Apea 3p final exam 2023/2024(summer-fall qtr)
Chlamydia - ✔✔ANSW✔✔..Most Common STI in US.
S&S - Genital Ulceration, Lymphadenopathy, Occular Trachoma, Proctitis, Cervical
Motion Tenderness, Assymptomatic. Can cause PID
Chlamydia Diagnostic & Treatment - ✔✔ANSW✔✔..Gold Standard - Nuclieic Acid
Amplification Test (NAAT) & Gen-Probe Assay
Tx: Azithromycin in pregnant patients, Amoxicillin if allergic.
Chron's Disease S&S - ✔✔ANSW✔✔..Chronic Bloody Diarrhea
Fatigue, Abdomnial Pain
Weight Loss/Fever
Skip Lesions, Cobblestone appearance
Fistulas are common
Slow progressive inflammation of small/large intestine
Tx is Budesonide 5-aminosalicylates
Cirrhosis S&S - ✔✔ANSW✔✔..Coagulopathy
Thrombocytopenia in early stages
Bleeding Varices
Hepatic Encephalopathy
ALOC and Tremors
Psychiatric - Depression/Anxiety
Arthralgia
Glucose Intolerance
Can be caused by Autoimmune disorders
Cluster Headache Presentation - ✔✔ANSW✔✔..Always unilateral, begins around
temple/eye, pain peaks within minutes; excruciating/explosive, rhinorrhea, tears, eye
becomes red
ETOH can be a trigger
Combined Oral Contraceptive contraindications - ✔✔ANSW✔✔..Hx of breast/estrogen-
related cancers, migraine w/aura, female >35yrs & smoker.
Contraindications for Hydrochlorothiazide - ✔✔ANSW✔✔..Sulfa allergy, PCN
hypersensitivity, Asthma, Gout
COPD - ✔✔ANSW✔✔..Progressive pathological changes to the airway and/or alveoli
due to increased inflammatory response to pollutants or inhaled irritants
,COPD Diagnostics - ✔✔ANSW✔✔..Gold Standard - Spirometry with bronchodilation.
Other criteria - Prolonged expiratory phase, wheezing with forced exhalation, barrel
chest & tripod position in late phase.
Coronary Artery Disease (CAD) treatment - ✔✔ANSW✔✔..Aotrvastatin/Rosuvastatin =
If LDL>150 use high doses. Watch for LFTs & arthralgia. Change type & dose if issues.
Helps stabilize plaques.
Croup - ✔✔ANSW✔✔..Acute viral illness
S&S - Barking Cough, Stridor, Sub-glottal swelling, Hoarseness.
Croup Treatment - ✔✔ANSW✔✔..Racemic Epinephrine, Corticosteroids, Cool-Mist
Humidification
** DO NOT USE TONGUE DEPRESSORS, CAN CAUSE SPASM!!
Decongestant contraindication in Pediatrics - ✔✔ANSW✔✔..Do not give under 2yrs old
Depression Treatment - ✔✔ANSW✔✔..Unipolar Depression - sertraline (Zoloft) &
escitalopram (Lexapro)
* Start with 4wks of treatment then re-evaluate for dose adjustment for a minimum of 6
months
Diabetes Mellitus - ✔✔ANSW✔✔..A1c over 6.5 or fasting glucose over 126 on 2
separate occasions
Metformin is first line treatment
Diabetic Neuropathy - ✔✔ANSW✔✔..Occurs in distal lower extremities r/t long-term
hyperglycemia
S&S include
Parestehsias
Burning
Muscle Weakness
Difficulty with Coordination/Balance
Diagnosing Peripheral Artery Disease (PAD) - ✔✔ANSW✔✔..Gold Standard =
Angiography
Ankle Brachial Index (ABI)
Diastolic Murmurs (Abnormal) - ✔✔ANSW✔✔..AR = Aortic Regurgitation (Angina, HF,
Dizziness, Chest Pain)
MS = Mitral Stenosis (Dyspnea, AFib)
Dysmenorrhea - ✔✔ANSW✔✔..Painful cramping w/menstruation
Tx: Heating Pad, NSAIDs, Oral Contraceptives
, Empyema - ✔✔ANSW✔✔..Prescence of pus in the pleural space. Develops when
pulmonary lymphatics become blocked leadingn to an outpouring of contaminated
lymph fluid into the pleural space.
