APEA PREDICTOR REMEDIATION
EXAM WITH CORRECT
ANSWERS 2025
AFIB/ EKG finding ( correct answers ) Abnormal atrial depolarization w/
ventricular
normal
CHAOS IN THE
depolarization
NO P
ATRIUM
waves
Types of AFIB ( correct answers ) Controlled-
<100 bpm
Uncontrolled- >100
bpm
Management & Meds ( rate control, rhythm control, anticoags) ( correct
answers
Rate control:
) Metoprolol (BBS) or Diltiazem
rhythm control w/ antiarrhythmics
(CCBs)
( Amiodarone)
Anticoags- Warfarin - ASSESS CHADS-VASC
score
CHADS-VASC score ( correct answers ) Stroke risk tool used
for AFIB
CHF, HTN, >/= 75 yo, DM, prior stroke/
TIA/Thromboembolism
Amiodarone (MOA, LONG TERM USE CAUSES?) ( correct answers )
prevents
conduction of unwanted cardiac
impulses
Test tip: assess chest x-ray & PFTs prior to
initiation
Long term use can lead to hypothyroidism, pulmonary toxicity & optic
neuropathy
Warfarin ( correct answers ) normal:1
Tx: if <2 increase dose; antidote:
goal:2-3,
Vitamin
INR 2-9: Khold & drop
INR >10 (- BLEEDING): Oral
dose
Vit K>10 (+ BLEEDING_):
INR
IV vit K
Things to avoid with Wafarin ( correct answers ) Green leafy vegs, mayo,
canola oil,
beef
liver,
Drug to drug interaction (Warfarin) 8 A'S ( correct answers ) ABX,
antidepressants, alternative (St. Johns wort, Gingko), antiplatelet,
antifungal,
and anti-
inflammatories, amiodarone,
acetaminophen
HTN (goal) ( correct answers ) <140/90 in pts <60 and past hx
of HTN/DM
<150/90 in pts >60 (more flexibity b/c arteries
get stiff)
JNC <130/80; If ACVSD risk >10 initiate
HTN meds
,TX HTN (1ST) ( correct answers ) Lifestyle modifications,
herbal ( COQ10)
ACE Inhibitors ( slow down how much AT2 your body makes)
( correct
"PRIL" Captopril,
answersEnalapril,
)
Afosiopril
Antihypertensive. Blocks ACE ( angiotension converting enzyme)
lungs from angiotensin I to angiotensin II (powerful vasoconstrictor).
converting
Decreases BP,
Decreased Aldosterone secretions, Sodium and fluid loss. Heart and renal
for
protective
*Orthostatic Hypotension, cough, angioedema,
DM
HYPERKALEMIA RISK
ARB (Angiotensin Receptor Blocker) ( blocks the receptors that use AT2 use
to narrow
the blood vessels)( correct answers ) -Sartan
antagonizes action of
(losartan
Heart and renal protective
aldosterone
for DM
Hyperkalemia risk,
dizziness
THIAZIDE ( correct answers ) HCTZ or
chlorthalidone
Blocks the sodium chloride channel in the distal convoluted tubule of
the kidney(
decrease sodium reabsorption and therefore decreases fluid
reabsorption)
preferred in osteoporosis & AA
Avoid in pts w/ hypercholestermia, gout and DM; causes increases in
pts.
uric acid,triglycerides, and
glucose,
calcium
Calcium channel blockers ( correct answers ) agents that inhibit
the entryions
calcium of into heart muscle cells, causing a slowing of the heart rate, a
lessening
the demand of for oxygen and nutrients, and a relaxing of the smooth
musclevessels
blood cells oftothe
cause dilation; used to prevent or treat angina
pectoris, some
arrhythmias, and
Preferred in >65 yo &
hypertension
AA pts
SE: ankle edema,
AVOID IN PTS WITH GERD- WEAKENS GASTRIC
headaches
SPHINCTER
Idiopathic systolic HTN ( correct answers ) Caused by stiff arteries;
thyroid, DM, seen in pts >60; bp goal:
overactive
<150 systolic
TX:
CCB
Kawaski (CREAM) ( correct answers ) Acute febrile illness of
unknown in
resulting cause
vascular
inflammation
leading cause of heart disease in
< 5 yo
high fever (up to 104 greater than 5 days), strawberry tongue,
peripheral edema,
conjunctival redness, peeling polymorphic rash over trunk, cervical
lymphadenopathy
(Often unilateral) dry lips, hand/foot
swelling
, TX of Kawasaki ( correct answers ) Aspirin &
IVIG Resolves in 4-8 weeks; f/u w. cardiology
Murmurs s3 & s4 ( correct answers ) S3-
Gallop-inheard
heard HF or@ the end of diastole,
S4- Atrial kick- heard right before systole caused by uncontrolled
pregnancy
HTN or LV
hypertrophy; benign finding in elderly
Systolic murmur ( MR PASS MVP) ( correct answers ) Mitral
regurgitation-
valve mitralproperly and causes blood to flow backward into left
doesn't close
atrium radiates
heart; of the to the axillae; can cause
circulation issues
physiological- innocent murmur; turbulent
blood flow
aortic stenosis- narrowing of the aortic valve, can cause dyspnea, syncope
and angina
on
systolic mitral valve prolapse- mitral valve's flaps bulge into the left
exertion
atriumduring
heart of thecontraction phase of the
heart.
