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