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3P APEA EXAM PREPARATION GUIDE:
COMPREHENSIVE PRACTICE
QUESTIONS AND DETAILED
RATIONALES FOR CERTIFICATION
SUCCESS
symptoms of hyperglycemia - - -- ANSWER>>> --polyuria, polydipsia,
polyphagia a patient sustained facial trauma and has nose pain, NP should obtain nasal bone
xrays if what is present - - -- ANSWER>>> --septal hematoma, deviation of
septum NOT if tenderness and swelling is secluded to nasal bony bridge
urine loss associated with laughing, sneezing, coughing is called - - --
ANSWER>>> --stress incontinence
initial evaluation of this includes - - -- ANSWER>>> --bladder stress test- stands
with full bladder, and coughs or performs valsalva maneuver
functional incontinence - - -- ANSWER>>> --inability to get to the toilet
overflow incontinence - - -- ANSWER>>> --enlarged bladder and volume
leakage overflow
urge incontinence - - -- ANSWER>>> --incontinence w urge to void
bipolar disorder- manic behavior - - -- ANSWER>>> --increased sexuality
- disinhibition by removing clothing when not asked
- flight of ideas WITHOUT organization
- loud rapid speech that is IMPOSSIBLE to interrupt
what does a normal cervix during pregnancy look like - - -- ANSWER>>> --
bluish cervix with friability due to increased vascularity
normal non pregnant cervix looks like - - -- ANSWER>>> --pink color
best physical assessment to rule out a high ankle sprain - - -- ANSWER>>> --
squeeze tests compression of tibia and fibula together suggests ligament damage and high ankle sprain
thompson test - - -- ANSWER>>> --assesses achilles tendon
what is the diagnostic you would do for this - - -- ANSWER>>> --upper
endoscopy can't feel fetal butt or head at maternal fundus during leopold maneuver what is
the position of the baby then - - -- ANSWER>>> --transverse lie presentation
(side ways horizontal)
Charcot's triad - - -- ANSWER>>> --abdominal pain, fever, jaundice
acute colangitis need ERCP
PAD - - -- ANSWER>>> --pale/white when elevated
red when lowered
PVD - - -- ANSWER>>> --hyperpigmentation, dryness, tightness
regular screening for colorectal cancer starts when - - -- ANSWER>>> --
between 45- 75 and select few over the age of 75
Apley scratch test procedure - - -- ANSWER>>> --touch hand to opposite
scapula from above and below as if scratching back
assesses rotator cuff disorders and capsulitis
physical exam finding of trichomoniasis - - -- ANSWER>>> --erythematous
vaginal mucosa with small red spots
workup for new schizophrenia - - -- ANSWER>>> --Mental status exam
EEG
MRI of brain CBC CMP
screen for depression - - -- ANSWER>>> --ABG, LFTs, electrolytes, ACTH for
possible addisons disease dexamethasone suppression for cushing blood alcohol urine tocx
pilonidal cyst - - -- ANSWER>>> --small tuft of hair surrounded by halo of
erythema in crack
renal agenesis - - -- ANSWER>>> --absence of one or both kidneys
what is one assessing when they place the ball of their hand over a patient's chest
- -- ANSWER>>> --thrills- buzzing or vibrating sensations caused by turbulent blood flow due to heart murmurs or aortic insufficency heaves- use entire fingerpad or palm over chest wall
tinea corporis - - -- ANSWER>>> --ringworm of the body
pruritic, scaly, erythematous plaques on the back from contact w animals
acrocyanosis - - -- ANSWER>>> --Temporary cyanotic condition, usually in
newborns resulting in a bluish color around the lips, hands and fingernails, feet and toenails. May last for a few hours and disappear with warming.
