APEA 3P Exam LATEST VERSION 307
QUESTIONS AND ANSWERS WITH STUDY GUIDE
DETAILED AND VERIFIED FOR GUARANTEED PASS,
LATEST UPDATE 2025 GRADED A
Treatment for Bacterial meningitis-patient - CORRECT 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 - CORRECT
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) - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER
Give one dose of menactra or menveo if never had either
Rocky mountain spotted fever (RMSF) symptoms - CORRECT
ANSWER Fever
chills
N/V
myalgia
arthralgia
2-5 days later develop petechial rash on forearms, ankles, and wrists
that spreads towards trunk and becomes generalised. sometimes
rash develops on palms and soles
**RASH DEVELOPS INWARDS**
RMSF pneumonic (RMSF) - CORRECT ANSWER R-Rash
M-Muscle aches (myalgia)
S-Stomach aches (nausea and vomiting)
F-Fever (>102 F)
Rocky Mountain Spotted Fever (RMSF): Located: - CORRECT
ANSWER •Think "Rocky"- North Carolina, Oklahoma, Arkansas,
Tennessee, Missouri
Spring to Fall (April to September)
Rocky Mountain Spotted Fever (RMSF): DX - CORRECT ANSWER
PCR assay by indirect immunofluorescence antibody (IFA) assay for
immunoglobulin G (IgG) for Rickettsia Rickettsii
Rocky Mountain Spotted Fever (RMSF): tx - CORRECT ANSWER
Doxycycline is always first line for all ages
100 mg every 12 hours x 7-10 days
Can be fatal if not treated within the first 5 days
Erythema Migrans (early Lyme disease): Symptoms - CORRECT
ANSWER Usually appears in 7-14 days after being bitten by a deer
tick; range 3-30 days
,Target bull's-eye Rash is hot to touch with rough texture. Expanding
red rash with central clearing • Common locations are belt line,
axillary area, behind the knees, and groin area • Positive for flu like
symptoms. Lesions and rash resolve within a few weeks with or
without treatment
Erythema Migrans (early Lyme disease): DX - CORRECT ANSWER
Dx: • First step is enzyme immunoassay (EIA) also knows as ELISA if
negative no further testing needed. If positive confirm with Western
Blot test (aka indirect immunofluorescence assay (IFA) for Borrelia
Burgdorferi
1. Enzyme immunoassay
2. western blot test (immunoflurorescence assay/ IFA)
Exam Tip: E before I
Will have increased ESR
Erythema Migrans (early Lyme disease): TX - CORRECT ANSWER
Doxycycline is always first line for all ages
100 mg BID x 10-21 days
Remove ticks by grasping with tweezers or forceps close to the skin
and pulling gently with steady pressure. After removing the tick, clean
area with rubbing alcohol, iodine scrub, or soap and water. Dispose of
the tick by flushing it into the toilet
Tick repellant skin use - CORRECT ANSWER DEET
Tick repellant clothing use - CORRECT ANSWER Permethrin
Brown Recluse Spider Bite: SX - CORRECT ANSWER • Fever,
chills • Nausea and Vomiting • Located in the arms, upper legs, or the
trunk • Bitten area becomes swollen, red, and tender, or can be
painless • Blisters appear within 24-48 hours • Necrotic in center,
which kills the tissue
**can be painless
, Brown Recluse Spider Bite treatment - CORRECT ANSWER
Treatment: • Ice packs to wound as the cold inactivates the toxin •
Treat like cellulitis of the skin • Antibiotic ointment at first and watch
Skin lesions - CORRECT ANSWER primary skin lesions
Macule Vesicle Papule MVP Size: <1 CM
Macule - CORRECT ANSWER Flat, nonpalpable, but visually
distinct areas on the skin surface with color different from the
person's normal skin; less than 1 cm
FRECKLE
Vesicle - CORRECT ANSWER elevated, raised lesion filled with
serous fluid (herpetic lesions)
Papule - CORRECT ANSWER palpable solid lesion (acne, moles)
primary skin lesions >1cm in size - CORRECT ANSWER Nodule
Plaque
Bullae (Blister)
Pustule
Wheal
Nodule - CORRECT ANSWER raised solid lesion (BCC)
Plaque - CORRECT ANSWER solid raised lesion with flat top
(psoriasis)
Bulla/Bullae - CORRECT ANSWER elevated superficial blister
filled with serous fluid (2nd degree burn, impetigo)
Pustule - CORRECT ANSWER circumscribed elevated lesion
containing pus (acne pustules)
Secondary Skin Lesions-Lichenification - CORRECT ANSWER
thickening of the epidermis with exaggeration of normal skin due to
