APEA 3P Exam latest update 2023
/ 2024 /apea 3p graded A+
Most common type of skin cancer in USA - ANSWER-Skin cancer
Most common type of skin cancer - ANSWER-basal cell carcinoma
basal cell carcinoma symptoms - ANSWER-Appearance varies; smooth, shiny bump,
pink to pearly white
Basal cell carcinoma common locations - ANSWER-cheeks, nose, face, neck, arms,
back
basal cell carcinoma diagnosis gold standard - ANSWER-biopsy. if not an option, refer
to derm
Actinic keratosis - 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 - ANSWER-Biopsy.
if not an option, refer to derm
Actinic keratosis treatment gold standard - 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 - ANSWER-chronic red scaly rough textured lesion w/ irregular
borders
crusting or bleeding may be present
,Squamous cell carcinoma common locations - ANSWER-rims of ears, lips, nose, face
and top of hands
precursor lesion to squamous cell cancer - ANSWER-actinic keratosis
squamous cell carcinoma diagnosis by? - ANSWER-biopsy gold standard. if biopsy is
not an option, refer to dermatology .
Risk factors for skin cancer(melanoma and both non-melanoma) - 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) - 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 - 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 - ANSWER-soft, round, wart-like growth that is light tan to black
and looks pasted on
asymptomatic &benign
Bacterial Meningitis Bacteria - ANSWER-Streptococcus pneumoniae- most common
strain
Haemophilus influenzae
Neisseria meningitidis
Escherichia coli
*others
Bacterial meningitis symptoms (Classic Triad) - 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 - ANSWER-yes!
Treatment for Bacterial meningitis-patient - 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 - 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)
/ 2024 /apea 3p graded A+
Most common type of skin cancer in USA - ANSWER-Skin cancer
Most common type of skin cancer - ANSWER-basal cell carcinoma
basal cell carcinoma symptoms - ANSWER-Appearance varies; smooth, shiny bump,
pink to pearly white
Basal cell carcinoma common locations - ANSWER-cheeks, nose, face, neck, arms,
back
basal cell carcinoma diagnosis gold standard - ANSWER-biopsy. if not an option, refer
to derm
Actinic keratosis - 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 - ANSWER-Biopsy.
if not an option, refer to derm
Actinic keratosis treatment gold standard - 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 - ANSWER-chronic red scaly rough textured lesion w/ irregular
borders
crusting or bleeding may be present
,Squamous cell carcinoma common locations - ANSWER-rims of ears, lips, nose, face
and top of hands
precursor lesion to squamous cell cancer - ANSWER-actinic keratosis
squamous cell carcinoma diagnosis by? - ANSWER-biopsy gold standard. if biopsy is
not an option, refer to dermatology .
Risk factors for skin cancer(melanoma and both non-melanoma) - 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) - 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 - 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 - ANSWER-soft, round, wart-like growth that is light tan to black
and looks pasted on
asymptomatic &benign
Bacterial Meningitis Bacteria - ANSWER-Streptococcus pneumoniae- most common
strain
Haemophilus influenzae
Neisseria meningitidis
Escherichia coli
*others
Bacterial meningitis symptoms (Classic Triad) - 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 - ANSWER-yes!
Treatment for Bacterial meningitis-patient - 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 - 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)
