APEA 3P HIGH STAKES MOCK EXAM AND
STUDY MATERIAL WITH CASE SCENARIOS
AND ADVANCED PRACTICE APPLICATIONS
◉ 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
STUDY MATERIAL WITH CASE SCENARIOS
AND ADVANCED PRACTICE APPLICATIONS
◉ 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
