APEA 3P FINAL EXAM WITH SOLUTIONS LATEST UPDATE 2024

1. Which headache sign does not warrant an immediate investigation? 1) aggravated or relieved by change of position 2) precipitated by Valsalva manuever 3) new onset after age 50 4) relieved with use of common analgesics Headaches that respond and are relieved by common analgesics (like overthe-counter pain relief medications) are usually indicative of primary headache disorders like tension-type headaches or migraines, which are less likely to be associated with serious underlying conditions. In contrast, headaches that are aggravated or relieved by change of position, precipitated by Valsalva maneuver (like coughing, bending, or lifting), or new onset after age 50 can be indicative of more serious underlying conditions and typically warrant further medical investigation. 2. During a migraine, what happens to the cerebral arteries? 1) They dilate 2) They constrict 3) They vibrate 4) They pulsate The pathophysiology of migraines is complex and involves various neurological and vascular changes. One of the vascular changes believed to occur during a migraine is the dilation of cerebral arteries. This dilation can contribute to the sensation of throbbing or pulsating pain, which is a characteristic feature of migraine headaches. 3. You are evaluating a 15-year-old patient for bipolar disorder. His parents tell you that he has severe mood swings, is easily distracted, and constantly corrects his teachers. You would have a high suspicion for bipolar if which symptom was present? 1) He is forgetful 2) He sleeps less than 4 hours nightly 3) He does not complete tasks 4) He blurts out answers in class inappropriately4. Decreased need for sleep, especially significantly less sleep like less than 4 hours nightly without feeling fatigued, is a common symptom during manic or hypomanic episodes in bipolar disorder. This symptom can be part of a broader pattern of increased energy, activity, and sometimes impulsivity or risk-taking behaviors. The other symptoms you listed, such as forgetfulness, not completing tasks, and blurting out answers in class, while concerning, could be indicative of a variety of conditions, including Attention-Deficit/Hyperactivity Disorder (ADHD) or other behavioral or mood disorders, and are not as specifically indicative of bipolar disorder as a significantly decreased need for sleep. It's important to conduct a thorough evaluation, often including physical examination, psychiatric assessment, and sometimes input from school or other settings, to differentiate between these possibilities and accurately diagnose and treat the condition. 5. Which risk factor is not associated with breast cancer? 1) Use of hormone replacement therapy 2) Personal or family history of breast cancer 3) Postmenopausal obesity 4) Low socioeconomic status While socioeconomic status can impact access to healthcare and subsequent screening or treatment for breast cancer, it is not in itself a direct risk factor for the development of breast cancer. The other options listed - use of hormone replacement therapy, personal or family history of breast cancer, and postmenopausal obesity - are recognized risk factors for breast cancer. 6. A 26-year-old woman with bulimia is likely to be: 1) Of average weight 2) Not concerned with weight 3) Very underweight 4) Very overweight Individuals with bulimia nervosa often maintain a body weight that is average or slightly above or below average. This differentiates bulimia from anorexia nervosa, where individuals are typically very underweight. Peoplewith bulimia engage in recurrent episodes of binge eating followed by inappropriate compensatory behaviors such as purging, fasting, or excessive exercise. However, these behaviors do not typically result in the significant weight loss seen in anorexia nervosa, leading many individuals with bulimia to maintain an average weight range. 7. What medication is used to relieve acute wheezing in a patient with asthma? 1) Oral corticosteroid 2) Short-acting beta-agonist 3) Long-acting beta-agonist 4) Inhaled corticosteroid Short-acting beta-agonists, such as albuterol, are commonly used to provide quick relief from acute bronchoconstriction and wheezing in asthma. These medications work by rapidly relaxing the muscles in the airways, making it easier to breathe. They are often administered via an inhaler or a nebulizer for immediate effect.