what's a risk factor for asthma - - -- ANSWER>>> --prematurity, GERD, obesity,
air pollution, second hand smoke, animals, pollens
neurogenic claudication - - -- ANSWER>>> --pain with walking or prolonged
standing, radiating from the spinal area into the buttocks, thighs,lower legs, or feet pain relieved with squatting
normal wet diapers per day for a child - - -- ANSWER>>> -- 6 - 8
if patient has elevated PSA test and abnormal digital rectal exam next diagnostic
is - - -- ANSWER>>> --MRI guides decision for biopsy
when should one screen for prostate CA - - -- ANSWER>>> -- 55 - 70
scotomas - - -- ANSWER>>> --fixed specks or defects
Rosving sign - - -- ANSWER>>> --RLQ pain intensified during LLQ palpation-
associated with peritoneal irritation & appendicitis
psoas sign - - -- ANSWER>>> --RLQ pain with extension of right thigh indicative
of appendicitis
obturator sign - - -- ANSWER>>> --RLQ on internal rotation of right thigh
indicative of appendicitis
cephalhematoma - - -- ANSWER>>> --collection of blood between periosteum
and skull bone that it covers does not cross suture line results from trauma during birth caused by rupture of blood vessels and disappear
primary vs central adrenal insufficency - - -- ANSWER>>> --central: caused by
underlying pituitary deficiency, causing delayed weight gain and grwoth primary: salt cravings, postural dizziness, hyperpigmentation of elbows and knees due to mineralcoticoid deficiency
Koplik spots - - -- ANSWER>>> --small, blue-white spots with red halo over oral
mucosa; early sign of measles 1 - 3 mm white lesions w buccal mucosa surrounded by erythematous bases
which patient is highest risk of developing pneumonia - - -- ANSWER>>> ---
seizure history
- under 5 or > 65
- long term care facility
- asthma
- chronic lung disease
- diabetes
- immunosuppression
- or daily asa use in kids < 19 which of the following locations is best to assess aortic pulsations in a patient who
has a carotid obstruction - - -- ANSWER>>> --brachial artery
NOT TEMPORAL ARTERY
OBSTRUCTED nasolacrimal duct is called - - -- ANSWER>>> --canaliculitis
causing discharge from the puncta or corner of the eye
pinguecula - - -- ANSWER>>> --yellowish mass on the conjunctiva that may be
related to exposure to ultraviolet light, dry climates, and dust
blepharitis - - -- ANSWER>>> --inflammation of the glands and eyelash follicles
along the margin of the eyelids
tracheomalacia - - -- ANSWER>>> --weakness of the trachea
if the trachea is narrowed due to accumulation of granulation tissue it is called - - -
- ANSWER>>> --tracheal stenosis
cryptochorchidism - - -- ANSWER>>> --undescended testicles
should descend on own by 4 months old if the R testis is absent w palpation of the scrotal sack on a full term infant, which
of the following historical findings is most likely - - -- ANSWER>>> --low birth
weight inguinal hernia small for gestational age family hx
what about a large decrease - - -- ANSWER>>> --osteoporosis
> 2.5 standard deviations below the young adult mean to qualify
what dermatome is associated w umbilicus - - -- ANSWER>>> --T
nipples - - -- ANSWER>>> --T
knee - - -- ANSWER>>> --L
neck - - -- ANSWER>>> --C
oral glucose tolerance test is done when - - -- ANSWER>>> --initial screening
for all pregnant women between 24-28 weeks
ankylosing spondylitis - - -- ANSWER>>> --a form of rheumatoid arthritis that
primarily causes inflammation of the joints between the vertebrae improvement w exercise no improvement w rest gradual onset
smegma - - -- ANSWER>>> --thick, cheesy secretion that accumulates under
the labia minora of the male foreskin
causing infection or balanitis
best position for patient to auscultate for aortic insufficiency - - --
ANSWER>>> --sitting up leaning forward and exhaling
