APEA PREDICTOR EXAM 2024/2025 WITH 100% ACCURATE SOLUTIONS, Exams of Nursing

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APEA PREDICTOR EXAM 2024/

WITH 100% ACCURATE SOLUTIONS

APEA PREDICTOR EXAM 2024/

WITH 100% ACCURATE SOLUTIONS

What is the biggest side effect of colchicine? - PRECISE ANSWER ✔✔ diarrhea How would you describe the appearance of molluscum contagiosum? - PRECISE ANSWER ✔✔ papules that are umbilicated and contain a caseous plug How do we treat a broken clavicle in an infant? - PRECISE ANSWER ✔✔ no treatment; it should heal on it's own At what week of pregnancy is the uterus palpable just above the pubic symphysis? - PRECISE ANSWER ✔✔ week 12 At what week of pregnancy is the fundus palpable halfway between the pubic symphysis and umbilicus? - PRECISE ANSWER ✔✔ week 16 At what week of pregnancy is the fundus of the uterus at the umbilicus? - PRECISE ANSWER ✔✔ week 20 At what week of pregnancy is the fundus of the uterus halfway between the xiphoid process and umbilicus? - PRECISE ANSWER ✔✔ week 28

At what week of pregnancy is the fundus just below the xiphoid process? - PRECISE ANSWER ✔✔ week 34 Increased sweat production is a sign of what endocrine disorder? - PRECISE ANSWER ✔✔ hyperthyroidism What is Paget's disease? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ bisphosphonates How should pregnant women wear their seatbelt? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ parvovirus aka slapped cheek disease aka erythema infectiosum Which type of prevention are vaccinations? - PRECISE ANSWER ✔✔ primary When should patients begin antiretroviral therapy for HIV infection? - PRECISE ANSWER ✔✔ as soon as it is detected, even if in the acute phase

What are the first generation antihistamines? - PRECISE ANSWER ✔✔ diphenhydramine (benadryl) and chlorpeniramine (actifed) What are s/s of the secondary stage of syphilis? - PRECISE ANSWER ✔✔ rash on hands and feet, lymphadenopathy, fever What is the recommended treatment for chronic bacterial prostatitis? - PRECISE ANSWER ✔✔ a fluoroquinolone (cipro or levo) + bactrim What is the recommended treatment for acute prostatitis? - PRECISE ANSWER ✔✔ cipro (if not STI related) or ceftriaxone What are s/s of an intraductal breast papilloma? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ in those who are on any type of nitrate or triptan because it could result in hypotension What class of drug is sildenafil (viagra)? - PRECISE ANSWER ✔✔ a PDE 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? - PRECISE ANSWER ✔✔ think P meaning pain, A meaning absent or weak pulses, eschar or shiny legs, intermittent claudication What is first line treatment for PAD? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ do not elevate the feet; keep them down How do we diagnose PAD? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ decrease the weekly dose by 5-10% If a patient on coumadin's INR is 4.1-5.0, what should you do? - PRECISE ANSWER ✔✔ hold one dose then decrease the weekly dose by 10% If a patient's INR is greater than 5, what should you do? - PRECISE ANSWER ✔✔ consult cards, likely would hold two doses then decrease the weekly dose An anorexic patient will have a BMI of what? - PRECISE ANSWER ✔✔ less than 18 What is primary amenorrhea? - PRECISE ANSWER ✔✔ 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 - PRECISE ANSWER ✔✔ 3 months What do we need to do first when a patient comes in with secondary amenorrhea? - PRECISE ANSWER ✔✔ rule out pregnancy

Anorexia can put you at risk for what? - PRECISE ANSWER ✔✔ osteoporosis, amenorrhea, cardiac damage Amenorrhea is considered a risk factor for what? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ they get their period back If a pregnant woman has syphilis, what should we do? - PRECISE ANSWER ✔✔ treat it with penicillin while she is pregnant because there is risk for spontaneous abortion What is the causative organism of mastitis? - PRECISE ANSWER ✔✔ staph What is the first line treatment for mastitis? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ numerous sexual partners Preeclampsia most commonly shows up at what time in pregnancy? - PRECISE ANSWER ✔✔ around week 20

