APEA EXAM Gestational diabetes

Gestational diabetes screening occurs between what weeks’ gestation? 24-48
When you ask the patient to take a deep breath in and then palpate over the RUQ abdomen. Positive when pain is elicited. This is a sign of ___________. Murphy’s sign; cholecystitis
What are names of LABA medications? salmeterol
What is encopresis in children? stool incontinence after the age of being toilet trained
The medical term for being cross-eyed? strabismus
What is atopic dermatitis? eczema
Tests used to diagnose developmental hip dysplasia? Barlow and Ortolani maneuvers
What is the female athlete triad? disordered eating, amenorrhea, osteoporosis
How do patients with aortic regurgitation typically present? they will have a long asymptomatic period followed by exercise intolerance, then dyspnea at rest. The left ventricle eventually fails unless the aortic valve is replaced.
What does the rash of fifth disease (a viral exanthem) look like? maculopapular rash that blanches easily and may be accompanied by joint aches
What cardiac abnormalities are expected to be heard on auscultation of a pregnant patient? a venous hum murmur and an S3
When a headache accompanies a stroke, is this most often hemorrhagic or ischemic? hemorrhagic
AV nicking is most commonly seen on retinal exam of which chronic condition? hypertension
Within 6 months of being started on a TCA or SSRI, what is a common side effect that occurs? weight gain
When does otitis media with effusion usually occur? either before or after an episode of acute otitis media. This effusion is not infected fluid but it is considered a breeding ground for bacteria. This should not be treated with antibiotics.
The medical term for jock itch? tinea cruris
Tinea cruris “jock itch” is a common __________ infection and should be treated with what? fungal; OTC antifungal cream
What are teaching points for males to avoid contracting tinea cruris? dry off after swimming and don’t stay in a wet bathing suit
Tinea cruris can affect the inner thighs but never what else? the penis or scrotum
On microscopic exam, what is most likely to be seen in the presence of a bacterial infection? cocci and rods
On microscopic exam, what is most likely to be seen in the presence of a candidal infection? yeasts
What are dermatophytes? Fungi
On microscopic exam, what is most likely to be seen in the presence of a dermatophytic (fungal) infection? hyphae that are long, thin, and branching (such as in the case of tinea pedis, tinea cruris, and tinea corporis)
The medical term for ringworm? tinea corporis
What is the most common cause of viral pneumonia in peds? RSV
Viral pneumonia is the most common type of pneumonia in children of what ages? 6 months to 5 years
What is the simplest way to screen for nutritional adequacy in older adults? measure their weight
How are scabies treated? via permethrin and good hygiene
What are common side effects of NSAIDs? renal impairment, acute renal failure, gastritis
What is the most common cause of pernicious anemias? vitamin B12 deficiency
How should oral iron supplements be taken? on an empty stomach with something acidic and high in calcium such as orange juice
Group A strep pharyngitis can be accompanied by what symptoms other than the classic Centor criteria? abdominal pain, nausea, and vomiting
A stool specimen that is positive for WBCs is a sign of what? a viral or bacterial infection
The only type of incontinence that would not benefit from pelvic floor therapy is what? overflow incontinence
What do the skin manifestations of a penicillin allergy look like? hives
What are symptoms that someone will experience as soon as they are started on a SSRI and when will this resolve? headache, nausea, insomnia, restlessness, agitation; will resolve in 2 weeks
What causes the dry cough in people taking an ACEI? the buildup of bradykinin which is usually degraded by ACE
ACEI induced coughs usually begin how soon after starting the medication? within 2 weeks
COPD is often associated with what sequelae? anxiety and depression
When should an antiviral be started in a patient with shingles? within 72 hours of the onset of symptoms
What is the drug of choice for treating UTIs in male patients? bactrim for 7-10 days
What is the leading cause of CKD and ESRD in the united states? diabetes
What is the usual recommendation about administering MMR and varicella immunizations? they should be given on the same day or at least one month apart
What are the classic symptoms of an atopic pregnancy? amenorrhea, vaginal bleeding, abdominal pain
What is sideroblastic anemia? when the bone marrow is unable to incorporate iron into hemoglobin. This may be either inherited or acquired.
Can a pregnant woman get the MMR vaccine while pregnant? yes
Why are the carotid arteries auscultated for bruits? this is indicative of generalized atherosclerosis
What is roseola? a viral exanthem characterized by a high fever for 3 days then abrupt stopping of the fever and a maculopapular rash that blanches. also known as exanthem subitum.
