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3P Exam Study APEA Exam 2025/2026 Accurate
Real Exam Questions and Correct Answers
What is the treatment time for enterobiasis? - answer>>>2 weeks What are the anti-hypertensives used in pregnancy? - answer>>>Methyldopa (Alpha- 2 - Agonist), Labetalol, Nifedipine, Hydralazine What would cause decrease in Digoxin levels? - answer>>>Antacids Taking Pyridium for UTI, what can Pyridium cause? - answer>>>Hemolytic Anemia What can PCOS result in? - answer>>>Increased insulin levels (Hyperinsulinemia), Androgens, Hirsutism What is a characteristic of Placenta Previa? - answer>>>Painless, red bleeding What is a chacteristic of Rheumatoid Arthritis? - answer>>>Tender, warm, swollen joints Medications that can cause ototoxicity? - answer>>>Aminoglycosides, loop diuretics, NSAIDs, antihistamines, nasal decongestants What does MCV lab value measure? - answer>>>Mean Corpuscular Volume helps diagnose different types of anemia such as B12 & Folate (Macrocytic) and Fe anemia (Microcytic) Rhogam is given at how many week gestation? - answer>>>27- 28 weeks
What are Janeway lesions and what do they indicate? - answer>>>They are irregular, non-tender hemorrhagic macules located on the hands and feet. Seen in Infective Endocarditis What are Osler's Nodes and what do they indicate? - answer>>>They are split pea-sized, erythematous, tender nodules located on the pads of the fingers and toes. Seen in Infective Endocarditis What is the recommendation for Warfarin management when a patient misses a dose? - answer>>>If within 12 hours of the dose time, take it. If over 12 hours patient will need a INR redraw What do we need to know about ACEs and ARBs? - answer>>>A dry hacking cough is a common side effect of ACEs and will go away within a week after discontinuing. ACEs & ARBs are indicated for patients with DM, CKD, and HTN. Not recommended as 1st line agent with African Americans & can cause angioedema. Contraindications for Hydrochlorothiazide - answer>>>Sulfa allergy, PCN hypersensitivity, Asthma, Gout Systolic Murmurs (Benign) - answer>>>MR = Mitral Regurge (SOB/Fatigue HF) Peyton Manning = Physiologic Murmur (Asymptomatic) AS = Aortic Stenosis (Angina, Syncope HF) MVP = Mitral Valve Prolapse ("Click", Women 14 - 30, Palpitations, Chest Pain Diastolic Murmurs (Abnormal) - answer>>>AR = Aortic Regurgitation (Angina, HF, Dizziness, Chest Pain) MS = Mitral Stenosis (Dyspnea, AFib) What does S1 indicate? - answer>>>S1 Closure of the Atrioventricular Valves (Mitral & Tricuspid Valves)
Vesicle: Blister <1cm i.e. HSV, Chickenpox Bulla: Blister >1cm i.e. 2nd Degree Burn, Bullous Pemphigod Plaque: Raised, flat-top >1cm i.e. Psoriasis & Seborrheic Keratoses Patch: Flat, discolored >1cm i.e. Vitiligo & Port-Wine Stains Wheal: Raised & Red Area i.e. Hives & Insect Bite reaction Keloid - answer>>>Hyperthrophic scar that is invasive beyond point of original injury What is Tinea Capitis and What is the treatment? - answer>>>Scalp Ring-Worm. Round, scaly patches on scalp (Cradle Cap). Treatment is Grisefulvin 500mg with high fat meals for 4-6weeks What is Tinea Corporis and What is the treatment? - answer>>>Body Ring-Worm. Red, scaly plaques on the body or trunk in a ring-like/circular pattern. Topical Azoles (I.E. Clotrimazole) for 2 weeks. How do you assess Melanoma? - answer>>>ABCDE (Asymmetry, Border, Color, Diameter >6mm, and Evolution/Elevation Signs & Symptoms of Psoriasis? - answer>>>Silvery-White Scales, Pitted Nails, Positive Auspitz Sign (Pinpoint bleeding when lesions/scales are scraped) Facts about Shingles (Herpes Zoster) - answer>>>- Unilateral Dermatomal Rash which starts as a painful red rash (patch) and progresses to blisters (vesicles).
- Post herpetic neuralgia pain is common and can last longer than 1 month after rash resolves.
- May transmit chickenpox virus to unvaccinated & susceptible patients.
