APEA 3P Exam LATEST VERSION 307
QUESTIONS AND ANSWERS WITH STUDY GUIDE
DETAILED AND VERIFIED FOR GUARANTEED PASS,
LATEST UPDATE 2025 GRADED A
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)
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
QUESTIONS AND ANSWERS WITH STUDY GUIDE
DETAILED AND VERIFIED FOR GUARANTEED PASS,
LATEST UPDATE 2025 GRADED A
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)
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
