APEA EXAM Gestational diabetes

  1. Gestational diabetes screening occurs between what weeks’ gestation? 24-48
  2. 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
  3. What are names of LABA medications? salmeterol
  4. What is encopresis in children? stool incontinence after the age of being toilet trained
  5. The medical term for being cross-eyed? strabismus
  6. What is atopic dermatitis? eczema
  7. Tests used to diagnose developmental hip dysplasia? Barlow and Ortolani maneuvers
  8. What is the female athlete triad? disordered eating, amenorrhea, osteoporosis
  9. 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.
  10. What does the rash of fifth disease (a viral exanthem) look like? maculopapular rash that blanches easily and may be accompanied by joint aches
  11. What cardiac abnormalities are expected to be heard on auscultation of a pregnant patient? a venous hum murmur and an S3
  12. When a headache accompanies a stroke, is this most often hemorrhagic or ischemic? hemorrhagic
  13. AV nicking is most commonly seen on retinal exam of which chronic condition? hypertension
  14. Within 6 months of being started on a TCA or SSRI, what is a common side effect that occurs? weight gain
  15. 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.
  16. The medical term for jock itch? tinea cruris
  17. Tinea cruris “jock itch” is a common __________ infection and should be treated with what?  fungal; OTC antifungal cream
  18. What are teaching points for males to avoid contracting tinea cruris? dry off after swimming and don’t stay in a wet bathing suit
  19. Tinea cruris can affect the inner thighs but never what else? the penis or scrotum
  20. On microscopic exam, what is most likely to be seen in the presence of a bacterial infection? cocci and rods
  21. On microscopic exam, what is most likely to be seen in the presence of a candidal infection? yeasts
  22. What are dermatophytes? Fungi
  23. 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)
  24. The medical term for ringworm? tinea corporis
  25. What is the most common cause of viral pneumonia in peds? RSV
  26. Viral pneumonia is the most common type of pneumonia in children of what ages? 6 months to 5 years
  27. What is the simplest way to screen for nutritional adequacy in older adults? measure their weight
  28. How are scabies treated? via permethrin and good hygiene
  29. What are common side effects of NSAIDs? renal impairment, acute renal failure, gastritis
  30. What is the most common cause of pernicious anemias? vitamin B12 deficiency
  31. How should oral iron supplements be taken? on an empty stomach with something acidic and high in calcium such as orange juice
  32. Group A strep pharyngitis can be accompanied by what symptoms other than the classic Centor criteria? abdominal pain, nausea, and vomiting
  33. A stool specimen that is positive for WBCs is a sign of what? a viral or bacterial infection
  34. The only type of incontinence that would not benefit from pelvic floor therapy is what? overflow incontinence
  35. What do the skin manifestations of a penicillin allergy look like? hives
  36. 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
  37. What causes the dry cough in people taking an ACEI? the buildup of bradykinin which is usually degraded by ACE
  38. ACEI induced coughs usually begin how soon after starting the medication? within 2 weeks
  39. COPD is often associated with what sequelae? anxiety and depression
  40. When should an antiviral be started in a patient with shingles? within 72 hours of the onset of symptoms
  41. What is the drug of choice for treating UTIs in male patients? bactrim for 7-10 days
  42. What is the leading cause of CKD and ESRD in the united states? diabetes
  43. 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
  44. What are the classic symptoms of an atopic pregnancy? amenorrhea, vaginal bleeding, abdominal pain
  45. What is sideroblastic anemia? when the bone marrow is unable to incorporate iron into hemoglobin. This may be either inherited or acquired.
  46. Can a pregnant woman get the MMR vaccine while pregnant? yes
  47. Why are the carotid arteries auscultated for bruits? this is indicative of generalized atherosclerosis
  48. 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.
