APEA NR667 QUESTIONS AND ANSWERS 2025
Ch. and Go = doxy 100mg BID x 7 days and rocephin (ceftriaxone) 500mg IM if <330lb,
if >330lbs than 1gm IM. - CORRECT ANSWER-
Ch.=doxy 100mg BID x 7 days. Alternative: azithromycin 1gm oral single dose or leva
500mg daily x 7. In pregnancy Azithromycin 1 gm oral single dose or Anoxic 500 mg
TID for 7 days. Rescreen in 3 mos. due to rates of reinfection and f/u in 1 mo. if
pregnant. - CORRECT ANSWER-
Symptoms of chlamydia is vaginal/urethral white/gray discharge, dysuria, mild
abdominal pain, cervical motion tenderness, salinities, edematous/congested/friable
cervix. In women can manifest as cervicitis, urethritis, PID. Untreated risk for infertility
and ectopic prig. In men can lead to urethritis, epididymitis, prostatitis, prostates.
Conjunctivitis and pharyngitis in both men and women. LABS: NAATS- highly sensitive
for Ch. and Go done through vaginal swab in women and U/A in men. Pregnancy test of
cure 3-4wks after TX and retest in 3rd trimester. Most common in <25yo - CORRECT
ANSWER-
Go alone TX w/ rocephin 500mg IM <330lbs, if >330lb than 1gm IM. Gonorrhea
painless in women and painful in men. Assessment in men: purulent urethral discharge,
dysuria, testicular pain. Women: end cervical discharge, dysuria, Bartholin’s gland
abscess, abnormal vat bleeding, cervical motion tenderness, bad/pelvic pain. LABS:
NAAT u/a tin men, gram stain exudate, DNA probe, Culture of exudate or joint aspirate
on Thayer Martin agar. - CORRECT ANSWER-
Syphilis (Tryponema pallidum). Testing: EIA or CIA and if positive then Confirm w RPR.
Benzedrine PCN G (Bacilli) 2.4 million units IM in adults and 50,000 units/kg IM in
children. If PCN allergy, then Doxy 100mg BID x 14 days or tetracycline 500mg TID x
14 days. - CORRECT ANSWER-
Syphilis presents as a single, painless open sore (chancre) at site of inoculation
(genitals, mouth, skin, or rectum that heals by itself in 3-6 wks.). Can go unnoticed if
untreated can cause skin rashes, fever, and swollen lymph nodes. Primary: painless
chancre, Secondary: nonoperatic rash on palms and feet. Condylar late- white
papules/warts. Latent: Asymptomatic + titer. Tertiary: neurosyphilis, soft tissue tumor,
valvar damage. - CORRECT ANSWER-
,Trichomonas’s: Metronidazole 500mg pop BID x 7 days (women) If HIV+ retest in 3mos
{NAAT}; Metronidazole 2gm pop in a single dose (men and pregnant
women/breastfeeding). Alternate TX: Imidazole 2g pop in a single dose. Can be
asymptomatic. Vaginal discharge: frothy, yellow-green, cervical petechial "strawberry
cervix". Men: dysuria, asymptomatic, epididymitis and prostatitis. DX: wet prep will see
flagellated motile cells. POC tests for trick in women: Affirm and Odom. PCR testing
urine for men. - CORRECT ANSWER-
HIV: Antiretroviral therapy (ART). Pregnancy - zidovudine (Retroviral) start as soon as
HIV Ds. Newborns give within 8 hrs. Bacteria: PCP (P. jirovecci pneumonia). DX:
HIV1/HIV2 antigen antibody immunoassay if + confirm with differentiation. If - order
RNA. Other ELISA for screen and Western blot to confirm. - CORRECT ANSWER-
AFP and knowing high for twins. Low for DS: Alpha-fetoprotein assess for genetic
defects. This will be elevated with twins and can be elevated in neural tube defects such
as spine bifida. Low AFP may mean that the baby has a genetic disorder such as
Down's syndrome. - CORRECT ANSWER-
Damage listeria can cause: Can lead to meningitis. Long term consequences may
include mental retardation, seizures, paralysis, blindness, and deafness. - CORRECT
ANSWER-
Roam and when to give: Immune globulin to prevent mothers who are RH (-) and TX
thrombocytopenia purpura in those who are RH (+). Give @ 28 wks. of pregnancy to
prevent exposure the last few months. - CORRECT ANSWER-
Know what placental abruption looks like: S/S abdominal and back pain. Painful Vaginal
bleeding, contractions, uterine tenderness. Globular shaped uterine fundus on
palpation. - CORRECT ANSWER-
probable presumptive PG shit: Amenorrhea, nausea, fatigue, frequent urination, breast
enlargement and tenderness, constipation, and food cravings. - CORRECT ANSWER-
A few menopausal sq. Like best OTC supplement: Black Cohosh (hot flashes), flaxseed
(night sweats), calcium, vitamin D, St. John's worth (mood swings) - CORRECT
ANSWER-
Best way to tell the diff between breast cancer and breast cyst: U/S (?) - CORRECT
ANSWER-
, Dark pigment through the fingernail and what does it mean: Herpetic whitlow was an
answer. It was on the finger (infection of skin around fingernail caused by HSV painful
blisters on fingers. Splinter hemorrhages under fingernail can occur with heart infection
such as endocarditis. - CORRECT ANSWER-
One was like a baby was TX for Ute extensively and what next. It was weird answers.
