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APEA QBank AANP Review questions and answers rated A solutions
Gestational diabetes screening occurs between what weeks gestation? 24-48 When you ask the patient to take a deep breath in and then palpate over t... [Show More] he RUQ abdomen. Positive when pain is elicited. This is a sign of ___________. Murphy's sign; cholecystitis What are names of LABA medications? salmeterol What is encopresis in children? stool incontinence after the age of being toilet trained The medical term for being cross-eyed strabismus What is atopic dermatitis? eczema Tests used to diagnose developmental hip dysplasia Barlow and Ortolani maneuvers What is the female athlete triad? disordered eating, amenorrhea, osteoporosis How do patients with aortic regurgitation typically present? they will have a long asymptomatic period followed by exercise intolerance, then dyspnea at rest. The left ventricle eventually fails unless the aortic valve is replaced. What does the rash of fifth disease (a viral exanthem) look like? maculopapular rash that blanches easily and may be accompanied by joint aches What cardiac abnormalities are expected to be heard on auscultation of a pregnant patient? a venous hum murmur and an S3 When a headache accompanies a stroke, is this most often hemorrhagic or ischemic? hemorrhagic AV nicking is most commonly seen on retinal exam of which chronic condition? hypertension Within 6 months of being started on a TCA or SSRI, what is a common side effect that occurs? weight gain When does otitis media with effusion usually occur? either before or after an episode of acute otitis media. This effusion is not infected fluid but it is considered a breeding ground for bacteria. This should not be treated with antibiotics. The medical term for jock itch tinea cruris Tinea cruris "jock itch" is a common __________ infection and should be treated with what? fungal; OTC antifungal cream What are teaching points for males to avoid contracting tinea cruris? dry off after swimming and don't stay in a wet bathing suit Tinea cruris can affect the inner thighs but never what else? the penis or scrotum On microscopic exam, what is most likely to be seen in the presence of a bacterial infection? cocci and rods On microscopic exam, what is most likely to be seen in the presence of a candidal infection? yeasts What are dermatophytes? fungi On microscopic exam, what is most likely to be seen in the presence of a dermatophytic (fungal) infection? hyphae that are long, thin, and branching (such as in the case of tinea pedis, tinea cruris, and tinea corporis) The medical term for ringworm tinea corporis What is the most common cause of viral pneumonia in peds? RSV Viral pneumonia is the most common type of pneumonia in children of what ages? 6 months to 5 years What is the simplest way to screen for nutritional adequacy in older adults? measure their weight How are scabies treated? via permethrin and good hygiene What are common side effects of NSAIDs? renal impairment, acute renal failure, gastritis What is the most common cause of pernicious anemias? vitamin B12 deficiency How should oral iron supplements be taken? on an empty stomach with something acidic and high in calcium such as orange juice Group A strep pharyngitis can be accompanied by what symptoms other than the classic Centor criteria? abdominal pain, nausea, and vomiting A stool specimen that is positive for WBCs is a sign of what? a viral or bacterial infection The only type of incontinence that would not benefit from pelvic floor therapy is what? overflow incontinence What do the skin manifestations of a penicillin allergy look like? hives What are symptoms that someone will experience as soon as they are started on a SSRI and when will this resolve? headache, nausea, insomnia, restlessness, agitation; will resolve in 2 weeks What causes the dry cough in people taking an ACEI? the buildup of bradykinin which is usually degraded by ACE ACEI induced coughs usually begin how soon after starting the medication? within 2 weeks COPD is often associated with what sequelae? anxiety and depression When should an antiviral be started in a patient with shingles? within 72 hours of the onset of symptoms What is the drug of choice for treating UTIs in male patients? bactrim for 7-10 days What is the leading cause of CKD and ESRD in the united states? diabetes What is the usual recommendation about administering MMR and varicella immunizations? they should be given on the same day or at least one month apart What are the classic symptoms of an atopic pregnancy? amenorrhea, vaginal bleeding, abdominal pain What is sideroblastic anemia? when the bone marrow is unable to incorporate iron into hemoglobin. This may be either inherited or acquired. Can a pregnant woman get the MMR vaccine while pregnant? yes Why are the carotid arteries auscultated for bruits? this is indicative of generalized atherosclerosis What is roseola? a viral exanthem characterized by a high fever for 3 days then abrupt stopping of the fever and a maculopapular rash that blanches. also known as exanthem subitum. What are signs indicative of a meningitis infection? Kernig and Brudzinski's signs Cancer in the bone marrow that results in skeletal destruction multiple myeloma What is the average age of diagnosis of multiple myeloma? 65 a skin disorder that causes the nose to enlarge and become red, bumpy, and bulbous rhinophyma What are physical exam findings common in alcohol abuse? tremors, macrocytosis (due to vitamin B12 and folate deficiencies common in alcoholics), hypertension, rhinophyma, peripheral neuropathy, teleangectasia, hepatosplenomegaly What is the first sign of sexual maturation in a male? an increase in testicular size (tanner stage 2) The inability to name a familiar object anomia What happens to a womans vital signs when she is in her second trimester of pregnancy? her blood pressure decreases What is the most common cause of acute pharyngitis in children? respiratory viruses A depressed patient is started on an SSRI. When should another antidepressant be tried if there is no response? 