What are signs indicative of a meningitis infection? Kernig and Brudzinski’s signs
Cancer in the bone marrow that results in skeletal destruction? multiple myeloma
What is the average age of diagnosis of multiple myeloma? 65
a skin disorder that causes the nose to enlarge and become red, bumpy, and bulbous? rhinophyma
What are physical exam findings common in alcohol abuse? tremors, macrocytosis (due to vitamin B12 and folate deficiencies common in alcoholics), hypertension, rhinophyma, peripheral neuropathy, teleangectasia, hepatosplenomegaly
What is the first sign of sexual maturation in a male? an increase in testicular size (tanner stage 2)
The inability to name a familiar object? anomia
What happens to a womans vital signs when she is in her second trimester of pregnancy? her blood pressure decreases
What is the most common cause of acute pharyngitis in children? respiratory viruses
A depressed patient is started on an SSRI. When should another antidepressant be tried if there is no response? 8-12 weeks
If the number of bacteria on a urinalysis are greater than ____________________, this is indicative of a UTI? 100,000
What are signs of a ruptured TM other than the obviously ruptured TM? muffled hearing and bright red blood in the canal
Osgood Schlatter disease produces pain where? in the knees
Growing pains usually occur when? at nighttime
Children with complaints of midbone pain should be worked for what MNM differential? acute lymphocytic leukemia
NSAIDs should be used in caution with what patient population? anyone with hypertension because they cause sodium retention and increase blood pressure
What is the most common cause of secondary dysmenorrhea? endometriosis; symptoms include spotting in between periods, cervical stenosis or displacement, nodular or tender uterosacral ligaments
When should AAA screening be performed via US? once for all males age 65-75 who have ever smoked
What is responsible for the transmission of poison ivy? the oils from the plant itself. So the only way someone can pass it on to another person is if they still have oil from the plant on their skin (like if they haven’t bathed). Note that the fluid inside the blisters is not contagious
Actinic keratosis is a precursor for what? squamos cell carcinoma
What is papilledema? swelling of the optic nerve and disc secondary to increased ICP. Often co-occurring with a headache
Is sexual activity safe during pregnancy? it can expose someone to STDs and it can also stimulate preterm labor due to stimulation of the lower uterine segment and release of oxtocin
A report of “knee locking” is a classic complaint of what? a meniscal tear
Can a pregnant woman be on levothyroxine during pregnancy? yes, she should continue it and have TSH checked monthly because she may need a higher dose as thyroid hormone needs increase during pregnancy
What characterizes mild persistent asthma? asthma where symptoms occur more than twice weekly
People who do not have a spleen (asplenic) are at a greater risk of what? more susceptible to bacterial infections
What 2 things put someone at the highest risk of developing pancreatitis? gallstones and alcohol abuse. Hypertriglyceridemia can also cause it.
What are the RF for GI bleeding? age 75 or older, warfarin use, daily NSAID use, chronic steroid use, PMHx of GI bleed
When two or more RF for a GI bleed are present, we should not start a patient on aspirin without what? a daily PPI
What medication is first line for the treatment of asymptomatic bacteriuria or UTI in pregnancy? nitrofurantoin
Athletic amenorrhea increases one’s risk of developing what? osteoporosis; this is because there is a loss of body fat and body fat is what produces estrogen so estrogen levels decline
An intervention being performed to prevent the occurrence of the same event happening again is an example of ___________ prevention. Give an example. secondary; taking a daily aspirin to prevent another stroke after already having one
What is Strattera (atomoxetine) used for? ADHD; side effect includes increased BP and HR so monitor closely
What is the drug Danazol and what is it used for? an androgen used in the treatment of endometriosis and fibrocystic breast disease
Danazol, an androgen, has what potential side effects? edema, hirsutism, hair loss, vocal changes
The Mirena (Levonorgestrol) IUD stays in for how long? 5 years
What is the most common reason for persistent gonorrhea infections? failure of the patient to abstain from unprotected sexual intercourse
What class of drug is theophylline? What does it do? methylxanthine; it’s a bronchodilator
Beta blockers are contraindicated in which cardiovascular condition? variant (prinzmetal) angina bc they may induce coronary vasospasm from unopposed alpha receptor activity
What class of drug is Ropinirole (requip) and what is it used for? dopamine agonist; restless leg syndrome
Are males or females more likely to commit suicide? males
How do depression vs. anxiety differ in the way that they affect sleep? anxiety usually causes people to have problems falling asleep whereas depression causes early morning wakening
What is the most common cause of pneumonia in all ages? strep pneumo
What is the most common cause of hemorrhagic stroke? hypertension
What helps prevent infection by maintaining the acidic environment of the ear canal? cerumen
Mortality associated with Kawasaki disease is most likely related to what? coronary artery aneurysm
What is Kawasaki disease? an acute febrile illness of early childhood characterized by vasculitis of the medium sized arteries, most noticeable in the coronary vessels
Serial echos must be performed in a patient with Kawasaki disease in order to rule out coronary artery aneurysms. When should these occur? at the time of diagnosis, 1-2 weeks after onset of illness, 5-6 weeks after onset of illness
What is the most common cause of croup? parainfluenza virus
What are the two subsets of impetigo? bullous (fluid filled) or nonbullous (honey crusts)
