APEA BUNDLED EXAMS COMPREHENSIVE
SCRIPT 2026 COMPLETE QUESTIONS AND
SOLUTIONS GRADED A+
⩥ Cellulitis treatment. Answer: First line: Abscess/cellulitis is I&D (if
<5 cm no PO antibiotic needed) • Check for tetanus vaccine status
Nonpurulent: Cephalexin (Keflex) 500 mg or Dicloxacillin q 6 hours for
5-10 days
Purulent (MRSA): Wound culture o Follow up in 48 hours Bactrim BS
BID x 10 days o If you suspect osteomyelitis order an MRI
If allergic to Penicillin: Azithromycin (Z-Pack x 5 days)
⩥ Erysipelas:. Answer: Bacteria: Group A Streptococcus
Located: • Involves upper dermis and superficial lymphatics • Found on
the cheeks and shins
⩥ Erysipelas: Symptoms. Answer: Symptoms: • Bright red plaque or
induration with sharp or elevated margins on the face or lower legs • If
fever and chills present pt. is septic (hospitalization is recommended)
⩥ Erysipelas: Treatment. Answer: If treating facial erysipelas assume
MRSA is present.
,Use appropriate antibiotics or refer to ER if septic
Dicloxacillin QID, Cephalexin or Clindamycin x 10 days
If allergic to Penicillin: Azithromycin (Z-Pack x 5 days)
⩥ MRSA: Treatment. Answer: Bactrim
Doxycycline
Minocycline
Clindamycin
--> If patient is allergic to Sulfa do not use Bactrim
⩥ Human bites. Answer: "Dirtiest" bite of all. Watch for closed-fist
injuries of the hands (may involve joint capsule and tendon damage).
Eikenella corrodens & numerous bacteria may be involved
⩥ Animal bites:. Answer: Cat bites have a higher risk of infection that
dog bites Redness, swelling, pain
Systemic symptoms may develop within 12-24 hours
⩥ Treatment for human bites and animal bites. Answer: •Augmentin
875/125 mg BID x 10 days or IV antibiotics in ER Penicillin Allergy §
Doxycycline BID or Bactrim DS BID PLUS Flagyl BID or Clindamycin
TID
Also give Tetanus booster if needed
,Evaluate for rabies prophylaxis
⩥ Tetanus Vaccination. Answer: Initial series (3 doses) DTaP (infants to
age 6): 5 doses Ages 7 and older
Td or Tdap Need every 10 years for lifetime Common reaction: pain at
injection site in 24-48 hours
Contaminated wounds: give one dose if last dose was more than 5 years
ago or is due
⩥ Impetigo. Answer: Bacteria (Gram Positive): Beta Streptococcus or
Streptococcus aureus
Most common bacterial skin infection in young children ages 2-5
⩥ Impetigo symptoms. Answer: Itchy pink-red lesions, evolve into
vesiculopustules that rupture easily, honeycolored crusts (from dried
serous exudate)
Very pruritic and contagious
⩥ Impetigo Treatment. Answer: Order C&S of fluid
, Severe Case= Keflex or Dicloxacillin QID x 10 days
Penicillin Allergy o Give Azithromycin 250 mg x 5 days or o
Clindamycin x 10 days
**If no blisters- topical mupirocin ointment (bactroban) 2% x 10 days
⩥ Acne Vulgaris (common acne): treatment. Answer: First line is always
topical retinoid such as tretinoin cream (Retin-A)
⩥ Acne: Mild treatmetn. Answer: open comedones blackheads/closed
comedones (whiteheads) w/ or w/o papules
topical retinoid (Retin-A)
**Acne will worsen during first 4-6 weeks**
IF no improvement in 8-12 weeks, increase dose or ADD benzoyl
peroxide and/or erythromycin
⩥ Acne: Moderate (topicals plus antibiotics). Answer: papules and
pustules with comedones (3 part treatment)
Topical retinoid (Retin-A) AND topical benzoyl peroxide AND oral
antibiotic (Tetracycline or Minocycline) x 3-4 weeks --> Exam usually
asks about moderate
SCRIPT 2026 COMPLETE QUESTIONS AND
SOLUTIONS GRADED A+
⩥ Cellulitis treatment. Answer: First line: Abscess/cellulitis is I&D (if
<5 cm no PO antibiotic needed) • Check for tetanus vaccine status
Nonpurulent: Cephalexin (Keflex) 500 mg or Dicloxacillin q 6 hours for
5-10 days
Purulent (MRSA): Wound culture o Follow up in 48 hours Bactrim BS
BID x 10 days o If you suspect osteomyelitis order an MRI
If allergic to Penicillin: Azithromycin (Z-Pack x 5 days)
⩥ Erysipelas:. Answer: Bacteria: Group A Streptococcus
Located: • Involves upper dermis and superficial lymphatics • Found on
the cheeks and shins
⩥ Erysipelas: Symptoms. Answer: Symptoms: • Bright red plaque or
induration with sharp or elevated margins on the face or lower legs • If
fever and chills present pt. is septic (hospitalization is recommended)
⩥ Erysipelas: Treatment. Answer: If treating facial erysipelas assume
MRSA is present.