8-12 weeks If the number of bacteria on a urinalysis are greater than ____________________, this is indicative of a UTI. 100,000 What are signs of a ruptured TM other than the obviously ruptured TM? muffled hearing and bright red blood in the canal Osgood Schlatter disease produces pain where? in the knees Growing pains usually occur when? at nighttime Children with complaints of midbone pain should be worked for what MNM differential? acute lymphocytic leukemia NSAIDs should be used in caution with what patient population? anyone with hypertension because they cause sodium retention and increase blood pressure What is the most common cause of secondary dysmenorrhea? endometriosis; symptoms include spotting in between periods, cervical stenosis or displacement, nodular or tender uterosacral ligaments When should AAA screening be performed via US? once for all males age 65-75 who have ever smoked What is responsible for the transmission of poison ivy? the oils from the plant itself. So the only way someone can pass it on to another person is if they still have oil from the plant on their skin (like if they haven't bathed). Note that the fluid inside the blisters is not contagious Actinic keratosis is a precursor for what? squamos cell carcinoma What is papilledema? swelling of the optic nerve and disc secondary to increased ICP. Often co-occurring with a headache Is sexual activity safe during pregnancy? it can expose someone to STDs and it can also stimulate preterm labor due to stimulation of the lower uterine segment and release of oxtocin [Show Less]
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APEA Predictor Exam Missed Questions with complete solutions
What is the biggest side effect of colchicine? diarrhea How would you describe the appearance of molluscum contagiosum? papules that are umbilicat... [Show More] ed and contain a caseous plug How do we treat a broken clavicle in an infant? no treatment; it should heal on it's own At what week of pregnancy is the uterus palpable just above the pubic symphysis? week 12 At what week of pregnancy is the fundus palpable halfway between the pubic symphysis and umbilicus? week 16 At what week of pregnancy is the fundus of the uterus at the umbilicus? week 20 At what week of pregnancy is the fundus of the uterus halfway between the xiphoid process and umbilicus? week 28 At what week of pregnancy is the fundus just below the xiphoid process? week 34 Increased sweat production is a sign of what endocrine disorder? hyperthyroidism What is Paget's disease? 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? bisphosphonates How should pregnant women wear their seatbelt? 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? parvovirus aka slapped cheek disease aka erythema infectiosum Which type of prevention are vaccinations? primary When should patients begin antiretroviral therapy for HIV infection? as soon as it is detected, even if in the acute phase What are the first generation antihistamines? diphenhydramine (benadryl) and chlorpeniramine (actifed) What are s/s of the secondary stage of syphilis? rash on hands and feet, lymphadenopathy, fever What is the recommended treatment for chronic bacterial prostatitis? a fluoroquinolone (cipro or levo) + bactrim What is the recommended treatment for acute prostatitis? cipro (if not STI related) or ceftriaxone What are s/s of an intraductal breast papilloma? 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? 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? in those who are on any type of nitrate or triptan because it could result in hypotension What class of drug is sildenafil (viagra)? 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? think P meaning pain, A meaning absent or weak pulses, eschar or shiny legs, intermittent claudication What is first line treatment for PAD? 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? do not elevate the feet; keep them down How do we diagnose PAD? 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? 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? 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? 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? decrease the weekly dose by 5-10% If a patient on coumadin's INR is 4.1-5.0, what should you do? hold one dose then decrease the weekly dose by 10% If a patient's INR is greater than 5, what should you do? consult cards, likely would hold two doses then decrease the weekly dose An anorexic patient will have a BMI of what? less than 18 What is primary amenorrhea? 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 3 months What do we need to do first when a patient comes in with secondary amenorrhea? rule out pregnancy Anorexia can put you at risk for what? osteoporosis, amenorrhea, cardiac damage Amenorrhea is considered a risk factor for what? 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? they get their period back If a pregnant woman has syphilis, what should we do? treat it with penicillin while she is pregnant because there is risk for spontaneous abortion What is the causative organism of mastitis? staph What is the first line treatment for mastitis? 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? numerous sexual partners Preeclampsia most commonly shows up at what time in pregnancy? around week 20 How do we treat UTIs in a pregnant woman? 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? about 10 days before menses What can be a sequelae of an ectopic pregnancy? pelvic inflammatory disease and infertility due to scarring of the fallopian tube (salpingitis) What is the Coomb's test and when is this completed? 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? 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? 