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APEA PREDICTOR EXAM QUESTIONS AND
CORRECT ANSWERS
What is the biggest side effect of colchicine? - Correct Answers_diarrhea How would you describe the appearance of molluscum contagiosum? - Correct Answers_papules that are umbilicated and contain a caseous plug How do we treat a broken clavicle in an infant? - Correct Answers_no treatment; it should heal on it's own At what week of pregnancy is the uterus palpable just above the pubic symphysis? - Correct Answers_week 12 At what week of pregnancy is the fundus palpable halfway between the pubic symphysis and umbilicus? - Correct Answers_week 16 At what week of pregnancy is the fundus of the uterus at the umbilicus? - Correct Answers_week 20 At what week of pregnancy is the fundus of the uterus halfway between the xiphoid process and umbilicus? - Correct Answers_week 28 At what week of pregnancy is the fundus just below the xiphoid process? - Correct Answers_week 34
Increased sweat production is a sign of what endocrine disorder? - Correct Answers_hyperthyroidism What is Paget's disease? - Correct Answers_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? - Correct Answers_bisphosphonates How should pregnant women wear their seatbelt? - Correct Answers_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? - Correct Answers_parvovirus aka slapped cheek disease aka erythema infectiosum Which type of prevention are vaccinations? - Correct Answers_primary When should patients begin antiretroviral therapy for HIV infection? - Correct Answers_as soon as it is detected, even if in the acute phase What are the first generation antihistamines? - Correct Answers_diphenhydramine (benadryl) and chlorpeniramine (actifed) What are s/s of the secondary stage of syphilis? - Correct Answers_rash on hands and feet, lymphadenopathy, fever What is the recommended treatment for chronic bacterial prostatitis? - Correct Answers_a fluoroquinolone (cipro or levo) + bactrim What is the recommended treatment for acute prostatitis? - Correct Answers_cipro (if not STI related) or ceftriaxone
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? - Correct Answers_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?
- Correct Answers_Rifampin 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? - Correct Answers_decrease the weekly dose by 5 - 10% If a patient on coumadin's INR is 4.1-5.0, what should you do? - Correct Answers_hold one dose then decrease the weekly dose by 10% If a patient's INR is greater than 5, what should you do? - Correct Answers_consult cards, likely would hold two doses then decrease the weekly dose An anorexic patient will have a BMI of what? - Correct Answers_less than 18 What is primary amenorrhea? - Correct Answers_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 - Correct Answers_3 months What do we need to do first when a patient comes in with secondary amenorrhea? - Correct Answers_rule out pregnancy Anorexia can put you at risk for what? - Correct Answers_osteoporosis, amenorrhea, cardiac damage
Amenorrhea is considered a risk factor for what? - Correct Answers_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? - Correct Answers_they get their period back If a pregnant woman has syphilis, what should we do? - Correct Answers_treat it with penicillin while she is pregnant because there is risk for spontaneous abortion What is the causative organism of mastitis? - Correct Answers_staph What is the first line treatment for mastitis? - Correct Answers_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? - Correct Answers_numerous sexual partners Preeclampsia most commonly shows up at what time in pregnancy? - Correct Answers_around week 20 How do we treat UTIs in a pregnant woman? - Correct Answers_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? - Correct Answers_about 10 days before menses What can be a sequelae of an ectopic pregnancy? - Correct Answers_pelvic inflammatory disease and infertility due to scarring of the fallopian tube (salpingitis)
In terms of the breasts, _____________ is used for screening and _____________ is used for diagnosis. - Correct Answers_mammogram; ultrasound When do we screen for group B strep in pregnancy? - Correct Answers_weeks 35 - 37 When do we perform alpha fetoprotein screening in pregnancy? - Correct Answers_15- 20 weeks Alpha fetoprotein screening in pregnancy can help determine the presence of what in pregnancy? - Correct Answers_spina bifida and anencephaly What is placenta previa? - Correct Answers_when the placenta blocks the cervical opening of the uterus What is placenta abruptio? - Correct Answers_when the placenta either fully or partially detaches from the uterine wall When does placental abruption most commonly occur? - Correct Answers_in the third trimester What is the major difference in symptomalogy between placenta abruptio and placenta previa? - Correct Answers_a placental abruption is painful whereas placenta previa is painless If a pregnant woman comes in with painless vaginal bleeding, what should we be considering? - Correct Answers_placenta previa What is the recommended treatment for polymyalgia rheumatica? - Correct Answers_steroids