- Treatment consists of Acyclovir, Valacyclovir, or Famciclovir and most effective if started within 48-72hrs of rash appearance.
Facts about Contact Dermatitis (Eczema) - answer>>>- Papules or Vesicles typically 5mm or less which are red, raised bumps
- Skin becomes dry, scaly, and rough leading to formation of crusts or flakes on skin surface
- If scratched or irritated, the skin may ooze
- Treatment consists of Corticosteroids, Antihistamines, Calcineurin Inhibitors (Tacrolimus) Facts about Acne Vulgaris - answer>>>- Inflammatory skin disorder where androgen- dependent sebaceous glands produce excess sebum.
- Usually affects face, anterior & posterior chest, Upper Back, Shoulders, and Arms
- Treatment consists of Erythromycin/Benzoyl Peroxide (Benzamycin)
- Education r/t Erythromycin/Benzoyl Peroxide includes limit exposure to sunlight and can decrease resistance to erythromycin Facts about Atopic Dermatitis - answer>>>- Patchy plaque-like rash
- Can occur in people with other atopic conditions such as Asthma and Allergic Rhinitis (Hay Fever) Eye exam findings in DM & HTN - answer>>>- AV Nicking = Arteries indent and displace veins
- Cotton Wool Spots = White or grayish fluffy lesions on the retina
- Flame Hemorrhages = Flame-like hemorrhages along the retinal nerve fiber layer
- Dot & Blot Hemorrhages = Small hemorrhages caused by rupture of weakened blood vessels - Hallmark sign of diabetic retinopathy Acute Sinusitis Tx for Adults & Pediatrics - answer>>>- Viral is symptomatic treatment only
Eye Emergencies - answer>>>Papilledema - r/t Increased ICP, Swollen Optic Disc, and Engorged Tortuous Vein Acute Closed-Angle Glaucoma - Sudden onset severe eye pain and Rapid loss of vision Foreign Object in Eye - answer>>>Only attempt to remove with wet cotton swab and if not able send to ophthamologist stat Meniere's Disease - answer>>>Vertigo, Tinitus, and Pressure in the Right Ear Hyperopia (Farsightedness) - answer>>>Light that is focused behind the retina causes the visual disturbance Mononucleosis - answer>>>condition caused by the Epstein-Barr virus and characterized by an increase in mononuclear cells (monocytes and lymphocytes) in the blood along with enlarged lymph nodes (lymphadenopathy), fatigue, and sore throat (pharyngitis) Which medication is most commonly associated with hypoglycemia? - answer>>>Sulfonylureas i.e. Glyburide, Glipizide, Glimepiride What does myxedema indicate and what is the clinical presentation? - answer>>>Myxedema indicates hypothyroidism. S&S include hypothermia, thickening of the tongue, disorientation, and swelling of the face, hands, feet. Hyperthyroidism S&S - answer>>>Tachycardia, AFib, weight loss, hyperactiivity, heat insensitivity, moist skin, exophthalmos. Hyperprolactinemia - answer>>>Menstrual Dysfunction Erectile Dysfunction
Breast Pain Loss of Libido Vaginal Dryness Infertility Lactation Hyperandrogenism - answer>>>High levels of androgens in females Acne Seborrhea (Oily/Flaky Skin) Androgenic Alopecia (hair loss on scalp) Hirsuitism Infrequent/Absent menstruation Can be caused by PCOS Diabetes Mellitus - answer>>>A1c over 6.5 or fasting glucose over 126 on 2 separate occasions Metformin is first line treatment Diabetic Neuropathy - answer>>>Occurs in distal lower extremities r/t long-term hyperglycemia S&S include Parestehsias Burning Muscle Weakness Difficulty with Coordination/Balance Giardiasis S&S - answer>>>Foul Smelling Stools
GERD S&S - answer>>>Pyrosis (heartburn) Regurgitation Post-Nasal Drip Chronic Cough Chronic Sore Throat Hoarseness Tx PPI BIDx14 days H Pylori Algorrithm - answer>>>Amoxicillin BID & Clarithromycin BID PPIO BIDx14 days IF PCN Allergies then: Metronidazole & Clarithromycin BID PPIx14 days What GERD symptom is alarming? - answer>>>Odynophagia (Pain with swallowing) Chron's Disease S&S - answer>>>Chronic Bloody Diarrhea Fatigue, Abdomnial Pain Weight Loss/Fever Skip Lesions, Cobblestone appearance Fistulas are common Slow progressive inflammation of small/large intestine Tx is Budesonide 5-aminosalicylates Gastroenteritis Common Pathogens - answer>>>Adults:
