3P APEA /APEA 3P EXAM AND STUDYGUIDE 2024
ACTUAL EXAM COMPLETE 350 QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW VERSION!!
Most common type of skin cancer in USA - ANSWERSkin cancer
Most common type of skin cancer - ANSWERbasal cell carcinoma
basal cell carcinoma symptoms - ANSWERAppearance varies; smooth, shiny bump,
pink to pearly white
Basal cell carcinoma common locations - ANSWERcheeks, nose, face, neck, arms,
back
basal cell carcinoma diagnosis gold standard - ANSWERbiopsy. if not an option, refer to
derm
Actinic keratosis - ANSWERPrecursor 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 - ANSWERBiopsy.
if not an option, refer to derm
Actinic keratosis treatment gold standard - ANSWERsmall- 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 - ANSWERchronic red scaly rough textured lesion w/ irregular
borders
crusting or bleeding may be present
Squamous cell carcinoma common locations - ANSWERrims of ears, lips, nose, face
and top of hands
,precursor lesion to squamous cell cancer - ANSWERactinic keratosis
squamous cell carcinoma diagnosis by? - ANSWERbiopsy gold standard. if biopsy is
not an option, refer to dermatology .
Risk factors for skin cancer(melanoma and both non-melanoma) - ANSWERBlistering
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) - ANSWERasymmetry (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 - ANSWERMost 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 - ANSWERsoft, round, wart-like growth that is light tan to black and
looks pasted on
asymptomatic &benign
Bacterial Meningitis Bacteria - ANSWERStreptococcus pneumoniae- most common
strain
Haemophilus influenzae
Neisseria meningitidis
Escherichia coli
*others
Bacterial meningitis symptoms (Classic Triad) - ANSWERHigh 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 - ANSWERyes!
Treatment for Bacterial meningitis-patient - ANSWERIV 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 - ANSWERClose 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) - ANSWERTests 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 - ANSWERTests 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 - ANSWERGive 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 - ANSWERGive one dose of menactra or
menveo if never had either
Rocky mountain spotted fever (RMSF) symptoms - ANSWERFever
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) - ANSWERR-Rash
M-Muscle aches (myalgia)
S-Stomach aches (nausea and vomiting)
F-Fever (>102 F)
Rocky Mountain Spotted Fever (RMSF): Located: - ANSWER•Think "Rocky"- North
Carolina, Oklahoma, Arkansas, Tennessee, Missouri
Spring to Fall (April to September)
, Rocky Mountain Spotted Fever (RMSF): DX - ANSWERPCR assay by indirect
immunofluorescence antibody (IFA) assay for immunoglobulin G (IgG) for Rickettsia
Rickettsii
Rocky Mountain Spotted Fever (RMSF): tx - ANSWERDoxycycline 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 - ANSWERUsually 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 - ANSWERDx: • 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 - ANSWERDoxycycline 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 - ANSWERDEET
Tick repellant clothing use - ANSWERPermethrin
Brown Recluse Spider Bite: SX - 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