How do we treat UTIs in a pregnant woman? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ about 10 days before menses What can be a sequelae of an ectopic pregnancy? - PRECISE ANSWER ✔✔ pelvic inflammatory disease and infertility due to scarring of the fallopian tube (salpingitis) What is the Coomb's test and when is this completed? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ IUD

The vaginal ring for contraception must be taken out how often? - PRECISE ANSWER ✔✔ every 3 weeks If a patient is on birth control and is currently having breakthrough bleeding, then what do we do? - PRECISE ANSWER ✔✔ increase the progesterone How do we treat temporal arteritis? - PRECISE ANSWER ✔✔ steroids If a patient is on birth control and they miss one pill, what should they do? - PRECISE ANSWER ✔✔ double up If a patient is on birth control and they miss two pills, what should they do? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ 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. - PRECISE ANSWER ✔✔ mammogram; ultrasound When do we screen for group B strep in pregnancy? - PRECISE ANSWER ✔✔ weeks 35-

When do we perform alpha fetoprotein screening in pregnancy? - PRECISE ANSWER ✔✔ 15-20 weeks Alpha fetoprotein screening in pregnancy can help determine the presence of what in pregnancy? - PRECISE ANSWER ✔✔ spina bifida and anencephaly What is placenta previa? - PRECISE ANSWER ✔✔ when the placenta blocks the cervical opening of the uterus What is placenta abruptio? - PRECISE ANSWER ✔✔ when the placenta either fully or partially detaches from the uterine wall When does placental abruption most commonly occur? - PRECISE ANSWER ✔✔ in the third trimester What is the major difference in symptomalogy between placenta abruptio and placenta previa? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ placenta previa What is the recommended treatment for polymyalgia rheumatica? - PRECISE ANSWER ✔✔ steroids

Patients with SLE are going to have what abnormal labwork? - PRECISE ANSWER ✔✔ elevated ESR and CRP How do we treat lupus flares? - PRECISE ANSWER ✔✔ steroids What are common sequelae of fibromyalgia? - PRECISE ANSWER ✔✔ insomnia and depression What is a great treatment option for fibromyalgia? - PRECISE ANSWER ✔✔ amitriptyline (a TCA) because it helps with chronic pain, sleep, and depression How is fibromyalgia diagnosed? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ when the femoral head of the hip is out of place What is the trendelenburg sign and when is it positive? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ walking with a limp SCFE is most common in which patient population? - PRECISE ANSWER ✔✔ adolescents What is legg-calve-perthe disease? - PRECISE ANSWER ✔✔ avascular necrosis of the femoral head due to a lack of blood supply Legg-calve-perthes disease is most common in which patient population? - PRECISE ANSWER ✔✔ young children What is the radiographic study of choice for the knee? - PRECISE ANSWER ✔✔ MRI What is the radiographic study of choice for the back? - PRECISE ANSWER ✔✔ x ray What is bursitis? - PRECISE ANSWER ✔✔ a fluid collection in the bursa of a joint How is bursitis treated? - PRECISE ANSWER ✔✔ a needle to instill intraarticular steroids and then pull off fluid Bursitis can be a __________ issue - PRECISE ANSWER ✔✔ recurrent

The medical term for knock knees - PRECISE ANSWER ✔✔ genu valgum The medical term for bow legs - PRECISE ANSWER ✔✔ genu varum What is myasthenia gravis? - PRECISE ANSWER ✔✔ an autoimmune disorder that causes muscle weakness of the voluntary muscles Genu valgum is caused by a problem with what? - PRECISE ANSWER ✔✔ the medial collateral ligament; think valgum as in gum makes your knees stick together Genu varum is caused by a problem with what? - PRECISE ANSWER ✔✔ the lateral collateral ligament What are shin splints? - PRECISE ANSWER ✔✔ a medial tibial syndrome caused by overuse of the muscles How do we treat shin splints? - PRECISE ANSWER ✔✔ rest and avoidance of exercise until the pain resolves What is the tell-tale difference between a herniated disc and sciatica? - PRECISE ANSWER ✔✔ sciatica feels better when you stand, a herniated disc feels better when you sit down

