BARKLEY 3P EXAM QUESTIONS WITH 100%
CORRECT ANSWERS WITH RATIONALES
2025/2026 LATEST UPDATE EXAM A patient
presents with chronic neuropathic pain in his
feet secondary to type 2 diabetes. Of the
following, the best therapeutic choice would be
Aortic regurgitation - Answer-A soft, high pitched, blowing diastolic decrescendo
murmur best heard at the 3rd left interspace at base, initiated with S2 and heard
when the patient sits up and leans forward.
Mitral stenosis - Answer-A low pitched diastolic rumble that does not radiate,
best heard at the apex when in the left lateral position.
Aortic stenosis - Answer-A loud, harsh murmur occurring midsystole, radiating
down the side of the neck and down to the apex.
Mitral regurgitation - Answer-A loud blowing murmur heard at the apex that is
pansystolic.
,Osteoporosis - Answer-The most common metabolic bone disease characterized
by chronic, progressive, systemic low bone mass and deterioration of bone tissue,
leading to increased skeletal fragility and deformity.
Bone deformity - Answer-The most common clinical manifestation of
osteoporosis.
Somogyi effect - Answer-Characterized by a combination of hypoglycemia
followed by rebound hyperglycemia.
Dawn phenomenon - Answer-Nocturnal hypoglycemia stimulates hyperglycemia
counter-regulation in the morning.
B cell deficiency - Answer-Inability to make antibodies.
Placenta - Answer-A barrier that ultimately exposes the baby to any drug that the
mother takes.
Mucopurulent rhinitis - Answer-A condition for which antibiotic use is most likely
appropriate if present for two days.
Dry cough lasting 7 days - Answer-Not typically appropriate for antibiotic use.
Clear rhinorrhea for 3 weeks - Answer-Not typically appropriate for antibiotic use.
,Cough and mucopurulent rhinitis for 3 weeks - Answer-Most likely appropriate for
antibiotic use.
Hyperprolactinemia - Answer-A side effect of aripiprazole (Abilify).
Gynecomastia - Answer-A side effect of aripiprazole (Abilify).
Diabetes - Answer-Can be induced in certain patients by aripiprazole (Abilify).
Myocarditis - Answer-Can be induced in certain patients by aripiprazole (Abilify).
Facial movements after cerebrovascular accident - Answer-Raising both sides of
the mouth is not possible.
Inability to fight off cancer cells - Answer-A characteristic of B cell deficiency.
Increased incidence of granulomas - Answer-Not a characteristic of B cell
deficiency.
Increased incidence of anemia - Answer-Not a characteristic of B cell deficiency.
Syndrome of inappropriate antidiuretic hormone (SIADH) - Answer-Defined as
hyponatremia despite normal or increased plasma volume, resulting from
impaired water excretion due to excess H2O versus deficiency of sodium.
, Graphesthesia - Answer-A test where a patient is asked to close their eyes and
trace the outline of a number into the palm of their hand to assess tactile
sensation.
Testosterone replacement therapy - Answer-Associated with cardiovascular risks,
including myocardial infarction, and is not indicated for patients with low
testosterone levels.
Split S2 heart sound - Answer-A normal phenomenon that occurs on end
inspiration, where the aortic valve closes significantly earlier than the pulmonic
valve.
Torsades de pointes - Answer-A type of polymorphic ventricular tachycardia that
is more common in females due to a prolonged QT interval.
Zolpidem (Ambien CR) - Answer-The most effective agent to help a patient with
insomnia that involves both difficulty falling asleep and maintaining sleep.
Hirschberg test - Answer-A test that assesses parallel alignment of the eyes by
shining a light towards the patient's eyes and assessing the reflection of light on
the corneas.
Testosterone level of 250 ng/dL - Answer-Indicates a low testosterone level in a
male patient desiring testosterone replacement to enhance libido.
Azole antifungals - Answer-Most likely to cause torsades de pointes in females, as
they have a prolonged QT interval that is 10 microseconds longer than in men.