how about for aortic regurgitation - - -- ANSWER>>> --sitting, leaning forward
and holding their breath after exhalation
what about for cardiomyopathy - - -- ANSWER>>> --increases with valsalva
what condition can develop from high serum lead levels - - -- ANSWER>>> --
anemia
hematochezia causes what symptoms - - -- ANSWER>>> --asymptomatic
likely from adenomatous polyps
onycholysis - - -- ANSWER>>> --Lifting of the nail plate from the nail bed
without pain due to trauma
typical or classic migraines - - -- ANSWER>>> --unilateral pulsating pain
aggravated by bright lights and loud noises
which would produce resonance on percussion of the chest - - -- ANSWER>>> -
- simple chronic bronchitis COPD- hyperresonance pna and pleural effusion- dullness w percussion WILL HAVE DECREASED OR ABSENT BREATH SOUNDS WITH PNA OR PLEURAL EFFUSION
what is legal blindness - - -- ANSWER>>> --20/200 or worse in the better eye w
corrected lenses
wilms tumor - - -- ANSWER>>> --malignant tumor of the kidney occurring in
childhood
spermatocele of epididymis - - -- ANSWER>>> --painless movable cystic mass
above testicle
varicocele feels like - - -- ANSWER>>> --soft bag of worms
pacemaker failure symptoms - - -- ANSWER>>> --hiccups, dizziness, syncope,
palpitations
ethmoidal sinuses - - -- ANSWER>>> --between the eyes
risk factor for MS - - -- ANSWER>>> --northern european descent
female at birth
family hx
blinking cranial nerve - - -- ANSWER>>> --cranial nerve V
common symptoms of early aortic stenosis - - -- ANSWER>>> --exertional
angina and dizziness
bullous myringitis - - -- ANSWER>>> --Small vesicles containing blood on the
drum; accompany mucoplasma pneumonia and virus infections can cause hearing loss and blood tinged discharge, not really fever
Brudzinski's sign - - -- ANSWER>>> --Severe neck stiffness causes a patient's
hips and knees to flex when the neck is flexed.
Normal CV finding on well child exam in healthy preschooler - - --
ANSWER>>> --vibratory quality murmur
how does 12 mo old communicate - - -- ANSWER>>> --say one word w
meaning point to objects follow one step commands with gestures
secondary enuresis - - -- ANSWER>>> --occurs in a child who has had at least 6
months of nighttime dryness but now has incontience
symptoms of HELLP syndrome - - -- ANSWER>>> --upper abodminal pain, RUQ,
MID EPIGASTRIC, N/V/MALAISE, VISION CHANGES, PROTEINURIA, HTN
turner syndrome - - -- ANSWER>>> --A chromosomal disorder in females
causes webbing of neck, short stature, wide spaced nipples
neonatal hyperbilirubinemia is more common in which newborns - - --
ANSWER>>> --those w down synrome
exclusively breast feeding, preamture
glomerulonephritis assessment findings - - -- ANSWER>>> --azotemia, foamy
urine due to proteinuria also HTN, weightloss
ankle brachial index tests - - -- ANSWER>>> --tests risk for pAD
compares BP in ankle and arm lowindex suggests narrowing or blockage of arteries
impetigo - - -- ANSWER>>> --bacterial skin infection characterized by isolated
pustules that become crusted and rupture
vitiligo - - -- ANSWER>>> --localized loss of skin pigmentation characterized by
milk-white patches
risk factor for latent TB - - -- ANSWER>>> --homeless
or lived in correctional facility
rheumatic fever - - -- ANSWER>>> --can get joint pain that migrates from joint
to joint commonly the first metatarsophalangeal joint
early early sx of varicella - - -- ANSWER>>> --loss of appetite
fever malaise sore throat rash then develops within 24 hours
COPD lung sounds may sound like - - -- ANSWER>>> --early inspiratory crackles
gold standard for diagnosing bladder cancer - - -- ANSWER>>> --cystoscopy
how to assess abdomen - - -- ANSWER>>> --inspect
auscultate percuss palpate should assess size of liver on R side percuss for splenic enlargement using traube's space
