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3P EXAM STUDY APEA COMPREHENSIVE
AND ACTUAL CORRECT ANSWERS
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RICE = Rest, Ice,
Compression, Elevation
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Short acting
NSAIDs are ok
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Sprain - CorreCt Answers -Stretch or tear in a Ligament

Strain - CorreCt Answers -Stretch or tear in a muscle or tendon

Ortolani's Click - CorreCt Answers -A click is heard or felt as dislocation is
reduced

Barlows Maneuver - CorreCt Answers -Feeling of a slip of the femoral head
slips away from the Acetabulum (toward the butt)

Meningitis assessment finding - CorreCt Answers -Positive Kernig or
Brudzinski sign

Adam's Sign - CorreCt Answers -Evaluation for scoliosis
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McMurray Test - CorreCt Answers -Palpable or auditory click while rotating
and extending the knee

Gout - CorreCt Answers -Acute joint pain with swelling, warmth, and
erythema begins abruptly and involves a single joint
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Gout Treatment - CorreCt Answers -Acute Gout - Colchicine
Chronic Gout (2 or more attacks/year) - Allopurinol - decreases production
of uric acid

GTPAL - CorreCt Answers -Gravidia - # of times a woman has been
pregnant multiples = 1
Term - Number of children at >37 weeks
Preterm - Number of children at 20-37 weeks
Abortion - Abortions/Miscarriages
Living - living children, twins count individually

Fundal Height - CorreCt Answers -Distance from the pubic bone to the top
of the uterus in centimeters
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i
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24cm = 24wks

Preeclampsia - CorreCt Answers -BP > 140/90 & Proteinuria (300mg/24hr
urine sample) or edema, pulmonary edema, visual impairments, impaired
renal or hepatic function
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e
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Abnormal placement of the placenta near or
covering the internal cervical os

1st line Treatment of UTI in pregnancy - CorreCt Answers -Nitrofurantoin
(Macrobid)

Rhogam - CorreCt Answers -Given at 28wks gestation, within 72hrs of
delivery and any maternal hemorrhage, ectopic pregnancy, and abortion

Vaccines that are safe in pregnancy - CorreCt Answers -Flu vaccine, Tdap,
COVID

Abruptio Placentae (Placental Abruption) - CorreCt Answers Absent/Profuse vaginal bleeding, abnormal painful uterine contractions,
uterine tenderness, rigid & board-like uterus on palpatation

Bulimia Presentation - CorreCt Answers -Recurrent episodes of eating,
binging, and purging
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e
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Also
known as factitious disorder by proxy
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Other criteria - Prolonged expiratory phase, wheezing with forced
exhalation, barrel chest & tripod position in late phase
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Develops when pulmonary lymphatics become blocked leadingn to an
outpouring of contaminated lymph fluid into the pleural space
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S&S - Dyspnea, atelectasis, pleural pain
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Treatment of Mycoplasma Pneumoniae "Walking PNA" - CorreCt Answers Infants - Amoxicillin
School age - Amoxicillin or Macrolide

Treatment of Streptococcus Pneumoniae "Deadly" - CorreCt Answers Previously Healthy - Macrolide or Doxycycline
Previously Healthy with Recent Abx use - Flouroquinolone or Advanced
Macrolide (Azithromycin) PLUS high dose Amoxicillin
Comorbidities with No ABX use - Advanced macrolide OR Flouroquinolone
Comorbidities recent ABX - Flouroquinolone or Advanced Macrolide PLUS
beta-lactam

Pertusis - CorreCt Answers -Whooping cough caused by Bordatella
Pertussis
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Pertussis Treatment - CorreCt Answers -macrolide (Azithromycin) or
sulfonamide (Bactrim)
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Pregnant
women get Tdap @ 27/28wks

Tuberculosis (TB) Diagnostics - CorreCt Answers -Gold Standard - sputum
sample
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Do treat latent, but not infectious