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? IUD The vaginal ring for contraception must be taken out how often? every 3 weeks If a patient is on birth control and is currently having breakthrough bleeding, then what do we do? increase the progesterone How do we treat temporal arteritis? steroids If a patient is on birth control and they miss one pill, what should they do? double up If a patient is on birth control and they miss two pills, what should they do? 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? 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. mammogram; ultrasound When do we screen for group B strep in pregnancy? weeks 35-37 When do we perform alpha fetoprotein screening in pregnancy? 15-20 weeks Alpha fetoprotein screening in pregnancy can help determine the presence of what in pregnancy? spina bifida and anencephaly What is placenta previa? when the placenta blocks the cervical opening of the uterus What is placenta abruptio? when the placenta either fully or partially detaches from the uterine wall When does placental abruption most commonly occur? in the third trimester What is the major difference in symptomalogy between placenta abruptio and placenta previa? 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? placenta previa What is the recommended treatment for polymyalgia rheumatica? steroids Patients with SLE are going to have what abnormal labwork? elevated ESR and CRP How do we treat lupus flares? steroids What are common sequelae of fibromyalgia? insomnia and depression What is a great treatment option for fibromyalgia? amitriptyline (a TCA) because it helps with chronic pain, sleep, and depression How is fibromyalgia diagnosed? 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? when the femoral head of the hip is out of place What is the trendelenburg sign and when is it positive? 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? walking with a limp SCFE is most common in which patient population? adolescents What is legg-calve-perthe disease? avascular necrosis of the femoral head due to a lack of blood supply Legg-calve-perthes disease is most common in which patient population? young children What is the radiographic study of choice for the knee? MRI What is the radiographic study of choice for the back? x ray What is bursitis? a fluid collection in the bursa of a joint How is bursitis treated? a needle to instill intraarticular steroids and then pull off fluid Bursitis can be a __________ issue recurrent The medical term for knock knees genu valgum The medical term for bow legs genu varum What is myasthenia gravis? an autoimmune disorder that causes muscle weakness of the voluntary muscles Genu valgum is caused by a problem with what? the medial collateral ligament; think valgum as in gum makes your knees stick together Genu varum is caused by a problem with what? the lateral collateral ligament What are shin splints? a medial tibial syndrome caused by overuse of the muscles How do we treat shin splints? rest and avoidance of exercise until the pain resolves What is the tell-tale difference between a herniated disc and sciatica? sciatica feels better when you stand, a herniated disc feels better when you sit down When will spinal or lumbar stenosis feel better? when the patient sits down What is Korsakoff syndrome? a deficiency in thiamine and folate caused by alcoholism [Show Less]
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APEA QBank Practice Test Set #2 questions with answers 2023
What is the treatment of choice for community acquired, uncomplicated pneumonia? amoxicillin Vitamin B12 deficiency anemia is a type of ___________... [Show More] _ anemia. pernicious; macrocytic Prostate infection or inflammation can cause a sharp rise in PSA values. When should this value go back down to normal levels and be checked after an acute infection? 4 weeks The most common cause of atypical pneumonia in adults mycoplasma pneumoniae An herbal supplement thought to help BPH saw palmetto A male patient presents to your clinic with a lump in his breast. How should we work this up? clinical breast exam, mammogram, AND ultrasound If a patient with strep comes back after 48 hours with no improvement on antibiotics, what should you then prescribe? a penicillin or cephalosporin with beta lactamase coverage How long must a tick be attached to the skin in order for Lyme disease to be transferred? 48 hours When should kids be treated for hypertension? if they also have diabetes, are symptomatic, have hypertension > 95th percentile, or when end organ damage is present ACEIs can cause what electrolyte abnormality? hyperkalemia A positive "drop arm" test is a sign of what? torn rotator cuff The medical term for spoon shaped nails koilonychia Koilonychia is a sign of what? iron deficiency anemia How is influenza diagnosed? a nasal swab What finding would be most likely to differentiate gout from septic arthritis? fever would be indicative of septic arthritis Diphenhydramine has __________ properties and is contraindicated in which patient populations? anticholinergic; elderly and those with glaucoma The medical term for flat feet pes planus How does plantar fasciitis usually present? as pain in the morning with resolution after several steps, but as it worsens the patient will start to complain of heel pain throughout the day and with walking Scope of practice for NPs is not influenced by which entity? a court of law Used to establish a designated level of professional competence licensure Treatment of subclinical hypothyroidism is generally not indicated unless the TSH is ___________. greater than 10 In the presence of an elevated serum TSH, what is the next step in management? repeat TSH plus free T4 Patients with a history of UC or Crohn's should have a colonoscopy how often? every 1-5 years due to the increased risk of colorectal cancer What is the first line treatment for community acquired atypical pneumonia? macrolides such azithromycin. If the pt cannot take a macrolide, then they can do levofloxacin or doxycycline What is metatarsus adductus? the medical term for in-toeing What is true regarding older adults who are overweight? mortality in older adults related to overweight states declines over time How do we manage rubella immunity in pregnant women? we screen all pregnant women with a rubella titer. If they had a protective rubella titer in a previous pregnancy, then they do not need to be checked again. If they are found to not be immune when pregnant, then she should be vaccinated AFTER delivery How is permethrin applied to the skin for scabies? a one time application to all skin below the neck and then left on for 8-12 hours is sufficient After exposure to HIV, when will the patient seroconvert and become positive? 