APEA PREDICTOR 2024 EXAM BEST ELABORATED Q
n n n n n n
UESTIONS AND ANSWERS ALREADY RANKED A+.
n n n n n
An15nyearsnoldnhighnschoolnstudentnwithnanmildnsorenthroatnandnlow-
gradenfevernthatnhasnpersistednfornaboutn3nweeks.nShenreportsngeneralnmalaise,nfatigue,na
ndnlossnofnappetite.nThenNPnsuspectsnmononucleosis.nWhichnofnthenfollowingnisnthenLEAS
Tnappropriatenintervention?
Palpatenthenlymphnnodesnandnspleen
ExaminenthenposteriornoropharynxnfornpetechiaenObtainnanCBC,nthroatnculture,nandnh
n
eterophilnantibodyntest.
ObtainnannurinalysesnandnserumnfornLFTsnandnamylasen-nANSWER-
n
ObtainnannurinalysesnandnserumnfornLFTsnandnamylase
Explanation:nmononucleosisnisnansymptomaticninfectionncausednbynthenEpstein-
Barnvirus.nCommonnisnpeoplen15-
24nyearsnofnage.nCommonnsignsnandnsymptomsnfollowingnincubationnperiodn(1-
2nmonths)nincludenfatigue,nchills,nmalaise,nanorexia,nwhitentonsillarnexudatesnandnlymphad
enopathynornposteriorncervicalnregion.nSplenomegalyncannbenpresent.nAnmaculopapularnorn
occasionallynanpetechialnrashnoccursninnlessnthann15%nofnpatients.nAndiagnosisnisnusuallyn
madenusingnthenMonospot.nInnaddition,nneutropenianandnlymphocytosisnarenusuallyndetect
edninnthenCBC
An32nyearsnoldnmalenpatientncomplaintnofnurinarynfrequencynandnburningnonnurinationnforn3n
days.nUrinalysesnrevealsnbacteriurianandnpositivennitrites.nHendeniesnanynpastnhx.nOfnurin
aryntractninfections.nTheninitialntreatmentnshouldnbe:
a.ntrimethoprim-sulfamethoxazolen(Bactrim,nSulfatrim)nforn7-
10ndaynb.nciprofloxacinn(Cipro)nforn3-5ndays
, c.nTrimethoprim-Sulfamethoxazolenforn3ndays
d.n750nmgnciprofloxacinnasnanone-timendosen-nANSWER-.ntrimethoprim-
sulfamethoxazolen(Bactrim,nSulfatrim)nforn7-10nday
Explanation:ntrimethoprim-
sulfamethoxazolen(TMPS)nisnusuallynnnappropriatenmedicationntontreatnurinaryntractninfectio
nsninnmostnpatients.nInnthencasenofncommunitynresistancentonTMPSn>20%^,nanothernmedic
ationnshouldnbensubstituted.nInnmen,nthenappropriatenlengthnofntimenisn7n10ndays.nWomennm
aynbentreatednforn3ndaysnfornuncomplicatednUTI
Whichnagentnisnmostneffectivenfornthentreatmentnofnnodulocysticnacne?nBenzoyl
peroxiden(Benzac)
n
Retinoicnacidn(RetinnA)n
Topicalntetracycline
Isotretinoinn-nANSWER-Isotretinoin
Explanation:nIsotretinoinn(Accutane)nisnansystemicnagentnindicatednforntreatmentnwithnsev
ereninflammatorynacne.nGuidelinesnfornitsnusenmustnbenclearlynunderstoodnbynthenpatient.n
Anwomannofnchildbearingnagenmustnusenanneffectivenmethodnofncontraceptionnbecauseniso
tretinoinnisn1nTherenarenmanynrestrictionsninnprescribingnthisnmedicationnbecausenofnthente
ratogenicneffectsnisngivennduringnpregnancy.nTherefore,nitnisnanpregnancyncategorynX.
