APEA 3P Exam Verified Questions and Answers

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 locations - cheeks, nose, face, neck, arms, back basal cell carcinoma diagnosis gold standard - biopsy. if not an option, refer to derm Actinic 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 Actinic keratosis diagnosis gold standard - Biopsy. if not an option, refer to derm Actinic keratosis treatment gold standard - 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 - chronic red scaly rough textured lesion w/ irregular borders crusting or bleeding may be present Squamous cell carcinoma common locations - rims of ears, lips, nose, face and top of hands precursor lesion to squamous cell cancer - actinic keratosis squamous cell carcinoma diagnosis by? - biopsy gold standard. if biopsy is not an option, 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 lengtiginous 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 - soft, round, wart-like growth that is light tan to black and looks pasted on asymptomatic &benign Bacterial Meningitis Bacteria - Streptococcus pneumoniae- most common strain Haemophilus influenzae Neisseria meningitidis Escherichia coli *others Bacterial meningitis 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 meningitis a reportable disease - yes! Treatment for Bacterial meningitis-patient - 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 - 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) - 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--