Kidney US. Nothing. Abdominal US. According to APEA videos it would be a renal and
bladder u/s for next step after ax (cephalosporin’s such as cefixime, cefdinir, ceftibuten
3-5 days if afebrile and 10 days if febrile). - CORRECT ANSWER-
Know GFR is top for kidney function. Under 30 stop metformin - GFR >60 is normal -
CORRECT ANSWER-
UTI TX. Bactrim DS (sulfa), Cipro (fluoroquinolone), Nitrofurantoin (Macro bid).
Cephalosporin’s reserve for children and pregnant women. Cephalexin, Anoxic,
Augmentin (1st trimester) and Nitrofurantoin 100mg (2nd and 3rd trimester). -
CORRECT ANSWER-
And Pylon and what diagnostic tool: Pyelonephritis is kidney infection that requires
hospitalization can cause complications such as abscesses, renal damage, sepsis,
renal failure, and death. Ds testing: U/A with positive WBC casts, CBC: leukocytosis,
increase seed rate. Blood culture and CT if septic. Fluoroquinolone TX preferred such
as Cipro. - CORRECT ANSWER-
A few kidney stones and TX and dx questions. U/A will have (+) blood results, pt. ℅
LBP, frequent urination. Renal U/S and/or CT of abdomen. - CORRECT ANSWER-
A few on abdominal sq. and findings. Like described the signs for appendicitis: RLQ
pain and tenderness, fever, n/v, positive Burney sign. - CORRECT ANSWER-
That's how it did for the knees. Tells you DX then you answer by what description fits
the right tests. - CORRECT ANSWER-
Labs seen for IBS vs inflammatory bowel: Inflammatory Bowel would check CRP and
ESR. Stool test of fecal calprotectin and lactoferrin to check for inflammation in GI tract
this will determine if IBD and if nag than its IBS. Two blood tests for IBS - IBSchek and
IBS-Smart this checks for antibodies that are related to IBS. Will assess for celiac in IBS
(IgA-tag) Tissue glutamines antibody. - CORRECT ANSWER-
Ch. and Go = doxy 100mg BID x 7 days and rocephin (ceftriaxone) 500mg IM if <330lb,
if >330lbs than 1gm IM. - CORRECT ANSWER-
Ch.=doxy 100mg BID x 7 days. Alternative: azithromycin 1gm oral single dose or leva
500mg daily x 7. In pregnancy Azithromycin 1 gm oral single dose or Anoxic 500 mg
TID for 7 days. Rescreen in 3 mos. due to rates of reinfection and f/u in 1 mo. if
pregnant. - CORRECT ANSWER-
Symptoms of chlamydia is vaginal/urethral white/gray discharge, dysuria, mild
abdominal pain, cervical motion tenderness, salinities, edematous/congested/friable
cervix. In women can manifest as cervicitis, urethritis, PID. Untreated risk for infertility
and ectopic prig. In men can lead to urethritis, epididymitis, prostatitis, prostates.
Conjunctivitis and pharyngitis in both men and women. LABS: NAATS- highly sensitive
for Ch. and Go done through vaginal swab in women and U/A in men. Pregnancy test of
cure 3-4wks after TX and retest in 3rd trimester. Most common in <25yo - CORRECT
ANSWER-
Go alone TX w/ rocephin 500mg IM <330lbs, if >330lb than 1gm IM. Gonorrhea
painless in women and painful in men. Assessment in men: purulent urethral discharge,
dysuria, testicular pain. Women: end cervical discharge, dysuria, Bartholin’s gland
abscess, abnormal vat bleeding, cervical motion tenderness, bad/pelvic pain. LABS:
NAAT u/a tin men, gram stain exudate, DNA probe, Culture of exudate or joint aspirate
on Thayer Martin agar. - CORRECT ANSWER-
Syphilis (Tryponema pallidum). Testing: EIA or CIA and if positive then Confirm w RPR.
