APEA 3P PREDICTOR UPDATED ACTUAL QUESTIONS AND CORRECT
ANSWERS
LAtEst UPdAtEd QUEstions & soLUtions
(A+ GUidE)
◉ Erectile Dysfunction Answer: Treatment PDE-5 inhibitor - contraindicated with nitrates
Causes - Anti-HTN meds, antidepressants, antiandrogens, recreational drugs
◉ #1 Risk Factor for Testicular & Penile Cancer Answer: Cryptochordism
◉ Prostatitis Answer: Inflammation of the prostate & usually bacterial
S&S: Frequency, urgency, fever, enlarged boggy warm prostate
◉ Prostatitis Treatment Answer: Chronic Prostatitis: Ciprofloxacin or Flouroquinolones
(Levofloxacin) for 4-12 wks or Bactrim 4-6 wks.
Treatment guided by Culture & Sensitivity
No Keflex (cephalexin)
◉ Testicular Torsion Answer: Acute onset testicular pain and loss of cremasteric reflex
on affected side. Most common in prepubertal boys
◉ Epididymitis Answer: Testicular pain onset over a few days (gradual) and cremasteric
reflex is present.
◉ Gonorrhea & Chlamydia treatment Answer: Doxycycline 100mg BIDx14 days &
Ceftriaxone x1 IM
◉ Migraine Treatment Answer: Rescue: Triptans
Prophylactic: Beta Blockers, antidepressants, anticonvulsants (Topamax, Propranolol,
Inderal)
◉ Migraine Presentation Answer: S&S: Unilateral 70% of time, Crescendo,
Nausea/Vomiting, Photophobia, and Auras, Duration: 4-72hrs
Patient Appearance: Pt desires a cool, quiet, dark room
◉ Cluster Headache Presentation Answer: Always unilateral, begins around
temple/eye, pain peaks within minutes; excruciating/explosive, rhinorrhea, tears, eye
becomes red
ETOH can be a trigger
,◉ Tension Headache Presentation Answer: Bilateral, pressure, tightness, band-like,
waxes and wanes
◉ Parkinson's Disease Answer: Deficiency of Dopamine and destruction of cells in the
substantia nigra
◉ Parkinson's Disease Presentation Answer: Bradykinesia, rigidity, resting tremor ("pill
rolling"), postural instability
◉ Parkinson's Disease Treatment Answer: Dopaminergic agents, Carbidopa/levadopa
(Do not give to patients with narrow angle glaucoma)
◉ Beer's List Answer: a list of drugs for which you should not give or monitoring is
especially important in elderly patients
Anti-cholinergics, anti-spasmotics, scopolamine, meclizine, promethazine
High risk of confusion, dry mouth, constipation.
◉ Meningitis Answer: Inflammation of the brain and spinal cord meninges result from
bacteria, virus, or fungi. Headache is caused by meningeal irritation. Tx is
cephalosporins (Ceftriaxone).
◉ Transient Ischemic Attack (TIA) Answer: brief episode of loss of blood flow to the
brain, usually caused by a partial occlusion that results in temporary neurologic deficit
(impairment). Typically resolves within hours; often precedes a CVA
◉ Seizures Answer: Uncontrolled electrical activity within the brain
◉ Scoliosis Answer: Lateral curvature of the spine greater than 10 degrees
◉ Rheumatoid Arthritis Answer: Autoimmune disorder characterized by thickened
synovial membrane, joints are warm, swollen, and tender, which can lead to bone
erosion.
◉ Osteoarthritis Answer:
◉ Osteoarthritis Treatment Answer: Weight-bearing exercise, weight loss, Cymbalta,
duloxetine, tramadol. RICE = Rest, Ice, Compression, Elevation. Acetaminophen not
recommended. Short acting NSAIDs are ok. Refer to ortho for injections.
◉ Sprain Answer: Stretch or tear in a Ligament
◉ Strain Answer: Stretch or tear in a muscle or tendon
◉ Ortolani's Click Answer: A click is heard or felt as dislocation is reduced
, ◉ Barlows Maneuver Answer: Feeling of a slip of the femoral head slips away from the
Acetabulum (toward the butt)
◉ Meningitis assessment finding Answer: Positive Kernig or Brudzinski sign
◉ Adam's Sign Answer: Evaluation for scoliosis.
