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CM APEA PRE PREDICTOR EXAM LATEST 2024-
2025 ACTUAL EXAM COMPLETE 1770 QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED
ANSWERS) GUARANTEED PASS
What is the biggest side effect of colchicine?
diarrhea
How would you describe the appearance of molluscum contagiosum?
papules that are umbilicated and contain a caseous plug
How do we treat a broken clavicle in an infant?
no treatment; it should heal on it's own
At what week of pregnancy is the uterus palpable just above the pubic symphysis?
week 12
At what week of pregnancy is the fundus palpable halfway between the pubic symphysis and umbilicus?
week 16
At what week of pregnancy is the fundus of the uterus at the umbilicus?
week 20
At what week of pregnancy is the fundus of the uterus halfway between the xiphoid process and umbilicus?
week 28
At what week of pregnancy is the fundus just below the xiphoid process?
week 34
Increased sweat production is a sign of what endocrine disorder?
hyperthyroidism
What is Paget's disease?
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?
bisphosphonates
How should pregnant women wear their seatbelt?
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?
parvovirus aka slapped cheek disease aka erythema infectiosum
If a patient has GABHS but has an allergy to penicillins, what is the second line option?
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?
in those who are on any type of nitrate or triptan because it could result in hypotension
What class of drug is sildenafil (viagra)?
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
What are the symptoms of peripheral artery disease?
think P meaning pain, A meaning absent or weak pulses, eschar or shiny legs, intermittent claudication
What is first line treatment for PAD?
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?
do not elevate the feet; keep them down
How do we diagnose PAD?
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?
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?
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?
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?
decrease the weekly dose by 5-10%
If a patient on coumadin's INR is 4.1-5.0, what should you do?
hold one dose then decrease the weekly dose by 10%
If a patient's INR is greater than 5, what should you do?
consult cards, likely would hold two doses then decrease the weekly dose
they get their period back
If a pregnant woman has syphilis, what should we do?
treat it with penicillin while she is pregnant because there is risk for spontaneous abortion
What is the causative organism of mastitis?
staph
What is the first line treatment for mastitis?
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?
numerous sexual partners
Preeclampsia most commonly shows up at what time in pregnancy?
around week 20
How do we treat UTIs in a pregnant woman?
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?
about 10 days before menses
What can be a sequelae of an ectopic pregnancy?
pelvic inflammatory disease and infertility due to scarring of the fallopian tube (salpingitis)
What is the Coomb's test and when is this completed?
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?
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?
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?
IUD
The vaginal ring for contraception must be taken out how often?
every 3 weeks
If a patient is on birth control and is currently having breakthrough bleeding, then what do we do?
When do we perform alpha fetoprotein screening in pregnancy?
15-20 weeks
Alpha fetoprotein screening in pregnancy can help determine the presence of what in pregnancy?
spina bifida and anencephaly
What is placenta previa?
when the placenta blocks the cervical opening of the uterus
What is placenta abruptio?
when the placenta either fully or partially detaches from the uterine wall
When does placental abruption most commonly occur?
in the third trimester
What is the major difference in symptomalogy between placenta abruptio and placenta previa?
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?
placenta previa
What is the recommended treatment for polymyalgia rheumatica?
steroids
Patients with SLE are going to have what abnormal labwork?
elevated ESR and CRP
How do we treat lupus flares?
steroids
What are common sequelae of fibromyalgia?
insomnia and depression
What is a great treatment option for fibromyalgia?
amitriptyline (a TCA) because it helps with chronic pain, sleep, and depression
How is fibromyalgia diagnosed?
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?
when the femoral head of the hip is out of place
What is the trendelenburg sign and when is it positive?
a fluid collection in the bursa of a joint
How is bursitis treated?
a needle to instill intraarticular steroids and then pull off fluid
Bursitis can be a __________ issue
recurrent
The medical term for knock knees
genu valgum
The medical term for bow legs
genu varum
What is myasthenia gravis?
an autoimmune disorder that causes muscle weakness of the voluntary muscles
Genu valgum is caused by a problem with what?
the medial collateral ligament; think valgum as in gum makes your knees stick together
Genu varum is caused by a problem with what?
the lateral collateral ligament
What are shin splints?
a medial tibial syndrome caused by overuse of the muscles
How do we treat shin splints?
rest and avoidance of exercise until the pain resolves
What is the tell-tale difference between a herniated disc and sciatica?
sciatica feels better when you stand, a herniated disc feels better when you sit down
When will spinal or lumbar stenosis feel better?
when the patient sits down
What is Korsakoff syndrome?
a deficiency in thiamine and folate caused by alcoholism
What changes to the vagina occur with aging?
dryness, loss of rugae, less pubic hair
What is a navicular fracture?
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
How can we abort cluster headaches?
calcium or 100% oxygen application
Which type of headaches come with lacrimation and sinus symptoms?
cluster headaches
What does the apprehension test assess for?
used to assess for stability of the shoulder or knee; assesses for stability
How does the parathyroid gland regulate calcium?
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?
carbamazepine (tegretol) or amitriptyline. also want to do gabapentin or something for nerve pain
What is the recommended treatment for Bell's palsy?
steroids and anti-virals
How is the pain of trigeminal neuralgia vs temporal arteritis different?
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?
beta blockers, amitriptyline, venlafaxine, topamax, valproate
What is Addison's disease?
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?
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
molar pregnancy
What bacteria is the leading cause of urethritis?
neisseria gonorrhea
What is the most common cause of hypercortisolism?
excessive ACTH production
How do we treat developmental hip dysplasia in a child under 6 months?
Pavlik harness; if older than 6 months may need surgery
Which pap smear result is considered to be HPV positive?
LSIL
If a patient has LSIL with a negative HPV test, what would you do?
repeat in 1 year
If a patient has LSIL with no HPV test or a positive HPV test, what should you do?
refer for colposcopy
If a patient's pap results show NILM, what should you do?
repeat in 3 years
If a patient's pap results show ASC-H or HSIL what should you do?
refer for colposcopy
The valgus stress test assesses what?
the medial collateral ligament
The varus stress test assesses what?
the lateral collateral ligament
The Lachman's test assesses what?
the ACL
The McMurray's test assesses for what?
a torn meniscus
The anterior drawer test assesses what?
the acl
The posterior drawer test assesses what?
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
dawn phenomenon
How can you tell between the dawn and somogyi effect?
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
