APEA Major Questions and Correct Detailed
Answers – APEA – 2025/2026 Complete Exam
Practice Questions with Answers
SECTION 1: PATHOPHYSIOLOGY
1. A 55-year-old patient with a history of hypertension and hyperlipidemia
presents with progressive shortness of breath and fatigue. On auscultation, you
hear late inspiratory crackles at the lung bases. Which breath sound finding is
most consistent with left-sided heart failure?
• A. Vesicular with late inspiratory crackles
• B. Diminished vesicular sounds
• C. Bronchial breath sounds
• D. Expiratory wheezing
Answer: A
Rationale: Left-sided heart failure causes pulmonary congestion, resulting in
vesicular breath sounds with late inspiratory crackles (rales) at the lung bases. This
occurs due to fluid accumulation in the alveoli and interstitial spaces .
2. A patient with cirrhosis presents with an enlarged spleen on physical
examination. This finding is most suggestive of:
• A. Hepatic encephalopathy
• B. Portal hypertension
• C. Hepatocellular carcinoma
• D. Ascites
, Answer: B
Rationale: Splenomegaly in a patient with cirrhosis indicates portal hypertension.
Increased pressure in the portal vein causes congestion in the splenic vein, leading
to splenic enlargement .
3. What is the earliest manifestation of cystic fibrosis in an infant?
• A. Chronic cough
• B. Failure to thrive
• C. Salty taste on the skin
• D. Meconium ileus
Answer: C
Rationale: The earliest manifestation of cystic fibrosis is often a salty taste on the
skin, detected by parents or during newborn screening. This occurs due to
abnormal chloride transport in sweat glands .
4. Which finding on ophthalmoscopic examination is characteristic of
glaucomatous cupping?
• A. Tiny red spots around the macula
• B. Pale appearance of the optic disc
• C. Dark specks between the fundus and lens
• D. Narrowing of retinal arterioles
Answer: B
Rationale: Glaucomatous cupping appears as a pale, enlarged optic disc cup with
thinning of the neuroretinal rim. It results from progressive loss of retinal ganglion
cells due to elevated intraocular pressure .
Answers – APEA – 2025/2026 Complete Exam
Practice Questions with Answers
SECTION 1: PATHOPHYSIOLOGY
1. A 55-year-old patient with a history of hypertension and hyperlipidemia
presents with progressive shortness of breath and fatigue. On auscultation, you
hear late inspiratory crackles at the lung bases. Which breath sound finding is
most consistent with left-sided heart failure?
• A. Vesicular with late inspiratory crackles
• B. Diminished vesicular sounds
• C. Bronchial breath sounds
• D. Expiratory wheezing
Answer: A
Rationale: Left-sided heart failure causes pulmonary congestion, resulting in
vesicular breath sounds with late inspiratory crackles (rales) at the lung bases. This
occurs due to fluid accumulation in the alveoli and interstitial spaces .
2. A patient with cirrhosis presents with an enlarged spleen on physical
examination. This finding is most suggestive of:
• A. Hepatic encephalopathy
• B. Portal hypertension
• C. Hepatocellular carcinoma
• D. Ascites
, Answer: B
Rationale: Splenomegaly in a patient with cirrhosis indicates portal hypertension.
Increased pressure in the portal vein causes congestion in the splenic vein, leading
to splenic enlargement .
3. What is the earliest manifestation of cystic fibrosis in an infant?
• A. Chronic cough
• B. Failure to thrive
• C. Salty taste on the skin
• D. Meconium ileus
Answer: C
Rationale: The earliest manifestation of cystic fibrosis is often a salty taste on the
skin, detected by parents or during newborn screening. This occurs due to
abnormal chloride transport in sweat glands .
4. Which finding on ophthalmoscopic examination is characteristic of
glaucomatous cupping?
• A. Tiny red spots around the macula
• B. Pale appearance of the optic disc
• C. Dark specks between the fundus and lens
• D. Narrowing of retinal arterioles
Answer: B
Rationale: Glaucomatous cupping appears as a pale, enlarged optic disc cup with
thinning of the neuroretinal rim. It results from progressive loss of retinal ganglion
cells due to elevated intraocular pressure .