Norovirus, Enteric Adenovirus, Astrovirus Salmonella - Most Common Foodborne Illness Giardia Lambia - Most Common Parasitic Infants: Norovirus, Enteric Adenovirus, Astrovirus Campylobacter jejuni Pyloric Stenosis presentation - answer>>>Occurs in first few weeks of life: Projectile Vomiting Non-bileous Vomiting Visible Peristalsis after feeding Hungry/Irritable/Dehydration/Electrolyte Imbalance Hepatitis B & C - answer>>>Bloodborne/Body fluids highly infectious Patient's who test positive should be testedd for HIV r/t common transmission routes Enterobiasis vermicularis (Pinworm) Infection - answer>>>Helminths can be transmitted by the bite of blood sucking insects Tx: Pyrantel Pamoate - One dose initially, then another dose in 2 weeks. Re-Test after 2 weeks of last dose Ulcerative Colitis - answer>>>chronic inflammation of the colon with ulcerations Which enzyme is not produced in the pancreas? - answer>>>Pepsin Small Bowel Obstruction - answer>>>Crampy & Intermittent Abdominal Pain
Iron Supplementation/Replacement Therapy - answer>>>Take 1 - 2hrs before meal on an empty stomach with Vitamin C. Take for 4 - 6 months. After iron replacement is complete, continue treatment for 12 weeks and repeat CBC Rhogam, give when? - answer>>>28 weeks of pregnancy, and after 72hrs of delivery Rhogam, why given? - answer>>>To prevent hemolytic anemia of the newborn with mothers who are Rh negative Sickle Cell - answer>>>Autosomal recessive characterized by ischemic tissue injury and chronic severe hemolytic anemia Dx: Hemoglobin electroparesis Repeated sickling epiosodes can cause cells to become permanently sickled. Benign Prostatic Hyperplasia (BPH) - answer>>>Enlargement of the prostate which narrows the urethral lumen. Risk Factors: Elevated PSA, Blacks & Asians, Age BPH assessment findings - answer>>>Firm smooth enlarged prostate. BPH S&S - answer>>>Dribbling after urination Excessive nocturnal urination Frequency Sense of incomplete bladder emptying Incontinence Sexual dysfunction
BPH Treatment - answer>>>*Gold standard TURP Medications Alpha 1 adrenergic antagonist (tamsulosin) - relaxes smooth muscle in the prostate - immediate relief 5 Alpha Reductase inhibitor (finasteride) - inhibits conversion of testosterone to DHT - Long term and takes 6-12months to start working Hydrocele - answer>>>Peritoneal fluid collection in the scrotum. Painless swelling in scrotum, feels heavy, and transillumination of the scrotum will light up brightly Penile Cancer - answer>>>Squamous cell carcinoma - Thick white plaques, large scaly growths. Bleeding is late sign. Risk Factors: HPV, AIDs, uncircumcised, smoking, psoriasis, cryptochordism Erectile Dysfunction - answer>>>Treatment PDE- 5 inhibitor - contraindicated with nitrates Causes - Anti-HTN meds, antidepressants, antiandrogens, recreational drugs #1 Risk Factor for Testicular & Penile Cancer - answer>>>Cryptochordism Prostatitis - answer>>>Inflammation of the prostate & usually bacterial S&S: Frequency, urgency, fever, enlarged boggy warm prostate Prostatitis Treatment - answer>>>Chronic Prostatitis: Ciprofloxacin or Flouroquinolones (Levofloxacin) for 4-12 wks or Bactrim 4-6 wks. Treatment guided by Culture & Sensitivity No Keflex (cephalexin)
Parkinson's Disease Presentation - answer>>>Bradykinesia, rigidity, resting tremor ("pill rolling"), postural instability Parkinson's Disease Treatment - answer>>>Dopaminergic agents, Carbidopa/levadopa (Do not give to patients with narrow angle glaucoma) Beer's List - answer>>>a list of drugs for which you should not give or monitoring is especially important in elderly patients Anti-cholinergics, anti-spasmotics, scopolamine, meclizine, promethazine High risk of confusion, dry mouth, constipation. Meningitis - answer>>>Inflammation of the brain and spinal cord meninges result from bacteria, virus, or fungi. Headache is caused by meningeal irritation. Tx is cephalosporins (Ceftriaxone). Transient Ischemic Attack (TIA) - answer>>>brief episode of loss of blood flow to the brain, usually caused by a partial occlusion that results in temporary neurologic deficit (impairment). Typically resolves within hours; often precedes a CVA Seizures - answer>>>Uncontrolled electrical activity within the brain Scoliosis - answer>>>Lateral curvature of the spine greater than 10 degrees Rheumatoid Arthritis - answer>>>Autoimmune disorder characterized by thickened synovial membrane, joints are warm, swollen, and tender, which can lead to bone erosion. Osteoarthritis - answer>>>
