APEA PREDICTOR EXAM 2026
QUESTIONS AND ANSWERS
1. A 68-year-old male with a history of heart failure with reduced ejection fraction (HFrEF)
and an EF of 35% presents for follow-up. He is currently taking lisinopril 20mg daily and
metoprolol succinate 50mg daily. His blood pressure is 118/74 mmHg and heart rate is 62
bpm. According to the latest guidelines, which medication should be added next to reduce
mortality?
A. Amlodipine
B. Empagliflozin
C. Furosemide
D. Isosorbide mononitrate
Answer: B
Conceptual Explanation: SGLT2 inhibitors like empagliflozin are now recommended as
foundational therapy for HFrEF regardless of diabetes status because they significantly
reduce the risk of cardiovascular death and heart failure hospitalizations.
,2. A 45-year-old female presents with a ‘herald patch’ on her back, followed by a widespread
eruption of smaller ovoid erythematous lesions in a ‘Christmas tree’ pattern. Which of the
following is the most appropriate management?
A. Topical ketoconazole
B. Oral acyclovir
C. Oral prednisone taper
D. Reassurance and symptomatic treatment
Answer: D
Conceptual Explanation: This presentation is classic for Pityriasis Rosea, which is a self-
limiting condition. Treatment focuses on reassurance and managing pruritus with
antihistamines or topical steroids if needed.
3. An elderly patient presents with gradual memory loss, visual hallucinations, and fluctuating
levels of alertness. Physical exam reveals mild parkinsonism. What is the most likely
diagnosis?
A. Alzheimer’s disease
B. Vascular dementia
C. Frontotemporal dementia
D. Dementia with Lewy Bodies
Answer: D
, Conceptual Explanation: Dementia with Lewy Bodies is characterized by the triad of
fluctuating cognition, visual hallucinations, and spontaneous motor features of
parkinsonism.
4. Which of the following laboratory findings is most characteristic of a patient with iron
deficiency anemia?
A. Increased Ferritin, Increased TIBC
B. Decreased Ferritin, Decreased TIBC
C. Decreased Ferritin, Increased TIBC
D. Increased Ferritin, Decreased TIBC
Answer: C
Conceptual Explanation: In iron deficiency anemia, iron stores are depleted (low ferritin),
and the body produces more transferrin to compensate, leading to an increased Total Iron
Binding Capacity (TIBC).
5. A 32-year-old pregnant woman at 28 weeks gestation tests positive for gestational
diabetes. What is the first-line management for this patient?
A. Metformin
B. Glyburide
C. Insulin
D. Dietary modification and exercise
QUESTIONS AND ANSWERS
1. A 68-year-old male with a history of heart failure with reduced ejection fraction (HFrEF)
and an EF of 35% presents for follow-up. He is currently taking lisinopril 20mg daily and
metoprolol succinate 50mg daily. His blood pressure is 118/74 mmHg and heart rate is 62
bpm. According to the latest guidelines, which medication should be added next to reduce
mortality?
A. Amlodipine
B. Empagliflozin
C. Furosemide
D. Isosorbide mononitrate
Answer: B
Conceptual Explanation: SGLT2 inhibitors like empagliflozin are now recommended as
foundational therapy for HFrEF regardless of diabetes status because they significantly
reduce the risk of cardiovascular death and heart failure hospitalizations.
,2. A 45-year-old female presents with a ‘herald patch’ on her back, followed by a widespread
eruption of smaller ovoid erythematous lesions in a ‘Christmas tree’ pattern. Which of the
following is the most appropriate management?
A. Topical ketoconazole
B. Oral acyclovir
C. Oral prednisone taper
D. Reassurance and symptomatic treatment
Answer: D
Conceptual Explanation: This presentation is classic for Pityriasis Rosea, which is a self-
limiting condition. Treatment focuses on reassurance and managing pruritus with
antihistamines or topical steroids if needed.
3. An elderly patient presents with gradual memory loss, visual hallucinations, and fluctuating
levels of alertness. Physical exam reveals mild parkinsonism. What is the most likely
diagnosis?
A. Alzheimer’s disease
B. Vascular dementia
C. Frontotemporal dementia
D. Dementia with Lewy Bodies
Answer: D
, Conceptual Explanation: Dementia with Lewy Bodies is characterized by the triad of
fluctuating cognition, visual hallucinations, and spontaneous motor features of
parkinsonism.
4. Which of the following laboratory findings is most characteristic of a patient with iron
deficiency anemia?
A. Increased Ferritin, Increased TIBC
B. Decreased Ferritin, Decreased TIBC
C. Decreased Ferritin, Increased TIBC
D. Increased Ferritin, Decreased TIBC
Answer: C
Conceptual Explanation: In iron deficiency anemia, iron stores are depleted (low ferritin),
and the body produces more transferrin to compensate, leading to an increased Total Iron
Binding Capacity (TIBC).
5. A 32-year-old pregnant woman at 28 weeks gestation tests positive for gestational
diabetes. What is the first-line management for this patient?
A. Metformin
B. Glyburide
C. Insulin
D. Dietary modification and exercise
