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apea predictor

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A 15 years old high school student with a mild sore throat and low-grade fever that has persisted for about 3 weeks. She reports general malaise, fatigue, and loss of appetite. The NP suspects mononucleosis. Which of the following is the LEAST appropriate intervention? Palpate the lymph nodes and spleen Examine the posterior oropharynx for petechiae Obtain a CBC, throat culture, and heterophil antibody test. Obtain an urinalyses and serum for LFTs and amylase - ANSWER-Obtain an urinalyses and serum for LFTs and amylase

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APEA PREDICTOR 2024 EXAM BEST ELABORATED Q
n n n n n n




UESTIONS AND ANSWERS ALREADY RANKED A+.
n n n n n




An15nyearsnoldnhighnschoolnstudentnwithnanmildnsorenthroatnandnlow-
gradenfevernthatnhasnpersistednfornaboutn3nweeks.nShenreportsngeneralnmalaise,nfatigue,na
ndnlossnofnappetite.nThenNPnsuspectsnmononucleosis.nWhichnofnthenfollowingnisnthenLEAS
Tnappropriatenintervention?
Palpatenthenlymphnnodesnandnspleen
ExaminenthenposteriornoropharynxnfornpetechiaenObtainnanCBC,nthroatnculture,nandnh
n



eterophilnantibodyntest.
ObtainnannurinalysesnandnserumnfornLFTsnandnamylasen-nANSWER-
n



ObtainnannurinalysesnandnserumnfornLFTsnandnamylase




Explanation:nmononucleosisnisnansymptomaticninfectionncausednbynthenEpstein-
Barnvirus.nCommonnisnpeoplen15-
24nyearsnofnage.nCommonnsignsnandnsymptomsnfollowingnincubationnperiodn(1-
2nmonths)nincludenfatigue,nchills,nmalaise,nanorexia,nwhitentonsillarnexudatesnandnlymphad
enopathynornposteriorncervicalnregion.nSplenomegalyncannbenpresent.nAnmaculopapularnorn
occasionallynanpetechialnrashnoccursninnlessnthann15%nofnpatients.nAndiagnosisnisnusuallyn
madenusingnthenMonospot.nInnaddition,nneutropenianandnlymphocytosisnarenusuallyndetect
edninnthenCBC


An32nyearsnoldnmalenpatientncomplaintnofnurinarynfrequencynandnburningnonnurinationnforn3n
days.nUrinalysesnrevealsnbacteriurianandnpositivennitrites.nHendeniesnanynpastnhx.nOfnurin
aryntractninfections.nTheninitialntreatmentnshouldnbe:
a.ntrimethoprim-sulfamethoxazolen(Bactrim,nSulfatrim)nforn7-
10ndaynb.nciprofloxacinn(Cipro)nforn3-5ndays

, c.nTrimethoprim-Sulfamethoxazolenforn3ndays
d.n750nmgnciprofloxacinnasnanone-timendosen-nANSWER-.ntrimethoprim-
sulfamethoxazolen(Bactrim,nSulfatrim)nforn7-10nday




Explanation:ntrimethoprim-
sulfamethoxazolen(TMPS)nisnusuallynnnappropriatenmedicationntontreatnurinaryntractninfectio
nsninnmostnpatients.nInnthencasenofncommunitynresistancentonTMPSn>20%^,nanothernmedic
ationnshouldnbensubstituted.nInnmen,nthenappropriatenlengthnofntimenisn7n10ndays.nWomennm
aynbentreatednforn3ndaysnfornuncomplicatednUTI


Whichnagentnisnmostneffectivenfornthentreatmentnofnnodulocysticnacne?nBenzoyl
peroxiden(Benzac)
n



Retinoicnacidn(RetinnA)n
Topicalntetracycline
Isotretinoinn-nANSWER-Isotretinoin




Explanation:nIsotretinoinn(Accutane)nisnansystemicnagentnindicatednforntreatmentnwithnsev
ereninflammatorynacne.nGuidelinesnfornitsnusenmustnbenclearlynunderstoodnbynthenpatient.n
Anwomannofnchildbearingnagenmustnusenanneffectivenmethodnofncontraceptionnbecauseniso
tretinoinnisn1nTherenarenmanynrestrictionsninnprescribingnthisnmedicationnbecausenofnthente
ratogenicneffectsnisngivennduringnpregnancy.nTherefore,nitnisnanpregnancyncategorynX.


Ann18ny/onwomannisntakingnancombinednhormonalnoralncontraceptive.nShenshouldnbeninstru
ctedntonusenanbackupnmethodnfornthenpreventionnofnpregnancy
a.nThroughoutnthenweeknofnplacebonpills
Ifnprescribedntopiramaten(Topamax)nfornthentreatmentnofnmigraines.

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