3 months Is age less than 18 years a risk factor for an ectopic pregnancy? no; but personal history of PID, an IUD, previous ectopic pregnancy, previous tubal surgery, pathology, or ligation all are risk factors What is Tanner stage 5 of breast development in females? projection of the nipple only What are two common classes of drugs that interact with grapefruit juice? statins and CCBs Ankle inversion is a common complaint from a patient with what? a lateral ankle sprain How can we best diagnose coarctation of the aorta? by comparing the upper and lower extremity blood pressures What is the most important risk factor for developing breast cancer in women of average risk? age hey stopped at top of page 7 What is the recommended treatment for blepharitis? erythromycin 1cm ribbon 5x daily for 7 days What is the recommended treatment for severe anorexia with delusions? 2nd atypical antipsychotics What lab values need to be monitored in a patient on Tizanidine? LFTs and BP at baseline and 1 month after the max dose is achieved (can cause hepatotoxicity and hypotension) What class of drug is dabigatran (pradaxa)? direct thrombin inhibitor The most effective treatments for acne related to increased sebum production are what? oral contraceptives and isotretinoin Oral contraceptive regimen in which both the estrogen and progesterone concentrations vary throughout the cycle quadriphasic Oral contraceptive regimen in which the estrogen and progestin doses are fixed throughout the cycle monophasic Oral contraceptive regimen in which in the estrogen dose remains the same for the first 21 days of the cycle, while progestin is lower in the first half and higher in the second half biphasic Oral contraceptive regimen in which the estrogen remains consistent and the progestin dose varies triphasic Patients who are receiving beta blockers may find what treatment for allergies ineffective? treatments containing epinephrine For a patient on warfarin who needs to receive a tetracycline antibiotic, how will we adjust their warfarin? tetracyclines depress prothrombin activity, same as warfarin, so we need to decrease the warfarin to avoid an increase in INR and significant bleeding What is the herbal, valerian root often used for? insomnia/sleep, ADHD, anxiety, depression What is the herbal, saw palmetto, often used for? BPH What is the herbal, black kohosh, often used for? symptoms of menopause - hot flashes What is the herbal, St. John's wart, often used for? depression What are the intrauterine transplacental infections that can be passed from mother to infant? think TORCH; toxoplasmosis, Other (syphilis, varicella zoster, parvovirus) Rubella, Cytomegalovirus and Herpes simplex, as well as tuberculosis. Note that chlamydia is NOT transplacental, but rather transvaginal during childbirth The antibiotic of choice for a dog bite augmentin; doxy if there is a penicillin allergy Obese women should gain how much weight during pregnancy? 11-20 pounds Overweight women should gain how much weight during pregnancy? 15-25 pounds Normal weight people should gain how much weight during pregnancy? 25-35 pounds Underweight people should gain how much weight during pregnancy? 28-40 pounds Pregnant women should increase their daily caloric intake by how many calories per day? 300 Immunizations are considered to be what level of prevention? primary Children can start to ride a tricycle around age _____ 3 A gray or white ring present around the peripheral iris arcus senilis What causes arcus senilis? it is a normal, benign condition with aging, but can also occur in younger people as a result of high cholesterol and triglycerides How is a diagnosis of neuroblastoma confirmed? via serum catecholamine testing and a biopsy Are saturated or unsaturated fatty acids better for you? unsaturated Which patient populations are thalassemias most common in? mediterranean countries (greece and turkey), asia, africa Is Meniere's disease most often unilateral or bilateral? unilateral What type of hearing loss occurs in Meniere's disease? sensorineural Dix Hallpike maneuver is the standard clinical test for _______ BPPV How do we test cerebellar function? rapid alternating movements, finger to nose test, balance (romberg), gait The first sign of puberty in girls thelarche (breast budding) When the uterine lining grows in to the uterine muscle wall adenomyosis; this is often asymptomatic and may result in heavier periods What are the 4 components of Tetralogy of Fallot? VSD, pulmonic stenosis, overriding aorta, right ventricular hypertrophy What does the murmur of Tet of Fallot sound like? harsh systolic murmur at the left upper sternal border What is a tet spell? when the child turns blue during crying or feeding How do we treat thrush in infants? application of nystatin to inside of the mouth, sterilize all pacifiers and bottle nipples; a topical antifungal may be applied to the nipples HMO and PPOs are called what? managed care plans TCAs can cause what worsened problem in a patient with BPH? urinary retention [Show Less]
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APEA Predictor Exam Missed Questions Part 2 questions and answers 2023