Negative for functional scoliosis if curve straightens out
Positive for structural scoliosis if curve remains
◉ Fat Pad Sign Answer: radiographic finding that can indicate an underlying injury or
fracture in the elbow joint, specifically around the olecranon process of the ulna bone.
◉ McMurray Test Answer: Palpable or auditory click while rotating and extending the
knee
◉ Gout Answer: Acute joint pain with swelling, warmth, and erythema begins abruptly
and involves a single joint. Normal uric acid levels are common during acute attack.
◉ Gout Treatment Answer: Acute Gout - Colchicine
Chronic Gout (2 or more attacks/year) - Allopurinol - decreases production of uric acid
◉ GTPAL Answer: Gravidia - # of times a woman has been pregnant multiples = 1
Term - Number of children at >37 weeks
Preterm - Number of children at 20-37 weeks
Abortion - Abortions/Miscarriages
Living - living children, twins count individually
◉ Fundal Height Answer: Distance from the pubic bone to the top of the uterus in
centimeters. After 24 weeks fundal height should equal the number of weeks the patient
has been pregnant. i.e. 24cm = 24wks
◉ Preeclampsia Answer: BP > 140/90 & Proteinuria (300mg/24hr urine sample) or
edema, pulmonary edema, visual impairments, impaired renal or hepatic function.
◉ Preeclampsia Treatment Answer: Magnesium Sulfate
Anti-Hypertensives i.e. methyldopa, labetalol, nifedipine
Corticosteroids for fetus lung development if preterm birth expected
◉ Naegeles Rule Answer: First day of LMP, subtract 3 months, add 7 days
◉ Placenta Previa Answer: Painless, bright red bleeding in a woman >20 weeks
gestation. Abnormal placement of the placenta near or covering the internal cervical os
◉ 1st line Treatment of UTI in pregnancy Answer: Nitrofurantoin (Macrobid)
ANSWERS
LAtEst UPdAtEd QUEstions & soLUtions
(A+ GUidE)
◉ Erectile Dysfunction Answer: Treatment PDE-5 inhibitor - contraindicated with nitrates
Causes - Anti-HTN meds, antidepressants, antiandrogens, recreational drugs
◉ #1 Risk Factor for Testicular & Penile Cancer Answer: Cryptochordism
◉ Prostatitis Answer: Inflammation of the prostate & usually bacterial
S&S: Frequency, urgency, fever, enlarged boggy warm prostate
◉ Prostatitis Treatment Answer: Chronic Prostatitis: Ciprofloxacin or Flouroquinolones
(Levofloxacin) for 4-12 wks or Bactrim 4-6 wks.
Treatment guided by Culture & Sensitivity
No Keflex (cephalexin)
◉ Testicular Torsion Answer: Acute onset testicular pain and loss of cremasteric reflex
on affected side. Most common in prepubertal boys
◉ Epididymitis Answer: Testicular pain onset over a few days (gradual) and cremasteric
reflex is present.
◉ Gonorrhea & Chlamydia treatment Answer: Doxycycline 100mg BIDx14 days &
Ceftriaxone x1 IM
◉ Migraine Treatment Answer: Rescue: Triptans
Prophylactic: Beta Blockers, antidepressants, anticonvulsants (Topamax, Propranolol,
Inderal)
◉ Migraine Presentation Answer: S&S: Unilateral 70% of time, Crescendo,
Nausea/Vomiting, Photophobia, and Auras, Duration: 4-72hrs
Patient Appearance: Pt desires a cool, quiet, dark room
◉ Cluster Headache Presentation Answer: Always unilateral, begins around
temple/eye, pain peaks within minutes; excruciating/explosive, rhinorrhea, tears, eye
becomes red
ETOH can be a trigger
,◉ Tension Headache Presentation Answer: Bilateral, pressure, tightness, band-like,
waxes and wanes
◉ Parkinson's Disease Answer: Deficiency of Dopamine and destruction of cells in the
substantia nigra
◉ Parkinson's Disease Presentation Answer: Bradykinesia, rigidity, resting tremor ("pill
rolling"), postural instability
◉ Parkinson's Disease Treatment Answer: Dopaminergic agents, Carbidopa/levadopa
(Do not give to patients with narrow angle glaucoma)
◉ Beer's List Answer: a list of drugs for which you should not give or monitoring is
especially important in elderly patients
Anti-cholinergics, anti-spasmotics, scopolamine, meclizine, promethazine
High risk of confusion, dry mouth, constipation.
