APEA 3P ADVANCED QUESTIONS AND
x x x x
ANSWERS questions & x x x
answers (2023/2024) x x
already graded a, x x x
You xare xauscultating xJon's xchest. xWhen xhe xsits xup xand xleans xforward, xyou xcan xhear
xa xhigh xpitched, xblowing xmurmur xat xS2. xWhat xdoes xthis xtype xof xmurmur xmost xlikely
xindicate?
a. Mitral xstenosis
b. Aortic xStenosis
c. Mitral xregurgitation
d. Aortic xregurgitation x- xCORRECT xANSWER-d. xAortic xregurgitation
Aortic xregurg xis xsoft, xhigh xpitched, xblowing xdiastolic xdecrescendo xthat xbest xheard xat
xthe x3rd xleft xinterspace xat xbase. xMurmur xinitiated xw/ xS2 xand xheard xwhen xPt xsits xup
xand xleans xforward. xMitral xStenosis= xlow xpitched xdiastolic xrumble x& xdoesn't xradiate.
xBest xheard xin xapex xwhen xin xleft xlateral xposition. xAortic xstenosis= xloud, xharsh
xmurmur xmidsystole, xradiated xdown xthe xside xof xneck xand xdown xapex. xMitral xregurg=
xloud xblowing xmurmur xheard xat xapex xand xis xpansystolic.
Which xof xthe xfollowing xis xthe xmost xcommon xclinical xmanifestation xof xosteoporosis?
a. Bone xdeformity
b. Bone xpain
c. Pathologic xfracture
d. Fat xembolism x- xCORRECT xANSWER-a. xBone xdeformity
most xcommon xmetabolic xbone xdisease, xis xchronic, xprogressive, x& xsystemic; xLow
xbone xmass xand xdeterioration xof xbone xtissue, x= xleads xto xincreased xskeletal xfragility x&
xdeformity. xOsteoporosis xusually xnot xapparent xuntil xAFTER xa xfracture; x2/3 xof
xvertebral xfractures xare xpainless. xFat xembolism xfrom xfat xobstruction xd/t xinjury xor
xtrauma x& xnot xcommon xin xosteoporosis.
A xmale xpatient xrequests xa xphosphodiesterase xinhibitor xto xtreat xerectile xdysfunction.
,x Which xof xthe xfollowing xis xappropriate?
, x a. xTadalafil x(Cialis) xmay xbe xused xat xa xdose xof x2.5 xmg xdaily xif xsexual xactivity xwill
xtake xplace xtwo xor xmore xtimes xper xweek.
b. Vardenafil x(Levitra), x5 xmg, xmay xbe xtaken xwith xa xhigh-fat xmeal xfour xhours xbefore
xsexual xactivity
c. Sildenafil x(Viagra), x50 xmg, xmay xbe xtaken xone xhour xbefore xsexual xactivity xas
xlong xas xthe xpatient xhas xa xresting xblood xpressure xbelow x170/110 xmm xHg
d. Avanafil x(Stendra) xis xrecommended xat x50 xmg xfor xall xpatients, xand xmay xbe xtaken
x30 xminutes xbefore xsexual xactivity. x- xCORRECT xANSWER-a. xTadalafil x(Cialis) xmay
xbe xused xat xa xdose xof x2.5 xmg xdaily xif xsexual xactivity xwill xtake xplace xtwo xor xmore
xtimes xper xweek.
Which xof xthe xfollowing xis xNOT xpart xof xVirchow's xTriad?
a. Hypercoagulability
xb. xDamage xto xendothelial xcells
xc. xSympathetic xtone
xd. xTurbulent xblood xflow x- xCORRECT xANSWER-c. xSympathetic xtone
Virchow's xtriad xis xa xmethod xof xdescribing xthe xthree xmain xfactors xthat xlead xto xa
x thrombosis x-- xsympathetic xtone xis xnot xone xof xthose xand xdoesn't xaffect xblood
xclotting. xHypercoagulability xdoes xlead xto xclotting, xincluding xmalignancy, xtrauma,
xsepsis, xand xthrombophilia. xEndothelial xcell xdamage xis xpart xof xVirchow's xtriad xbc xit
xcauses xblood xto xclot xby xpromoting xplatelet xadherence xto xthe xwall xof xthe xvessels;
xvascular xwall xinjury xis xthe xsecond xaspect xof xVirchow's xtriad. xLastly, xturbulent xblood
xflow xis xa xconstituent xof xcirculatory xstasis xthe xthird xcomponent xof xthe xtriad, xwhich
xcan xbe xcaused xby xatrial xfibrillation, xvenous xobstruction, xand xventricular xdysfunction
A xpatient xwith xkidney xstones xalso xpresents xwith xhypercalcemia xand xmental
xconfusion. xThe xpractitioner xshould xevaluate xthe xpatient xfor xwhich xof xthe xfollowing?