What is the recommended treatment for cat scratch disease? usually self-limiting and presents with lymphadenopathy that goes away on it's own; severe case... [Show More] s may benefit from azithromycin What is the most common cause of traveler's diarrhea? e coli What bacteria is responsible for causing cat scratch disease? bartonella henselae What are the 4 different components of tetralogy of fallot? overriding aorta, pulmonary stenosis, right ventricular hypertrophy, and a ventricular septal defect What does the murmur auscultated in tetralogy of fallot sound like? systolic murmur best heard at the left upper sternal border What does the murmur auscultated in a ventricular septal defect sound like? systolic murmur best heard at the left lower sternal border Where is the aorta best auscultated? at the second ICS to to the right of the sternum Where is the pulmonary artery best auscultated? at the second ICS to the left of the sternum What is a scotoma? a blind spot or aura that obstructs part of your vision Is presbyopia nearsightedness or farsightedness? farsightedness meaning it can be harder to see things up close, such as reading a newspaper and may need to hold it farther away or use reading glasses Is myopia nearsightedness or farsightedness? nearsightedness meaning it is hard to see things far away Do cataracts cause myopia or presbyopia? myopia; meaning nearsightedness and they make things blurry that are farther away which is why driving at night becomes difficult What is the USPSTF's recommendation on scoliosis screening for adolescents? insufficient When should adolescent girls be screened for scoliosis? as early as 10 years old and then again at age 12 When should adolescent boys be screening for scoliosis? between age 12-13 What is Auspitz sign? the appearance of small bleeding points after successive layers of scale have been removed from the surface of psoriatic papules or plaques A positive Auspitz sign is indicative of what? psoriasis When are pregnant women screening for gestational diabetes? week 24-28 What is round ligament pain? a deep, sharp, stabbing or stretching sensation that begins or worsens with movement and can be unilateral or bilateral. This is a normal and benign part of pregnancy What are the components of the fetal biophysical profile? nonstress test (heart rate monitoring), amniotic fluid analysis, fetal movements, fetal tone, and fetal breathing How is the fetal biophysical profile performed? via ultrasound and fetal heart rate monitoring When is the fetal biophysical profile often performed? in the third trimester, often after week 28-32 What is a normal kick count in pregnancy? at least 10 kicks in a consecutive two hour period How much weight should an underweight woman gain in pregnancy? 28-40 pounds How much weight should a normal weight woman gain in pregnancy? 25-35 pounds How much weight should an overweight woman gain in pregnancy? 15-25 pounds How much weight should an obese woman gain in pregnancy? 11-20 pounds Underweight and normal weight woman should be gaining how much weight per week in their second and third trimesters? 1 pound Overweight and obese women should be gaining how much weight per week in their second and third trimesters? 0.5 pounds What is the biggest risk associated with scabies? secondary infection due to itching What do scabies look like on the skin? red papular bumps that have s shaped burrows on them; may have fluid coming from them Sickle cell anemia is what type of anemia? normocytic How is sickle cell anemia diagnosed? hemoglobin electrophoresis Which age group is rheumatic fever most common in? children ages 5-15 What are the major symptoms of rheumatic fever? carditis, arthritis, chorea, erythema marginatum (rash), subcutaneous nodules What are the minor symptoms of rheumatic fever? fever, elevated ESR, prolonged PR interval How do we treat rheumatic fever? refer to the hospital What is chorea? abnormal involuntary movements What are the main s/s of rubeiola (measles) Koplick spots + the 3 c's - cough, coryza, conjunctivitis GABHS infection puts individuals at the highest risk of developing what sequelae? peritonsillar abscess, glomerulonephritis, rheumatic fever What is the diagnostic criteria for acute rheumatic fever? 2 major criteria OR 1 major + 2 minor criteria PLUS evidence of a recent strep infection When can a breastfeeding mother breast feed again after drinking alcohol? wait 2-3 hours per drink consumed before breastfeeding again Can a mother take methadone while pregnant and breastfeeding? yes Does subsequent mean before or after? after What is the recommended treatment for Kawasaki disease? refer to the ED, will likely need IVIG and high dose aspirin What are the s/s of Kawasaki disease? fever + CREAM (conjunctivitis, rash, erythema of palms and soles, adenopathy cervical, mucous membranes) Kawasaki disease is caused by what? an acute vasculitis of the small and medium blood vessels What is the main difference between Kawasaki disease and scarlet fever? KD has conjunctivitis and scarlet fever does not The rash associated with acute rheumatic fever erythema marginatum The rash associated with parvovirus aka slapped cheek aka fifth disease erythema infectiosum What does erythema marginatum of rheumatic fever look like? erythematous with a central clearing, not itchy The medical term for tennis elbow lateral epicondylitis What is the leading cause of death in anorexia? suicide Erikson stage from birth to 18 months trust vs mistrust Erikson stage from 18 months to 3 years autonomy vs shame and doubt Erikson stage from 3-5 years initiative vs guilt Erikson stage from 5-13 years industry vs inferiority Erikson stage from 13-21 years identity vs role confusion Erikson stage from 21-39 years intimacy vs isolation Erikson stage from 40-65 years generativity vs stagnation Erikson stage for 65 and older ego integrity vs despair Macrobid/nitrofurantoin is contraindicated in which patients? those with renal insufficiency Treatment options for complicated UTI cipro or levo x 5-7 days Treatment options for uncomplicated UTI bactrim x 3 days, macrobid x 5 days, fosfamycin 1g one time dose Olecranon bursitis is pain in which region of the elbow? the posterior elbow; will also have swelling and warmth Lateral epicondylitis manifests as what type of elbow pain? weak grip and pain with gripping, pain with rotation of the wrist and forearm The