Benzedrine PCN G (Bacilli) 2.4 million units IM in adults and 50,000 units/kg IM in
children. If PCN allergy, then Doxy 100mg BID x 14 days or tetracycline 500mg TID x
14 days. - CORRECT ANSWER-
Syphilis presents as a single, painless open sore (chancre) at site of inoculation
(genitals, mouth, skin, or rectum that heals by itself in 3-6 wks.). Can go unnoticed if
untreated can cause skin rashes, fever, and swollen lymph nodes. Primary: painless
chancre, Secondary: nonoperatic rash on palms and feet. Condylar late- white
papules/warts. Latent: Asymptomatic + titer. Tertiary: neurosyphilis, soft tissue tumor,
valvar damage. - CORRECT ANSWER-
,Trichomonas’s: Metronidazole 500mg pop BID x 7 days (women) If HIV+ retest in 3mos
{NAAT}; Metronidazole 2gm pop in a single dose (men and pregnant
women/breastfeeding). Alternate TX: Imidazole 2g pop in a single dose. Can be
asymptomatic. Vaginal discharge: frothy, yellow-green, cervical petechial "strawberry
cervix". Men: dysuria, asymptomatic, epididymitis and prostatitis. DX: wet prep will see
flagellated motile cells. POC tests for trick in women: Affirm and Odom. PCR testing
urine for men. - CORRECT ANSWER-
HIV: Antiretroviral therapy (ART). Pregnancy - zidovudine (Retroviral) start as soon as
HIV Ds. Newborns give within 8 hrs. Bacteria: PCP (P. jirovecci pneumonia). DX:
HIV1/HIV2 antigen antibody immunoassay if + confirm with differentiation. If - order
RNA. Other ELISA for screen and Western blot to confirm. - CORRECT ANSWER-
AFP and knowing high for twins. Low for DS: Alpha-fetoprotein assess for genetic
defects. This will be elevated with twins and can be elevated in neural tube defects such
as spine bifida. Low AFP may mean that the baby has a genetic disorder such as
Down's syndrome. - CORRECT ANSWER-
Damage listeria can cause: Can lead to meningitis. Long term consequences may
include mental retardation, seizures, paralysis, blindness, and deafness. - CORRECT
ANSWER-
Roam and when to give: Immune globulin to prevent mothers who are RH (-) and TX
thrombocytopenia purpura in those who are RH (+). Give @ 28 wks. of pregnancy to
prevent exposure the last few months. - CORRECT ANSWER-
Know what placental abruption looks like: S/S abdominal and back pain. Painful Vaginal
bleeding, contractions, uterine tenderness. Globular shaped uterine fundus on
palpation. - CORRECT ANSWER-
probable presumptive PG shit: Amenorrhea, nausea, fatigue, frequent urination, breast
enlargement and tenderness, constipation, and food cravings. - CORRECT ANSWER-
A few menopausal sq. Like best OTC supplement: Black Cohosh (hot flashes), flaxseed
(night sweats), calcium, vitamin D, St. John's worth (mood swings) - CORRECT
ANSWER-
Best way to tell the diff between breast cancer and breast cyst: U/S (?) - CORRECT
ANSWER-
, Dark pigment through the fingernail and what does it mean: Herpetic whitlow was an
answer. It was on the finger (infection of skin around fingernail caused by HSV painful
blisters on fingers. Splinter hemorrhages under fingernail can occur with heart infection
such as endocarditis. - CORRECT ANSWER-
One was like a baby was TX for Ute extensively and what next. It was weird answers.
Kidney US. Nothing. Abdominal US. According to APEA videos it would be a renal and
bladder u/s for next step after ax (cephalosporin’s such as cefixime, cefdinir, ceftibuten
3-5 days if afebrile and 10 days if febrile). - CORRECT ANSWER-
Know GFR is top for kidney function. Under 30 stop metformin - GFR >60 is normal -
CORRECT ANSWER-
UTI TX. Bactrim DS (sulfa), Cipro (fluoroquinolone), Nitrofurantoin (Macro bid).
Cephalosporin’s reserve for children and pregnant women. Cephalexin, Anoxic,
Augmentin (1st trimester) and Nitrofurantoin 100mg (2nd and 3rd trimester). -
CORRECT ANSWER-
And Pylon and what diagnostic tool: Pyelonephritis is kidney infection that requires
hospitalization can cause complications such as abscesses, renal damage, sepsis,
renal failure, and death. Ds testing: U/A with positive WBC casts, CBC: leukocytosis,
increase seed rate. Blood culture and CT if septic. Fluoroquinolone TX preferred such
as Cipro. - CORRECT ANSWER-
A few kidney stones and TX and dx questions. U/A will have (+) blood results, pt. ℅
LBP, frequent urination. Renal U/S and/or CT of abdomen. - CORRECT ANSWER-
A few on abdominal sq. and findings. Like described the signs for appendicitis: RLQ
pain and tenderness, fever, n/v, positive Burney sign. - CORRECT ANSWER-
That's how it did for the knees. Tells you DX then you answer by what description fits
the right tests. - CORRECT ANSWER-
Labs seen for IBS vs inflammatory bowel: Inflammatory Bowel would check CRP and
ESR. Stool test of fecal calprotectin and lactoferrin to check for inflammation in GI tract
this will determine if IBD and if nag than its IBS. Two blood tests for IBS - IBSchek and
IBS-Smart this checks for antibodies that are related to IBS. Will assess for celiac in IBS
(IgA-tag) Tissue glutamines antibody. - CORRECT ANSWER-
