APEA 3P EXAM WITH DETAILED ANSWERS (2025 UPDATED)
1. Most .common .type .of .skin .cancer .in .USA: .Skin .cancer
2. Most .common .type .of .skin .cancer: .basal .cell .carcinoma
3. basal .cell .carcinoma .symptoms: .Appearance .varies; .smooth, .shiny .bump, .pink
. to .pearly .white
4. Basal .cell .carcinoma .common .locations: .cheeks, .nose, .face, .neck, .arms, .back
5. basal .cell .carcinoma .diagnosis .gold .standard: .biopsy. .if .not .an .option, .refer .to
derm
.
6. 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
7. Actinic .keratosis .diagnosis .gold .standard: .Biopsy.
if .not .an .option, .refer .to .derm
.
8. 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!!**
9. squamous .cell .cancer: .chronic .red .scaly .rough .textured .lesion .w/ .irregular
. borders
crusting .or .bleeding .may .be .present
10. Squamous .cell .carcinoma .common .locations: .rims .of .ears, .lips, .nose, .face
. and .top .of .hands
11. precursor .lesion .to .squamous .cell .cancer: .actinic .keratosis
1 ./
.26
,12. squamous .cell .carcinoma .diagnosis .by?: .biopsy .gold .standard. .if .biopsy .is
. not .an .option, .refer .to .dermatology ..
13. 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
14. 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
15. 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
2 ./
.26
,16. seborrheic .keratosis: .soft, .round, .wart-like .growth .that .is .light .tan .to .black .and
looks .pasted .on
asymptomatic .&benign
.
17. Bacterial .Meningitis .Bacteria: .Streptococcus .pneumoniae- .most .common
strain
.
Haemophilus .influenzae
Neisseria .meningitidis
.
. Escherichia .coli
*others
18. 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 .(pur-
. pura) .which .are .non-blanchable
19. Is .bacterial .meningitis .a .reportable .disease: .yes!
20. 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
com- . plications .that .may .arrive .and .support .family
.
21. 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
3 ./
.26
, **AVOID .RIFAMPIN .IN .PREGNANCY
22. 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--
23. Kernig's .sign: .Tests .for .meningeal .irritation
patient .supine. .flex .patients .hips .and .knees .in .a .right .angle, .then .slowly .straight-
. en/extend .the .legs .up
+ .result .if .when .the .patient .complains .of .pain .during .extension .of .leg
24. MCV4 .(meningococcal .vaccine) .Age .11-19: .Give .one .dose .of .menactra .or
. menveo
primary .dose .given .age .12 .or .younger .give .a .booster .at .age .16-18
25. MCV4 .(meningococcal .vaccine) .Age .19-21: .Give .one .dose .of .menactra .or
. menveo .if .never .had .either
4 ./
.26
1. Most .common .type .of .skin .cancer .in .USA: .Skin .cancer
2. Most .common .type .of .skin .cancer: .basal .cell .carcinoma
3. basal .cell .carcinoma .symptoms: .Appearance .varies; .smooth, .shiny .bump, .pink
. to .pearly .white
4. Basal .cell .carcinoma .common .locations: .cheeks, .nose, .face, .neck, .arms, .back
5. basal .cell .carcinoma .diagnosis .gold .standard: .biopsy. .if .not .an .option, .refer .to
derm
.
6. 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
7. Actinic .keratosis .diagnosis .gold .standard: .Biopsy.
if .not .an .option, .refer .to .derm
.
8. 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!!**
9. squamous .cell .cancer: .chronic .red .scaly .rough .textured .lesion .w/ .irregular
. borders
crusting .or .bleeding .may .be .present
10. Squamous .cell .carcinoma .common .locations: .rims .of .ears, .lips, .nose, .face
. and .top .of .hands
11. precursor .lesion .to .squamous .cell .cancer: .actinic .keratosis
1 ./
.26
,12. squamous .cell .carcinoma .diagnosis .by?: .biopsy .gold .standard. .if .biopsy .is
. not .an .option, .refer .to .dermatology ..
13. 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
14. 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
15. 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
2 ./
.26
,16. seborrheic .keratosis: .soft, .round, .wart-like .growth .that .is .light .tan .to .black .and
looks .pasted .on
asymptomatic .&benign
.
17. Bacterial .Meningitis .Bacteria: .Streptococcus .pneumoniae- .most .common
strain
.
Haemophilus .influenzae
Neisseria .meningitidis
.
. Escherichia .coli
*others
18. 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 .(pur-
. pura) .which .are .non-blanchable
19. Is .bacterial .meningitis .a .reportable .disease: .yes!
20. 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
com- . plications .that .may .arrive .and .support .family
.
21. 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
3 ./
.26
, **AVOID .RIFAMPIN .IN .PREGNANCY
22. 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--
23. Kernig's .sign: .Tests .for .meningeal .irritation
patient .supine. .flex .patients .hips .and .knees .in .a .right .angle, .then .slowly .straight-
. en/extend .the .legs .up
+ .result .if .when .the .patient .complains .of .pain .during .extension .of .leg
24. MCV4 .(meningococcal .vaccine) .Age .11-19: .Give .one .dose .of .menactra .or
. menveo
primary .dose .given .age .12 .or .younger .give .a .booster .at .age .16-18
25. MCV4 .(meningococcal .vaccine) .Age .19-21: .Give .one .dose .of .menactra .or
. menveo .if .never .had .either
4 ./
.26
