APEA PREDICTOR EXAM 2026/2027
QUESTIONS AND ANSWERS
1. A 65-year-old patient presents with a new-onset holosystolic murmur heard best at the
apex, radiating to the left axilla. What is the most likely diagnosis?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Mitral Stenosis
D. Aortic Regurgitation
Answer: A
Conceptual Explanation: Mitral regurgitation is characterized by a holosystolic murmur
heard best at the apex with radiation to the axilla. Aortic stenosis radiates to the carotids.
2. Which of the following is the first-line treatment for a patient diagnosed with mild to
moderate Hidradenitis Suppurativa?
A. Oral Isotretinoin
B. Topical Clindamycin
C. Intravenous Ceftriaxone
D. Oral Prednisone
,Answer: B
Conceptual Explanation: Topical clindamycin is the recommended first-line treatment for
Hurley Stage I (mild) hidradenitis suppurativa.
3. A patient with a history of hypertension and CKD Stage 3 presents with a blood pressure of
152/94. Which class of medication is preferred for kidney protection?
A. ACE Inhibitors
B. Loop Diuretics
C. Calcium Channel Blockers
D. Beta Blockers
Answer: A
Conceptual Explanation: ACE inhibitors or ARBs are preferred in patients with Chronic
Kidney Disease (CKD) because they reduce intraglomerular pressure and proteinuria.
4. According to the GINA guidelines, what is the preferred rescue medication for a patient
with Step 1 asthma?
A. SABA (Albuterol) alone
B. Long-acting Beta Agonists alone
C. Oral Corticosteroids
D. Low-dose ICS-formoterol as needed
Answer: D
, Conceptual Explanation: Current GINA guidelines recommend low-dose ICS-formoterol
as the preferred reliever to reduce the risk of severe exacerbations, even in Step 1.
5. Which cranial nerve is assessed when asking a patient to shrug their shoulders against
resistance?
A. CN X (Vagus)
B. CN XII (Hypoglossal)
C. CN XI (Spinal Accessory)
D. CN IX (Glossopharyngeal)
Answer: C
Conceptual Explanation: CN XI (Spinal Accessory) innervates the sternocleidomastoid
and trapezius muscles; shoulder shrugging tests this nerve.
6. A 4-year-old child is brought in for a routine check-up. The mother is concerned that the
child is not yet drawing a square. Is this a developmental delay?
A. No, drawing a square is typically a 4-year-old milestone
B. Yes, children should draw squares by age 3
C. Yes, children should draw squares by age 2
D. No, drawing a square is typically a 5-year-old milestone
Answer: A
QUESTIONS AND ANSWERS
1. A 65-year-old patient presents with a new-onset holosystolic murmur heard best at the
apex, radiating to the left axilla. What is the most likely diagnosis?
A. Mitral Regurgitation
B. Aortic Stenosis
C. Mitral Stenosis
D. Aortic Regurgitation
Answer: A
Conceptual Explanation: Mitral regurgitation is characterized by a holosystolic murmur
heard best at the apex with radiation to the axilla. Aortic stenosis radiates to the carotids.
2. Which of the following is the first-line treatment for a patient diagnosed with mild to
moderate Hidradenitis Suppurativa?
A. Oral Isotretinoin
B. Topical Clindamycin
C. Intravenous Ceftriaxone
D. Oral Prednisone
,Answer: B
Conceptual Explanation: Topical clindamycin is the recommended first-line treatment for
Hurley Stage I (mild) hidradenitis suppurativa.
3. A patient with a history of hypertension and CKD Stage 3 presents with a blood pressure of
152/94. Which class of medication is preferred for kidney protection?
A. ACE Inhibitors
B. Loop Diuretics
C. Calcium Channel Blockers
D. Beta Blockers
Answer: A
Conceptual Explanation: ACE inhibitors or ARBs are preferred in patients with Chronic
Kidney Disease (CKD) because they reduce intraglomerular pressure and proteinuria.
4. According to the GINA guidelines, what is the preferred rescue medication for a patient
with Step 1 asthma?
A. SABA (Albuterol) alone
B. Long-acting Beta Agonists alone
C. Oral Corticosteroids
D. Low-dose ICS-formoterol as needed
Answer: D
, Conceptual Explanation: Current GINA guidelines recommend low-dose ICS-formoterol
as the preferred reliever to reduce the risk of severe exacerbations, even in Step 1.
5. Which cranial nerve is assessed when asking a patient to shrug their shoulders against
resistance?
A. CN X (Vagus)
B. CN XII (Hypoglossal)
C. CN XI (Spinal Accessory)
D. CN IX (Glossopharyngeal)
Answer: C
Conceptual Explanation: CN XI (Spinal Accessory) innervates the sternocleidomastoid
and trapezius muscles; shoulder shrugging tests this nerve.
6. A 4-year-old child is brought in for a routine check-up. The mother is concerned that the
child is not yet drawing a square. Is this a developmental delay?
A. No, drawing a square is typically a 4-year-old milestone
B. Yes, children should draw squares by age 3
C. Yes, children should draw squares by age 2
D. No, drawing a square is typically a 5-year-old milestone
Answer: A