S&S - Cyanosis, pleural pain, fever, tachycardia
Endocarditis Treatment - ✔✔ANSW✔✔..Zosyn/Vancomycin
Enterobiasis vermicularis (Pinworm) Infection - ✔✔ANSW✔✔..Helminths can be
transmitted by the bite of blood sucking insects
Tx:
Pyrantel Pamoate - One dose initially, then another dose in 2 weeks. Re-Test after 2
weeks of last dose
Epididymitis - ✔✔ANSW✔✔..Testicular pain onset over a few days (gradual) and
cremasteric reflex is present.
Erectile Dysfunction - ✔✔ANSW✔✔..Treatment PDE-5 inhibitor - contraindicated with
nitrates
Causes - Anti-HTN meds, antidepressants, antiandrogens, recreational drugs
Estrogen HRT contraindications - ✔✔ANSW✔✔..Breast Cancer, Undiagnosed Vaginal
Bleeding, Pregnancy, Clots, active Liver Disease
Eye Emergencies - ✔✔ANSW✔✔..Papilledema - r/t Increased ICP, Swollen Optic Disc,
and Engorged Tortuous Vein
Acute Closed-Angle Glaucoma - Sudden onset severe eye pain and Rapid loss of vision
Eye exam findings in DM & HTN - ✔✔ANSW✔✔..- AV Nicking = Arteries indent and
displace veins
- Cotton Wool Spots = White or grayish fluffy lesions on the retina
- Flame Hemorrhages = Flame-like hemorrhages along the retinal nerve fiber layer
- Dot & Blot Hemorrhages = Small hemorrhages caused by rupture of weakened blood
vessels - Hallmark sign of diabetic retinopathy
Facts about Acne Vulgaris - ✔✔ANSW✔✔..- Inflammatory skin disorder where
androgen-dependent sebaceous glands produce excess sebum.
- Usually affects face, anterior & posterior chest, Upper Back, Shoulders, and Arms
- Treatment consists of Erythromycin/Benzoyl Peroxide (Benzamycin)
- Education r/t Erythromycin/Benzoyl Peroxide includes limit exposure to sunlight and
can decrease resistance to erythromycin
Facts about Atopic Dermatitis - ✔✔ANSW✔✔..- Patchy plaque-like rash
- Can occur in people with other atopic conditions such as Asthma and Allergic Rhinitis
(Hay Fever)
Chlamydia - ✔✔ANSW✔✔..Most Common STI in US.
S&S - Genital Ulceration, Lymphadenopathy, Occular Trachoma, Proctitis, Cervical
Motion Tenderness, Assymptomatic. Can cause PID
Chlamydia Diagnostic & Treatment - ✔✔ANSW✔✔..Gold Standard - Nuclieic Acid
Amplification Test (NAAT) & Gen-Probe Assay
Tx: Azithromycin in pregnant patients, Amoxicillin if allergic.
Chron's Disease S&S - ✔✔ANSW✔✔..Chronic Bloody Diarrhea
Fatigue, Abdomnial Pain
Weight Loss/Fever
Skip Lesions, Cobblestone appearance
Fistulas are common
Slow progressive inflammation of small/large intestine
Tx is Budesonide 5-aminosalicylates
Cirrhosis S&S - ✔✔ANSW✔✔..Coagulopathy
Thrombocytopenia in early stages
Bleeding Varices
Hepatic Encephalopathy
ALOC and Tremors
Psychiatric - Depression/Anxiety
Arthralgia
Glucose Intolerance
Can be caused by Autoimmune disorders
Cluster Headache Presentation - ✔✔ANSW✔✔..Always unilateral, begins around
temple/eye, pain peaks within minutes; excruciating/explosive, rhinorrhea, tears, eye
becomes red
ETOH can be a trigger
Combined Oral Contraceptive contraindications - ✔✔ANSW✔✔..Hx of breast/estrogen-
related cancers, migraine w/aura, female >35yrs & smoker.
Contraindications for Hydrochlorothiazide - ✔✔ANSW✔✔..Sulfa allergy, PCN
hypersensitivity, Asthma, Gout
COPD - ✔✔ANSW✔✔..Progressive pathological changes to the airway and/or alveoli
due to increased inflammatory response to pollutants or inhaled irritants
,COPD Diagnostics - ✔✔ANSW✔✔..Gold Standard - Spirometry with bronchodilation.
Other criteria - Prolonged expiratory phase, wheezing with forced exhalation, barrel
chest & tripod position in late phase.
