Ultimate APEA 3P 2026/2027 Exam Prep Bundle – 4 Real Exams, Answer Key, and Complete Study Guide for Success

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Ultimate APEA 3P 2026/2027 Exam Prep

Bundle – 4 Real Exams, Answer Key, and

Complete Study Guide for Success




1. A 58-year-old male with hypertension and type 2

diabetes presents for a follow-up. His blood pressure is

148/90 mmHg. Current medications: lisinopril 20 mg daily,

metformin 1000 mg BID. What is the most appropriate next

step?

A. Add hydrochlorothiazide 12.5 mg daily

B. Increase lisinopril to 40 mg daily

C. Add amlodipine 5 mg daily

D. Continue current regimen and reassess in 3 months

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Answer: A. Add hydrochlorothiazide 12.5 mg daily

Rationale: For patients with diabetes and hypertension, the

target BP is <130/80 mmHg. This patient is not at goal on an

ACE inhibitor alone. Adding a low-dose thiazide diuretic is

first-line add-on therapy per JNC 8/ACC/AHA guidelines.

Increasing lisinopril to 40 mg may cause hyperkalemia or renal

issues. Amlodipine is also an option but thiazide is preferred

first add-on .

2. A 72-year-old female reports 3 months of bilateral hand

stiffness and pain that is worse in the morning and lasts

over 1 hour. She also has dry eyes and dry mouth. On

exam, you note swollen MCP and PIP joints bilaterally.

What is the most likely diagnosis?

A. Osteoarthritis

B. Rheumatoid arthritis

C. Sjögren's syndrome with inflammatory arthritis

D. Gout

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Answer: C. Sjögren's syndrome with inflammatory arthritis
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p. Rationale: The patient has sicca symptoms (dry eyes, dry
p. p. p. p. p. p. p. p.




p. mouth) combined with symmetric inflammatory polyarthritis.
p. p. p. p. p.




p. Primary Sjögren's syndrome can present with extraglandular
p. p. p. p. p. p.




p. manifestations including arthritis. Rheumatoid arthritis is also p. p. p. p. p. p.




p. possible but the sicca symptoms point to Sjögren's.
p. p. p. p. p. p. p.




Osteoarthritis does not cause prolonged morning stiffness. p. p. p. p. p. p.




p . Goutistypicallymonoarticular.
p. p. p. p.




3. A 45-year-old obese female presents with right upper
p. p. p. p. p. p. p.




p . quadrant pain after fatty meals. Ultrasound shows
p. p. p. p. p. p.




p. gallstones. She is otherwise healthy. What is the p. p. p. p. p. p. p.




p. appropriate management? p.




A. Ursodeoxycholic acid therapy p. p.




B. Laparoscopic cholecystectomy p .




C. Low-fat diet and observation p. p. p.




D. ERCP with sphincterotomy p. p.

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Answer: B. Laparoscopic cholecystectomyp . p . p .




Rationale: Symptomatic cholelithiasis (pain after fatty meals) is
p. p. p. p. p. p. p.




p. an indication for cholecystectomy. Observation is for
p. p. p. p. p. p.




p. asymptomatic stones. Ursodeoxycholic acid is for dissolving p. p. p. p. p. p.




p. cholesterol stones in patients who cannot undergo surgery.
p. p. p. p. p. p. p.




ERCP is for common bile duct stones, not uncomplicated
p. p. p. p. p. p. p. p.




p. gallbladder stones . p. p.




4. A 28-year-old male presents with acute onset of severe
p. p. p. p. p. p. p. p.




p. testicular pain, nausea, and vomiting. On exam, the testis is
p. p. p. p. p. p. p. p. p.




p . tender, elevated, and there is absent cremasteric reflex.
p. p. p. p. p. p. p.




p . What is the priority action?
p. p. p. p.




A. Obtain scrotal ultrasound p. p.




B. Prescribe antibiotics for epididymitis p. p. p.




C. Immediate surgical consultation for possible testicular torsion p . p . p . p . p . p .




D. Administer analgesics and reassess in 2 hours p. p. p. p. p. p.




Answer: C. Immediate surgical consultation for possible
p. p. p. p. p. p.




p . testicular torsion p.