Croup - CorreCt Answers -Acute viral illness
S&S - Barking Cough, Stridor, Sub-glottal swelling, Hoarseness
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S&S - Genital Ulceration, Lymphadenopathy, Occular Trachoma, Proctitis,
Cervical Motion Tenderness, Assymptomatic
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Gonorrhea - CorreCt Answers -Common with Chlamydia
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if Chlamydia also suspected give
Doxycycline 100mg BIDx7 days

Bacterial Vaginosis - CorreCt Answers -Not an STI
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S&S - Fishy smell, watery discharge, clue cells, increased alkalosis
Tx: metronidazole (Flagyl), Lactobacillus Probiotics

Genital Herpes - CorreCt Answers -Herpes Simplex Virus Type 1 or 2,
transmitted with direct contact with active lesions or with virus containing
fluid
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Pt can be infectious
while shedding virus
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Can be
cauliflower like if perianal
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e
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Dx: NAAT
Tx: metronidazole (Flagyl)

Pediculosis Pubis - CorreCt Answers -Tx: Permethrin (Nix)

HIV early signs - CorreCt Answers -Fever, fatigue, swollen lymphnodes,
sore throat

HIV late signs - CorreCt Answers -Rapid weight loss, recurring fever, night
sweats, fatigue, chronic diarrhea, swollen glands

When does HIV progress to AIDs? - CorreCt Answers -When the number of
CD4 cells fall below 200

Overflow Incontinence - CorreCt Answers -The bladder cannot empty
properly r/t bladder dysfunction, urinary tract blockage, or underactive
bladder muscles
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e
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Tx: Anticholinergics i
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Oxybutynin

Stress Incontinence - CorreCt Answers -Involuntary leakage of urine during
physical activities or movements that put pressure on the bladder
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e
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Taking Pyridium for UTI, what can Pyridium cause? - CorreCt Answers Hemolytic Anemia

What can PCOS result in? - CorreCt Answers -Increased insulin levels
(Hyperinsulinemia), Androgens, Hirsutism

What are the anti-hypertensives used in pregnancy? - CorreCt Answers Methyldopa (Alpha-2-Agonist), Labetalol, Nifedipine, Hydralazine

What is a characteristic of Placenta Previa? - CorreCt Answers -Painless,
red bleeding

What is a chacteristic of Rheumatoid Arthritis? - CorreCt Answers -Tender,
warm, swollen joints

Medications that can cause ototoxicity? - CorreCt Answers Aminoglycosides, loop diuretics, NSAIDs, antihistamines, nasal
decongestants

What is the treatment time for enterobiasis? - CorreCt Answers -2 weeks

What does MCV lab value measure? - CorreCt Answers -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? - CorreCt Answers -27-28
weeks

What are Janeway lesions and what do they indicate? - CorreCt Answers They are irregular, non-tender hemorrhagic macules located on the hands
and feet
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Seen in Infective Endocarditis

What is the recommendation for Warfarin management when a patient
misses a dose? - CorreCt Answers -If within 12 hours of the dose time, take
it
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ACEs & ARBs are indicated for patients with DM,
CKD, and HTN
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Contraindications for Hydrochlorothiazide - CorreCt Answers -Sulfa
allergy, PCN hypersensitivity, Asthma, Gout

Systolic Murmurs (Benign) - CorreCt Answers -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) - CorreCt Answers -AR = Aortic
Regurgitation (Angina, HF, Dizziness, Chest Pain)
MS = Mitral Stenosis (Dyspnea, AFib)

What does S1 indicate? - CorreCt Answers -S1 Closure of the
Atrioventricular Valves (Mitral & Tricuspid Valves)

What does S2 indicate? - CorreCt Answers -S2 Closure of the Semilunar
Valves (Aortic & Pulmonic Valves)

S3 is often heard in? - CorreCt Answers -CHF, possibly normal for athletic
adolescents

