APEA 3P EXAM WITH QUESTIONS AND
CORRECT ANSWERS LATEST UPDATE The
groove of the metacarpophalangeal joint
can be palpated by having the patient... -
CORRECT ANSWFlex their hand/spread
their fingers When auscultating breath
sound
Strep Throat, Nonpuruluent SSTI Risks - ANSWERo Rheumatic fever, scarlet fever, acute
poststreptococcal glomerulonephritis, poststreptococcal reactive arthritis (develops within 1 month
after strep)
,Strep throat, purulent risks - ANSWER• Suppurative (Pus):
Tonsillopharyngeal abscess, cellulitis, OM, sinusitis
Strep throat • Centor Criteria: - ANSWER• Be able to connect Centor Criteria with Strep Throat
Fever (1 point)
Anterior cervical lymphadenopathy (1 point)
Tonsillar exudate (1 point)
Absence of cough (1 point)
Age 3-14 (1 point)
Age 15-44 (0 points)
Age >44 (-1 point)
Score of 0-1 unlikely need to test for strep; score of 3-4 confirm with rapid strep test
Hypertension Retinopathy - ANSWERCotton wool, Retinal arterioles constriction
• Copper/silver wire arterioles
• AV nicking (mild retinopathy)
• Retinal Hemorrhages
Diabetic Retinopathy: - ANSWERdamage to the retina as a complication of uncontrolled diabetes
Symptoms:
• Cotton wool spots (moderate retinopathy)
• Micro-aneurysms
• Neovascularization
Koplik's Spots - ANSWERSymptoms:
• "Clusters of small size red papules with white centers in the buccal mucosa by lower molars"
• Caused by Rubeola (Measles) o Rubeola and Koplik's have an "O"
,• Fever, conjunctivitis, coryza, cough
• Morbilliform rash
Hear Murmurs: Gold standard DX - ANSWEREchocardiography (TEE)
Systolic murmurs occur when? - ANSWERDuring S1
mitral regurgitation - ANSWERRadiates to axilla
5th intercostal space (ICS) by mid clavicular line (MCL), apex, apical area
Aortic Stenosis (mid systolic ejection): - ANSWERRadiates to neck!
Higher risk of sudden death • Location:
oAortic area, 2nd ICS by right upper sternum; at the base of the heart by the right upper sternum; base
of heart on the right side of sternum
Diastolic murmurs occur when - ANSWERS2 Heart sound
diastolic murmurs are always - ANSWERPATHOLOGICAL-indicative of heart disease
Mitral stenosis (Mid/late diastolic) - ANSWERAfib most common risk-emboli risk
narrowing of the mitral valve
Only murmur you listen to with your Bell
**Dyspnea most common symptom**
Heart Murmur Grading System: - ANSWERGrades I-VI :
• Grade I: Barely audible
• Grade II: Audible
• Grade III: Clearly audible
• Grave IV: First time thrill is present (more than likely will ask for this on exam)
, • Grade V:Hear the murmur even with edge of stethoscope off
• Grade VI: Murmur is so loud that it can be heard with entire stethoscope off chest
S3 sound associated with? - ANSWERHeart failure
Sounds like "Kentucky"
Abnormal in ages under 35
S3 is a normal heart sound in: - ANSWERPregnancy, young children, athletes
How to listen to S4 - ANSWERBell of stethoscope
Sounds like "Tennessee"
Late diastole is when __Valves close; occurs in S1 - ANSWERLate diastole, S1, is when the AV valves close
Late diastole is when __valves close; occurs in S2 - ANSWERLate diastole, S2, is when the SL valves close
Motivated-S1 heart sound-Lub includes what valves - ANSWERMotivated (S1 heart sound-lub)
M (mitral valve)
T (tricuspid valve)
AV (atrioventricular valves)
Apples- s2 heart sound-dub-includes what valves - ANSWERA (aortic valve)
P (pulmonic valve)
S (semilunar valves)
Isolated systolic hypertension (ISH) - ANSWERSystolic is 140+ and diastolic is 90 or less--occurs mainly in
older adults
HTN meds that cause heartburn - ANSWERCCB, BB, alpha agonists