Coronary Artery Disease (CAD) treatment - ✔✔ANSW✔✔..Aotrvastatin/Rosuvastatin =
If LDL>150 use high doses. Watch for LFTs & arthralgia. Change type & dose if issues.
Helps stabilize plaques.
Croup - ✔✔ANSW✔✔..Acute viral illness
S&S - Barking Cough, Stridor, Sub-glottal swelling, Hoarseness.
Croup Treatment - ✔✔ANSW✔✔..Racemic Epinephrine, Corticosteroids, Cool-Mist
Humidification
** DO NOT USE TONGUE DEPRESSORS, CAN CAUSE SPASM!!
Decongestant contraindication in Pediatrics - ✔✔ANSW✔✔..Do not give under 2yrs old
Depression Treatment - ✔✔ANSW✔✔..Unipolar Depression - sertraline (Zoloft) &
escitalopram (Lexapro)
* Start with 4wks of treatment then re-evaluate for dose adjustment for a minimum of 6
months
Diabetes Mellitus - ✔✔ANSW✔✔..A1c over 6.5 or fasting glucose over 126 on 2
separate occasions
Metformin is first line treatment
Diabetic Neuropathy - ✔✔ANSW✔✔..Occurs in distal lower extremities r/t long-term
hyperglycemia
S&S include
Parestehsias
Burning
Muscle Weakness
Difficulty with Coordination/Balance
Diagnosing Peripheral Artery Disease (PAD) - ✔✔ANSW✔✔..Gold Standard =
Angiography
Ankle Brachial Index (ABI)
Diastolic Murmurs (Abnormal) - ✔✔ANSW✔✔..AR = Aortic Regurgitation (Angina, HF,
Dizziness, Chest Pain)
MS = Mitral Stenosis (Dyspnea, AFib)
Dysmenorrhea - ✔✔ANSW✔✔..Painful cramping w/menstruation
Tx: Heating Pad, NSAIDs, Oral Contraceptives
, Empyema - ✔✔ANSW✔✔..Prescence of pus in the pleural space. Develops when
pulmonary lymphatics become blocked leadingn to an outpouring of contaminated
lymph fluid into the pleural space.
S&S - Cyanosis, pleural pain, fever, tachycardia
Endocarditis Treatment - ✔✔ANSW✔✔..Zosyn/Vancomycin
Enterobiasis vermicularis (Pinworm) Infection - ✔✔ANSW✔✔..Helminths can be
transmitted by the bite of blood sucking insects
Tx:
Pyrantel Pamoate - One dose initially, then another dose in 2 weeks. Re-Test after 2
weeks of last dose
Epididymitis - ✔✔ANSW✔✔..Testicular pain onset over a few days (gradual) and
cremasteric reflex is present.
Erectile Dysfunction - ✔✔ANSW✔✔..Treatment PDE-5 inhibitor - contraindicated with
nitrates
Causes - Anti-HTN meds, antidepressants, antiandrogens, recreational drugs
Estrogen HRT contraindications - ✔✔ANSW✔✔..Breast Cancer, Undiagnosed Vaginal
Bleeding, Pregnancy, Clots, active Liver Disease
Eye Emergencies - ✔✔ANSW✔✔..Papilledema - r/t Increased ICP, Swollen Optic Disc,
and Engorged Tortuous Vein
Acute Closed-Angle Glaucoma - Sudden onset severe eye pain and Rapid loss of vision
Eye exam findings in DM & HTN - ✔✔ANSW✔✔..- AV Nicking = Arteries indent and
displace veins
- Cotton Wool Spots = White or grayish fluffy lesions on the retina
- Flame Hemorrhages = Flame-like hemorrhages along the retinal nerve fiber layer
- Dot & Blot Hemorrhages = Small hemorrhages caused by rupture of weakened blood
vessels - Hallmark sign of diabetic retinopathy
Facts about Acne Vulgaris - ✔✔ANSW✔✔..- Inflammatory skin disorder where
androgen-dependent sebaceous glands produce excess sebum.
- Usually affects face, anterior & posterior chest, Upper Back, Shoulders, and Arms
- Treatment consists of Erythromycin/Benzoyl Peroxide (Benzamycin)
- Education r/t Erythromycin/Benzoyl Peroxide includes limit exposure to sunlight and
can decrease resistance to erythromycin
Facts about Atopic Dermatitis - ✔✔ANSW✔✔..- Patchy plaque-like rash
- Can occur in people with other atopic conditions such as Asthma and Allergic Rhinitis
(Hay Fever)
