APEA 3P Exam Questions And Answers.

APEA 3P Exam Questions And
Answers

Most common type of skin cancer in USA - Correct Answer - Skin cancer
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Most common type of skin cancer - Correct Answer - basal cell carcinoma
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basal cell carcinoma symptoms - Correct Answer - Appearance varies; smooth, shiny bump, pink to pearly
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white
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Basal cell carcinoma common locations - Correct Answer - cheeks, nose, face, neck, arms, back
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basal cell carcinoma diagnosis gold standard - Correct Answer - biopsy. if not an option, refer to derm
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Actinic keratosis - Correct Answer - Precursor to squamous cell carcinoma
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numerous dry, round and pink to red lesions w/ rough and scaly texture
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--> does not heal, slow growing in sun exposed areas
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Actinic keratosis diagnosis gold standard - Correct Answer - Biopsy.
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if not an option, refer to derm
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Actinic keratosis treatment gold standard - Correct Answer - small- cryotherapy
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large- number 5-FU (5-flouracil aka efudex). 5-FU medication Causes skin to ooze, crust, scab and be red
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**5-flouracil/ efudex-wear sunscreen!!** m m




squamous cell cancer - Correct Answer - chronic red scaly rough textured lesion w/ irregular borders
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crusting or bleeding may be present
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Squamous cell carcinoma common locations - Correct Answer - rims of ears, lips, nose, face and top of
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hands
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precursor lesion to squamous cell cancer - Correct Answer - actinic keratosis
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squamous cell carcinoma diagnosis by? - Correct Answer - biopsy gold standard. if biopsy is not an option,
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refer to dermatology .
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,Risk factors for skin cancer(melanoma and both non-melanoma) - Correct Answer - Blistering sunburn as
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a child, history of sunburns, light skin, chronic exposure to UV light (sunlight/tanning beds), moles, family
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hx for skin cancer
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Melanoma symptoms (ABCDE) - Correct Answer - asymmetry (shape/uneven texture)
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border (irregular/notched/blurred)
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color (variegated colors from black, blue, dark to light brown)
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diameter (size >6mm size of pencil eraser or larger)
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evolving (changes in color/size/shape)
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may be itchy m m




Acral lengtiginous melanoma - Correct Answer - Most common type of melanoma in dark skinned
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individuals (blacks & asians)
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--> look for longitudinal brown to black bands under the nailbed. a changing spot or mole in the palms, or
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the soles of the feet
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seborrheic keratosis - Correct Answer - soft, round, wart-like growth that is light tan to black and looks
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pasted on
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asymptomatic &benign m




Bacterial Meningitis Bacteria - Correct Answer - Streptococcus pneumoniae- most common strain
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Haemophilus influenzae m




Neisseria meningitidis m




Escherichia coli m




*others

Bacterial meningitis symptoms (Classic Triad) - Correct Answer - High fever
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Nuchal rigidity m




rapid change in mental status w/ headache
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Triad=neck up m




erythematous spot-like rash (petechiae) ecchymosis to purple-colored lesions (purpura) which are non-
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blanchable

Is bacterial meningitis a reportable disease - Correct Answer - yes!
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,Treatment for Bacterial meningitis-patient - Correct Answer - IV Abx ASAP, resp/droplet iso for first 24-48
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hrs, hydrate (low maintenance after initial fluid correction), Maintain ventilation and reduce increased
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intra cranial pressure if present (dexamethosone(to reduce inflammation, mannitol to diurese the brain),
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low stim environment, tx complications that may arrive and support family
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Treatment for bacterial meningitis-close encounter - Correct Answer - Close contacts should be treated
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w/ rifampin 600 mg q 12 hours x 2 days
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**Rifampin changes urine color to reddish orange and can stain contacts
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**AVOID RIFAMPIN IN PREGNANCY m m m




Brudzinkski sign (meningeal irritation) - Correct Answer - Tests for meningeal irritation
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Patient supine, raise BACK of head and flex chin towards chest
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+ result if pt automatically beds both hips
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--Brudzinski and back of head start with B as well as bends--
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Kernig's sign - Correct Answer - Tests for meningeal irritation
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patient supine. flex patients hips and knees in a right angle, then slowly straighten/extend the legs up
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+ result if when the patient complains of pain during extension of leg
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MCV4 (meningococcal vaccine) Age 11-19 - Correct Answer - Give one dose of menactra or menveo
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primary dose given age 12 or younger give a booster at age 16-18
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MCV4 (meningococcal vaccine) Age 19-21 - Correct Answer - Give one dose of menactra or menveo if
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never had either
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Rocky mountain spotted fever (RMSF) symptoms - Correct Answer - Fever
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chills

N/V

myalgia

arthralgia

2-5 days later develop petechial rash on forearms, ankles, and wrists that spreads towards trunk and
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becomes generalised. sometimes rash develops on palms and soles
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**RASH DEVELOPS INWARDS** m m

, RMSF pneumonic (RMSF) - Correct Answer - R-Rash
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m M-Muscle aches (myalgia) m m m




m S-Stomach aches (nausea and vomiting) m m m m m




m F-Fever (>102 F) m m




Rocky Mountain Spotted Fever (RMSF): Located: - Correct Answer - •Think "Rocky"- North Carolina,
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Oklahoma, Arkansas, Tennessee, Missouri
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m Spring to Fall (April to September)
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Rocky Mountain Spotted Fever (RMSF): DX - Correct Answer - PCR assay by indirect immunofluorescence
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antibody (IFA) assay for immunoglobulin G (IgG) for Rickettsia Rickettsii
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Rocky Mountain Spotted Fever (RMSF): tx - Correct Answer - Doxycycline is always first line for all ages
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100 mg every 12 hours x 7-10 days
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m Can be fatal if not treated within the first 5 days
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Erythema Migrans (early Lyme disease): Symptoms - Correct Answer - Usually appears in 7-14 days after
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being bitten by a deer tick; range 3-30 days
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Target bull's-eye Rash is hot to touch with rough texture. Expanding red rash with central clearing •
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Common locations are belt line, axillary area, behind the knees, and groin area • Positive for flu like
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symptoms. Lesions and rash resolve within a few weeks with or without treatment
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Erythema Migrans (early Lyme disease): DX - Correct Answer - Dx: • First step is enzyme immunoassay
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(EIA) also knows as ELISA if negative no further testing needed. If positive confirm with Western Blot test
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(aka indirect immunofluorescence assay (IFA) for Borrelia Burgdorferi
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1. Enzyme immunoassay
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2. western blot test (immunoflurorescence assay/ IFA)
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Exam Tip: E before I
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Will have increased ESR
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Erythema Migrans (early Lyme disease): TX - Correct Answer - Doxycycline is always first line for all ages
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100 mg BID x 10-21 days
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