APEA 3P PREP-GL EXAM WITH VERIFIED QUESTIONS AND ANSWERS
An 83-year-old patient is diagnosed with diverticulitis. The most common
complaint is:
rectal
... [Show More] bleeding.
bloating and
cramping.
left lower quadrant pain.
frequentbelchingand
flatulence.
C.
Diverticular disease is more common in older adults. About 70% of
patients diagnosed with diverticulitis have left lower quadrant pain.
Rectal bleeding may have varied etiologies, such as rectal carcinoma or
hemorrhoids. Bloating and cramping are often found in patients with
diverticular disease (diverticulosis) but not specifically diverticulitis.
Belching and flatulence arenot specifically associatedwith diverticulosis.
What is true regarding older adults who are overweight?
This is clearly associated with increased mortality in older
adults. Mortality in older adults related to overweight states
declines over time.BMI is a good way to assess nutritional
status in older adults.
There are nopotential metabolic or functional benefits to weight loss in
olderadults.B.
Overweight and obese states are not as important in predicting mortality
in older adults as they are in their younger counterparts. After age 65
years (some studies demonstrate after age 70), weight is less significant
in decreasing risk for mortalitythan in younger adults. There are some
benefits to weight loss in the obese older adults. One of them is better
balance and decreased risk for falls. Others include less sleep apnea,
decreased risk of diabetes, and decreased rates of shortness of breath
with respiratory and cardiac diseases.
The relationship between colon polyps and colon cancer is those polyps:
eventually, all become malignant.
have a slow progression to colon
cancer. have a rapid progression to
colon cancer.have no relationship to
colon cancer.
B.
Colon polyps are usually slow-growing and take a long time to progress to
cancer. This is the reason that a colonoscopy does not need to be
repeated annually. Whilenot all polyps grow slowly, this is the usual
progression.
A 5-year-old has been diagnosed with pinworms. He lives with his mother.
There areno other members of the household. How should his mother be
managed?
Reassure the mother that if she develops symptoms, she will need to be
treated.Visually assess the mother’s rectum for redness or presence of
worms.
Have the mother collect a stool specimen and send it to the
laboratory. Perform the “scotchtape” test andlook at the collection
under the microscope.D.
The diagnosis of pinworms (Enterobiasis) is made by using a piece of
scotch tape ona tongue depressor. It is touched against the patient’s
rectum. The greatest yield of eggs will occur during the nighttime or early
AM. Eggs will be found here if they are present. Worms and eggs are
rarely found in stool specimens, so this is not a good plan. When the
scotch tape is examined under a low power microscope, the eggs will be
easily visualized since they are large and bean shaped. The finding of an
adult worm would confirm the diagnosis. These are large enough to be
seen with
the naked eye. If the mother is symptomatic, she should be treated with
or withouta rectal exam. It is very likely she is infected.
A patient has been diagnosed with hepatitis B. The most commonly
reported riskfactor is:
drinking contaminated
water.eating
contaminated food.
exposure toblood.
sexual
exposure.
D.
Hepatitis B is transmitted by blood and body fluids. While exposure to
infected blood or blood products would significantly increase the risk of
infection in unvaccinated people, this is much less likely than becoming
infected via sexual exposure or IV drug use. Hepatitis A is transmitted
via fecal-oral routes. Drinkingcontaminated water and eating
contaminated food implicate hepatitis A as the etiologic agent.
The three most common causes of bacterial diarrhea in the US are
Salmonella,Campylobacter, and:
E. coli.
Enteroviru
s.Yersinia.
Shigell
a.D.
Shigella will be shed continuously in the stool and should be easily
identified on stool culture. When bacterial gastroenteritis is suspected, a
stool specimen could beordered for confirmation. Generally, these three
pathogens are easily identified if they are present. Enterovirus produces
a viral form of diarrhea. Yersinia produces the deadly disease called
bubonic plague. E. coli is atypical colonic pathogen.
What medication used to treat patients who have GERD provides the fastest
relief ofheartburn symptoms?
Calcium
carbonate
Ranitidine
Amantadine
Pantoprazole
A.
Calcium carbonate is an antacid. It provides rapid changes in gastric pH.
This provides relief that can be noticed immediately. The increase in pH
lasts for about30 minutes and corresponds with resolution of
symptoms. However, as pH decreases within 30 minutes, symptoms may
return. Ranitidine is an H2 blocker. Itprovides relief in 1-2 hours. This
usually lasts for about 6-12 hours. Amantadine is an antiviral not used to
treat GERD. Pantoprazole is a proton pump inhibitor. This provides relief [Show Less]