APEA PRE-PREDICTOR FINAL
EXAM STUDY GUIDE. GRADED
A+. WITH QUESTIONS AND
100% VERIFIED ANSWERS.
LATEST UPDATE
In myasthenia gravis, weakness is a result of insufficient acetylcholine
transmission at the neuromuscular junction; however, weakness can also occur
with overdosing of the cholinergic medications used to treat myasthenia. What
symptom helps differentiate a myasthenic crisis from a cholinergic crisis? -
Ans✔✔-Muscle fasciculations
A 74-year-old man presents after his wife witnessed him grab his head in pain
and fall to the floor. He has not regained consciousness. His current blood
pressure is 150/96 mm Hg, and his heart rate is 65 bpm. Emergent head CT
shows a subarachnoid hemorrhage. - Ans✔✔-Nimodipine (CCB)
A 75-year-old man is involved in a motor vehicle accident and strikes his
forehead on the windshield. He complains of neck pain and severe burning in
his shoulders and arms. His physical examination reveals weakness of his upper
extremities. What type of spinal cord injury does this patient have? - Ans✔✔-
central cord syndrome
,A 37-year-old man fell from a ladder as he finished hanging the Christmas lights
on his house. The right side of his head hit the alley cement, and he lost
consciousness for about 1 minute; he woke up with a headache, but he had no
other complaints. A few hours later, the patient is brought to the emergency
room by his neighbor because of an intense headache, confusion, and left hand
hemiparesis. On examination, the patient has a bruise located over the right
temporal region, mydriasis, and right deviation of the right eye, papilledema,
and left extensor plantar response. An emergency CT scan of the head without
contrast reveals a lens-shaped hyper-density under the right temporal bone
with mass effect and edema. What is the most likely diagnosis? - Ans✔✔-
Epidural hematoma
A 1-year-old boy presents with increasing lethargy. He is barely responsive, and
his parents deny any trauma or injury. What is the most common cause of
nontraumatic altered levels of consciousness? - Ans✔✔-Infection
A 44-year-old man starts to notice that his eyelids are drooping. Some time
afterwards, his jaw becomes weak. He has difficulty swallowing and also
experiences weakness in his limbs. He is quite embarrassed when he eats
because he must use his hand to help support his jaw. His weakness gets
progressively worse. Finally, he seeks medical attention. His physical
examination demonstrates the weakness in his limbs; however, no sensory
defects are present. A Tensilon test is done and is positive. His doctor is
concerned about an associated malignancy. What is the underlying pathology
of this disease? - Ans✔✔-Antibodies to the acetylcholine receptor
A 31-year-old woman presents with a purpural rash covering her arms, legs,
and abdomen. She also has fever, chills, nausea, abdominal tenderness,
tachycardia, and generalized myalgias. Prior to the development of the rash,
the patient noted that she had a headache, cough, and sore throat. Laboratory
studies were positive for Gram-negative diplococci in the blood, along with
thrombocytopenia and an elevation in PMNs. Urinalysis showed blood, protein,
,and casts. The patient denies any foreign travel and does not have any sick
contacts. However, she does work part time as a nurse in a local hospital. The
patient is diagnosed with Meningococcemia; she is admitted to the hospital
and placed in respiratory isolation. What major course of therapy should this
patient receive? - Ans✔✔-Antibiotics
A 54-year-old man presents after having a generalized seizure. The patient is
HIV positive, but he has been unable to afford antiretroviral therapy since
losing his job 2 years ago. Other than cachexia, the physical exam is
unremarkable. Upon further inquiry, the patient also notes that he has become
short- tempered and hypercritical; at times, he seems confused. An MRI of the
brain is performed, and it reveals several cortical ring-enhancing lesions. -
Ans✔✔-Toxoplasma encephalitis
A 37-year-old woman presents to her GP surgery with a history of right-sided
facial weakness and peri-auricular discomfort since she awoke this morning.
She is afebrile. What is the most likely diagnosis? - Ans✔✔-Bell's Palsy
A 62-year-old man presents with vision problems and difficulty swallowing.
