APEA PREDICTOR EXAM 2026
COMPREHENSIVE REVIEW
1. A 65-year-old male presents with exertional dyspnea and syncope. Physical exam reveals a
harsh systolic crescendo-decrescendo murmur at the second right intercostal space radiating
to the carotids. Which diagnosis is most likely?
A. Mitral Regurgitation
B. Mitral Stenosis
C. Aortic Regurgitation
D. Aortic Stenosis
Answer: D
Conceptual Explanation: Aortic stenosis typically presents with a harsh systolic murmur
at the right upper sternal border radiating to the carotids, often associated with syncope,
angina, and heart failure.
2. Which of the following laboratory findings is most characteristic of iron deficiency anemia?
A. Increased Ferritin and Decreased TIBC
B. Decreased Ferritin and Increased TIBC
C. Normal MCV and Increased Reticulocytes
,D. Increased Serum Iron and Decreased Transferrin
Answer: B
Conceptual Explanation: In iron deficiency anemia, ferritin (iron stores) is low, and Total
Iron Binding Capacity (TIBC) increases as the body attempts to compensate for low iron
levels.
3. A 45-year-old female patient with a BMI of 32 presents with RUQ pain that radiates to the
right scapula, especially after eating a fatty meal. What is the most likely diagnosis?
A. Acute Pancreatitis
B. Gastroesophageal Reflux Disease
C. Cholecystitis
D. Peptic Ulcer Disease
Answer: C
Conceptual Explanation: Cholecystitis often presents with RUQ pain (Murphy’s sign) that
radiates to the right scapula, triggered by high-fat meals.
4. According to the JNC-8 guidelines, what is the blood pressure goal for a 62-year-old patient
with Chronic Kidney Disease?
A. <120/80 mmHg
B. <130/80 mmHg
C. <140/90 mmHg
, D. <150/90 mmHg
Answer: C
Conceptual Explanation: For patients of all ages with CKD or diabetes, JNC-8 recommends
a target blood pressure of less than 140/90 mmHg.
5. A patient presents with a ‘curtain dropping’ sensation over their vision and sudden
floaters. This is a medical emergency most consistent with:
A. Acute Angle-Closure Glaucoma
B. Cataracts
C. Macular Degeneration
D. Retinal Detachment
Answer: D
Conceptual Explanation: Retinal detachment is characterized by a sudden appearance of
floaters and the sensation of a curtain closing over the visual field.
6. Which antidepressant is preferred in elderly patients due to its low side-effect profile
regarding sedation and anticholinergic effects?
A. Amitriptyline
B. Paroxetine
C. Sertraline
D. Fluoxetine
COMPREHENSIVE REVIEW
1. A 65-year-old male presents with exertional dyspnea and syncope. Physical exam reveals a
harsh systolic crescendo-decrescendo murmur at the second right intercostal space radiating
to the carotids. Which diagnosis is most likely?
A. Mitral Regurgitation
B. Mitral Stenosis
C. Aortic Regurgitation
D. Aortic Stenosis
Answer: D
Conceptual Explanation: Aortic stenosis typically presents with a harsh systolic murmur
at the right upper sternal border radiating to the carotids, often associated with syncope,
angina, and heart failure.
2. Which of the following laboratory findings is most characteristic of iron deficiency anemia?
A. Increased Ferritin and Decreased TIBC
B. Decreased Ferritin and Increased TIBC
C. Normal MCV and Increased Reticulocytes
,D. Increased Serum Iron and Decreased Transferrin
Answer: B
Conceptual Explanation: In iron deficiency anemia, ferritin (iron stores) is low, and Total
Iron Binding Capacity (TIBC) increases as the body attempts to compensate for low iron
levels.
3. A 45-year-old female patient with a BMI of 32 presents with RUQ pain that radiates to the
right scapula, especially after eating a fatty meal. What is the most likely diagnosis?
A. Acute Pancreatitis
B. Gastroesophageal Reflux Disease
C. Cholecystitis
D. Peptic Ulcer Disease
Answer: C
Conceptual Explanation: Cholecystitis often presents with RUQ pain (Murphy’s sign) that
radiates to the right scapula, triggered by high-fat meals.
4. According to the JNC-8 guidelines, what is the blood pressure goal for a 62-year-old patient
with Chronic Kidney Disease?
A. <120/80 mmHg
B. <130/80 mmHg
C. <140/90 mmHg
, D. <150/90 mmHg
Answer: C
Conceptual Explanation: For patients of all ages with CKD or diabetes, JNC-8 recommends
a target blood pressure of less than 140/90 mmHg.
5. A patient presents with a ‘curtain dropping’ sensation over their vision and sudden
floaters. This is a medical emergency most consistent with:
A. Acute Angle-Closure Glaucoma
B. Cataracts
C. Macular Degeneration
D. Retinal Detachment
Answer: D
Conceptual Explanation: Retinal detachment is characterized by a sudden appearance of
floaters and the sensation of a curtain closing over the visual field.
6. Which antidepressant is preferred in elderly patients due to its low side-effect profile
regarding sedation and anticholinergic effects?
A. Amitriptyline
B. Paroxetine
C. Sertraline
D. Fluoxetine