Osteoarthritis Treatment - answer>>>Weight-bearing exercise, weight loss, Cymbalta, duloxetine, tramadol. RICE = Rest, Ice, Compression, Elevation. Acetaminophen not recommended. Short acting NSAIDs are ok. Refer to ortho for injections. Sprain - answer>>>Stretch or tear in a Ligament Strain - answer>>>Stretch or tear in a muscle or tendon Ortolani's Click - answer>>>A click is heard or felt as dislocation is reduced Barlows Maneuver - answer>>>Feeling of a slip of the femoral head slips away from the Acetabulum (toward the butt) Meningitis assessment finding - answer>>>Positive Kernig or Brudzinski sign Adam's Sign - answer>>>Evaluation for scoliosis. Negative for functional scoliosis if curve straightens out Positive for structural scoliosis if curve remains Fat Pad Sign - answer>>>radiographic finding that can indicate an underlying injury or fracture in the elbow joint, specifically around the olecranon process of the ulna bone. McMurray Test - answer>>>Palpable or auditory click while rotating and extending the knee Gout - answer>>>Acute joint pain with swelling, warmth, and erythema begins abruptly and involves a single joint. Normal uric acid levels are common during acute attack.
Rhogam - answer>>>Given at 28wks gestation, within 72hrs of delivery and any maternal hemorrhage, ectopic pregnancy, and abortion Vaccines that are safe in pregnancy - answer>>>Flu vaccine, Tdap, COVID Abruptio Placentae (Placental Abruption) - answer>>>Absent/Profuse vaginal bleeding, abnormal painful uterine contractions, uterine tenderness, rigid & board-like uterus on palpatation Bulimia Presentation - answer>>>Recurrent episodes of eating, binging, and purging.
- Russell's Sign - knuckle scarring from induced vomiting Bulimia Treatment - answer>>>SSRIs i.e. fluoxetine (Prozac) & sertraline (Zoloft) Depression Treatment - answer>>>Unipolar Depression - sertraline (Zoloft) & escitalopram (Lexapro)
- Start with 4wks of treatment then re-evaluate for dose adjustment for a minimum of 6 months Anxiety Treatment - answer>>>busparone (Buspar) *Anxiety & Depression coexist - use GAD 7 scale to dx Major Depressive Disorder symptoms - answer>>>S: Sleep Disturbances I: Interest/Pleasure loss in activities once enjoyed (anhedonia) G: Guilt or Worthlessness feelings E: Decreased Energy or Fatigue C: Difficulty concentrating or making decisions A: Changes in appetite or weight (Increase/Decrease)
P: Psychomotor agitation or retardation (slow movements) S: Suicidal thoughts/behaviors Neurotransmitters in Depression - answer>>>Serotonin - Regulate mood, sleep, appetite, social behavior Norepinephrine - Mood, Arousal, Attention Dopamine - Pleasure, reward, motivation, movement GABA - Inhibitory - Calmness, Relaxation, Sedation NMDA (Glutamate) - Excitatory - Learning, Memory Munchausen syndrome by proxy - answer>>>A factitious disorder in which parents make up or produce illnesses in their loved one. Also known as factitious disorder by proxy. Suicide Screening - answer>>>Are you thinking of hurting yourself? If yes, do you have a plan? Do you have means to make the plan happen? Risk Factors: Prior attempts, adolescents, Males, Elderly males Asthma - Mild Intermittent - answer>>>Symptoms present < 2 days/week, or < 2 nights/month Asthma - Mild Persistent - answer>>>Symptoms present > 2days/week but not everyday, 3-4 nighttime awakenings/month Asthma - Moderate Persisent - answer>>>Daily symptoms or more than 3 - 4 nights per month