CORRECT ANSWERS LATEST UPDATE The
groove of the metacarpophalangeal joint
can be palpated by having the patient... -
CORRECT ANSWFlex their hand/spread
their fingers When auscultating breath
sound
Strep Throat, Nonpuruluent SSTI Risks - ANSWERo Rheumatic fever, scarlet fever, acute
poststreptococcal glomerulonephritis, poststreptococcal reactive arthritis (develops within 1 month
after strep)
,Strep throat, purulent risks - ANSWER• Suppurative (Pus):
Tonsillopharyngeal abscess, cellulitis, OM, sinusitis
Strep throat • Centor Criteria: - ANSWER• Be able to connect Centor Criteria with Strep Throat
Fever (1 point)
Anterior cervical lymphadenopathy (1 point)
Tonsillar exudate (1 point)
Absence of cough (1 point)
Age 3-14 (1 point)
Age 15-44 (0 points)
Age >44 (-1 point)
Score of 0-1 unlikely need to test for strep; score of 3-4 confirm with rapid strep test
Hypertension Retinopathy - ANSWERCotton wool, Retinal arterioles constriction
• Copper/silver wire arterioles
• AV nicking (mild retinopathy)
• Retinal Hemorrhages
Diabetic Retinopathy: - ANSWERdamage to the retina as a complication of uncontrolled diabetes
Symptoms:
• Cotton wool spots (moderate retinopathy)
• Micro-aneurysms
• Neovascularization
Koplik's Spots - ANSWERSymptoms:
• "Clusters of small size red papules with white centers in the buccal mucosa by lower molars"
• Caused by Rubeola (Measles) o Rubeola and Koplik's have an "O"
,• Fever, conjunctivitis, coryza, cough
• Morbilliform rash
Hear Murmurs: Gold standard DX - ANSWEREchocardiography (TEE)
Systolic murmurs occur when? - ANSWERDuring S1
mitral regurgitation - ANSWERRadiates to axilla
5th intercostal space (ICS) by mid clavicular line (MCL), apex, apical area
Aortic Stenosis (mid systolic ejection): - ANSWERRadiates to neck!
Higher risk of sudden death • Location:
oAortic area, 2nd ICS by right upper sternum; at the base of the heart by the right upper sternum; base
of heart on the right side of sternum
Diastolic murmurs occur when - ANSWERS2 Heart sound
diastolic murmurs are always - ANSWERPATHOLOGICAL-indicative of heart disease
Mitral stenosis (Mid/late diastolic) - ANSWERAfib most common risk-emboli risk
narrowing of the mitral valve
Only murmur you listen to with your Bell
**Dyspnea most common symptom**
Heart Murmur Grading System: - ANSWERGrades I-VI :
• Grade I: Barely audible
• Grade II: Audible
• Grade III: Clearly audible
• Grave IV: First time thrill is present (more than likely will ask for this on exam)
, • Grade V:Hear the murmur even with edge of stethoscope off
• Grade VI: Murmur is so loud that it can be heard with entire stethoscope off chest
S3 sound associated with? - ANSWERHeart failure
Sounds like "Kentucky"
Abnormal in ages under 35
S3 is a normal heart sound in: - ANSWERPregnancy, young children, athletes
How to listen to S4 - ANSWERBell of stethoscope
Sounds like "Tennessee"
Late diastole is when __Valves close; occurs in S1 - ANSWERLate diastole, S1, is when the AV valves close
Late diastole is when __valves close; occurs in S2 - ANSWERLate diastole, S2, is when the SL valves close
Motivated-S1 heart sound-Lub includes what valves - ANSWERMotivated (S1 heart sound-lub)
M (mitral valve)
T (tricuspid valve)
AV (atrioventricular valves)
Apples- s2 heart sound-dub-includes what valves - ANSWERA (aortic valve)
P (pulmonic valve)
S (semilunar valves)
Isolated systolic hypertension (ISH) - ANSWERSystolic is 140+ and diastolic is 90 or less--occurs mainly in
older adults
HTN meds that cause heartburn - ANSWERCCB, BB, alpha agonists
