APEA 3P Practice Test Set 2 | Questions And
Correct Answers (Verified Answers) Plus
Rationales 2026/2027 Q&A | Instant
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1. A patient presents with sudden onset of the worst headache of life, new
neurological deficits, and is over 50 years old. What is the most appropriate next
step?
A. Prescribe sumatriptan
B. Schedule routine follow-up in 2 weeks
C. Immediate investigation for serious pathology
D. Recommend over-the-counter analgesics
Correct Answer: C
Rationale: Sudden onset worst headache, new neurological deficits, or new headache in
patients over 50 warrant prompt evaluation to rule out serious pathology such as
subarachnoid hemorrhage or intracranial mass .
2. A patient with hyperandrogenism would most likely present with which clinical
finding?
A. Dry skin
B. Hirsutism
C. Polydipsia
D. Menorrhagia
Correct Answer: B
Rationale: Hirsutism (excessive male-pattern hair growth) is a hallmark sign of
hyperandrogenism in females, commonly seen in conditions like polycystic ovary
syndrome .
3. The four classic signs of Tetralogy of Fallot include all of the following EXCEPT:
A. Ventricular septal defect
B. Overriding aorta
,C. Pulmonary stenosis
D. Left ventricular hypertrophy
Correct Answer: D
Rationale: The four classic signs of Tetralogy of Fallot are ventricular septal defect,
overriding aorta, pulmonary stenosis, and right ventricular hypertrophy (not left) .
4. A 4-month-old infant is found to have a disparity between brachial and femoral
pulses. This finding is most consistent with:
A. Patent ductus arteriosus
B. Coarctation of the aorta
C. Ventricular septal defect
D. Tetralogy of Fallot
Correct Answer: B
Rationale: Coarctation of the aorta (CoA) presents with diminished or delayed femoral
pulses compared to brachial pulses in infants. Blood pressure will be higher in upper
extremities than lower .
5. A teenager presents with sudden, severe, unilateral scrotal pain. The most likely
diagnosis is:
A. Hydrocele
B. Testicular torsion
C. Epididymitis
D. Inguinal hernia
Correct Answer: B
Rationale: Testicular torsion presents with sudden onset of severe unilateral scrotal pain
due to twisting of the spermatic cord compromising blood flow. This is a urologic
emergency requiring prompt surgical intervention .
6. Small amounts of urine leak from a full bladder in the absence of the need to
urinate describes which type of incontinence?
A. Stress incontinence
B. Urge incontinence
C. Overflow incontinence
D. Functional incontinence
,Correct Answer: C
Rationale: Overflow incontinence occurs when the bladder becomes over-distended
due to obstruction or neurological impairment, causing small amounts of urine to leak
without the sensation of need to void .
7. Cryptorchidism is a risk factor for which malignancy?
A. Prostate cancer
B. Testicular cancer
C. Renal cell carcinoma
D. Bladder cancer
Correct Answer: B
Rationale: Cryptorchidism (undescended testicle) is a well-established risk factor for
testicular cancer. Patients with this history require careful monitoring .
8. A patient presents with fever, lethargy, petechiae, neurological involvement,
Janeway lesions, and Osler's nodes. This is consistent with:
A. Kawasaki disease
B. Endocarditis
C. Meningitis
D. Sepsis
Correct Answer: B
Rationale: Endocarditis presents with fever, petechiae, Janeway lesions, Osler's nodes,
and neurological involvement due to septic emboli. These findings warrant immediate
echocardiography and blood cultures .
9. Unexplained fever for 5 days accompanied by bilateral non-purulent
conjunctivitis, cervical lymphadenopathy, edema of hands/feet, strawberry
tongue, and macular rash is characteristic of:
A. Endocarditis
B. Kawasaki disease
C. Scarlet fever
D. Measles
Correct Answer: B
Rationale: Kawasaki disease is diagnosed with fever for at least 5 days plus 4 of 5
criteria including bilateral conjunctivitis, cervical lymphadenopathy, extremity edema,
, strawberry tongue, and macular rash. Early treatment prevents coronary artery
aneurysms .
10. Patients taking statins who report muscle pain should be evaluated for:
A. Elevated LFTs
B. Elevated CK (creatine kinase)
C. Elevated BUN
D. Elevated serum creatinine
Correct Answer: B
Rationale: Muscle pain in patients on statins requires CK level monitoring. Elevated CK
can indicate myopathy. High-intensity statins (atorvastatin 40-80mg, rosuvastatin 20-
40mg) have higher risk of myopathy .
11. A patient presents with chest pain described as stabbing, sticking, or dull and
aching, reproducible with palpation. This is characteristic of:
A. Myocardial infarction
B. Costochondritis
C. Pericarditis
D. Pulmonary embolism
Correct Answer: B
Rationale: Costochondritis presents with chest pain that is reproducible with palpation,
often described as stabbing or aching. Unlike cardiac pain, it is not exertional .
12. Persistent, sharp, knife-like chest pain that worsens with inspiration and
improves when leaning forward is characteristic of:
A. Myocardial infarction
B. Costochondritis
C. Pericarditis and pleuritic pain
D. Pneumothorax
Correct Answer: C
Rationale: Pericarditis typically presents with sharp, pleuritic chest pain that worsens
with inspiration and improves when sitting up and leaning forward .
