PAEA EOC EXAM, PAEA SUMMATIVE PRACTICE (NEW UPDATED VERSION) LATEST
ACTUAL EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED QUESTIONS AND ANSWERS) |
GUARANTEED PASS A+ [2025]
PAEA EOC Practice Exam
1. A 65-year-old man presents with chest pain radiating to his left arm. EKG shows ST-elevation
in leads II, III, and aVF. Which coronary artery is most likely occluded?
A) Left anterior descending
B) Left circumflex
C) Right coronary artery
D) Posterior descending artery
Rationale: ST-elevation in II, III, and aVF indicates an inferior MI, usually supplied by the right
coronary artery.
2. A patient with type 2 diabetes presents with polyuria, polydipsia, and fruity-smelling breath.
Which lab finding is most consistent with this presentation?
A) Hypoglycemia
B) Hyperosmolar hyperglycemic state
C) Diabetic ketoacidosis
D) Hypokalemia
Rationale: Polyuria, polydipsia, and fruity breath suggest DKA; labs would show
hyperglycemia, ketonemia, and metabolic acidosis.
3. A 24-year-old woman presents with acute onset shortness of breath and pleuritic chest pain
after a long flight. What is the most likely diagnosis?
A) Pneumonia
B) Pulmonary embolism
C) Asthma exacerbation
D) Myocardial infarction
Rationale: Acute dyspnea with recent immobilization suggests PE. Risk factors include
prolonged travel, OCP use, and hypercoagulable states.
2026 Graded A+ EXAM
,4. A 50-year-old man presents with fatigue, jaundice, and elevated AST > ALT. Which is the
most likely cause?
A) Alcoholic hepatitis
B) Viral hepatitis
C) Non-alcoholic fatty liver disease
D) Hemochromatosis
Rationale: AST:ALT > 2:1 is classic for alcoholic hepatitis.
5. A patient with asthma presents with wheezing and use of accessory muscles. Which is the
first-line therapy?
A) Oral prednisone
B) Inhaled corticosteroid
C) Short-acting beta-agonist (SABA)
D) Leukotriene receptor antagonist
Rationale: Acute exacerbations are treated with inhaled SABA for rapid bronchodilation.
6. A 70-year-old woman presents with sudden onset unilateral weakness and slurred speech. CT
scan shows no hemorrhage. What is the next step?
A) Administer tPA if within window
B) Immediate anticoagulation
C) Surgery
D) Observation only
Rationale: Ischemic stroke without hemorrhage is treated with tPA if within 3–4.5 hours from
onset.
7. A patient presents with fever, sore throat, and posterior cervical lymphadenopathy. Rapid strep
test is positive. Best initial treatment?
A) Amoxicillin
B) Azithromycin
C) Ciprofloxacin
D) No antibiotics
Rationale: Group A streptococcal pharyngitis is treated with penicillin or amoxicillin.
2026 Graded A+ EXAM
,8. A 30-year-old woman presents with heat intolerance, palpitations, and exophthalmos. Which
lab is most consistent?
A) Low TSH, high free T4
B) High TSH, low T4
C) Low TSH, low T4
D) Normal TSH, high T4
Rationale: Graves’ disease presents with hyperthyroidism (low TSH, high T4) and eye signs.
9. Which antihypertensive is contraindicated in pregnancy?
A) Labetalol
B) Methyldopa
C) ACE inhibitor
D) Nifedipine
Rationale: ACE inhibitors are teratogenic and should be avoided in pregnancy.
10. A 60-year-old man presents with painless hematuria. Most concerning etiology?
A) Urinary tract infection
B) Bladder cancer
C) Kidney stones
D) Benign prostatic hyperplasia
Rationale: Painless gross hematuria in adults is concerning for malignancy, especially bladder
cancer.
11. A 25-year-old man presents with severe right lower quadrant pain, nausea, and fever. Most
likely diagnosis?
A) Gastroenteritis
B) Appendicitis
C) Cholecystitis
D) Renal colic
Rationale: RLQ pain with nausea, fever, and leukocytosis suggests acute appendicitis.
12. A patient presents with acute confusion, agitation, and tremor. History includes alcohol use
disorder. Which is the likely diagnosis?
2026 Graded A+ EXAM
, A) Alcohol withdrawal
B) Delirium tremens
C) Wernicke encephalopathy
D) Sepsis
Rationale: Alcohol withdrawal can present with tremor, agitation, and hallucinations; severe
cases are DTs.
13. First-line therapy for community-acquired pneumonia in an otherwise healthy adult?
A) Amoxicillin
B) Vancomycin
C) Piperacillin-tazobactam
D) Levofloxacin
Rationale: Outpatient CAP in healthy adults is usually treated with amoxicillin or doxycycline.
14. A 55-year-old man presents with persistent heartburn and dysphagia. Next best diagnostic
step?
A) EGD (endoscopy)
B) Barium swallow
C) PPI trial only
D) Colonoscopy
Rationale: Alarm symptoms (dysphagia) require endoscopy to rule out malignancy.
15. A patient presents with fatigue and pallor. Labs show low MCV, low ferritin, high TIBC.
Most likely diagnosis?
A) Iron deficiency anemia
B) Vitamin B12 deficiency
C) Anemia of chronic disease
D) Hemolytic anemia
Rationale: Low ferritin and high TIBC indicate iron deficiency anemia.
16. A 45-year-old man presents with sudden, severe, tearing chest pain radiating to the back. BP
is unequal in arms. Most likely diagnosis?