Which protein is an important mediator of the inflammatory response and serves as a messenger at the site of antigen (allergen) invasion? cytokines; they are released by mast cells in response to an invading antigen and recruit leukocytes and eosinophils
Paroxysmal events associated with abnormal electrical discharges of neurons in the brain
seizures
What is HELLP syndrome in pregnancy? stands for hemolysis, elevated liver enzymes, and low platelets; is characterized by thrombocytopenia, hemolytic anemia, and liver dysfunction
HELLP syndrome in pregnancy is due to what? endothelial dysfunction
Patients with acute coronary syndrome typically have plaque erosion caused by what? accumulation of hyaluronan and neutrophils
Which diagnostic study is most helpful for differentiating Alzheimer’s disease from dementia with Lewy bodies? PET scan
ADHD is a risk factor for both depression and what else? substance abuse
Epididymitis with orchitis is commonly related to what? genitourinary infections
Mycoplasma genitalium is most commonly associated with which disease presentation in men? urethritis, especially if persistent or recurrent
trachomatis stands for what common type of bacteria infection? chlamydia
Chlamydia passed from a mother to a newborn can result in which problems for the newborn? conjunctivitis and pneumonia
In a patient with patent ductus arteriosus, where is the murmur best heard? localized at the left clavicle and is both systolic and diastolic
What is the ductus arteriosus? provides the fetus with a pathway from the pulmonary artery to the aorta in utero in order to skip the lungs
What are examples of some conditions that have multifactorial inheritance? diabetes, obesity, arthritis, cancer, Alzheimers
Seborrheic dermatitis is basically the same thing as what? eczema of the scalp
The flow of air coming in and out of the lungs in one inhalation and one exhalation? peak expiratory flow
What does an incentive spirometer measure? peak expiratory flow
What happens in the luteal phase of the menstrual cycle? LH and FSH decrease, the ruptured follicle closes after an egg has been released and forms the corpus luteum, which produces progesterone. Estrogen and progesterone remain high and it is those two things that cause the lining of the uterus to thicken further in preparation for fertilization
What is a sign of the initial appearance of measurable histamines in a patient with allergic rhinitis? sneezing
The bacteria responsible for syphilis is called what? treponema pallidum
The STI, chancroid, is caused by what responsible bacteria? haemophilus ducreyi
What is the most common cause of septic arthritis? staph aureus
The STI, mycoplasma genitalium, is unique in what way? it lacks a cell wall and has a terminal tip-like structure which allows it to attach to and enter other cells. It then modulates the host’s immune response
What are the 3 secondary causes of type 2 diabetes? prolonged physical or emotional stress, pregnancy, drugs such as steroids and hormonal contraceptives
How does hyperinsulinemia in PCOS work? insulin resistance occurs in all places except for the ovary which remains sensitive to insulin. This insulin upregulates androgen production.
Which drug classes are responsible for causing urinary retention? antihistamines, TCAs, antispasmodics, bronchodilators, antipsychotics, carbidopa levodopa
A 75 year old patient is experiencing progressive confusion and memory deterioration. Which condition mimics dementia that this patient should be tested for? neurosyphilis
Which hormones in late pregnancy can block insulin and cause gestational diabetes? cortisol, estrogen, and placental lactogen
Target shaped skin lesions as a result of a hypersensitivity reaction to certain infections and drugs? erythema multiforme
An abnormal growth of squamos epithelium in the middle ear and mastoid? cholesteatoma
The cremasteric reflex is assessed in infants for what purpose? to assess for retractile testicles; this occurs when the reflex is too strong and it pulls the testicle out of the body and into the groin; this is normal and should go away by puberty
Patient populations who may present atypically when having a MI include who? diabetics, females, elderly
A disorder that results in the destruction of platelets due to an autoimmune response? idiopathic thrombocytopenia purpura
Pelvic inflammatory disease is most commonly caused by what? chlamydia and gonorrhea
A protruding abdominal mass after bending over, lifting, or coughing, and is painful with coughing, is often what in adults? inguinal hernia
Hiatal hernias cause what type of symptoms? GERD
What is the name of an immature female gamete? oocyte
The fused ovum and sperm once fertilization has occurred? zygote
What are conditions that are often co-occurring with alopecia areata? atopic dermatitis, vitiligo, thyroid disease, collagen-vascular diseases, Down syndrome
The medical term for eczema? atopic dermatitis
The leading cause of death in infants under the age of 1? sudden unexplained infant death
How is varicella zoster transmitted? via the respiratory tract
The presence of pruritic papules, macules, and vesicles in various stages of healing? varicella zoster
What is presbycusis? age related hearing loss
Age is the most common cause of presbycusis, but what other conditions may play a role in quickening the onset of this? white, infections, smoking, hypertenson, diabetes, vascular disease, immune disorders, hormonal factors
The fascia layer of the male anatomy that the anterior 2/3s of the testicle resides in? tunica vaginalis
A subtype of strabismus that describes an inward turning of the eye? esotropia
The abducens nerve (CN VI) is responsible for what? lateral movement of the eye outward
The trochlear nerve is responsible for what extraocular movement? down and inward movement
Why is primary open-angle glaucoma considered a chronic glaucoma? there is a SLOW rise in intraocular pressure
A benign epidermal tumor that is a well-demarcated, coin-like, pigmented lesion with a stuck on appearance? seborrheic keratosis
The most common precancerous skin lesion that results from years of repeated sun exposure? actinic keratosi