Ann18ny/onwomannisntakingnancombinednhormonalnoralncontraceptive.nShenshouldnbeninstru
ctedntonusenanbackupnmethodnfornthenpreventionnofnpregnancy
a.nThroughoutnthenweeknofnplacebonpills
Ifnprescribedntopiramaten(Topamax)nfornthentreatmentnofnmigraines.
n n n n n n
UESTIONS AND ANSWERS ALREADY RANKED A+.
n n n n n
An15nyearsnoldnhighnschoolnstudentnwithnanmildnsorenthroatnandnlow-
gradenfevernthatnhasnpersistednfornaboutn3nweeks.nShenreportsngeneralnmalaise,nfatigue,na
ndnlossnofnappetite.nThenNPnsuspectsnmononucleosis.nWhichnofnthenfollowingnisnthenLEAS
Tnappropriatenintervention?
Palpatenthenlymphnnodesnandnspleen
ExaminenthenposteriornoropharynxnfornpetechiaenObtainnanCBC,nthroatnculture,nandnh
n
eterophilnantibodyntest.
ObtainnannurinalysesnandnserumnfornLFTsnandnamylasen-nANSWER-
n
ObtainnannurinalysesnandnserumnfornLFTsnandnamylase
Explanation:nmononucleosisnisnansymptomaticninfectionncausednbynthenEpstein-
Barnvirus.nCommonnisnpeoplen15-
24nyearsnofnage.nCommonnsignsnandnsymptomsnfollowingnincubationnperiodn(1-
2nmonths)nincludenfatigue,nchills,nmalaise,nanorexia,nwhitentonsillarnexudatesnandnlymphad
enopathynornposteriorncervicalnregion.nSplenomegalyncannbenpresent.nAnmaculopapularnorn
occasionallynanpetechialnrashnoccursninnlessnthann15%nofnpatients.nAndiagnosisnisnusuallyn
madenusingnthenMonospot.nInnaddition,nneutropenianandnlymphocytosisnarenusuallyndetect
edninnthenCBC
An32nyearsnoldnmalenpatientncomplaintnofnurinarynfrequencynandnburningnonnurinationnforn3n
days.nUrinalysesnrevealsnbacteriurianandnpositivennitrites.nHendeniesnanynpastnhx.nOfnurin
aryntractninfections.nTheninitialntreatmentnshouldnbe:
a.ntrimethoprim-sulfamethoxazolen(Bactrim,nSulfatrim)nforn7-
10ndaynb.nciprofloxacinn(Cipro)nforn3-5ndays
, c.nTrimethoprim-Sulfamethoxazolenforn3ndays
d.n750nmgnciprofloxacinnasnanone-timendosen-nANSWER-.ntrimethoprim-
sulfamethoxazolen(Bactrim,nSulfatrim)nforn7-10nday
Explanation:ntrimethoprim-
sulfamethoxazolen(TMPS)nisnusuallynnnappropriatenmedicationntontreatnurinaryntractninfectio
nsninnmostnpatients.nInnthencasenofncommunitynresistancentonTMPSn>20%^,nanothernmedic
ationnshouldnbensubstituted.nInnmen,nthenappropriatenlengthnofntimenisn7n10ndays.nWomennm
aynbentreatednforn3ndaysnfornuncomplicatednUTI
Whichnagentnisnmostneffectivenfornthentreatmentnofnnodulocysticnacne?nBenzoyl
peroxiden(Benzac)
n
Retinoicnacidn(RetinnA)n
Topicalntetracycline
Isotretinoinn-nANSWER-Isotretinoin
Explanation:nIsotretinoinn(Accutane)nisnansystemicnagentnindicatednforntreatmentnwithnsev
ereninflammatorynacne.nGuidelinesnfornitsnusenmustnbenclearlynunderstoodnbynthenpatient.n
Anwomannofnchildbearingnagenmustnusenanneffectivenmethodnofncontraceptionnbecauseniso
tretinoinnisn1nTherenarenmanynrestrictionsninnprescribingnthisnmedicationnbecausenofnthente
ratogenicneffectsnisngivennduringnpregnancy.nTherefore,nitnisnanpregnancyncategorynX.
Ann18ny/onwomannisntakingnancombinednhormonalnoralncontraceptive.nShenshouldnbeninstru
ctedntonusenanbackupnmethodnfornthenpreventionnofnpregnancy
a.nThroughoutnthenweeknofnplacebonpills
Ifnprescribedntopiramaten(Topamax)nfornthentreatmentnofnmigraines.