S4 is often heard in? - CorreCt Answers -Diastolic HF, Left Ventricular
Hypertrophy (LVH), Poorly controlled HTN, MI

Treatment of Peripheral Artery Disease (PAD) - CorreCt Answers Antiplatelets (Plavix, ASA), Pentoxifylline (Decreases blood viscosity)

Diagnosing Peripheral Artery Disease (PAD) - CorreCt Answers -Gold
Standard = Angiography
Ankle Brachial Index (ABI)

Coronary Artery Disease (CAD) treatment - CorreCt Answers Aotrvastatin/Rosuvastatin = If LDL>150 use high doses
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Change type & dose if issues
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What medications are indicated for HF treatment? - CorreCt Answers ACEs, ARBs, ARNI w/BBs, Aldosterone Recepter Antagonists

What is the treatment for Sarcopter Scabiei (Scabies)? - CorreCt Answers Topical Permetherin massaged from head to soles of feet and wash off with
shower or bath after 8-14hrs
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Names of skin lesions? - CorreCt Answers -Macule: Flat <1cm i
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freckle
Papule: Raised <1cm i
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acne
Nodule: Raised >1cm i
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lipoma
Vesicle: Blister <1cm i
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HSV, Chickenpox
Bulla: Blister >1cm i
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2nd Degree Burn, Bullous Pemphigod

Plaque: Raised, flat-top >1cm i
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Psoriasis & Seborrheic Keratoses
Patch: Flat, discolored >1cm i
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Vitiligo & Port-Wine Stains
Wheal: Raised & Red Area i
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Hives & Insect Bite reaction

Keloid - CorreCt Answers -Hyperthrophic scar that is invasive beyond point
of original injury

What is Tinea Capitis and What is the treatment? - CorreCt Answers -Scalp
Ring-Worm
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Treatment is
Grisefulvin 500mg with high fat meals for 4-6weeks

What is Tinea Corporis and What is the treatment? - CorreCt Answers Body Ring-Worm
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Topical Azoles (I
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Clotrimazole) for 2 weeks
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- Post herpetic neuralgia pain is common and can last longer than 1 month
after rash resolves
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- Treatment consists of Acyclovir, Valacyclovir, or Famciclovir and most
effective if started within 48-72hrs of rash appearance
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- 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 - CorreCt Answers -- 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 - CorreCt Answers -- 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 - CorreCt Answers -- Viral is
symptomatic treatment only
- Bacterial tx is Amoxicillin 1st line if symptoms >10 days and include
purulent nasal discharge, fever, unilateral face/tooth pain

Snellen Test - CorreCt Answers -Test of CN II (Optic Nerve)

Which medications can cause ototoxicity? - CorreCt Answers Aminoglycosides
Loop Diuretics
Quinine
ASA

Allergic Rhinitis - CorreCt Answers -Eosinophils elevated in Allergies,
Wheezes, Parasites
Tx is Fluticasone (Flonase)

Acute Bacterial Rhinosinusitis treatment - CorreCt Answers -If patient is
allergic to PCN, then Doxycycline is the best alternative

Which Immunoglobuliin is responsible for symptoms of Allergies & Allergic
Rhinitis? - CorreCt Answers -IgE

Assessment of a 4yr old visual acuity results in 20/30 in L eye and 20/40 in
R eye - CorreCt Answers -Means vision is normal for his age
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Medication given for Benign Paroxysmal Positional Vertigo - CorreCt
Answers -Meclizine (Antivert)

Pterygium - CorreCt Answers -A growth of fleshy tissue on the conjunctiva
that can extend onto the cornea
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e
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S&S include
hypothermia, thickening of the tongue, disorientation, and swelling of the
face, hands, feet
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Hyperprolactinemia - CorreCt Answers -Menstrual Dysfunction
Erectile Dysfunction
Breast Pain
Loss of Libido
Vaginal Dryness
Infertility
Lactation