Over the last week, he has had a constellation of symptoms; they began with
numbness and tingling in his feet and progressed to weakness that now affects
both lower and upper extremities. Within the last day, he has started to notice
difficulty swallowing and double vision. He also feels it is difficult for him to
take a big breath. His past medical history is noncontributory, and he takes no
medications. Exam reveals bilateral absence of patellar and ulnar reflexes. A
lumbar puncture is performed to confirm the diagnosis. What cerebrospinal
fluid (CSF) finding is most likely? - Ans✔✔-Elevated CSF proteins
A 70-year-old woman is brought to your attention by her family because of the
slowly progressive gait disorder, the impairment of mental function, and
urinary incontinence. About 1 year ago, she started having weakness and
, tiredness in her legs, followed by unsteadiness; her steps became shorter and
shorter, and she also experienced unexplained backward falls. She is becoming
emotionally indifferent, inattentive, and her actions and thinking have became
"dull". Over the past month, she has started having urinary urgency and
involuntary leaking of urine. What is most likely the best method of treating
the patient's urinary problems? - Ans✔✔-Ventriculoperitoneal shunt
A 5-month-old male infant presents after a seizure involving all 4 limbs. His
mother tells you that he was born full term without any complications, and he
was well until 2 days ago when he developed a fever. He vomited multiple
times yesterday and was irritable. He was given antipyretic medication for his
fever. He has no known allergies. On physical exam, his temperature is 102.7 F,
and his pulse is 154/min; BP is 90/50 mmHg, and RR is 20/min. He is lethargic,
pale, and focal neurological deficits are present. His anterior fontanel is
bulging. You suspect that he has bacterial meningitis. After drawing blood
samples for investigations, what is the most appropriate next step? - Ans✔✔-
intravenous empirical antibiotics
A 12-year-old girl presents with a 3-day history of progressive dysarthria,
dysphagia, and weakness. The patient was well until 3 days prior to admission
to the hospital; at that time, she developed the onset and subsequent gradual
worsening of dysarthria. She attributed the dysarthria to a sore throat that she
had had about 2 weeks earlier. 3 days prior to admission, she also had the
onset of mild dysphagia; it mostly occurred with liquids. 24 hours prior to
admission, she developed weakness in both upper extremities, which increased
and began to involve the lower extremities. This limb weakness was neither
worsened by activity nor improved by rest. A nerve conduction study reveals a
moderate degree of mostly motor demyelinating peripheral neuropathy, highly
suggestive of Guillain- Barre. What statement best describes the patient's
prognosis? - Ans✔✔-Her rapidly evolving clinical course indicates a poor
prognosis
EXAM STUDY GUIDE. GRADED
A+. WITH QUESTIONS AND
100% VERIFIED ANSWERS.
LATEST UPDATE
In myasthenia gravis, weakness is a result of insufficient acetylcholine
transmission at the neuromuscular junction; however, weakness can also occur
with overdosing of the cholinergic medications used to treat myasthenia. What
symptom helps differentiate a myasthenic crisis from a cholinergic crisis? -
Ans✔✔-Muscle fasciculations
A 74-year-old man presents after his wife witnessed him grab his head in pain
and fall to the floor. He has not regained consciousness. His current blood
pressure is 150/96 mm Hg, and his heart rate is 65 bpm. Emergent head CT
shows a subarachnoid hemorrhage. - Ans✔✔-Nimodipine (CCB)
A 75-year-old man is involved in a motor vehicle accident and strikes his
forehead on the windshield. He complains of neck pain and severe burning in
his shoulders and arms. His physical examination reveals weakness of his upper
extremities. What type of spinal cord injury does this patient have? - Ans✔✔-
central cord syndrome
,A 37-year-old man fell from a ladder as he finished hanging the Christmas lights
on his house. The right side of his head hit the alley cement, and he lost
consciousness for about 1 minute; he woke up with a headache, but he had no
other complaints. A few hours later, the patient is brought to the emergency
room by his neighbor because of an intense headache, confusion, and left hand
hemiparesis. On examination, the patient has a bruise located over the right
temporal region, mydriasis, and right deviation of the right eye, papilledema,
and left extensor plantar response. An emergency CT scan of the head without
contrast reveals a lens-shaped hyper-density under the right temporal bone
with mass effect and edema. What is the most likely diagnosis? - Ans✔✔-
Epidural hematoma
A 1-year-old boy presents with increasing lethargy. He is barely responsive, and
his parents deny any trauma or injury. What is the most common cause of
nontraumatic altered levels of consciousness? - Ans✔✔-Infection
A 44-year-old man starts to notice that his eyelids are drooping. Some time