◉ Meningitis Answer: Inflammation of the brain and spinal cord meninges result from
bacteria, virus, or fungi. Headache is caused by meningeal irritation. Tx is
cephalosporins (Ceftriaxone).
◉ Transient Ischemic Attack (TIA) Answer: brief episode of loss of blood flow to the
brain, usually caused by a partial occlusion that results in temporary neurologic deficit
(impairment). Typically resolves within hours; often precedes a CVA
◉ Seizures Answer: Uncontrolled electrical activity within the brain
◉ Scoliosis Answer: Lateral curvature of the spine greater than 10 degrees
◉ Rheumatoid Arthritis Answer: Autoimmune disorder characterized by thickened
synovial membrane, joints are warm, swollen, and tender, which can lead to bone
erosion.
◉ Osteoarthritis Answer:
◉ Osteoarthritis Treatment Answer: Weight-bearing exercise, weight loss, Cymbalta,
duloxetine, tramadol. RICE = Rest, Ice, Compression, Elevation. Acetaminophen not
recommended. Short acting NSAIDs are ok. Refer to ortho for injections.
◉ Sprain Answer: Stretch or tear in a Ligament
◉ Strain Answer: Stretch or tear in a muscle or tendon
◉ Ortolani's Click Answer: A click is heard or felt as dislocation is reduced
, ◉ Barlows Maneuver Answer: Feeling of a slip of the femoral head slips away from the
Acetabulum (toward the butt)
◉ Meningitis assessment finding Answer: Positive Kernig or Brudzinski sign
◉ Adam's Sign Answer: Evaluation for scoliosis.
Negative for functional scoliosis if curve straightens out
Positive for structural scoliosis if curve remains
◉ Fat Pad Sign Answer: radiographic finding that can indicate an underlying injury or
fracture in the elbow joint, specifically around the olecranon process of the ulna bone.
◉ McMurray Test Answer: Palpable or auditory click while rotating and extending the
knee
◉ Gout Answer: Acute joint pain with swelling, warmth, and erythema begins abruptly
and involves a single joint. Normal uric acid levels are common during acute attack.
◉ Gout Treatment Answer: Acute Gout - Colchicine
Chronic Gout (2 or more attacks/year) - Allopurinol - decreases production of uric acid
◉ GTPAL Answer: Gravidia - # of times a woman has been pregnant multiples = 1
Term - Number of children at >37 weeks
Preterm - Number of children at 20-37 weeks
Abortion - Abortions/Miscarriages
Living - living children, twins count individually
◉ Fundal Height Answer: Distance from the pubic bone to the top of the uterus in
centimeters. After 24 weeks fundal height should equal the number of weeks the patient
has been pregnant. i.e. 24cm = 24wks
◉ Preeclampsia Answer: BP > 140/90 & Proteinuria (300mg/24hr urine sample) or
edema, pulmonary edema, visual impairments, impaired renal or hepatic function.
◉ Preeclampsia Treatment Answer: Magnesium Sulfate
Anti-Hypertensives i.e. methyldopa, labetalol, nifedipine
Corticosteroids for fetus lung development if preterm birth expected
◉ Naegeles Rule Answer: First day of LMP, subtract 3 months, add 7 days
◉ Placenta Previa Answer: Painless, bright red bleeding in a woman >20 weeks
gestation. Abnormal placement of the placenta near or covering the internal cervical os
◉ 1st line Treatment of UTI in pregnancy Answer: Nitrofurantoin (Macrobid)
