APEA-Style Practice Questions with Explanations (50)
Cardiovascular
1. AV nicking on retinal exam suggests what condition?
Answer: Hypertension
Explanation: Chronic hypertension causes thickening of retinal arterioles. When these
stiffened arteries cross veins, they compress them, producing AV nicking, a classic sign of
hypertensive retinopathy.
2. What is the first-line medication for uncomplicated hypertension?
Answer: Thiazide diuretic
Explanation: Guidelines recommend thiazide diuretics (e.g., hydrochlorothiazide) as first-
line therapy because they effectively lower blood pressure and reduce cardiovascular events.
3. Which medication class commonly causes a persistent dry cough?
Answer: ACE inhibitors
Explanation: ACE inhibitors increase bradykinin levels, which can irritate the lungs and
produce a chronic dry cough. If intolerable, patients are usually switched to an ARB.
4. The most common cause of heart failure in adults is:
Answer: Coronary artery disease
Explanation: Damage to heart muscle from ischemia or prior myocardial infarction weakens
the heart’s ability to pump effectively.
5. What electrolyte abnormality is associated with ACE inhibitors?
Answer: Hyperkalemia
Explanation: ACE inhibitors reduce aldosterone levels, decreasing potassium excretion by the
kidneys and causing elevated potassium.
Endocrine
6. Leading cause of chronic kidney disease (CKD):
Answer: Diabetes mellitus
Explanation: Persistent high blood glucose damages kidney filtration units (glomeruli), leading
to diabetic nephropathy.
7. Which test monitors long-term glucose control?
Answer: HbA1c
Explanation: HbA1c measures the average blood glucose level over the past 2–3 months by
assessing glycosylated hemoglobin.
, 8. What HbA1c level indicates diabetes?
Answer: ≥ 6.5%
Explanation: Diagnostic criteria for diabetes include HbA1c ≥6.5%, fasting glucose ≥126
mg/dL, or abnormal oral glucose tolerance test.
9. First-line medication for type 2 diabetes:
Answer: Metformin
Explanation: Metformin decreases hepatic glucose production and improves insulin
sensitivity. It is preferred due to effectiveness, safety, and weight neutrality.
10. Which diabetic medication commonly causes hypoglycemia?
Answer: Sulfonylureas
Explanation: Drugs such as glipizide and glyburide stimulate pancreatic insulin secretion,
which can lead to low blood glucose levels.
Infectious Diseases
11. Most common cause of bacterial pneumonia:
Answer: Streptococcus pneumoniae
Explanation: This organism is responsible for the majority of community-acquired
pneumonia cases.
12. Most common cause of viral pneumonia in children:
Answer: Respiratory Syncytial Virus (RSV)
Explanation: RSV is a leading cause of lower respiratory infections in infants and young
children.
13. Most common cause of urinary tract infections:
Answer: Escherichia coli
Explanation: E. coli normally lives in the gut and can enter the urinary tract, especially in
females due to shorter urethra.
14. First-line treatment for strep throat:
Answer: Penicillin or Amoxicillin
Explanation: Group A Streptococcus is highly sensitive to penicillin antibiotics.
15. When should antiviral therapy for shingles be started?
Answer: Within 72 hours
Explanation: Early treatment with antivirals such as acyclovir or valacyclovir reduces severity
and duration of symptoms.
Cardiovascular
1. AV nicking on retinal exam suggests what condition?
Answer: Hypertension
Explanation: Chronic hypertension causes thickening of retinal arterioles. When these
stiffened arteries cross veins, they compress them, producing AV nicking, a classic sign of
hypertensive retinopathy.
2. What is the first-line medication for uncomplicated hypertension?
Answer: Thiazide diuretic
Explanation: Guidelines recommend thiazide diuretics (e.g., hydrochlorothiazide) as first-
line therapy because they effectively lower blood pressure and reduce cardiovascular events.
3. Which medication class commonly causes a persistent dry cough?
Answer: ACE inhibitors
Explanation: ACE inhibitors increase bradykinin levels, which can irritate the lungs and
produce a chronic dry cough. If intolerable, patients are usually switched to an ARB.
4. The most common cause of heart failure in adults is:
Answer: Coronary artery disease
Explanation: Damage to heart muscle from ischemia or prior myocardial infarction weakens
the heart’s ability to pump effectively.
5. What electrolyte abnormality is associated with ACE inhibitors?
Answer: Hyperkalemia
Explanation: ACE inhibitors reduce aldosterone levels, decreasing potassium excretion by the
kidneys and causing elevated potassium.
Endocrine
6. Leading cause of chronic kidney disease (CKD):
Answer: Diabetes mellitus
Explanation: Persistent high blood glucose damages kidney filtration units (glomeruli), leading
to diabetic nephropathy.
7. Which test monitors long-term glucose control?
Answer: HbA1c
Explanation: HbA1c measures the average blood glucose level over the past 2–3 months by
assessing glycosylated hemoglobin.
, 8. What HbA1c level indicates diabetes?
Answer: ≥ 6.5%
Explanation: Diagnostic criteria for diabetes include HbA1c ≥6.5%, fasting glucose ≥126
mg/dL, or abnormal oral glucose tolerance test.
9. First-line medication for type 2 diabetes:
Answer: Metformin
Explanation: Metformin decreases hepatic glucose production and improves insulin
sensitivity. It is preferred due to effectiveness, safety, and weight neutrality.
10. Which diabetic medication commonly causes hypoglycemia?
Answer: Sulfonylureas
Explanation: Drugs such as glipizide and glyburide stimulate pancreatic insulin secretion,
which can lead to low blood glucose levels.
Infectious Diseases
11. Most common cause of bacterial pneumonia:
Answer: Streptococcus pneumoniae
Explanation: This organism is responsible for the majority of community-acquired
pneumonia cases.
12. Most common cause of viral pneumonia in children:
Answer: Respiratory Syncytial Virus (RSV)
Explanation: RSV is a leading cause of lower respiratory infections in infants and young
children.
13. Most common cause of urinary tract infections:
Answer: Escherichia coli
Explanation: E. coli normally lives in the gut and can enter the urinary tract, especially in
females due to shorter urethra.
14. First-line treatment for strep throat:
Answer: Penicillin or Amoxicillin
Explanation: Group A Streptococcus is highly sensitive to penicillin antibiotics.
15. When should antiviral therapy for shingles be started?
Answer: Within 72 hours
Explanation: Early treatment with antivirals such as acyclovir or valacyclovir reduces severity
and duration of symptoms.