Hyperandrogenism - CorreCt Answers -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 - CorreCt Answers -A1c over 6
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ReTest after 2 weeks of last dose

Ulcerative Colitis - CorreCt Answers -chronic inflammation of the colon
with ulcerations

Which enzyme is not produced in the pancreas? - CorreCt Answers -Pepsin

Small Bowel Obstruction - CorreCt Answers -Crampy & Intermittent
Abdominal Pain
Nausea/Vomiting
inability to pass gas

Acute Lymphoblastic Leukemia (ALL) - CorreCt Answers -Most common
Leukemia in children
S&S:
Fever, Thrombocytopenia, Anemia, Gingival Hyperplasia (swelling), Bone
pain

Beta Thalassemia - CorreCt Answers -Genetic disorder where there is
decreased or absent production of hemoglobin
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Caused by decrease in intrinsic factor r/t autoimmune destruction of
parietal cells leading to reduced vitamin B12 absorption

Vitamin B-12 S&S - CorreCt Answers -Cognitive impairment
Fatigue/Weakness
Ataxia
Neuropathy
Glossitis
Mouth Ulcers

Iron Supplementation/Replacement Therapy - CorreCt Answers -Take 12hrs before meal on an empty stomach with Vitamin C
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After iron replacement is complete, continue treatment for 12 weeks and
repeat CBC

Rhogam, give when? - CorreCt Answers -28 weeks of pregnancy, and after
72hrs of delivery

Rhogam, why given? - CorreCt Answers -To prevent hemolytic anemia of
the newborn with mothers who are Rh negative

Sickle Cell - CorreCt Answers -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
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Risk Factors: Elevated PSA, Blacks & Asians, Age

BPH assessment findings - CorreCt Answers -Firm smooth enlarged
prostate
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Painless swelling in scrotum, feels heavy, and transillumination of the
scrotum will light up brightly

Penile Cancer - CorreCt Answers -Squamous cell carcinoma - Thick white
plaques, large scaly growths
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Risk Factors: HPV, AIDs, uncircumcised, smoking, psoriasis,
cryptochordism

Erectile Dysfunction - CorreCt Answers -Treatment PDE-5 inhibitor contraindicated with nitrates
Causes - Anti-HTN meds, antidepressants, antiandrogens, recreational
drugs

#1 Risk Factor for Testicular & Penile Cancer - CorreCt Answers Cryptochordism

Prostatitis - CorreCt Answers -Inflammation of the prostate & usually
bacterial
S&S: Frequency, urgency, fever, enlarged boggy warm prostate

Prostatitis Treatment - CorreCt Answers -Chronic Prostatitis: Ciprofloxacin
or Flouroquinolones (Levofloxacin) for 4-12 wks or Bactrim 4-6 wks
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Most common in prepubertal boys

Epididymitis - CorreCt Answers -Testicular pain onset over a few days
(gradual) and cremasteric reflex is present
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Meningitis - CorreCt Answers -Inflammation of the brain and spinal cord
meninges result from bacteria, virus, or fungi
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Tx is cephalosporins (Ceftriaxone)
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Typically resolves within hours;
often precedes a CVA

Seizures - CorreCt Answers -Uncontrolled electrical activity within the
brain

Scoliosis - CorreCt Answers -Lateral curvature of the spine greater than 10
degrees

Rheumatoid Arthritis - CorreCt Answers -Autoimmune disorder
characterized by thickened synovial membrane, joints are warm, swollen,
and tender, which can lead to bone erosion
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Paget's Disease of Breast - CorreCt Answers -Red, itchy, swollen rash of
nipple/areola
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Peau D'Orange Breast Cancer - CorreCt Answers -Nipple retraction,
redness, persistent itching, warm skin

Combined Oral Contraceptive contraindications - CorreCt Answers -Hx of
breast/estrogen-related cancers, migraine w/aura, female >35yrs &
smoker

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