APEA 3P EXAMS REVIEWS WITH CORRECT ANSWERS

APEA 3P EXAMS REVIEWS WITH CORRECT ANSWERS Most common type of skin cancer in USA - CORRECT ANSWER-Skin cancer 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 basal cell carcinoma diagnosis gold standard - CORRECT ANSWER-biopsy. if not an option, refer to derm 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)