chronic skin itching (eczema)
QUESTIONS AND ANSWERS WITH STUDY GUIDE
DETAILED AND VERIFIED FOR GUARANTEED PASS,
LATEST UPDATE 2025 GRADED A
Treatment for Bacterial meningitis-patient - CORRECT 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 - CORRECT
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) - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER
Give one dose of menactra or menveo if never had either
Rocky mountain spotted fever (RMSF) symptoms - CORRECT
ANSWER Fever
chills
N/V
myalgia
arthralgia
2-5 days later develop petechial rash on forearms, ankles, and wrists
that spreads towards trunk and becomes generalised. sometimes
rash develops on palms and soles
**RASH DEVELOPS INWARDS**
RMSF pneumonic (RMSF) - CORRECT ANSWER R-Rash
M-Muscle aches (myalgia)
S-Stomach aches (nausea and vomiting)
F-Fever (>102 F)
Rocky Mountain Spotted Fever (RMSF): Located: - CORRECT
ANSWER •Think "Rocky"- North Carolina, Oklahoma, Arkansas,
Tennessee, Missouri
Spring to Fall (April to September)
Rocky Mountain Spotted Fever (RMSF): DX - CORRECT ANSWER
PCR assay by indirect immunofluorescence antibody (IFA) assay for
immunoglobulin G (IgG) for Rickettsia Rickettsii
Rocky Mountain Spotted Fever (RMSF): tx - CORRECT ANSWER
Doxycycline is always first line for all ages
100 mg every 12 hours x 7-10 days
Can be fatal if not treated within the first 5 days
Erythema Migrans (early Lyme disease): Symptoms - CORRECT
ANSWER Usually appears in 7-14 days after being bitten by a deer
tick; range 3-30 days
,Target bull's-eye Rash is hot to touch with rough texture. Expanding
red rash with central clearing • Common locations are belt line,
axillary area, behind the knees, and groin area • Positive for flu like
symptoms. Lesions and rash resolve within a few weeks with or
without treatment
Erythema Migrans (early Lyme disease): DX - CORRECT ANSWER
Dx: • First step is enzyme immunoassay (EIA) also knows as ELISA if
negative no further testing needed. If positive confirm with Western
Blot test (aka indirect immunofluorescence assay (IFA) for Borrelia
Burgdorferi
1. Enzyme immunoassay
2. western blot test (immunoflurorescence assay/ IFA)
Exam Tip: E before I
Will have increased ESR
Erythema Migrans (early Lyme disease): TX - CORRECT ANSWER
Doxycycline is always first line for all ages
100 mg BID x 10-21 days
Remove ticks by grasping with tweezers or forceps close to the skin
and pulling gently with steady pressure. After removing the tick, clean
area with rubbing alcohol, iodine scrub, or soap and water. Dispose of
the tick by flushing it into the toilet
Tick repellant skin use - CORRECT ANSWER DEET
Tick repellant clothing use - CORRECT ANSWER Permethrin
Brown Recluse Spider Bite: SX - CORRECT ANSWER • Fever,
chills • Nausea and Vomiting • Located in the arms, upper legs, or the
trunk • Bitten area becomes swollen, red, and tender, or can be
painless • Blisters appear within 24-48 hours • Necrotic in center,
which kills the tissue
**can be painless
, Brown Recluse Spider Bite treatment - CORRECT ANSWER
Treatment: • Ice packs to wound as the cold inactivates the toxin •
Treat like cellulitis of the skin • Antibiotic ointment at first and watch
Skin lesions - CORRECT ANSWER primary skin lesions
Macule Vesicle Papule MVP Size: <1 CM
Macule - CORRECT ANSWER Flat, nonpalpable, but visually
distinct areas on the skin surface with color different from the
person's normal skin; less than 1 cm
FRECKLE
Vesicle - CORRECT ANSWER elevated, raised lesion filled with
serous fluid (herpetic lesions)
Papule - CORRECT ANSWER palpable solid lesion (acne, moles)
primary skin lesions >1cm in size - CORRECT ANSWER Nodule
Plaque
Bullae (Blister)
Pustule
Wheal
Nodule - CORRECT ANSWER raised solid lesion (BCC)
Plaque - CORRECT ANSWER solid raised lesion with flat top
(psoriasis)
Bulla/Bullae - CORRECT ANSWER elevated superficial blister
filled with serous fluid (2nd degree burn, impetigo)
Pustule - CORRECT ANSWER circumscribed elevated lesion
containing pus (acne pustules)
Secondary Skin Lesions-Lichenification - CORRECT ANSWER
thickening of the epidermis with exaggeration of normal skin due to
chronic skin itching (eczema)
