims of ears, lips, nose,
face and top of hands
precursor lesion to squamous cell cancer- correct answer>>>actinic keratosis
squamous cell carcinoma diagnosis by?- correct answer>>>biopsy gold standard. if
biopsy is not an option, refer to dermatology .
Risk factors for skin cancer(melanoma and both non-melanoma)- correct
answer>>>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 answer>>>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 answer>>>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 answer>>>soft, round, wart-like growth that is light tan to
black and looks pasted on
asymptomatic &benign
Bacterial Meningitis Bacteria- correct answer>>>Streptococcus pneumoniae- most
common strain
Haemophilus influenzae
Neisseria meningitidis
Escherichia coli
*others
Bacterial meningitis symptoms (Classic Triad)- correct answer>>>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 answer>>>yes!
Treatment for Bacterial meningitis-patient- correct answer>>>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 answer>>>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 answer>>>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 answer>>>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 answer>>>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 answer>>>Give one dose of
menactra or menveo if never had either
Rocky mountain spotted fever (RMSF) symptoms- correct answer>>>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 answer>>>R-Rash
M-Muscle aches (myalgia)
S-Stomach aches (nausea and vomiting)
F-Fever (>102 F)
Rocky Mountain Spotted Fever (RMSF): Located:- correct answer>>>•Think "Rocky"-
North Carolina, Oklahoma, Arkansas, Tennessee, Missouri
Spring to Fall (April to September)
Rocky Mountain Spotted Fever (RMSF): DX- correct answer>>>PCR assay by indirect
immunofluorescence antibody (IFA) assay for immunoglobulin G (IgG) for Rickettsia
Rickettsii
Rocky Mountain Spotted Fever (RMSF): tx- correct answer>>>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 answer>>>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
Most common type of skin cancer- correct answer>>>basal cell carcinoma
basal cell carcinoma symptoms- correct answer>>>Appearance varies; smooth, shiny
bump, pink to pearly white
Basal cell carcinoma common locations- correct answer>>>cheeks, nose, face, neck,
arms, back
answers 2026/2027 version
Most common type of skin cancer in USA- correct answer>>>Skin cancer
Actinic keratosis- correct answer>>>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 answer>>>Biopsy.
if not an option, refer to derm
Actinic keratosis treatment gold standard- correct answer>>>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 answer>>>chronic red scaly rough textured lesion w/
irregular borders
crusting or bleeding may be present
Squamous cell carcinoma common locations- correct answer>>>rims of ears, lips, nose,
face and top of hands
precursor lesion to squamous cell cancer- correct answer>>>actinic keratosis
squamous cell carcinoma diagnosis by?- correct answer>>>biopsy gold standard. if
biopsy is not an option, refer to dermatology .
Risk factors for skin cancer(melanoma and both non-melanoma)- correct
answer>>>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 answer>>>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 answer>>>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 answer>>>soft, round, wart-like growth that is light tan to
black and looks pasted on
asymptomatic &benign
Bacterial Meningitis Bacteria- correct answer>>>Streptococcus pneumoniae- most
common strain
Haemophilus influenzae
Neisseria meningitidis
Escherichia coli
*others
Bacterial meningitis symptoms (Classic Triad)- correct answer>>>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 answer>>>yes!
Treatment for Bacterial meningitis-patient- correct answer>>>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 answer>>>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 answer>>>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 answer>>>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 answer>>>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 answer>>>Give one dose of
menactra or menveo if never had either
Rocky mountain spotted fever (RMSF) symptoms- correct answer>>>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 answer>>>R-Rash
M-Muscle aches (myalgia)
S-Stomach aches (nausea and vomiting)
F-Fever (>102 F)
Rocky Mountain Spotted Fever (RMSF): Located:- correct answer>>>•Think "Rocky"-
North Carolina, Oklahoma, Arkansas, Tennessee, Missouri
Spring to Fall (April to September)
Rocky Mountain Spotted Fever (RMSF): DX- correct answer>>>PCR assay by indirect
immunofluorescence antibody (IFA) assay for immunoglobulin G (IgG) for Rickettsia
Rickettsii
Rocky Mountain Spotted Fever (RMSF): tx- correct answer>>>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 answer>>>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
Most common type of skin cancer- correct answer>>>basal cell carcinoma
basal cell carcinoma symptoms- correct answer>>>Appearance varies; smooth, shiny
bump, pink to pearly white
Basal cell carcinoma common locations- correct answer>>>cheeks, nose, face, neck,
arms, back
