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APEA MEDICAL SURGICAL QUESTIONS TO REVIEW (RATED A+) /APEA REAL EXAM 2023/2024 LASTEST VERSION

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- Supraclavicular nodes: deep in the angle formed by the clavicle and the sternomastoid muscle. Enlargement of this node, especially on the left, suggests possible metastasis from a thoracic or an abdominal malignancy. - Posterior auricular nodes: superficial to the mastoid process, drain the po...

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  • January 8, 2024
  • 54
  • 2023/2024
  • Exam (elaborations)
  • Questions & answers

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  • apea medical surgical
  • apea medical surgical questions to review

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lOMoAR cPSD| 22789381




-




APEA MEDICAL SURGICAL

QUESTIONS TO REVIEW (RATED A+) /APEA REAL

EXAM 2023/2024 LASTEST VERSION


ENDOCRINE

- Acanthosis nigricans: a skin condition characterized by dark velvety patches in the body

folds and creases. Typically noted in patients who are obese or have diabetes.

- Cushing’s disease: presents with striae, skin atrophy, purpura, ecchymosis, telangiectasia,

acne, MOON face, BUFFALO hump, or hypertrichosis.

- Addison’s disease: also known as primary adrenal insufficiency and hypocortisolism, is a

long term endocrine disorder in which the adrenal glands do not produce adequate steroid

hormones. Hyperpigmentation of skin and mucous membranes is usually seen, symptoms

include fatigue, anorexia, chronic diarrhea, salt craving, mucosal pigmentation, and hair loss.

Lab tests for adrenal function show a subnormal rise in cortisol levels

- Hairy leukoplakia: usually in patients who have AIDS, thickened white patches in the

mouth, precancerous.

, lOMoAR cPSD| 22789381




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- Cystic fibrosis: a sweat test measures the amount of sodium and chloride in sweat and is

used to diagnose. CF patients have 2 to 5 times the normal amount of sodium and chloride in

their sweat.

- Adrenarche: early presence of pubic hair in girls aged 5 to 8 years old.

- Hypertrichosis: an abnormal amount of hair growth over the body.

- Thelarche: onset of female breast development.

- Adrenal hyperplasia: excess production of male sex hormones that results in short height,

early puberty and in females, abnormal genital development.

- Gigantism: abnormally high linear growth due to the excessive action of insulin-like

growth factor (IGF-I) while the epiphyseal growth plates are open during childhood.

- Acromegaly: same disorder of IGF-I but occurs after the growth plate cartilage fuses in

adulthood.

- Prolactinoma: a benign tumor (adenoma) of the pituitary gland that produces excessive

prolactin resulting in decreased levels of some sex hormones.

- Congenital adrenal hyperplasia: a group of autosomal recessive disorders, each of which

involves a deficiency of an enzyme involved in the synthesis or cortisol, aldosterone, or both.

- Precocious puberty: puberty that begins before age 8 in girls and before age 9 in boys.

- Gynecomastia: swelling of the breast tissue in boys or men.

- Adrenarche: early presence of pubic hair in girls aged 5 to 8 years old.

- Hirsutism: excess hair in women with excess hair growth of terminal hair in a male

pattern.

, lOMoAR cPSD| 22789381




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- Androgenetic alopecia: genetically determined disorder characterized by the gradual

conversion of terminal hairs into indeterminate and finally vellus hairs.

- Hashimoto’s thyroiditis: cold intolerance,, hair loss, and decreased perspiration.

- Lack of parathyroid hormone leads to decreased blood levels of CA and increased levels



of phosphorus and can lead to tetany.

- Hyperthyroidism: occurs due to excessive production of thyroid hormone by the thyroid

gland, thyrotoxicosis is a result of high levels of thyroid hormones. Associated with a fib,

systolic murmur, and cardiac failure. Women present with oligomenorrhea or infrequent

menstrual periods and fine silky hair with velvety appearance of skin and usually WARM



to touch. Often a localized or continuous bruit is audible over the lateral lobes of the thyroid

gland. Children: anxiousness, irritability, nervousness, poor restless sleep, increased

activity/fidgetiness, hyperactivity, increased appetite with or without weight loss, increased BMs

per day, decreased/poor school performance, difficulty concentrating that may be diagnosed as

late onset adhd, and a feeling of a “lump” in the throat.

- Hypothyroidism: sinus bradycardia, mild HTN (diastolic), and narrowed pulse pressure.

Symptoms include weight gain, bradycardia, anemia, myxedema, sparse coarse, and thin hair,

skin that appears rough, very dry, and COOL to touch

- HGB A1C: levels between 5/7% and 6/4% are reflective of impaired glucose metabolism.

, lOMoAR cPSD| 22789381




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- Type 1 DM: classic symptoms include polyuria, polydipsia, polyphagia, and unexplained

weight loss.

- Type 2 DM: classic symptoms include obesity and elevated cholesterol levels, diagnosed

when the A1C is 6.5% or greater.

- Gestational DM: diagnosed between 24 to 28 weeks of pregnancy based on a fasting one-

step or a two-step glucose tolerance test. In a one-step GTT, the patient receives 75 grams of oral

glucose and plasma glucose is measured at 1 and 2 horus. A patient has GDM is:

(1) Fasting blood glucose is >92 mg/dL (2) the 1 hour blood glucose test is >180 mg/dL or (3) 2

hour blood glucose is >153 mg/dL. In a two step GTT, 50 gm of glucose is administered to the

non-fasting patient. If the blood glucose is 130 mg/dL or higher, then a second test is performed

fasting and 100 gm of glucose is given. The patient is diagnosed with GDM if: (1) fasting blood

glucose is 95 mg/dL or higher, (2) 1 hour blood glucose is >180 mg/dL or (3) 2 hour blood

glucose is >155 mg/dL or higher (4) 3 hour blood glucose is >140 mg/dL or higher.

- Hyperfunctioning of the thyroid gland leads to hypermetabolic state causing an increase

in metabolic function, increased O2 consumption by tissues, and heat production.

Disorders include: graves disease, toxic goiter, thyroid storm (thyrotoxicosis)

- Myxedema coma: loss of brain function as result of severe, longstanding low level of

thyroid hormone in the blood (hypothyroidism), life threatening complication with symptoms

including hypothermia, hallucinations, disorientation, seizures, deep coma, significant edema,

swollen eyes, thickening of the tongue, difficulty breathing, and constipation.

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