Dental prophylaxis not necessary for MVP
Diastolic murmurs (ARMS DEALER)- sound when heart relaxes during beat
answers ) Aortic regurgitation- aortic valve doesn't close tightly
( correct
causing
mitral leaks the mitral valve is
stenosis-
narrowed
diastolic= DOOM- must be referred to
cardiology
Grading of murmurs ( correct answers ) • 1/6 murmur is just audible
by an
optimal expert in
• 2/6 is
setting.
• 3/6
quiet.
is moderately
• loud.
4/6 is markedly loud and accompanied by
• 5/6
a thrill.
is very loud and accompanied by
•a 6/6
thrill.
is audible without a
stethoscope.
• A grade I and II midsystolic murmur in an asymptomatic patient requires
workup.
no furtherIf the patient is
•symptomatic:
A grade III or echo.
higher holosystolic, or late systolic murmur
requires
Basal cell carcinoma ( correct answers ) Most common and least severe
type cancer;
skin of often characterized by light or pearly nodules w/ ulcerated
center
not heal,
that key
dofinding: telangiectasia fair-skinned w/ chronic UV
exposure,
refer to derm for biopsy and
removal
Bites (animals,
people)
Sxs, TX, f/u ( correct answers ) may produce redness, swelling & pain
within 12-24
hour
s
EXAM WITH CORRECT
ANSWERS 2025
AFIB/ EKG finding ( correct answers ) Abnormal atrial depolarization w/
ventricular
normal
CHAOS IN THE
depolarization
NO P
ATRIUM
waves
Types of AFIB ( correct answers ) Controlled-
<100 bpm
Uncontrolled- >100
bpm
Management & Meds ( rate control, rhythm control, anticoags) ( correct
answers
Rate control:
) Metoprolol (BBS) or Diltiazem
rhythm control w/ antiarrhythmics
(CCBs)
( Amiodarone)
Anticoags- Warfarin - ASSESS CHADS-VASC
score
CHADS-VASC score ( correct answers ) Stroke risk tool used
for AFIB
CHF, HTN, >/= 75 yo, DM, prior stroke/
TIA/Thromboembolism
Amiodarone (MOA, LONG TERM USE CAUSES?) ( correct answers )
prevents
conduction of unwanted cardiac
impulses
Test tip: assess chest x-ray & PFTs prior to
initiation
Long term use can lead to hypothyroidism, pulmonary toxicity & optic
neuropathy
Warfarin ( correct answers ) normal:1
Tx: if <2 increase dose; antidote:
goal:2-3,
Vitamin
INR 2-9: Khold & drop
INR >10 (- BLEEDING): Oral
dose
Vit K>10 (+ BLEEDING_):
INR
IV vit K
Things to avoid with Wafarin ( correct answers ) Green leafy vegs, mayo,
canola oil,
beef
liver,
Drug to drug interaction (Warfarin) 8 A'S ( correct answers ) ABX,
antidepressants, alternative (St. Johns wort, Gingko), antiplatelet,
antifungal,
and anti-
inflammatories, amiodarone,
acetaminophen
HTN (goal) ( correct answers ) <140/90 in pts <60 and past hx
of HTN/DM
<150/90 in pts >60 (more flexibity b/c arteries
get stiff)
JNC <130/80; If ACVSD risk >10 initiate
HTN meds
,TX HTN (1ST) ( correct answers ) Lifestyle modifications,
herbal ( COQ10)
ACE Inhibitors ( slow down how much AT2 your body makes)
( correct
"PRIL" Captopril,
answersEnalapril,
)
Afosiopril
Antihypertensive. Blocks ACE ( angiotension converting enzyme)
lungs from angiotensin I to angiotensin II (powerful vasoconstrictor).
