APEA 3P Exam Questions And Answers 100% Accurate Graded A+ Pass Guaranteed.

Most common type of skin cancer in USA - correct answer Skin cancer Most common type of skin cancer - correct answer basal cell carcinoma basal cell carcinoma symptoms - correct answer Appearance varies; smooth, shiny bump, pink to pearly white Basal cell carcinoma common locations - correct answer cheeks, nose, face, neck, arms, back basal cell carcinoma diagnosis gold standard - correct answer biopsy. if not an option, refer to derm Actinic keratosis - correct answer Precursor to squamous cell carcinoma numerous dry, round and pink to red lesions w/ rough and scaly texture --> does not heal, slow growing in sun exposed areas Actinic keratosis diagnosis gold standard - correct answer Biopsy. if not an option, refer to derm Actinic keratosis treatment gold standard - correct answer small- cryotherapy large- number 5-FU (5-flouracil aka efudex). 5-FU medication Causes skin to ooze, crust, scab and be red **5-flouracil/ efudex-wear sunscreen!!** squamous cell cancer - correct answer chronic red scaly rough textured lesion w/ irregular borders crusting or bleeding may be present Squamous cell carcinoma common locations - correct answer rims of ears, lips, nose, face and top of hands precursor lesion to squamous cell cancer - correct answer actinic keratosis squamous cell carcinoma diagnosis by? - correct answer biopsy gold standard. if biopsy is not an option, refer to dermatology . Risk factors for skin cancer(melanoma and both non-melanoma) - correct answer Blistering sunburn as a child, history of sunburns, light skin, chronic exposure to UV light (sunlight/tanning beds), moles, family hx for skin cancer Melanoma symptoms (ABCDE) - correct answer asymmetry (shape/uneven texture) border (irregular/notched/blurred) color (variegated colors from black, blue, dark to light brown) diameter (size >6mm size of pencil eraser or larger) evolving (changes in color/size/shape) may be itchy Acral lengtiginous melanoma - correct answer Most common type of melanoma in dark skinned individuals (blacks & asians) --> look for longitudinal brown to black bands under the nailbed. a changing spot or mole in the palms, or the soles of the feet seborrheic keratosis - correct answer soft, round, wart-like growth that is light tan to black and looks pasted on asymptomatic &benign Bacterial Meningitis Bacteria - correct answer Streptococcus pneumoniae- most common strain Haemophilus influenzae Neisseria meningitidis Escherichia coli *others Bacterial meningitis symptoms (Classic Triad) - correct answer High fever Nuchal rigidity rapid change in mental status w/ headache Triad=neck up erythematous spot-like rash (petechiae) ecchymosis to purple-colored lesions (purpura) which are non-blanchable Is bacterial meningitis a reportable disease - correct answer yes! 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) Secondary skin lesions- Scale - correct answer flaking skin (psoriasis) Secondary skin condition-crust - correct answer dried exudate (impetigo) Secondary skin condition-ulceration - correct answer eroding of epidermis and dermis (if deep can involve subcutaneous tissue) Secondary skin condition-scar - correct answer permanent fibrotic change following damage to dermis (surgical scars) Secondary skin condition-keloids/hypertrophic scars - correct answer overgrowth of scar tissue (more common in Black and Asian descent) Rule of 9's - correct answer Head and neck = 9% Upper Ex = 9% each Lower Ex = 9% each Front trunk = 18% Back trunk = 18% Rule of 9's =-child leg - correct answer Chlid one leg=13.5% One leg adult =18% Rule of 9's =child head - correct answer Child head- 18% (half of adult %) First degree (superficial): - correct answer Red to bright red skin and tenderness/pain second-degree (partial-thickness) burns - correct answer Painful red skin, bullae (blisters), reddened/weepy skin --> BLISTERS START AT SECOND DEGREE