CORRECT ANSWERS WITH RATIONALES
2025/2026 LATEST UPDATE EXAM A patient
presents with chronic neuropathic pain in his
feet secondary to type 2 diabetes. Of the
following, the best therapeutic choice would be
Aortic regurgitation - Answer-A soft, high pitched, blowing diastolic decrescendo
murmur best heard at the 3rd left interspace at base, initiated with S2 and heard
when the patient sits up and leans forward.
Mitral stenosis - Answer-A low pitched diastolic rumble that does not radiate,
best heard at the apex when in the left lateral position.
Aortic stenosis - Answer-A loud, harsh murmur occurring midsystole, radiating
down the side of the neck and down to the apex.
Mitral regurgitation - Answer-A loud blowing murmur heard at the apex that is
pansystolic.
,Osteoporosis - Answer-The most common metabolic bone disease characterized
by chronic, progressive, systemic low bone mass and deterioration of bone tissue,
leading to increased skeletal fragility and deformity.
Bone deformity - Answer-The most common clinical manifestation of
osteoporosis.
Somogyi effect - Answer-Characterized by a combination of hypoglycemia
followed by rebound hyperglycemia.
Dawn phenomenon - Answer-Nocturnal hypoglycemia stimulates hyperglycemia
counter-regulation in the morning.
B cell deficiency - Answer-Inability to make antibodies.
Placenta - Answer-A barrier that ultimately exposes the baby to any drug that the
mother takes.
Mucopurulent rhinitis - Answer-A condition for which antibiotic use is most likely
appropriate if present for two days.
Dry cough lasting 7 days - Answer-Not typically appropriate for antibiotic use.
Clear rhinorrhea for 3 weeks - Answer-Not typically appropriate for antibiotic use.
,Cough and mucopurulent rhinitis for 3 weeks - Answer-Most likely appropriate for
antibiotic use.
Hyperprolactinemia - Answer-A side effect of aripiprazole (Abilify).
Gynecomastia - Answer-A side effect of aripiprazole (Abilify).
Diabetes - Answer-Can be induced in certain patients by aripiprazole (Abilify).
Myocarditis - Answer-Can be induced in certain patients by aripiprazole (Abilify).
Facial movements after cerebrovascular accident - Answer-Raising both sides of
the mouth is not possible.
Inability to fight off cancer cells - Answer-A characteristic of B cell deficiency.
Increased incidence of granulomas - Answer-Not a characteristic of B cell
deficiency.
Increased incidence of anemia - Answer-Not a characteristic of B cell deficiency.
Syndrome of inappropriate antidiuretic hormone (SIADH) - Answer-Defined as
hyponatremia despite normal or increased plasma volume, resulting from
impaired water excretion due to excess H2O versus deficiency of sodium.
, Graphesthesia - Answer-A test where a patient is asked to close their eyes and
trace the outline of a number into the palm of their hand to assess tactile
sensation.
Testosterone replacement therapy - Answer-Associated with cardiovascular risks,
including myocardial infarction, and is not indicated for patients with low
testosterone levels.
Split S2 heart sound - Answer-A normal phenomenon that occurs on end
inspiration, where the aortic valve closes significantly earlier than the pulmonic
valve.
Torsades de pointes - Answer-A type of polymorphic ventricular tachycardia that
is more common in females due to a prolonged QT interval.
Zolpidem (Ambien CR) - Answer-The most effective agent to help a patient with
insomnia that involves both difficulty falling asleep and maintaining sleep.
Hirschberg test - Answer-A test that assesses parallel alignment of the eyes by
shining a light towards the patient's eyes and assessing the reflection of light on
the corneas.
Testosterone level of 250 ng/dL - Answer-Indicates a low testosterone level in a
male patient desiring testosterone replacement to enhance libido.
Azole antifungals - Answer-Most likely to cause torsades de pointes in females, as
they have a prolonged QT interval that is 10 microseconds longer than in men.