When will spinal or lumbar stenosis feel better? - PRECISE ANSWER ✔✔ when the patient sits down What is Korsakoff syndrome? - PRECISE ANSWER ✔✔ a deficiency in thiamine and folate caused by alcoholism What changes to the vagina occur with aging? - PRECISE ANSWER ✔✔ dryness, loss of rugae, less pubic hair What is a navicular fracture? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ osteoarthritis; rheumatoid arthritis What is Morton's neuroma? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ via a positive Muddler's or squeeze test causing pain What is the hook test? - PRECISE ANSWER ✔✔ used to assess for a bicep tendon issue

How do we treat any rotator cuff injuries? - PRECISE ANSWER ✔✔ wear a sling to stabilize the arm and refer to ortho How long do migraine headaches last? - PRECISE ANSWER ✔✔ 4-72 hours How can we abort cluster headaches? - PRECISE ANSWER ✔✔ calcium or 100% oxygen application Which type of headaches come with lacrimation and sinus symptoms? - PRECISE ANSWER ✔✔ cluster headaches What does the apprehension test assess for? - PRECISE ANSWER ✔✔ used to assess for stability of the shoulder or knee; assesses for stability How does the parathyroid gland regulate calcium? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ carbamazepine (tegretol) or amitriptyline. also want to do gabapentin or something for nerve pain What is the recommended treatment for Bell's palsy? - PRECISE ANSWER ✔✔ steroids and anti-virals

How is the pain of trigeminal neuralgia vs temporal arteritis different? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ beta blockers, amitriptyline, venlafaxine, topamax, valproate What is Addison's disease? - PRECISE ANSWER ✔✔ adrenal insufficiency; the patient will be low in cortisol and sodium but their potassium will be high What are s/s of Addison's disease? - PRECISE ANSWER ✔✔ bronze or discolored skin, salt cravings a rare complication of pregnancy characterized by the abnormal growth of trophoblasts, the cells that normally develop into the placenta - PRECISE ANSWER ✔✔ molar pregnancy What bacteria is the leading cause of urethritis? - PRECISE ANSWER ✔✔ neisseria gonorrhea What is the most common cause of hypercortisolism? - PRECISE ANSWER ✔✔ excessive ACTH production

How do we treat developmental hip dysplasia in a child under 6 months? - PRECISE ANSWER ✔✔ Pavlik harness; if older than 6 months may need surgery It is recommended that all children younger than __________ with sickle cell anemia take daily prophylactic antibiotics. What antibiotic is this? - PRECISE ANSWER ✔✔ 5 years old; penicillin When can cervical cancer screening stop if no abnormal screening history is present? - PRECISE ANSWER ✔✔ age 65 When should breast cancer screening begin and end with a biannual mammogram? - PRECISE ANSWER ✔✔ age 50- When should colorectal cancer screening stop? - PRECISE ANSWER ✔✔ age 85 Who qualifies for a low dose CT scan for lung cancer screening purposes? - PRECISE ANSWER ✔✔ age 50-80 years anyone who currently smokes or has stopped smoking within the last 5 years What does an ASC-US (atypical squamos cells of undetermined significance) pap smear result necessitate? - PRECISE ANSWER ✔✔ 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? - PRECISE ANSWER ✔✔ LSIL

If a patient has LSIL with a negative HPV test, what would you do?

