MSN 572 APEA 3P EXAM 3 2026 FINAL PAPER
SOLVED QUESTIONS WITH FULL SOLUTION
ALREADY PASSED
◉ Treatment for bacterial meningitis-close encounter.
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).
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.
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.
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.
Answer: Give one dose of menactra or menveo if never had either
◉ Rocky mountain spotted fever (RMSF) symptoms.
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).
Answer: R-Rash
,M-Muscle aches (myalgia)
S-Stomach aches (nausea and vomiting)
F-Fever (>102 F)
◉ Rocky Mountain Spotted Fever (RMSF): Located:.
Answer: •Think "Rocky"- North Carolina, Oklahoma, Arkansas,
Tennessee, Missouri
Spring to Fall (April to September)
◉ Rocky Mountain Spotted Fever (RMSF): DX.
Answer: PCR assay by indirect immunofluorescence antibody (IFA)
assay for immunoglobulin G (IgG) for Rickettsia Rickettsii
◉ Rocky Mountain Spotted Fever (RMSF): tx.
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
◉ Erythema Migrans (early Lyme disease): Symptoms.
Answer: Usually appears in 7-14 days after being bitten by a deer
tick; range 3-30 days
Target bull's-eye Rash is hot to touch with rough texture. Expanding
red rash with central clearing • Common locations are belt line,
, axillary area, behind the knees, and groin area • Positive for flu like
symptoms. Lesions and rash resolve within a few weeks with or
without treatment
◉ Erythema Migrans (early Lyme disease): DX.
Answer: Dx: • First step is enzyme immunoassay (EIA) also knows
as ELISA if negative no further testing needed. If positive confirm
with Western Blot test (aka indirect immunofluorescence assay
(IFA) for Borrelia Burgdorferi
1. Enzyme immunoassay
2. western blot test (immunoflurorescence assay/ IFA)
Exam Tip: E before I
Will have increased ESR
◉ Erythema Migrans (early Lyme disease): TX.
Answer: Doxycycline is always first line for all ages
100 mg BID x 10-21 days
Remove ticks by grasping with tweezers or forceps close to the skin
and pulling gently with steady pressure. After removing the tick,
clean area with rubbing alcohol, iodine scrub, or soap and water.
Dispose of the tick by flushing it into the toilet
SOLVED QUESTIONS WITH FULL SOLUTION
ALREADY PASSED
◉ Treatment for bacterial meningitis-close encounter.
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).
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.
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.
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.
Answer: Give one dose of menactra or menveo if never had either
◉ Rocky mountain spotted fever (RMSF) symptoms.
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).
Answer: R-Rash
,M-Muscle aches (myalgia)
S-Stomach aches (nausea and vomiting)
F-Fever (>102 F)
◉ Rocky Mountain Spotted Fever (RMSF): Located:.
Answer: •Think "Rocky"- North Carolina, Oklahoma, Arkansas,
Tennessee, Missouri
Spring to Fall (April to September)
◉ Rocky Mountain Spotted Fever (RMSF): DX.
Answer: PCR assay by indirect immunofluorescence antibody (IFA)
assay for immunoglobulin G (IgG) for Rickettsia Rickettsii
◉ Rocky Mountain Spotted Fever (RMSF): tx.
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
◉ Erythema Migrans (early Lyme disease): Symptoms.
Answer: Usually appears in 7-14 days after being bitten by a deer
tick; range 3-30 days
Target bull's-eye Rash is hot to touch with rough texture. Expanding
red rash with central clearing • Common locations are belt line,
, axillary area, behind the knees, and groin area • Positive for flu like
symptoms. Lesions and rash resolve within a few weeks with or
without treatment
◉ Erythema Migrans (early Lyme disease): DX.
Answer: Dx: • First step is enzyme immunoassay (EIA) also knows
as ELISA if negative no further testing needed. If positive confirm
with Western Blot test (aka indirect immunofluorescence assay
(IFA) for Borrelia Burgdorferi
1. Enzyme immunoassay
2. western blot test (immunoflurorescence assay/ IFA)
Exam Tip: E before I
Will have increased ESR
◉ Erythema Migrans (early Lyme disease): TX.
Answer: Doxycycline is always first line for all ages
100 mg BID x 10-21 days
Remove ticks by grasping with tweezers or forceps close to the skin
and pulling gently with steady pressure. After removing the tick,
clean area with rubbing alcohol, iodine scrub, or soap and water.
Dispose of the tick by flushing it into the toilet