medical term for golfer's elbow medial epicondylitis How does the pain in lateral vs. medial epicondylitis differ? lateral epicondylitis is worse with supination of the hand and medial epicondylitis is worse with pronation of the hand involves tapping a finger along the problem nerve tinel sign asking the patient to place both elbows on a table while keeping both forearms vertical and flexing both wrists phalen sign Which nerve runs on the side of the thumb median nerve Which nerve runs on the side of the pinky finger ulnar nerve What is ankylosing spondylitis? an inflammatory condition affecting the spine causing chronic back pain and stiffness that improves with exercise and enthesitis What is the treatment for ankylosing spondylitis? refer to rheumatology for possible DMARDs What are the s/s of polymyalgia rheumatica? chronic pain in the proximal joints (shoulders and hips) bilaterally with stiffness lasting for more than 45 minutes What is the recommended treatment for polymyalgia rheumatica? PO steroids and refer to Rheumatology to confirm the diagnosis Where are the biggest food sources of vitamin B12? fish, meat, poultry, eggs, and dairy products, also fortified breakfast cereals and fortified nutritional yeasts What is the gold standard for the diagnosis of herpes? nucleic acid amplification test Most cases of acute sinusitis are viral and how can we treat them? treat the symptoms with intranasal steroids and saline rinses What is the difference between chronic vs gestational hypertension? chronic htn is present before 20 weeks gestation or 12 weeks after delivery; gestational hypertension is after 20 weeks gestation Which is the recommended diagnostic when a patient has a breast lump? if less than 45, do an ultrasound. if older than 45, do a diagnostic mammogram. An overactive bladder is what type of incontinence? urge incontinence What is the recommended treatment for urge incontinence? anticholinergics like oxybutynin What is the recommended treatment for stress incontinence? alpha agonists like sudafed, TCAs What is the recommended treatment for BPH? alpha blockers like terazosin, doxazosin, tamsulosin Alcohol and marijuana worsen which type of incontinence? urge Which SSRI is safest in pregnancy? Which poses the most risk? sertraline; paroxetine Infants born to women who smoke are at increased risk for what? low birth weight and preterm delivery What is the best marker of an acute MI? troponin When do troponins peak after a MI? 12 hours When should an infant be able to display a conjugate gaze (track you all the way across the room)? 6 months Which medication is approved in Peds for the prevention of febrile seizures? diazepam Folic acid is which vitamin? vitamin B9 What is the dosage preferred for folic acid deficiency? 1-5mg daily Dosage of folic acid in pregnancy to prevent neural tube defects 400mcg daily What are ECG changes you may see on a patient with hypokalemia? tachyarrhythmas, ST depression, prolonged QT, and U wave present What are ECG changes you may see on a patient with hyperkalemia? peaked T waves A U wave present on EKG is thought to represent what? repolarization of the purkinje fibers What is considered legal blindness? 20/200 or worse What is the pain of temporal arteritis like? new onset headache, jaw pain with chewing Are nexplanon and norplant (levonorgestrol) combined contraceptives or progesterone only? progesterone only [Show Less]
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APEA Predictor Exam Missed Questions Part 3 100% correct answers
When should pediatrics be screened for hyperlipidemia? between 9 and 11 years old What is the tell-tale symptom of endometriosis? progressive dysm... [Show More] enorrhea What is treatment for first-line endometriosis? cyclic OCPs and NSAIDs How is endometriosis diagnosed? via transvaginal ultrasound What are risk factors for the development of cervical cancer? HIV, immunocompromised, low socioeconomic status, smoking, hispanic, DES daughters, long term contraceptive use What does the D in melanoma stand for? greater than 6mm in diameter or 1/4 of an inch Boutonniere deformities are indicative of what disease? rheumatoid arthritis What are the potassium sparing diuretics? spironolactone, triamterene, amiloride, eplenerone What class of diuretic is bumetanide? a loop diuretic, same as lasix What is Chovstek's sign? a contraction of ipsilateral facial muscles subsequent to percussion over the facial nerve, indicative of hypocalcemia What is Trousseau's sign? a carpopedal spasm induced by ischemia secondary to the inflation of a sphygmomanometer cuff, indicative of hypocalcemia Calcium is in an inverse relationship with what electrolyte? phosphorous When you see the trigger word "christmas tree", what rash should you consider? pityriasis rosea What is the recommended treatment for pityriasis rosea? nothing; it is a viral rash and can last up to two months before clearing on it's own Causing harm or damage deleterious How do you calculate ideal body weight for men? start at 106 pounds and then add 6 for every inch above 5 feet How is lichen sclerosus treated? topical steroids, topical calcineuronin inhibitors to suppress the immune system, topical or oral retinoids, phototherapy What is the tell-tale sign of malignant hypertension? retinopathy and blurred vision; characterized by a diastolic BP of greater than 130 What is the difference between a Parkinsonian tremor and an essential tremor? a Parkinson tremor is also known as a resting tremor and is seen at rest, may look like pill-rolling. an essential tremor is bilateral, symmetric and seen when the hands are doing something What can worsen and improve an essential tremor? worsened by stress or fatigue, improved by alcohol What is first-line treatment for trigeminal neuralgia? carbamazepine (tegretol) or amtriptyline Are Parkinsonian tremors unilateral or bilateral at first? unilateral Where is the TMJ best palpated? anterior to the tragus What are the primary bacteria in dog bites? staph, strep, and pasteurella What is the gold