13. Patients with spinal stenosis typically experience pain that:
A. Worsens with walking and improves with rest
B. Worsens with standing and improves with flexion
Correct Answers (Verified Answers) Plus
Rationales 2026/2027 Q&A | Instant
Download Pdf
1. A patient presents with sudden onset of the worst headache of life, new
neurological deficits, and is over 50 years old. What is the most appropriate next
step?
A. Prescribe sumatriptan
B. Schedule routine follow-up in 2 weeks
C. Immediate investigation for serious pathology
D. Recommend over-the-counter analgesics
Correct Answer: C
Rationale: Sudden onset worst headache, new neurological deficits, or new headache in
patients over 50 warrant prompt evaluation to rule out serious pathology such as
subarachnoid hemorrhage or intracranial mass .
2. A patient with hyperandrogenism would most likely present with which clinical
finding?
A. Dry skin
B. Hirsutism
C. Polydipsia
D. Menorrhagia
Correct Answer: B
Rationale: Hirsutism (excessive male-pattern hair growth) is a hallmark sign of
hyperandrogenism in females, commonly seen in conditions like polycystic ovary
syndrome .
3. The four classic signs of Tetralogy of Fallot include all of the following EXCEPT:
A. Ventricular septal defect
B. Overriding aorta
,C. Pulmonary stenosis
D. Left ventricular hypertrophy
Correct Answer: D
Rationale: The four classic signs of Tetralogy of Fallot are ventricular septal defect,
overriding aorta, pulmonary stenosis, and right ventricular hypertrophy (not left) .
4. A 4-month-old infant is found to have a disparity between brachial and femoral
pulses. This finding is most consistent with:
A. Patent ductus arteriosus
B. Coarctation of the aorta
C. Ventricular septal defect
D. Tetralogy of Fallot
Correct Answer: B
Rationale: Coarctation of the aorta (CoA) presents with diminished or delayed femoral
pulses compared to brachial pulses in infants. Blood pressure will be higher in upper
extremities than lower .
5. A teenager presents with sudden, severe, unilateral scrotal pain. The most likely
diagnosis is:
A. Hydrocele
B. Testicular torsion
C. Epididymitis
D. Inguinal hernia
Correct Answer: B
Rationale: Testicular torsion presents with sudden onset of severe unilateral scrotal pain
due to twisting of the spermatic cord compromising blood flow. This is a urologic
emergency requiring prompt surgical intervention .
6. Small amounts of urine leak from a full bladder in the absence of the need to
urinate describes which type of incontinence?
A. Stress incontinence
B. Urge incontinence
C. Overflow incontinence
D. Functional incontinence
,Correct Answer: C
Rationale: Overflow incontinence occurs when the bladder becomes over-distended
due to obstruction or neurological impairment, causing small amounts of urine to leak
without the sensation of need to void .
7. Cryptorchidism is a risk factor for which malignancy?
A. Prostate cancer
B. Testicular cancer
C. Renal cell carcinoma
D. Bladder cancer
Correct Answer: B
Rationale: Cryptorchidism (undescended testicle) is a well-established risk factor for
testicular cancer. Patients with this history require careful monitoring .
8. A patient presents with fever, lethargy, petechiae, neurological involvement,
Janeway lesions, and Osler's nodes. This is consistent with:
A. Kawasaki disease
B. Endocarditis
C. Meningitis
D. Sepsis
Correct Answer: B
Rationale: Endocarditis presents with fever, petechiae, Janeway lesions, Osler's nodes,
and neurological involvement due to septic emboli. These findings warrant immediate
echocardiography and blood cultures .
9. Unexplained fever for 5 days accompanied by bilateral non-purulent
conjunctivitis, cervical lymphadenopathy, edema of hands/feet, strawberry
tongue, and macular rash is characteristic of:
A. Endocarditis
B. Kawasaki disease
C. Scarlet fever
D. Measles
Correct Answer: B
Rationale: Kawasaki disease is diagnosed with fever for at least 5 days plus 4 of 5
criteria including bilateral conjunctivitis, cervical lymphadenopathy, extremity edema,
, strawberry tongue, and macular rash. Early treatment prevents coronary artery
aneurysms .
10. Patients taking statins who report muscle pain should be evaluated for:
A. Elevated LFTs
B. Elevated CK (creatine kinase)
C. Elevated BUN
D. Elevated serum creatinine
Correct Answer: B
Rationale: Muscle pain in patients on statins requires CK level monitoring. Elevated CK
can indicate myopathy. High-intensity statins (atorvastatin 40-80mg, rosuvastatin 20-
40mg) have higher risk of myopathy .
11. A patient presents with chest pain described as stabbing, sticking, or dull and
aching, reproducible with palpation. This is characteristic of:
A. Myocardial infarction
B. Costochondritis
C. Pericarditis
D. Pulmonary embolism
Correct Answer: B
Rationale: Costochondritis presents with chest pain that is reproducible with palpation,
often described as stabbing or aching. Unlike cardiac pain, it is not exertional .
12. Persistent, sharp, knife-like chest pain that worsens with inspiration and
improves when leaning forward is characteristic of:
A. Myocardial infarction
B. Costochondritis
C. Pericarditis and pleuritic pain
D. Pneumothorax
Correct Answer: C
Rationale: Pericarditis typically presents with sharp, pleuritic chest pain that worsens
with inspiration and improves when sitting up and leaning forward .
13. Patients with spinal stenosis typically experience pain that:
A. Worsens with walking and improves with rest
B. Worsens with standing and improves with flexion
