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APEA Predictor Exam With 135 Questions
What is the most common cause of hypercortisolism? -Correct Answer โ โ excessive ACTH production
How do we treat developmental hip dysplasia in a child under 6 months? -Correct Answer โ โ 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? -Correct Answer โ โ 5 years old; penicillin
When can cervical cancer screening stop if no abnormal screening history is present? -Correct Answer โ โ age 65
When should breast cancer screening begin and end with a biannual mammogram? -Correct Answer โ โ age 50-
When should colorectal cancer screening stop? -Correct Answer โ
โ age 85
Who qualifies for a low dose CT scan for lung cancer screening purposes? -Correct Answer โ โ 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? -Correct Answer โ โ Do HPV testing with this. If positive, repeat in one year if age 21- 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? -Correct Answer โ โ LSIL
If a patient has LSIL with a negative HPV test, what would you do? - Correct Answer โ โ repeat in 1 year
The anterior drawer test assesses what? -Correct Answer โ โ the acl
The posterior drawer test assesses what? -Correct Answer โ โ 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 -Correct Answer โ
โ dawn phenomenon
How can you tell between the dawn and somogyi effect? -Correct Answer โ โ 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.
What is the biggest side effect of colchicine? -Correct Answer โ โ diarrhea
How would you describe the appearance of molluscum contagiosum? -Correct Answer โ โ papules that are umbilicated and contain a caseous plug
How do we treat a broken clavicle in an infant? -Correct Answer โ โ no treatment; it should heal on it's own
At what week of pregnancy is the uterus palpable just above the pubic symphysis? -Correct Answer โ โ week 12
At what week of pregnancy is the fundus palpable halfway between the pubic symphysis and umbilicus? -Correct Answer โ โ week 16
At what week of pregnancy is the fundus of the uterus at the umbilicus? -Correct Answer โ โ week 20
At what week of pregnancy is the fundus of the uterus halfway between the xiphoid process and umbilicus? -Correct Answer โ โ week 28
Which type of prevention are vaccinations? -Correct Answer โ โ primary
When should patients begin antiretroviral therapy for HIV infection? - Correct Answer โ โ as soon as it is detected, even if in the acute phase
What are the first generation antihistamines? -Correct Answer โ โ diphenhydramine (benadryl) and chlorpeniramine (actifed)
What are s/s of the secondary stage of syphilis? -Correct Answer โ โ rash on hands and feet, lymphadenopathy, fever
What is the recommended treatment for chronic bacterial prostatitis? -Correct Answer โ โ a fluoroquinolone (cipro or levo) + bactrim
What is the recommended treatment for acute prostatitis? -Correct Answer โ โ cipro (if not STI related) or ceftriaxone
What are s/s of an intraductal breast papilloma? -Correct Answer โ โ 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? -Correct Answer โ โ 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? -Correct Answer โ โ in those who are on any type of nitrate or triptan because it could result in hypotension
What class of drug is sildenafil (viagra)? -Correct Answer โ โ 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
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? -Correct Answer โ โ 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? -Correct Answer โ โ 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? -Correct Answer โ โ decrease the weekly dose by 5-10%
If a patient on coumadin's INR is 4.1-5.0, what should you do? -Correct Answer โ โ hold one dose then decrease the weekly dose by 10%
If a patient's INR is greater than 5, what should you do? -Correct Answer โ โ consult cards, likely would hold two doses then decrease the weekly dose
An anorexic patient will have a BMI of what? -Correct Answer โ โ less than 18
What is primary amenorrhea? -Correct Answer โ โ 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 -Correct Answer โ โ 3 months
What do we need to do first when a patient comes in with secondary amenorrhea? -Correct Answer โ โ rule out pregnancy
Anorexia can put you at risk for what? -Correct Answer โ โ osteoporosis, amenorrhea, cardiac damage
Preeclampsia most commonly shows up at what time in pregnancy? - Correct Answer โ โ around week 20
How do we treat UTIs in a pregnant woman? -Correct Answer โ โ 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? -Correct Answer โ โ about 10 days before menses
What can be a sequelae of an ectopic pregnancy? -Correct Answer โ โ pelvic inflammatory disease and infertility due to scarring of the fallopian tube (salpingitis)
What is the Coomb's test and when is this completed? -Correct Answer โ โ 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? -Correct Answer โ โ 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? -Correct Answer โ โ 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? -Correct Answer โ โ IUD
The vaginal ring for contraception must be taken out how often? - Correct Answer โ โ every 3 weeks
If a patient is on birth control and is currently having breakthrough bleeding, then what do we do? -Correct Answer โ โ increase the progesterone
How do we treat temporal arteritis? -Correct Answer โ โ steroids
Alpha fetoprotein screening in pregnancy can help determine the presence of what in pregnancy? -Correct Answer โ โ spina bifida and anencephaly
What is placenta previa? -Correct Answer โ โ when the placenta blocks the cervical opening of the uterus
What is placenta abruptio? -Correct Answer โ โ when the placenta either fully or partially detaches from the uterine wall
When does placental abruption most commonly occur? -Correct Answer โ โ in the third trimester
What is the major difference in symptomalogy between placenta abruptio and placenta previa? -Correct Answer โ โ 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? -Correct Answer โ โ placenta previa
What is the recommended treatment for polymyalgia rheumatica? - Correct Answer โ โ steroids
Patients with SLE are going to have what abnormal labwork? -Correct Answer โ โ elevated ESR and CRP
How do we treat lupus flares? -Correct Answer โ โ steroids
What are common sequelae of fibromyalgia? -Correct Answer โ โ insomnia and depression
What is a great treatment option for fibromyalgia? -Correct Answer โ โ amitriptyline (a TCA) because it helps with chronic pain, sleep, and depression
How is fibromyalgia diagnosed? -Correct Answer โ โ 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? -Correct Answer โ โ when the femoral head of the hip is out of place
What is the radiographic study of choice for the back? -Correct Answer โ โ x ray
What is bursitis? -Correct Answer โ โ a fluid collection in the bursa of a joint
How is bursitis treated? -Correct Answer โ โ a needle to instill intraarticular steroids and then pull off fluid
Bursitis can be a __________ issue -Correct Answer โ โ recurrent
The medical term for knock knees -Correct Answer โ โ genu valgum
The medical term for bow legs -Correct Answer โ โ genu varum
What is myasthenia gravis? -Correct Answer โ โ an autoimmune disorder that causes muscle weakness of the voluntary muscles
Genu valgum is caused by a problem with what? -Correct Answer โ โ the medial collateral ligament; think valgum as in gum makes your knees stick together
Genu varum is caused by a problem with what? -Correct Answer โ
โ the lateral collateral ligament
What are shin splints? -Correct Answer โ โ a medial tibial syndrome caused by overuse of the muscles
How do we treat shin splints? -Correct Answer โ โ rest and avoidance of exercise until the pain resolves
What is the tell-tale difference between a herniated disc and sciatica? -Correct Answer โ โ sciatica feels better when you stand, a herniated disc feels better when you sit down
When will spinal or lumbar stenosis feel better? -Correct Answer โ โ when the patient sits down