standard treatment of giant cell arteritis? oral steroids and potential artery biopsy by rheum Who is a candidate for Truvada for Prep? if you are an IV drug user, have had a sexual partner with HIV in the last 6 months, do not consistently use a condom and engage in anal or vaginal sex, or have been diagnosed with a STD in the last 6 months Post exposure prophylaxis for someone with HIV should be completed when? within 72 hours of the exposure Who should be screened for HIV? everyone at least once from age 13-64 if low risk, and then more frequently if high risk Should patients undergo gonorrhea testing to confirm a cure after receiving treatment? only if they had pharyngeal gonorrhea, not vaginal or anal Tanner stage 1 female breast developmental prepubertal Tanner stage 2 female breast development thelarche; the breasts bud as a small mound and the areola increases in diameter Tanner stage 3 female breast development the areola, breast, and nipple grow together in one mount Tanner stage 4 female breast development the areola and nipple separate from the breast to form a secondary mound Tanner stage 5 female breast development mature nipples project only Tanner stage 1 male genital development prepubertal Tanner stage 2 male genital development testicles and scrotum enlarge Tanner stage 3 male genital development testicles continue to enlarge and the penis lengthens Tanner stage 4 male genital development penis lengthens, testicles enlarge, and the scrotum darkens Tanner stage 5 male genital development mature Antibiotic of choice for lyme disease doxycycline Antibiotic of choice for cellulitis keflex or cefdinir Antibiotic of choice for chlamydia azithromycin Antibiotic of choice for syphilis penicillin G Antibiotic of choice for bacterial vaginosis flagyl Antibiotic of choice for trichomoniasis flagyl Antibiotic of choice for acute prostatitis cipro (or ceftriaxone if STI related) Antibiotic of choice for PID ceftriaxone and doxycycline Antibiotic of choice for pyelonephritis cephalexin or bactrim Antibiotic of choice for MRSA bactrim, clindamycin, doxycycline Antibiotic of choice for dog or cat bite augmentin Antibiotic of choice for mastitis keflex Antibiotic of choice for chronic bacterial prostatitis bactrim plus cipro or levo What is the earliest sign of diabetic nephropathy on labwork? microalbuminuria in the urine Recommended treatment for verruca (warts) topical salicylic acid daily x 12 weeks Perineal pain is indicative of what in males? prostatitis [Show Less]
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APEA GASTRO QUESTIONS AND ANSWERS 2023
Metoclopramide (Reglan), an antiemetic, increases gastric motility by: blocking dopamine and serotonin receptors and enhancing the action of acetylcholine... [Show More] The class of medications most useful in the tx of chemo induced nausea and vomiting is the: Serotonin receptor antagonists-5-HT3 receptors antagonists ending in -setron The length of tx for oral metoclopramide should not exceed: 12 weeks, for adult use only, risk the development of tardive dyskinesia For pts who didn't respond to an initial course of triple therapy for H. pylori, an alternate regimen should be prescribed. It would include a PPI &: Metronidazole & tetracycline The following medication should not be administered concomitantly with clopidogrel (Plavix): Omeprazole (Prilosec)-reduces the effect of Plavix by blocking the conversion to its active form The most commonly reported side effect of metronidazole and clarithromycin combination therapy for H. pylori is: metallic taste H. pylori is naturally resistant to: Trimethoprim/sulfamethoxazole (Bactrim) Which of the following medications is classified as n antihistamine and a phenothiazine? Promethazine (Phenergan) In addition to metoclopramide (Reglan), another prokinetic drug used to improve gastric motility is: Erythromycin base (Ery-tab)-enhance emptying the stomach and/or gut and enhance the contractions of the gut The plasma elimination half-life of esomeprazole (Nexium) is: 1-1.5 hours Promethazine (Phenergan) should not be used in children younger than 2 years due to: respiratory depression-1st gen antihistamine A pt who has failed 2 courses of therapy for H. pylori should: Receive reinforced education about compliance with meds-often times the cause of tx failure Rabeprazole (Aciphex), used in the tx of reflux, is classified as a(n): PPI The brand name for famotidine is: Pepcid Pts should be advised to remove the scopolamine patch if an adverse reaction occurs, such as: Confusion Which therapy should be initiated in a pt with moderate C. dif infection who has failed to respond to tx with metronidazole (Flagyl)? Oral vancomycin-indicated for the tx of initial episode of mild to mod infection Scopolamine (Transderm-Scop) is indicated for the tx of nausea and vomiting associated with: Motion sickness Promethazine (Phenergan), a 1st gen antihistamine, is contraindicated in the presence of: Asthma Oral promethazine used for the tx of nausea and vomiting should be administered as needed every: 4 hours The scopolamine patch should be applied: Behind the ear Corticosteroids, used in the tx of ulcerative colitis, usually do NOT: Increase the effectiveness of antibiotics-decreases effectiveness The brand name for esomeprazole is: Nexium The antibiotics in triple therapy for the tx of H. pylori should be administered: Twice daily Corticosteroids, used in the tx of ulcerative colitis, are produced by the: Adrenal glands Ondansetron (Zofran) dosage should be adjusted in pts: With hepatic impairment-5-HT3 receptor antagonists dose limited in hepatic impairment Anticholinergic agents reduce nausea and vomiting by antagonizing the: Muscarinic receptors The brand name for prochlorperazine maleate is: Compazine Infliximab (Remicade), a tumor necrosis factor inhibitor, is: Used to tx Crohn's disease in children Lubiprostone (Amitiza), used in the tx of chronic constipation, is contraindicated in pts who have: Suspected mechanical bowel obstruction The brand name for metoclopramide, an