APEA PREDICTOR EXAM
COMPREHENSIVE PRACTICE
QUESTIONS AND ANSWERS
1. A 68-year-old male with a history of hypertension and smoking presents with a new-onset,
harsh systolic murmur heard best at the second right intercostal space, radiating to the
carotids. What is the most likely diagnosis?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Mitral Stenosis
D. Aortic Regurgitation
Answer: A
Conceptual Explanation: Aortic stenosis is characterized by a harsh systolic crescendo-
decrescendo murmur at the right upper sternal border that radiates to the neck.
2. Which of the following laboratory findings is most specific for a diagnosis of Iron Deficiency
Anemia?
A. Low Serum Ferritin
B. High Total Iron Binding Capacity (TIBC)
,C. Low Hemoglobin
D. Increased Mean Corpuscular Volume (MCV)
Answer: A
Conceptual Explanation: Serum ferritin is the most sensitive and specific test for iron
deficiency anemia, reflecting depleted iron stores.
3. A patient with Type 2 Diabetes is currently taking Metformin 1000mg BID but their A1c
remains at 8.2%. The patient has established Atherosclerotic Cardiovascular Disease (ASCVD).
Which medication class should be added next?
A. Sulfonylurea
B. DPP-4 Inhibitor
C. TZD
D. GLP-1 Receptor Agonist
Answer: D
Conceptual Explanation: According to ADA guidelines, for patients with established
ASCVD and suboptimal A1c, a GLP-1 receptor agonist with proven CVD benefit should be
prioritized.
4. Which physical exam maneuver is performed by deeply palpating the left lower quadrant
of the abdomen to elicit pain in the right lower quadrant?
A. Rovsing’s Sign
, B. Obturator Sign
C. Murphy’s Sign
D. Psoas Sign
Answer: A
Conceptual Explanation: Rovsing’s sign is a clinical sign of appendicitis where pressure
on the LLQ causes pain in the RLQ.
5. A 24-year-old female presents with a malodorous vaginal discharge. On exam, you note a
thin, grayish-white discharge and a ‘strawberry cervix’. What is the treatment of choice?
A. Metronidazole 500mg BID for 7 days
B. Fluconazole 150mg single dose
C. Tinidazole 2g single dose
D. Ceftriaxone 500mg IM
Answer: C
Conceptual Explanation: The presence of a strawberry cervix is pathognomonic for
Trichomoniasis, which is treated with a single high dose of Metronidazole or Tinidazole.
6. A 72-year-old patient presents with sudden vision loss in the right eye described as a
‘curtain coming down’. This is most consistent with:
A. Acute Angle-Closure Glaucoma
B. Retinal Detachment
COMPREHENSIVE PRACTICE
QUESTIONS AND ANSWERS
1. A 68-year-old male with a history of hypertension and smoking presents with a new-onset,
harsh systolic murmur heard best at the second right intercostal space, radiating to the
carotids. What is the most likely diagnosis?
A. Aortic Stenosis
B. Mitral Regurgitation
C. Mitral Stenosis
D. Aortic Regurgitation
Answer: A
Conceptual Explanation: Aortic stenosis is characterized by a harsh systolic crescendo-
decrescendo murmur at the right upper sternal border that radiates to the neck.
2. Which of the following laboratory findings is most specific for a diagnosis of Iron Deficiency
Anemia?
A. Low Serum Ferritin
B. High Total Iron Binding Capacity (TIBC)
,C. Low Hemoglobin
D. Increased Mean Corpuscular Volume (MCV)
Answer: A
Conceptual Explanation: Serum ferritin is the most sensitive and specific test for iron
deficiency anemia, reflecting depleted iron stores.
3. A patient with Type 2 Diabetes is currently taking Metformin 1000mg BID but their A1c
remains at 8.2%. The patient has established Atherosclerotic Cardiovascular Disease (ASCVD).
Which medication class should be added next?
A. Sulfonylurea
B. DPP-4 Inhibitor
C. TZD
D. GLP-1 Receptor Agonist
Answer: D
Conceptual Explanation: According to ADA guidelines, for patients with established
ASCVD and suboptimal A1c, a GLP-1 receptor agonist with proven CVD benefit should be
prioritized.
4. Which physical exam maneuver is performed by deeply palpating the left lower quadrant
of the abdomen to elicit pain in the right lower quadrant?
A. Rovsing’s Sign
, B. Obturator Sign
C. Murphy’s Sign
D. Psoas Sign
Answer: A
Conceptual Explanation: Rovsing’s sign is a clinical sign of appendicitis where pressure
on the LLQ causes pain in the RLQ.
5. A 24-year-old female presents with a malodorous vaginal discharge. On exam, you note a
thin, grayish-white discharge and a ‘strawberry cervix’. What is the treatment of choice?
A. Metronidazole 500mg BID for 7 days
B. Fluconazole 150mg single dose
C. Tinidazole 2g single dose
D. Ceftriaxone 500mg IM
Answer: C
Conceptual Explanation: The presence of a strawberry cervix is pathognomonic for
Trichomoniasis, which is treated with a single high dose of Metronidazole or Tinidazole.
6. A 72-year-old patient presents with sudden vision loss in the right eye described as a
‘curtain coming down’. This is most consistent with:
A. Acute Angle-Closure Glaucoma
B. Retinal Detachment