afterwards, his jaw becomes weak. He has difficulty swallowing and also
experiences weakness in his limbs. He is quite embarrassed when he eats
because he must use his hand to help support his jaw. His weakness gets
progressively worse. Finally, he seeks medical attention. His physical
examination demonstrates the weakness in his limbs; however, no sensory
defects are present. A Tensilon test is done and is positive. His doctor is
concerned about an associated malignancy. What is the underlying pathology
of this disease? - Ans✔✔-Antibodies to the acetylcholine receptor
A 31-year-old woman presents with a purpural rash covering her arms, legs,
and abdomen. She also has fever, chills, nausea, abdominal tenderness,
tachycardia, and generalized myalgias. Prior to the development of the rash,
the patient noted that she had a headache, cough, and sore throat. Laboratory
studies were positive for Gram-negative diplococci in the blood, along with
thrombocytopenia and an elevation in PMNs. Urinalysis showed blood, protein,
,and casts. The patient denies any foreign travel and does not have any sick
contacts. However, she does work part time as a nurse in a local hospital. The
patient is diagnosed with Meningococcemia; she is admitted to the hospital
and placed in respiratory isolation. What major course of therapy should this
patient receive? - Ans✔✔-Antibiotics
A 54-year-old man presents after having a generalized seizure. The patient is
HIV positive, but he has been unable to afford antiretroviral therapy since
losing his job 2 years ago. Other than cachexia, the physical exam is
unremarkable. Upon further inquiry, the patient also notes that he has become
short- tempered and hypercritical; at times, he seems confused. An MRI of the
brain is performed, and it reveals several cortical ring-enhancing lesions. -
Ans✔✔-Toxoplasma encephalitis
A 37-year-old woman presents to her GP surgery with a history of right-sided
facial weakness and peri-auricular discomfort since she awoke this morning.
She is afebrile. What is the most likely diagnosis? - Ans✔✔-Bell's Palsy
A 62-year-old man presents with vision problems and difficulty swallowing.
Over the last week, he has had a constellation of symptoms; they began with
numbness and tingling in his feet and progressed to weakness that now affects
both lower and upper extremities. Within the last day, he has started to notice
difficulty swallowing and double vision. He also feels it is difficult for him to
take a big breath. His past medical history is noncontributory, and he takes no
medications. Exam reveals bilateral absence of patellar and ulnar reflexes. A
lumbar puncture is performed to confirm the diagnosis. What cerebrospinal
fluid (CSF) finding is most likely? - Ans✔✔-Elevated CSF proteins
A 70-year-old woman is brought to your attention by her family because of the
slowly progressive gait disorder, the impairment of mental function, and
urinary incontinence. About 1 year ago, she started having weakness and
, tiredness in her legs, followed by unsteadiness; her steps became shorter and
shorter, and she also experienced unexplained backward falls. She is becoming
emotionally indifferent, inattentive, and her actions and thinking have became
"dull". Over the past month, she has started having urinary urgency and
involuntary leaking of urine. What is most likely the best method of treating
the patient's urinary problems? - Ans✔✔-Ventriculoperitoneal shunt
A 5-month-old male infant presents after a seizure involving all 4 limbs. His
mother tells you that he was born full term without any complications, and he
was well until 2 days ago when he developed a fever. He vomited multiple
times yesterday and was irritable. He was given antipyretic medication for his
fever. He has no known allergies. On physical exam, his temperature is 102.7 F,
and his pulse is 154/min; BP is 90/50 mmHg, and RR is 20/min. He is lethargic,
pale, and focal neurological deficits are present. His anterior fontanel is
bulging. You suspect that he has bacterial meningitis. After drawing blood
samples for investigations, what is the most appropriate next step? - Ans✔✔-
intravenous empirical antibiotics
A 12-year-old girl presents with a 3-day history of progressive dysarthria,
dysphagia, and weakness. The patient was well until 3 days prior to admission
to the hospital; at that time, she developed the onset and subsequent gradual
worsening of dysarthria. She attributed the dysarthria to a sore throat that she
had had about 2 weeks earlier. 3 days prior to admission, she also had the
onset of mild dysphagia; it mostly occurred with liquids. 24 hours prior to
admission, she developed weakness in both upper extremities, which increased
and began to involve the lower extremities. This limb weakness was neither
worsened by activity nor improved by rest. A nerve conduction study reveals a
moderate degree of mostly motor demyelinating peripheral neuropathy, highly
suggestive of Guillain- Barre. What statement best describes the patient's
prognosis? - Ans✔✔-Her rapidly evolving clinical course indicates a poor
prognosis
