APEA 3P Exam Questions and Correct Answers, Complete Solution 2024. 100% Verified.
Most common type of skin cancer in USA
Skin cancer
Most common type of skin cancer
basal cell carcinoma
basal cell carcinoma symptoms
Appearance varies; smooth, shiny bump, pink to pearly white
Basal cell ca...
APEA 3P Exam Questions and Correct Answers,
Complete Solution 2024. 100% Verified.
Most common type of skin cancer in USA
Skin cancer
Most common type of skin cancer
basal cell carcinoma
basal cell carcinoma symptoms
Appearance varies; smooth, shiny bump, pink to pearly white
Basal cell carcinoma common locations
cheeks, nose, face, neck, arms, back
basal cell carcinoma diagnosis gold standard
biopsy. if not an option, refer to derm
Actinic keratosis
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
Biopsy.
if not an option, refer to derm
Actinic keratosis treatment gold standard
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
chronic red scaly rough textured lesion w/ irregular borders
crusting or bleeding may be present
Squamous cell carcinoma common locations
rims of ears, lips, nose, face and top of hands
precursor lesion to squamous cell cancer
actinic keratosis
squamous cell carcinoma diagnosis by?
biopsy gold standard. if biopsy is not an option, refer to dermatology .
Risk factors for skin cancer(melanoma and both non-melanoma)
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)
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
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
soft, round, wart-like growth that is light tan to black and looks pasted on
asymptomatic &benign
Bacterial Meningitis Bacteria
Streptococcus pneumoniae- most common strain
Haemophilus influenzae
Neisseria meningitidis
Escherichia coli
*others
Bacterial meningitis symptoms (Classic Triad)
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
yes!
Treatment for Bacterial meningitis-patient
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
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)
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
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
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
, Give one dose of menactra or menveo if never had either
Rocky mountain spotted fever (RMSF) symptoms
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)
R-Rash
M-Muscle aches (myalgia)
S-Stomach aches (nausea and vomiting)
F-Fever (>102 F)
Rocky Mountain Spotted Fever (RMSF): Located:
•Think "Rocky"- North Carolina, Oklahoma, Arkansas, Tennessee, Missouri
Spring to Fall (April to September)
Rocky Mountain Spotted Fever (RMSF): DX
PCR assay by indirect immunofluorescence antibody (IFA) assay for immunoglobulin G
(IgG) for Rickettsia Rickettsii
Rocky Mountain Spotted Fever (RMSF): tx
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
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
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
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
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