Patients with SLE are going to have what abnormal labwork? - Correct Answers_elevated ESR and CRP How do we treat lupus flares? - Correct Answers_steroids What are common sequelae of fibromyalgia? - Correct Answers_insomnia and depression What is a great treatment option for fibromyalgia? - Correct Answers_amitriptyline (a TCA) because it helps with chronic pain, sleep, and depression How is fibromyalgia diagnosed? - Correct Answers_when at least 8 out of 11 points bilaterally are tender to touch and the symptoms have lasted longer than 3 months What is slipped capital femoral epiphysis? - Correct Answers_when the femoral head of the hip is out of place What is the trendelenburg sign and when is it positive? - Correct Answers_when the patient is standing straight and the pelvis on the unaffected side drops; this is a sign of a slipped capital femoral epiphysis What is the main characteristic of a slipped capital femoral epiphysis? - Correct Answers_walking with a limp SCFE is most common in which patient population? - Correct Answers_adolescents What is legg-calve-perthe disease? - Correct Answers_avascular necrosis of the femoral head due to a lack of blood supply Legg-calve-perthes disease is most common in which patient population? - Correct Answers_young children
What is the tell-tale difference between a herniated disc and sciatica? - Correct Answers_sciatica feels better when you stand, a herniated disc feels better when you sit down When will spinal or lumbar stenosis feel better? - Correct Answers_when the patient sits down What is Korsakoff syndrome? - Correct Answers_a deficiency in thiamine and folate caused by alcoholism What changes to the vagina occur with aging? - Correct Answers_dryness, loss of rugae, less pubic hair What is a navicular fracture? - Correct Answers_also known as a scaphoid fracture; this impacts the snuff box and causes tenderness there. This will have to be casted to stabilize the fracture Heberden and bouchard's nodes are indicative of what disease process? What about swan neck deformities? - Correct Answers_osteoarthritis; rheumatoid arthritis What is Morton's neuroma? - Correct Answers_a mass between the 3rd and 4th toes that feels like a pebble; most common in women who wear high heels or tight shoes How is Morton's neuroma diagnosed? - Correct Answers_via a positive Muddler's or squeeze test causing pain What is the hook test? - Correct Answers_used to assess for a bicep tendon issue How do we treat any rotator cuff injuries? - Correct Answers_wear a sling to stabilize the arm and refer to ortho
How long do migraine headaches last? - Correct Answers_4- 72 hours How can we abort cluster headaches? - Correct Answers_calcium or 100% oxygen application Which type of headaches come with lacrimation and sinus symptoms? - Correct Answers_cluster headaches What does the apprehension test assess for? - Correct Answers_used to assess for stability of the shoulder or knee; assesses for stability How does the parathyroid gland regulate calcium? - Correct Answers_when parathyroid hormone is released, it pulls calcium out of the blood and into the circulation in response to hypocalcemia. it also increases absorption of calcium from the intestine What is the first line treatment for trigeminal neuralgia? - Correct Answers_carbamazepine (tegretol) or amitriptyline. also want to do gabapentin or something for nerve pain What is the recommended treatment for Bell's palsy? - Correct Answers_steroids and anti- virals How is the pain of trigeminal neuralgia vs temporal arteritis different? - Correct Answers_in trigeminal neuralgia, the pain is like a shock hitting the side of your face whereas temporal arteritis is more like a headache What are the preventative treatment options for migraines? - Correct Answers_beta blockers, amitriptyline, venlafaxine, topamax, valproate What is Addison's disease? - Correct Answers_adrenal insufficiency; the patient will be low in cortisol and sodium but their potassium will be high
What does an ASC-US (atypical squamos cells of undetermined significance) pap smear result necessitate? - Correct Answers_Do HPV testing with this. If positive, repeat in one year if age 21 - 24 or send for colposcopy if older than 25. If negative, repeat pap in 3 years. Which pap smear result is considered to be HPV positive? - Correct Answers_LSIL If a patient has LSIL with a negative HPV test, what would you do? - Correct Answers_repeat in 1 year If a patient has LSIL with no HPV test or a positive HPV test, what should you do? - Correct Answers_refer for colposcopy If a patient's pap results show NILM, what should you do? - Correct Answers_repeat in 3 years If a patient's pap results show ASC-H or HSIL what should you do? - Correct Answers_refer for colposcopy The valgus stress test assesses what? - Correct Answers_the medial collateral ligament The varus stress test assesses what? - Correct Answers_the lateral collateral ligament The Lachman's test assesses what? - Correct Answers_the ACL The McMurray's test assesses for what? - Correct Answers_a torn meniscus The anterior drawer test assesses what? - Correct Answers_the acl The posterior drawer test assesses what? - Correct Answers_the posterior cruciate ligament (pcl)
a normal rise in blood sugar as a person's body prepares to wake up due to a release of cortisol and growth hormone - Correct Answers_dawn phenomenon How can you tell between the dawn and somogyi effect? - Correct Answers_If the blood sugar level is low at 2 a.m. to 3 a.m., suspect the Somogyi effect. If the blood sugar level is normal or high at 2 a.m. to 3 a.m., it's likely the dawn phenomenon.
