APEA Predictor

APEA Predictor Exam Missed Questions What is the biggest side effect of colchicine? Ans- diarrhea How would you describe the appearance of molluscum contagiosum? Ans- papules that are umbilicated and contain a caseous plug How do we treat a broken clavicle in an infant? Ans- no treatment; it should heal on it's own At what week of pregnancy is the uterus palpable just above the pubic symphysis? Ans- week 12 At what week of pregnancy is the fundus palpable halfway between the pubic symphysis and umbilicus? Ans- week 16 At what week of pregnancy is the fundus of the uterus at the umbilicus? Ans- week 20 At what week of pregnancy is the fundus of the uterus halfway between the xiphoid process and umbilicus? Ans- week 28 At what week of pregnancy is the fundus just below the xiphoid process? Ans- week 34 Increased sweat production is a sign of what endocrine disorder? Ans- hyperthyroidism What is Paget's disease? Ans- there is localized increased bone turnover and blood flow resulting in the breakdown of bone and replacing it with weakened and highly vascular bone putting the indiv at increased risk of fractures How do we treat Paget's diseease? Ans- bisphosphonates How should pregnant women wear their seatbelt? Ans- with the shoulder strap like a normal person and then the groin strap below the belly and across the hips What is another name for fifth disease? Ans- parvovirus aka slapped cheek disease aka erythema infectiosum Which type of prevention are vaccinations? Ans- primary When should patients begin antiretroviral therapy for HIV infection? Ans- as soon as it is detected, even if in the acute phase What are the first generation antihistamines? Ans- diphenhydramine (benadryl) and chlorpeniramine (actifed) What are s/s of the secondary stage of syphilis? Ans- rash on hands and feet, lymphadenopathy, fever What is the recommended treatment for chronic bacterial prostatitis? Ans- a fluoroquinolone (cipro or levo) + bactrim What is the recommended treatment for acute prostatitis? Ans- cipro (if not STI related) or ceftriaxone What are s/s of an intraductal breast papilloma? Ans- clear to bloody unilateral nipple discharge (bilateral is usually benign), and also a wart like lump palpated in the nipple area If a patient has GABHS but has an allergy to penicillins, what is the second line option? Ans- first generation cephalosporins, unless the allergy is severe, then you would consider macrolides like a - mycin PDE5 inhibitors (sildenafil, tadalafil) are contraindicated in which patient populations? Ans- in those who are on any type of nitrate or triptan because it could result in hypotension What class of drug is sildenafil (viagra)? Ans- a PDE5 inhibitor which can cause hypotension so you should do a full cardiac assessment before starting a patient on this and maybe do an EKG What are the symptoms of peripheral artery disease? Ans- think P meaning pain, A meaning absent or weak pulses, eschar or shiny legs, intermittent claudication What is first line treatment for PAD? Ans- walking and physical activity to improve circulation. second line is an aspirin or anti-platelet What should we tell our patients with PAD NOT to do? Ans- do not elevate the feet; keep them down How do we diagnose PAD? Ans- an ABI 7; doppler can also be used to diagnose as well but is the second choice What are s/s of peripheral vascular disease? Ans- think V meaning volume overload aka edema, may ache or be uncomfortable but is not painful, bounding pulses, ruddy discoloration If a patient is on Coumadin but then they may need to go on an antibiotic for an infection and Bactrim is the drug of choice, what should you do? Ans- Bactrim increases INR so we would want to decrease the coumadin dose while the patient is on this If a patient is on Coumadin but then they may need to go on Rifampin, what should you do? AnsRifampin decreases INR so we'd want to increase the coumadin dose If a patient on coumadin's INR is 3.1-4 ,what should you do? Ans- decrease the weekly dose by 5-10% If a patient on coumadin's INR is 4.1-5.0, what should you do? Ans- hold one dose then decrease the weekly dose by 10% If a patient's INR is greater than 5, what should you do? Ans- consult cards, likely would hold two doses then decrease the weekly dose An anorexic patient will have a BMI of what? Ans- less than 18 What is primary amenorrhea? Ans- when the patient has never gotten their period before (there is an absence of menarche) but they have all of their secondary sex characteristics Secondary amenorrhea is a lack of menses after _________ of not having a period; but you have had one before Ans- 3 months What do we need to do first when a patient comes in with secondary amenorrhea? Ans- rule out pregnancy Anorexia can put you at risk for what? Ans- osteoporosis, amenorrhea, cardiac damage Amenorrhea is considered a risk factor for what? Ans- osteoporosis What is the best indication of an anorexic patient doing better? They tell you they are eating more, they have weight gain, or they get their period back? Ans- they get their period back If a pregnant woman has syphilis, what should we do? Ans- treat it with penicillin while she is pregnant because there is risk for spontaneous abortion What is the causative organism of mastitis? Ans- staph What is the first line treatment for mastitis? Ans- keflex (a cephalosporin). If that doesn't work, then try another antibiotic. If that STILL doesn't work, then refer for an ultrasound What is one of the biggest risk factors for cervical cancer? Ans- numerous sexual partners Preeclampsia most commonly shows up at what time in pregnancy? Ans- around week 20 How do we treat UTIs in a pregnant woman? Ans- can either do penicillin, cephalosporin, or a macrolide (can NOT do doxy or a fluoroquinolone) When do fibrocystic breasts tend to flare up and cause tenderness and lumps? Ans- about 10 days before menses What can be a sequelae of an ectopic pregnancy? Ans- pelvic inflammatory disease and infertility due to scarring of the fallopian tube (salpingitis) What is the Coomb's test and when is this completed? Ans- test given 8 weeks in to pregnancy to determine a woman's RH compatibility If a patient's Coomb's test is positive, what do we do? Ans- nothing, she is RH positive so we do not need to treat If a patient's Coomb's test is negative, what do we do? Ans- give rhogam at 28 weeks and 72 hours after birth What is the only form of non-hormonal contraception other than barrier methods such as condoms? Ans- IUD The vaginal ring for contraception must be taken out how often? Ans- every 3 weeks If a patient is on birth control and is currently having breakthrough bleeding, then what do we do? Ansincrease the progesterone How do we treat temporal arteritis? Ans- steroids If a patient is on birth control and they miss one pill, what should they do? Ans- double up If a patient is on birth control and they miss two pills, what should they do? Ans- double up for 2 days If any woman comes in with painless vaginal bleeding between periods (esp if she is postmenopausal), what should you do? Ans- do a pregnancy test and then refer for endometrial biopsy to rule out endometrial cancer In terms of the breasts, _____________ is used for screening and _____________ is used for diagnosis. Ans- mammogram; ultrasound When do we screen for group B strep in pregnancy? Ans- we