converting
Decreases BP,
Decreased Aldosterone secretions, Sodium and fluid loss. Heart and renal
for
protective
*Orthostatic Hypotension, cough, angioedema,
DM
HYPERKALEMIA RISK
ARB (Angiotensin Receptor Blocker) ( blocks the receptors that use AT2 use
to narrow
the blood vessels)( correct answers ) -Sartan
antagonizes action of
(losartan
Heart and renal protective
aldosterone
for DM
Hyperkalemia risk,
dizziness
THIAZIDE ( correct answers ) HCTZ or
chlorthalidone
Blocks the sodium chloride channel in the distal convoluted tubule of
the kidney(
decrease sodium reabsorption and therefore decreases fluid
reabsorption)
preferred in osteoporosis & AA
Avoid in pts w/ hypercholestermia, gout and DM; causes increases in
pts.
uric acid,triglycerides, and
glucose,
calcium
Calcium channel blockers ( correct answers ) agents that inhibit
the entryions
calcium of into heart muscle cells, causing a slowing of the heart rate, a
lessening
the demand of for oxygen and nutrients, and a relaxing of the smooth
musclevessels
blood cells oftothe
cause dilation; used to prevent or treat angina
pectoris, some
arrhythmias, and
Preferred in >65 yo &
hypertension
AA pts
SE: ankle edema,
AVOID IN PTS WITH GERD- WEAKENS GASTRIC
headaches
SPHINCTER
Idiopathic systolic HTN ( correct answers ) Caused by stiff arteries;
thyroid, DM, seen in pts >60; bp goal:
overactive
<150 systolic
TX:
CCB
Kawaski (CREAM) ( correct answers ) Acute febrile illness of
unknown in
resulting cause
vascular
inflammation
leading cause of heart disease in
< 5 yo
high fever (up to 104 greater than 5 days), strawberry tongue,
peripheral edema,
conjunctival redness, peeling polymorphic rash over trunk, cervical
lymphadenopathy
(Often unilateral) dry lips, hand/foot
swelling
, TX of Kawasaki ( correct answers ) Aspirin &
IVIG Resolves in 4-8 weeks; f/u w. cardiology
Murmurs s3 & s4 ( correct answers ) S3-
Gallop-inheard
heard HF or@ the end of diastole,
S4- Atrial kick- heard right before systole caused by uncontrolled
pregnancy
HTN or LV
hypertrophy; benign finding in elderly
Systolic murmur ( MR PASS MVP) ( correct answers ) Mitral
regurgitation-
valve mitralproperly and causes blood to flow backward into left
doesn't close
atrium radiates
heart; of the to the axillae; can cause
circulation issues
physiological- innocent murmur; turbulent
blood flow
aortic stenosis- narrowing of the aortic valve, can cause dyspnea, syncope
and angina
on
systolic mitral valve prolapse- mitral valve's flaps bulge into the left
exertion
atriumduring
heart of thecontraction phase of the
heart.
Dental prophylaxis not necessary for MVP
Diastolic murmurs (ARMS DEALER)- sound when heart relaxes during beat
answers ) Aortic regurgitation- aortic valve doesn't close tightly
( correct
causing
mitral leaks the mitral valve is
stenosis-
narrowed
diastolic= DOOM- must be referred to
cardiology
Grading of murmurs ( correct answers ) • 1/6 murmur is just audible
by an
optimal expert in
• 2/6 is
setting.
• 3/6
quiet.
is moderately
• loud.
4/6 is markedly loud and accompanied by
• 5/6
a thrill.
is very loud and accompanied by
•a 6/6
thrill.
is audible without a
stethoscope.
• A grade I and II midsystolic murmur in an asymptomatic patient requires
workup.
no furtherIf the patient is
•symptomatic:
A grade III or echo.
higher holosystolic, or late systolic murmur
requires
Basal cell carcinoma ( correct answers ) Most common and least severe
type cancer;
skin of often characterized by light or pearly nodules w/ ulcerated
center
not heal,
that key
dofinding: telangiectasia fair-skinned w/ chronic UV
exposure,
refer to derm for biopsy and
removal
Bites (animals,
people)
Sxs, TX, f/u ( correct answers ) may produce redness, swelling & pain
within 12-24
hour
s