  49. What are signs indicative of a meningitis infection? Kernig and Brudzinski’s signs
  50. Cancer in the bone marrow that results in skeletal destruction? multiple myeloma
  51. What is the average age of diagnosis of multiple myeloma? 65
  52. a skin disorder that causes the nose to enlarge and become red, bumpy, and bulbous? rhinophyma
  53. 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
  54. What is the first sign of sexual maturation in a male? an increase in testicular size (tanner stage 2)
  55. The inability to name a familiar object? anomia
  56. What happens to a womans vital signs when she is in her second trimester of pregnancy? her blood pressure decreases
  57. What is the most common cause of acute pharyngitis in children? respiratory viruses
  58. A depressed patient is started on an SSRI. When should another antidepressant be tried if there is no response? 8-12 weeks
  59. If the number of bacteria on a urinalysis are greater than ____________________, this is indicative of a UTI? 100,000
  60. What are signs of a ruptured TM other than the obviously ruptured TM? muffled hearing and bright red blood in the canal
  61. Osgood Schlatter disease produces pain where? in the knees
  62. Growing pains usually occur when? at nighttime
  63. Children with complaints of midbone pain should be worked for what MNM differential? acute lymphocytic leukemia
  64. NSAIDs should be used in caution with what patient population? anyone with hypertension because they cause sodium retention and increase blood pressure
  65. 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
  66. When should AAA screening be performed via US? once for all males age 65-75 who have ever smoked
  67. 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
  68. Actinic keratosis is a precursor for what? squamos cell carcinoma
  69. What is papilledema? swelling of the optic nerve and disc secondary to increased ICP. Often co-occurring with a headache
  70. 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
  71. A report of “knee locking” is a classic complaint of what? a meniscal tear
  72. 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
  73. What characterizes mild persistent asthma? asthma where symptoms occur more than twice weekly
  74. People who do not have a spleen (asplenic) are at a greater risk of what? more susceptible to bacterial infections
  75. What 2 things put someone at the highest risk of developing pancreatitis? gallstones and alcohol abuse. Hypertriglyceridemia can also cause it.
  76. What are the RF for GI bleeding? age 75 or older, warfarin use, daily NSAID use, chronic steroid use, PMHx of GI bleed
  77. When two or more RF for a GI bleed are present, we should not start a patient on aspirin without what? a daily PPI
  78. What medication is first line for the treatment of asymptomatic bacteriuria or UTI in pregnancy? nitrofurantoin
  79. 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
  80. 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
  81. What is Strattera (atomoxetine) used for? ADHD; side effect includes increased BP and HR so monitor closely
  82. What is the drug Danazol and what is it used for? an androgen used in the treatment of endometriosis and fibrocystic breast disease
  83. Danazol, an androgen, has what potential side effects? edema, hirsutism, hair loss, vocal changes
  84. The Mirena (Levonorgestrol) IUD stays in for how long? 5 years
  85. What is the most common reason for persistent gonorrhea infections? failure of the patient to abstain from unprotected sexual intercourse
  86. What class of drug is theophylline? What does it do? methylxanthine; it’s a bronchodilator
  87. Beta blockers are contraindicated in which cardiovascular condition? variant (prinzmetal) angina bc they may induce coronary vasospasm from unopposed alpha receptor activity
  88. What class of drug is Ropinirole (requip) and what is it used for? dopamine agonist; restless leg syndrome
  89. Are males or females more likely to commit suicide? males
  90. 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
  91. What is the most common cause of pneumonia in all ages? strep pneumo
  92. What is the most common cause of hemorrhagic stroke? hypertension
  93. What helps prevent infection by maintaining the acidic environment of the ear canal? cerumen
  94. Mortality associated with Kawasaki disease is most likely related to what? coronary artery aneurysm
  95. 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
  96. 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
  97. What is the most common cause of croup? parainfluenza virus
  98. What are the two subsets of impetigo? bullous (fluid filled) or nonbullous (honey crusts)
  99. 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
  100. Paroxysmal events associated with abnormal electrical discharges of neurons in the brain
  101. seizures
  102. What is HELLP syndrome in pregnancy? stands for hemolysis, elevated liver enzymes, and low platelets; is characterized by thrombocytopenia, hemolytic anemia, and liver dysfunction