antiemetic, is: Reglan Which of the following medications used for the tx of GERD works by neutralizing hydrochloric (HCl) acid in the stomach to rapidly increase gastric pH? Calcium carbonate (Tums) The medication class indicated for the intermittent (on-demand) relief of mild gastroesophageal reflux is: antacids Side effects related to transdermal scopolamine may include: Urinary retention Oral metoclopramide is contraindicated in the patient diagnosed with: Epilepsy Which of the following is NOT a 5-HT3 receptor antagonist? Prochlorperazine (Compazine) The brand name of pantoprazole is: Protonix The medication that suppresses vestibular end-organ receptors and inhibits activation of central cholinergic pathways is: Meclizine (Antivert)-1st gen antihistamine The 1st line regimen for the tx of H. pylori is a PPI plus: Amoxicillin & clarithromycin Histamine receptor antagonists (H2RA), such as famotidine (Pepcid), inhibit acid secretions by: Blocking the parietal cells (acid-producers) from responding to histamine Prior to the initiation of long-term tx with a PPI and periodically during therapy, the NP should monitor serum: Mag-reduced intestinal absorption has led to hypomagnesemia The recommended duration of therapy for eradication of H. pylori is: 14 days-most effective Hyperosmotic agents and saline laxatives should be avoided or used with caution in pts who have: Heart failure-may seriously alter fluid and electrolyte balance In the pt with an allergy to penicillin, tx of H. pylori would include a PPI plus: Metronidazole & clarithromycin The dose of prochlorperazine should be initiated at the lowest dose and titrated slowly in: A 70-year old man [Show Less]
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APEA EENT of 2023 test scored A+
For tx of blepharitis, pts should be instructed to apply erythromycin ointment to the affected eye using: A 1 cm ribbon 5 times daily for 7 days Th... [Show More] e ophthalmic preparation that is NOT available OTC is: Hydroxypropyl cellulose (Lacrisert), a lubricant Oseltamivir (Tamiflu) is an antiviral agent, further classified as a(n): Neuraminidase inhibitor The duration of action of ocular decongestants such as oxymetazoline (Visine-LR) is approximately: 6 hours-pts should be advised to apply 1-2 drops in the affected eye q 6 hours The mechanism of action for macrolides is to: block the dissociation of peptidyl tRNA from ribosomes 2nd generation antihistamines: have a variety of anti-inflammatory properties-including decreased mast cell mediator properties and downregulation of adhesion molecule expression After the administration of olopatadine (Pataday) ophthalmic for allergic conjunctivitis, contact lenses should not be inserted for at least: 10 minutes-do not insert if eyes are red Which of the following is NOT a mechanism of action of ocular steroids? Promotes capillary proliferation and dilation The mechanism of action of polymyxin B/trimethoprim ophthalmic is: Increased cell wall permeability/inhibition of nucleic acid and protein synthesis Sulfacetamide/prednisolone (Blephamide) is NOT indicated in: Ocular mycobacterial infection (ocular tuberculosis) The mechanism of action of pheniramine is that it: Antagonized histamine-1 receptors The duration of action of meclizine (Antivert) is: 8 hours-1st gen antihistamine , onset ~1 hr with half-life of 6 hours The mechanism of action for mast cell stabilizers is: Inhibition of histamine release and slow reacting substances of anaphylaxis The brand name for sulfacetamide ophthalmic is: Bleph-10 The vasoconstrictive properties of alpha- agonist medications make them beneficial for the tx of: Sinus congestion-used to reduce edema and inflammation within sinus cavities The generic name for Dramamine is: Dimehydrinate Which risk factor would NOT prohibit the NP from prescribing prednisolone acetate (Pred Forte)? Superficial punctate keratitis Which of the following organisms is NOT susceptible to sulfacetamide ophthalmic (Bleph-10)? Psuedomonas aeruginosa- does not provide adequate coverage against Neisseria species A medication that acts on the hypothalamus to produce antipyresis is: Acetaminophen Azelasine (Astelin), for tx of allergic rhinitis, is classified as a nasal: Antihistamine A serious adverse reaction to clindamycin (Cleocin) is: Clostridium difficile-related colitis If ocular steroids are to be used for more than 10 days, monitoring should include: Ocular pressure The most effective tx for eradication of group A streptococcus in those who are apparent carriers is: Oral clindamycin (Cleocin) for 10 days Oxymetazoline nasal spray, a nasal decongestant, is manufactured under the brand name: Afrin Which of the following is a cholinergic agonist used in the tx of glaucoma? Pilocarpine (Pilopine HS) ophthalmic A common side effect related to the administration of cetirizine (Zyrtec) is: Drowsiness-admin at bedtime The onset of action of oxymetazoline (Afrin) is: 1o minutes, 2-3 sprays in each nostril q 10-12 hours First-line tx for children who are diagnosed with Strep pharyngitis is: Amoxicillin (Amoxil) Brand names of sulfamethoxazole/trimethoprim do NOT include: Azulfidine (sulfasalazine) The duration of action of azelastine (Optivar) ophthalmic drops is: 8 hours Naphazoline/pheniramine (Naphcon-A) is indicated in the treatment of: Allergic conjunctivitis Ocular steroids indicated for the tx of allergic conjunctivitis can be used in pts with: Herpes zoster keratitis Polycin-B is the brand name for: Polymyxin B and bacitracin The brand name for meclizine is: Antivert Due to potential drug-drug interactions, therapy should be monitored when a pt is receiving erythromycin (Eyemycin) ointment and: Warfarin-may increase serum concentration of Vit K antagonists such as warfarin Due to the potential development of pseudo tumor cerebri, tetracycline (Sumycin) should not be administered concomitantly with: Isotretinoin (Claravis)-may enhance the adverse/toxic effect of retinoic acid derivatives [Show Less]
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