• PRECISE ANSWER ✔✔ repeat in 1 year If a patient has LSIL with no HPV test or a positive HPV test, what should you do? - PRECISE ANSWER ✔✔ refer for colposcopy If a patient's pap results show NILM, what should you do? - PRECISE ANSWER ✔✔ repeat in 3 years If a patient's pap results show ASC-H or HSIL what should you do?
• PRECISE ANSWER ✔✔ refer for colposcopy The valgus stress test assesses what? - PRECISE ANSWER ✔✔ the medial collateral ligament The varus stress test assesses what? - PRECISE ANSWER ✔✔ the lateral collateral ligament The Lachman's test assesses what? - PRECISE ANSWER ✔✔ the ACL The McMurray's test assesses for what? - PRECISE ANSWER ✔✔ a torn meniscus The anterior drawer test assesses what? - PRECISE ANSWER ✔✔ the acl

The posterior drawer test assesses what? - PRECISE ANSWER ✔✔ 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 - PRECISE ANSWER ✔✔ dawn phenomenon How can you tell between the dawn and somogyi effect? - PRECISE ANSWER ✔✔ 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. A 14yo male with bronchitis is being treated with fluids and expectorants. He returns to the clinic with a fever of 103F, right pleuritic chest pain, and green sputum. Which of the following examination results would be expected? A. Right lower lobe crackles B. Decreased Fremitus C. Bilateral Wheezing D. Normal Percussion - PRECISE ANSWER ✔✔ A. Right lower lobe crackles. 2 year old child is diagnosed with radial head subluxation ("nursemaid's elbow"). After closed manipulation, the best indication of successful treatment is that: A. Swelling dissipates immediately

B. Pulse and sensation are restored C. The child quickly begins to use the affected arm D. A click is felt while the child is extending and rotating the arm - PRECISE ANSWER ✔✔ C. The child quickly begins to use the affected arm. Which of the following would be an appropriate alternative to erythromycin therapy in an 18 year old patient with Mycoplasma pneumoniae infection? A. Azithromycin (Zithromax) B. Cephalexin (Keflex) C. Amoxicillin D. Clindamycin (Cleocin) - PRECISE ANSWER ✔✔ A. Azithromycin A 10-month old presents with a rash, runny nose, and cough. Examination reveals a cluster of tiny white papuls with an erythematous base on the buccal mucosa. What does this suggest? A. Scarlet fever B. Rubella C. Erythema infectiosum D. Measles - PRECISE ANSWER ✔✔ D. Measles Office Spriometry performed with an albuterol nebulizer treatment can confirm a diagnosis of asthma because it indicates: A. Oxygen saturation B. Whether airway obstruction is from pulmonary fibrosis

C. Chronic carbon dioxide retention D. Whether a patient has reversible airway obstruction - PRECISE ANSWER ✔✔ D. Whether a patient has reversible airway obstruction An 18yr old patient presents with complaints of maxillary facial pain and yellow nasal discharge for 14 days. What is the appropriate initial pharmacologic intervention? A. Amoxicillin-Clavulanate (Augmentin) B. Ceftriaxone (Rocephin) C. Levofloxacin (Levaquin) D. Erythromycin - PRECISE ANSWER ✔✔ A. Amoxicillin-Clavulanate (Augmentin) Which of the following is the leading cause of cancer-related deaths in the majority of women? A. cervical Cancer B. Ovarian Cancer C. Breat Cancer D. Lung Cancer - PRECISE ANSWER ✔✔ D. Lung Cancer A 29-year old male with noncomplicated Chlamidia infection may exhibit: A. Urticaria B. No remarkable clinical symptoms C. A green mucoid penile discharge