  103. HELLP syndrome in pregnancy is due to what? endothelial dysfunction
  104. Patients with acute coronary syndrome typically have plaque erosion caused by what? accumulation of hyaluronan and neutrophils
  105. Which diagnostic study is most helpful for differentiating Alzheimer’s disease from dementia with Lewy bodies? PET scan
  106. ADHD is a risk factor for both depression and what else? substance abuse
  107. Epididymitis with orchitis is commonly related to what? genitourinary infections
  108. Mycoplasma genitalium is most commonly associated with which disease presentation in men? urethritis, especially if persistent or recurrent
  109. trachomatis stands for what common type of bacteria infection? chlamydia
  110. Chlamydia passed from a mother to a newborn can result in which problems for the newborn? conjunctivitis and pneumonia
  111. In a patient with patent ductus arteriosus, where is the murmur best heard? localized at the left clavicle and is both systolic and diastolic
  112. 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
  113. What are examples of some conditions that have multifactorial inheritance? diabetes, obesity, arthritis, cancer, Alzheimers
  114. Seborrheic dermatitis is basically the same thing as what? eczema of the scalp
  115. The flow of air coming in and out of the lungs in one inhalation and one exhalation? peak expiratory flow
  116. What does an incentive spirometer measure? peak expiratory flow
  117. 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
  118. What is a sign of the initial appearance of measurable histamines in a patient with allergic rhinitis? sneezing
  119. The bacteria responsible for syphilis is called what? treponema pallidum
  120. The STI, chancroid, is caused by what responsible bacteria? haemophilus ducreyi
  121. What is the most common cause of septic arthritis? staph aureus
  122. 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
  123. What are the 3 secondary causes of type 2 diabetes? prolonged physical or emotional stress, pregnancy, drugs such as steroids and hormonal contraceptives
  124. 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.
  125. Which drug classes are responsible for causing urinary retention? antihistamines, TCAs, antispasmodics, bronchodilators, antipsychotics, carbidopa levodopa
  126. A 75 year old patient is experiencing progressive confusion and memory deterioration. Which condition mimics dementia that this patient should be tested for? neurosyphilis
  127. Which hormones in late pregnancy can block insulin and cause gestational diabetes? cortisol, estrogen, and placental lactogen
  128. Target shaped skin lesions as a result of a hypersensitivity reaction to certain infections and drugs? erythema multiforme
  129. An abnormal growth of squamos epithelium in the middle ear and mastoid? cholesteatoma
  130. 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
  131. Patient populations who may present atypically when having a MI include who? diabetics, females, elderly
  132. A disorder that results in the destruction of platelets due to an autoimmune response? idiopathic thrombocytopenia purpura
  133. Pelvic inflammatory disease is most commonly caused by what? chlamydia and gonorrhea
  134. A protruding abdominal mass after bending over, lifting, or coughing, and is painful with coughing, is often what in adults? inguinal hernia
  135. Hiatal hernias cause what type of symptoms? GERD
  136. What is the name of an immature female gamete? oocyte
  137. The fused ovum and sperm once fertilization has occurred? zygote
  138. What are conditions that are often co-occurring with alopecia areata? atopic dermatitis, vitiligo, thyroid disease, collagen-vascular diseases, Down syndrome
  139. The medical term for eczema? atopic dermatitis
  140. The leading cause of death in infants under the age of 1? sudden unexplained infant death
  141. How is varicella zoster transmitted? via the respiratory tract
  142. The presence of pruritic papules, macules, and vesicles in various stages of healing? varicella zoster
  143. What is presbycusis? age related hearing loss
  144. 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
  145. The fascia layer of the male anatomy that the anterior 2/3s of the testicle resides in? tunica vaginalis
  146. A subtype of strabismus that describes an inward turning of the eye? esotropia
  147. The abducens nerve (CN VI) is responsible for what? lateral movement of the eye outward
  148. The trochlear nerve is responsible for what extraocular movement? down and inward movement
  149. Why is primary open-angle glaucoma considered a chronic glaucoma? there is a SLOW rise in intraocular pressure
  150. A benign epidermal tumor that is a well-demarcated, coin-like, pigmented lesion with a stuck on appearance? seborrheic keratosis
  151. The most common precancerous skin lesion that results from years of repeated sun exposure? actinic keratosi


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