APEA PREDICTOR COMPREHENSIVE
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A 65-year-old patient presents with a high-pitched, blowing diastolic murmur heard best at
the second right intercostal space. Which of the following is the most likely diagnosis?
A. Mitral Stenosis
B. Aortic Stenosis
C. Mitral Regurgitation
D. Aortic Regurgitation
Answer: D
Conceptual Explanation: Aortic regurgitation is a diastolic murmur heard at the second
right intercostal space (aortic area). Mitral stenosis is also diastolic but heard at the apex.
2. Which of the following laboratory findings is most indicative of iron deficiency anemia?
A. Elevated Ferritin
B. Increased Mean Corpuscular Volume (MCV)
C. Increased Total Iron Binding Capacity (TIBC)
D. Decreased Red Cell Distribution Width (RDW)
,Answer: C
Conceptual Explanation: In iron deficiency anemia, TIBC increases as the body attempts
to bind more iron, while ferritin and MCV decrease, and RDW increases due to variation in
cell size.
3. A patient with a history of COPD presents with increased sputum production and dyspnea.
Which antibiotic is first-line for a suspected bacterial exacerbation in a patient with
comorbidities?
A. Amoxicillin
B. Levofloxacin
C. Doxycycline
D. Azithromycin
Answer: B
Conceptual Explanation: Respiratory fluoroquinolones like Levofloxacin are
recommended for COPD exacerbations in patients with comorbidities or risk factors for
resistance.
4. Which cranial nerve is assessed by asking the patient to shrug their shoulders against
resistance?
A. CN X (Vagus)
B. CN IX (Glossopharyngeal)
, C. CN XII (Hypoglossal)
D. CN XI (Spinal Accessory)
Answer: D
Conceptual Explanation: Cranial Nerve XI (Spinal Accessory) innervates the trapezius
muscle, responsible for shoulder shrugging.
5. A 45-year-old female presents with a TSH of 7.2 mIU/L and a normal Free T4. She
complains of fatigue. What is the most appropriate next step?
A. Start Levothyroxine 50mcg
B. Diagnose Primary Hyperthyroidism
C. Order a Thyroid Ultrasound
D. Repeat TSH in 3-6 months
Answer: D
Conceptual Explanation: Subclinical hypothyroidism (elevated TSH, normal T4) often
requires monitoring rather than immediate treatment unless the TSH is >10 or the patient
is symptomatic/pregnant.
6. Which physical exam maneuver is used to assess for a torn anterior cruciate ligament
(ACL)?
A. Lachman Test
B. McMurray Test
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. A 65-year-old patient presents with a high-pitched, blowing diastolic murmur heard best at
the second right intercostal space. Which of the following is the most likely diagnosis?
A. Mitral Stenosis
B. Aortic Stenosis
C. Mitral Regurgitation
D. Aortic Regurgitation
Answer: D
Conceptual Explanation: Aortic regurgitation is a diastolic murmur heard at the second
right intercostal space (aortic area). Mitral stenosis is also diastolic but heard at the apex.
2. Which of the following laboratory findings is most indicative of iron deficiency anemia?
A. Elevated Ferritin
B. Increased Mean Corpuscular Volume (MCV)
C. Increased Total Iron Binding Capacity (TIBC)
D. Decreased Red Cell Distribution Width (RDW)
,Answer: C
Conceptual Explanation: In iron deficiency anemia, TIBC increases as the body attempts
to bind more iron, while ferritin and MCV decrease, and RDW increases due to variation in
cell size.
3. A patient with a history of COPD presents with increased sputum production and dyspnea.
Which antibiotic is first-line for a suspected bacterial exacerbation in a patient with
comorbidities?
A. Amoxicillin
B. Levofloxacin
C. Doxycycline
D. Azithromycin
Answer: B
Conceptual Explanation: Respiratory fluoroquinolones like Levofloxacin are
recommended for COPD exacerbations in patients with comorbidities or risk factors for
resistance.
4. Which cranial nerve is assessed by asking the patient to shrug their shoulders against
resistance?
A. CN X (Vagus)
B. CN IX (Glossopharyngeal)
, C. CN XII (Hypoglossal)
D. CN XI (Spinal Accessory)
Answer: D
Conceptual Explanation: Cranial Nerve XI (Spinal Accessory) innervates the trapezius
muscle, responsible for shoulder shrugging.
5. A 45-year-old female presents with a TSH of 7.2 mIU/L and a normal Free T4. She
complains of fatigue. What is the most appropriate next step?
A. Start Levothyroxine 50mcg
B. Diagnose Primary Hyperthyroidism
C. Order a Thyroid Ultrasound
D. Repeat TSH in 3-6 months
Answer: D
Conceptual Explanation: Subclinical hypothyroidism (elevated TSH, normal T4) often
requires monitoring rather than immediate treatment unless the TSH is >10 or the patient
is symptomatic/pregnant.
6. Which physical exam maneuver is used to assess for a torn anterior cruciate ligament
(ACL)?
A. Lachman Test
B. McMurray Test