D. A penile ulcer - PRECISE ANSWER ✔✔ B. No remarkable clinical symptoms To assess a patient's ability to think abstractly, a nurse practitioner could ask the patient: A. The meaning of a common proverb B. What action the patient would take if their was a fire in the house C. To count backwards from 100 by 7s D. To spell a word backward. - PRECISE ANSWER ✔✔ A. The meaning of a common proverb A common rule to follow when prescribing many medications for the elderly is to: A. Give most medications in the morning to allow slowed body functions to have time to adjust to the drug. B. Start at a lower dose than what is commonly prescribed for adults, and increase the dose slowly. C. Perform a creatinine clearance test for baseline data on all person over age 70 before starting on new medications. D. Give medication with a full glass of water to promote absorption and limit harm to the kidneys. - PRECISE ANSWER ✔✔ B. Start at a low dose than what is commonly prescribed for adults, and increase the dose slowly. A 72 year old female presents with a medical history unremarkable except for the occasional headache. She enjoyed emotional health throughout marriage and childrearing, although her family history is significant for strokes and nervous breakdowns. Since her

husband died a year ago, however, she has been waking every morning at 3am, is reluctant to go out although she has family member living nearby, and feels a continual urge to sleep. She cannot discuss her late husband without crying. Differential diagnoses would include: A. Stroke, depression, and hyperthyroidism B. Depression, Unresolved grief, and hypothyroidism C. Migraine, anxiety disorder, and hypertension D. Dementia, delirium, and pna - PRECISE ANSWER ✔✔ B. Depression, Unresolved grief, and hypothyroidism The parent of a 13-year old diagnosed with seizure disorder calls to report that the child is exhibiting symptoms of a cold, but has no fever. The nurse practitioner should advise the parent that development of fever may: A. make the seizure medication less effective B. Lower the seizure threshold C. Increase the seizure threshold D. Have no effect on the seizure threshold - PRECISE ANSWER ✔✔ B. Lower the seizure threshold After a 3-week camping trip, an 11-year old is seen for a target lesion with central clearing, located in the inguinal area. The patient has had a severe headache, malaise, fatigue, and generalized musculoskeletal pain for several days. Pharmacologic management of this condition includes: A. trimethoprim-sulamethoxazole (Bactrim)

B. Azithromycin (Zithromax) C. Metronidazole (Flagyl) D. Doxycycline (Doryx) - PRECISE ANSWER ✔✔ D. Doxycycline An 88 year old male presents with concerns about memory loss. He feels good, takes an aspirin daily, and has no chronic diseases. He lives alone, drives his own car, and manages his financial affairs. To evaluate his memory, which of the following tests should the nurse practitioner choose? A. Folstein Mini-Mental State examination B. Geriatric Depression Scale C. Minnesota Multiphasic Personality Inventory Myers-Briggs Test - PRECISE ANSWER ✔✔ A. Folstein Mini-mental state examination During development of a treatment plan for an 84 year old patient with hypothyroidism, the nurse practitioner has to keep in mind the worsening of: A. renal insufficiency B. Osteoporosis C. Dementia D. Anemia - PRECISE ANSWER ✔✔ B. Osteoporosis A 16 year old female in the first month of taking Ortho-Novum 7/7/7 complains of midcycle spotting. She hasn't missed any doses and uses no other medication. Which of the following is appropriate?

A. Modifying use B. Double dosing for 2 days C. Changing to Ortho-Novum 1/35 D. Providing reassurance - PRECISE ANSWER ✔✔ D. Providing reassurance The management of choice for polymyalgia rheumatica includes: A. whirlpool B. Prednisone C. Anelgesics D. Celebrex - PRECISE ANSWER ✔✔ B. Prednisone A 50 year old male presents with a chief complaint of malaise. Further questioning reveals that his primary concern is delayed ejaculation. He is currently taking the following medications: atenolol (Tenormin), 50 mg daily; paroxetine (Paxil), 20 mg daily; loratadine (Claritin-D), 1 tablet daily; and hydrochlorthoriazide (HCTZ), 25 mg daily. The most likely cause of the patient's concern would be: A. loratadine B. hydrochlorthoriazide (HCTZ) C. lisinopril (Zestril) D. paroxetine (Paxil) - PRECISE ANSWER ✔✔ D. Paroxetine (Paxil) A 3 year old patient presents at an inner-city clinic with fever, cough, malaise, and loss of appetite. The patient lives with several