APEA 3P PrEdictor ExAm

APEA 3P PrEdictor ExAm 2024/2025 – LAtEst UPdAtEd QUEstions & soLUtions (A+ GUidE)

◉ Erectile Dysfunction Answer: Treatment PDE-5 inhibitor - contraindicated with nitrates Causes - Anti-HTN meds, antidepressants, antiandrogens, recreational drugs

◉ #1 Risk Factor for Testicular & Penile Cancer Answer: Cryptochordism

◉ Prostatitis Answer: Inflammation of the prostate & usually bacterial

S&S: Frequency, urgency, fever, enlarged boggy warm prostate

◉ Prostatitis Treatment Answer: Chronic Prostatitis: Ciprofloxacin or Flouroquinolones (Levofloxacin) for 4-12 wks or Bactrim 4-6 wks.Treatment guided by Culture & Sensitivity No Keflex (cephalexin)

◉ Testicular Torsion Answer: Acute onset testicular pain and loss of cremasteric reflex on affected side. Most common in prepubertal boys

◉ Epididymitis Answer: Testicular pain onset over a few days (gradual) and cremasteric reflex is present.

◉ Gonorrhea & Chlamydia treatment Answer: Doxycycline 100mg BIDx14 days & Ceftriaxone x1 IM

◉ Migraine Treatment Answer: Rescue: Triptans Prophylactic: Beta Blockers, antidepressants, anticonvulsants (Topamax, Propranolol, Inderal)

◉ Migraine Presentation Answer: S&S: Unilateral 70% of time, Crescendo,

Nausea/Vomiting, Photophobia, and Auras, Duration: 4-72hrs

Patient Appearance: Pt desires a cool, quiet, dark room

◉ Cluster Headache Presentation Answer: Always unilateral, begins around

temple/eye, pain peaks within minutes; excruciating/explosive, rhinorrhea, tears, eye becomes red ETOH can be a trigger

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◉ Tension Headache Presentation Answer: Bilateral, pressure, tightness, band-like, waxes and wanes

◉ Parkinson's Disease Answer: Deficiency of Dopamine and destruction of cells in the substantia nigra

◉ Parkinson's Disease Presentation Answer: Bradykinesia, rigidity, resting tremor ("pill rolling"), postural instability

◉ Parkinson's Disease Treatment Answer: Dopaminergic agents, Carbidopa/levadopa (Do not give to patients with narrow angle glaucoma)

◉ Beer's List Answer: a list of drugs for which you should not give or monitoring is especially important in elderly patients Anti-cholinergics, anti-spasmotics, scopolamine, meclizine, promethazine High risk of confusion, dry mouth, constipation.

◉ Meningitis Answer: Inflammation of the brain and spinal cord meninges result from bacteria, virus, or fungi. Headache is caused by meningeal irritation. Tx is cephalosporins (Ceftriaxone).

◉ Transient Ischemic Attack (TIA) Answer: brief episode of loss of blood flow to the brain, usually caused by a partial occlusion that results in temporary neurologic deficit (impairment). Typically resolves within hours; often precedes a CVA

◉ Seizures Answer: Uncontrolled electrical activity within the brain

◉ Scoliosis Answer: Lateral curvature of the spine greater than 10 degrees

◉ Rheumatoid Arthritis Answer: Autoimmune disorder characterized by thickened

synovial membrane, joints are warm, swollen, and tender, which can lead to bone erosion.

◉ Osteoarthritis Answer:

◉ Osteoarthritis Treatment Answer: Weight-bearing exercise, weight loss, Cymbalta, duloxetine, tramadol. RICE = Rest, Ice, Compression, Elevation. Acetaminophen not recommended. Short acting NSAIDs are ok. Refer to ortho for injections.

◉ Sprain Answer: Stretch or tear in a Ligament

◉ Strain Answer: Stretch or tear in a muscle or tendon

◉ Ortolani's Click Answer: A click is heard or felt as dislocation is reduced

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◉ Barlows Maneuver Answer: Feeling of a slip of the femoral head slips away from the Acetabulum (toward the butt)

◉ Meningitis assessment finding Answer: Positive Kernig or Brudzinski sign

◉ Adam's Sign Answer: Evaluation for scoliosis.

Negative for functional scoliosis if curve straightens out Positive for structural scoliosis if curve remains

◉ Fat Pad Sign Answer: radiographic finding that can indicate an underlying injury or fracture in the elbow joint, specifically around the olecranon process of the ulna bone.

◉ McMurray Test Answer: Palpable or auditory click while rotating and extending the knee

◉ Gout Answer: Acute joint pain with swelling, warmth, and erythema begins abruptly and involves a single joint. Normal uric acid levels are common during acute attack.

◉ Gout Treatment Answer: Acute Gout - Colchicine

Chronic Gout (2 or more attacks/year) - Allopurinol - decreases production of uric acid

◉ GTPAL Answer: Gravidia - # of times a woman has been pregnant multiples = 1

Term - Number of children at >37 weeks Preterm - Number of children at 20-37 weeks Abortion - Abortions/Miscarriages Living - living children, twins count individually

◉ Fundal Height Answer: Distance from the pubic bone to the top of the uterus in centimeters. After 24 weeks fundal height should equal the number of weeks the patient has been pregnant. i.e. 24cm = 24wks

◉ Preeclampsia Answer: BP > 140/90 & Proteinuria (300mg/24hr urine sample) or edema, pulmonary edema, visual impairments, impaired renal or hepatic function.

◉ Preeclampsia Treatment Answer: Magnesium Sulfate

Anti-Hypertensives i.e. methyldopa, labetalol, nifedipine Corticosteroids for fetus lung development if preterm birth expected

◉ Naegeles Rule Answer: First day of LMP, subtract 3 months, add 7 days

◉ Placenta Previa Answer: Painless, bright red bleeding in a woman >20 weeks gestation. Abnormal placement of the placenta near or covering the internal cervical os

◉ 1st line Treatment of UTI in pregnancy Answer: Nitrofurantoin (Macrobid)

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