,Use appropriate antibiotics or refer to ER if septic
Dicloxacillin QID, Cephalexin or Clindamycin x 10 days
If allergic to Penicillin: Azithromycin (Z-Pack x 5 days)
⩥ MRSA: Treatment. Answer: Bactrim
Doxycycline
Minocycline
Clindamycin
--> If patient is allergic to Sulfa do not use Bactrim
⩥ Human bites. Answer: "Dirtiest" bite of all. Watch for closed-fist
injuries of the hands (may involve joint capsule and tendon damage).
Eikenella corrodens & numerous bacteria may be involved
⩥ Animal bites:. Answer: Cat bites have a higher risk of infection that
dog bites Redness, swelling, pain
Systemic symptoms may develop within 12-24 hours
⩥ Treatment for human bites and animal bites. Answer: •Augmentin
875/125 mg BID x 10 days or IV antibiotics in ER Penicillin Allergy §
Doxycycline BID or Bactrim DS BID PLUS Flagyl BID or Clindamycin
TID
Also give Tetanus booster if needed
,Evaluate for rabies prophylaxis
⩥ Tetanus Vaccination. Answer: Initial series (3 doses) DTaP (infants to
age 6): 5 doses Ages 7 and older
Td or Tdap Need every 10 years for lifetime Common reaction: pain at
injection site in 24-48 hours
Contaminated wounds: give one dose if last dose was more than 5 years
ago or is due
⩥ Impetigo. Answer: Bacteria (Gram Positive): Beta Streptococcus or
Streptococcus aureus
Most common bacterial skin infection in young children ages 2-5
⩥ Impetigo symptoms. Answer: Itchy pink-red lesions, evolve into
vesiculopustules that rupture easily, honeycolored crusts (from dried
serous exudate)
Very pruritic and contagious
⩥ Impetigo Treatment. Answer: Order C&S of fluid
, Severe Case= Keflex or Dicloxacillin QID x 10 days
Penicillin Allergy o Give Azithromycin 250 mg x 5 days or o
Clindamycin x 10 days
**If no blisters- topical mupirocin ointment (bactroban) 2% x 10 days
⩥ Acne Vulgaris (common acne): treatment. Answer: First line is always
topical retinoid such as tretinoin cream (Retin-A)
⩥ Acne: Mild treatmetn. Answer: open comedones blackheads/closed
comedones (whiteheads) w/ or w/o papules
topical retinoid (Retin-A)
**Acne will worsen during first 4-6 weeks**
IF no improvement in 8-12 weeks, increase dose or ADD benzoyl
peroxide and/or erythromycin
⩥ Acne: Moderate (topicals plus antibiotics). Answer: papules and
pustules with comedones (3 part treatment)
Topical retinoid (Retin-A) AND topical benzoyl peroxide AND oral
antibiotic (Tetracycline or Minocycline) x 3-4 weeks --> Exam usually
asks about moderate