A) Myocardial infarction
2026 Graded A+ EXAM
ACTUAL EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED QUESTIONS AND ANSWERS) |
GUARANTEED PASS A+ [2025]
PAEA EOC Practice Exam
1. A 65-year-old man presents with chest pain radiating to his left arm. EKG shows ST-elevation
in leads II, III, and aVF. Which coronary artery is most likely occluded?
A) Left anterior descending
B) Left circumflex
C) Right coronary artery
D) Posterior descending artery
Rationale: ST-elevation in II, III, and aVF indicates an inferior MI, usually supplied by the right
coronary artery.
2. A patient with type 2 diabetes presents with polyuria, polydipsia, and fruity-smelling breath.
Which lab finding is most consistent with this presentation?
A) Hypoglycemia
B) Hyperosmolar hyperglycemic state
C) Diabetic ketoacidosis
D) Hypokalemia
Rationale: Polyuria, polydipsia, and fruity breath suggest DKA; labs would show
hyperglycemia, ketonemia, and metabolic acidosis.
3. A 24-year-old woman presents with acute onset shortness of breath and pleuritic chest pain
after a long flight. What is the most likely diagnosis?
A) Pneumonia
B) Pulmonary embolism
C) Asthma exacerbation
D) Myocardial infarction
Rationale: Acute dyspnea with recent immobilization suggests PE. Risk factors include
prolonged travel, OCP use, and hypercoagulable states.
2026 Graded A+ EXAM
,4. A 50-year-old man presents with fatigue, jaundice, and elevated AST > ALT. Which is the
most likely cause?
A) Alcoholic hepatitis
B) Viral hepatitis
C) Non-alcoholic fatty liver disease
D) Hemochromatosis
Rationale: AST:ALT > 2:1 is classic for alcoholic hepatitis.
5. A patient with asthma presents with wheezing and use of accessory muscles. Which is the
first-line therapy?
A) Oral prednisone
B) Inhaled corticosteroid
C) Short-acting beta-agonist (SABA)
D) Leukotriene receptor antagonist
Rationale: Acute exacerbations are treated with inhaled SABA for rapid bronchodilation.
6. A 70-year-old woman presents with sudden onset unilateral weakness and slurred speech. CT
scan shows no hemorrhage. What is the next step?
A) Administer tPA if within window
B) Immediate anticoagulation
C) Surgery
D) Observation only
Rationale: Ischemic stroke without hemorrhage is treated with tPA if within 3–4.5 hours from
onset.
7. A patient presents with fever, sore throat, and posterior cervical lymphadenopathy. Rapid strep
test is positive. Best initial treatment?
A) Amoxicillin
B) Azithromycin
C) Ciprofloxacin
D) No antibiotics
Rationale: Group A streptococcal pharyngitis is treated with penicillin or amoxicillin.
2026 Graded A+ EXAM
,8. A 30-year-old woman presents with heat intolerance, palpitations, and exophthalmos. Which
lab is most consistent?
A) Low TSH, high free T4
B) High TSH, low T4
C) Low TSH, low T4
D) Normal TSH, high T4
Rationale: Graves’ disease presents with hyperthyroidism (low TSH, high T4) and eye signs.
9. Which antihypertensive is contraindicated in pregnancy?
A) Labetalol
B) Methyldopa
C) ACE inhibitor
D) Nifedipine
Rationale: ACE inhibitors are teratogenic and should be avoided in pregnancy.
10. A 60-year-old man presents with painless hematuria. Most concerning etiology?
A) Urinary tract infection
B) Bladder cancer
C) Kidney stones
D) Benign prostatic hyperplasia
Rationale: Painless gross hematuria in adults is concerning for malignancy, especially bladder
cancer.
11. A 25-year-old man presents with severe right lower quadrant pain, nausea, and fever. Most
likely diagnosis?
A) Gastroenteritis
B) Appendicitis
C) Cholecystitis
D) Renal colic
Rationale: RLQ pain with nausea, fever, and leukocytosis suggests acute appendicitis.
12. A patient presents with acute confusion, agitation, and tremor. History includes alcohol use
disorder. Which is the likely diagnosis?
2026 Graded A+ EXAM
, A) Alcohol withdrawal
B) Delirium tremens
C) Wernicke encephalopathy
D) Sepsis
Rationale: Alcohol withdrawal can present with tremor, agitation, and hallucinations; severe
cases are DTs.
13. First-line therapy for community-acquired pneumonia in an otherwise healthy adult?
A) Amoxicillin
B) Vancomycin
C) Piperacillin-tazobactam
D) Levofloxacin
Rationale: Outpatient CAP in healthy adults is usually treated with amoxicillin or doxycycline.
14. A 55-year-old man presents with persistent heartburn and dysphagia. Next best diagnostic
step?
A) EGD (endoscopy)
B) Barium swallow
C) PPI trial only
D) Colonoscopy
Rationale: Alarm symptoms (dysphagia) require endoscopy to rule out malignancy.
15. A patient presents with fatigue and pallor. Labs show low MCV, low ferritin, high TIBC.
Most likely diagnosis?
A) Iron deficiency anemia
B) Vitamin B12 deficiency
C) Anemia of chronic disease
D) Hemolytic anemia
Rationale: Low ferritin and high TIBC indicate iron deficiency anemia.
16. A 45-year-old man presents with sudden, severe, tearing chest pain radiating to the back. BP
is unequal in arms. Most likely diagnosis?
A) Myocardial infarction
2026 Graded A+ EXAM
