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APEA 3P EXAM|| ACTUAL EXAM ALL QUESTIONS
AND 100% CORRECT ANSWERS ALREADY
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1. Most common type of skin cancer in USA: Skin cancer
2. Most common type of skin cancer: basal cell carcinoma
3. basal cell carcinoma symptoms: Appearance varies; smooth, shiny bump,
pink to pearly white
4. Basal cell carcinoma common locations: cheeks, nose, face, neck, arms,
back
5. basal cell carcinoma diagnosis gold standard: biopsy. if not an option, refer
to derm
6. 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
7. Actinic keratosis diagnosis gold standard: Biopsy. if not an option, refer to
derm
8. 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!!**
9. squamous cell cancer: chronic red scaly rough textured lesion w/ irregular
borders
crusting or bleeding may be present
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10. Squamous cell carcinoma common locations: rims of ears, lips, nose, face
and top of hands
11. precursor lesion to squamous cell cancer: actinic keratosis
12. squamous cell carcinoma diagnosis by?: biopsy gold standard. if biopsy is
not an option, refer to dermatology .
13. 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
14. 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
15. 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
16. seborrheic keratosis: soft, round, wart-like growth that is light tan to black
and looks pasted on
asymptomatic &benign
17. Bacterial Meningitis Bacteria: Streptococcus pneumoniae- most common
strain
Haemophilus influenzae Neisseria meningitidis Escherichia coli
*others
18. Bacterial meningitis symptoms (Classic Triad): High fever Nuchal rigidity
rapid change in mental status w/ headache Triad=neck up
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erythematous spot-like rash (petechiae) ecchymosis to purple-colored lesions (pur-
pura) which are non-blanchable
19. Is bacterial meningitis a reportable disease: yes!
20. 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 com- plications that may arrive and support family
21. 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
22. 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--
23. Kernig's sign: Tests for meningeal irritation
patient supine. flex patients hips and knees in a right angle, then slowly straight-
en/extend the legs up
+ result if when the patient complains of pain during extension of leg
24. 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
25. MCV4 (meningococcal vaccine) Age 19-21: Give one dose of menactra or
menveo if never had either
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26. 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**
27. RMSF pneumonic (RMSF): R-Rash M-Muscle aches (myalgia)
S-Stomach aches (nausea and vomiting) F-Fever (>102 F)
28. Rocky Mountain Spotted Fever (RMSF): Located:: •Think "Rocky"- North
Carolina, Oklahoma, Arkansas, Tennessee, Missouri
Spring to Fall (April to September)
29. Rocky Mountain Spotted Fever (RMSF): DX: PCR assay by indirect
immuno- fluorescence antibody (IFA) assay for immunoglobulin G (IgG) for
Rickettsia Rick- ettsii
30. 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
31. 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
32. 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