a. Cushing xSyndrome
b. Conn's xSyndrome
c. Hyperparathyroidism
d. Addison's xdisease x- xCORRECT xANSWER-c. xHyperparathyroidism
Which xof xthe xfollowing xstatements xis xtrue xregarding xcontraceptives?
a. Because xoral xcontraceptives xmay xcause xharm xto xthe xfetus, xthey xare
xpregnancy xcategory xX xdrugs xin xpregnancy.
b. Oral xcontraceptives xare xlinked xto xthe xpromotion xof xovarian, xendometrial, xand
xbreast xcancer.
c. By xincreasing xangiotensin xand xaldosterone, xoral xcontraceptives xmay xincrease
xblood xpressure.
xd. xOral xcontraceptives xmay xreduce xthe xeffects xof xtheophylline, xbenzodiazepines,
xand xtricyclic xantidepressants x- xCORRECT xANSWER-c. xBy xincreasing xangiotensin
xand xaldosterone, xoral xcontraceptives xmay xincrease xblood xpressure.
estrogen xpromotes xaldosterone xproduction= xsodium xretention x& xHTN. xAlso xbelieved
xstimulates xhepatic xproduction xof xangiotensinogen, xaffecting xrenal xsystem xvia
xelevated
x x x x
ANSWERS questions & x x x
answers (2023/2024) x x
already graded a, x x x
You xare xauscultating xJon's xchest. xWhen xhe xsits xup xand xleans xforward, xyou xcan xhear
xa xhigh xpitched, xblowing xmurmur xat xS2. xWhat xdoes xthis xtype xof xmurmur xmost xlikely
xindicate?
a. Mitral xstenosis
b. Aortic xStenosis
c. Mitral xregurgitation
d. Aortic xregurgitation x- xCORRECT xANSWER-d. xAortic xregurgitation
Aortic xregurg xis xsoft, xhigh xpitched, xblowing xdiastolic xdecrescendo xthat xbest xheard xat
xthe x3rd xleft xinterspace xat xbase. xMurmur xinitiated xw/ xS2 xand xheard xwhen xPt xsits xup
xand xleans xforward. xMitral xStenosis= xlow xpitched xdiastolic xrumble x& xdoesn't xradiate.
xBest xheard xin xapex xwhen xin xleft xlateral xposition. xAortic xstenosis= xloud, xharsh
xmurmur xmidsystole, xradiated xdown xthe xside xof xneck xand xdown xapex. xMitral xregurg=
xloud xblowing xmurmur xheard xat xapex xand xis xpansystolic.
Which xof xthe xfollowing xis xthe xmost xcommon xclinical xmanifestation xof xosteoporosis?
a. Bone xdeformity
b. Bone xpain
c. Pathologic xfracture
d. Fat xembolism x- xCORRECT xANSWER-a. xBone xdeformity
most xcommon xmetabolic xbone xdisease, xis xchronic, xprogressive, x& xsystemic; xLow
xbone xmass xand xdeterioration xof xbone xtissue, x= xleads xto xincreased xskeletal xfragility x&
xdeformity. xOsteoporosis xusually xnot xapparent xuntil xAFTER xa xfracture; x2/3 xof
xvertebral xfractures xare xpainless. xFat xembolism xfrom xfat xobstruction xd/t xinjury xor
xtrauma x& xnot xcommon xin xosteoporosis.
A xmale xpatient xrequests xa xphosphodiesterase xinhibitor xto xtreat xerectile xdysfunction.
,x Which xof xthe xfollowing xis xappropriate?
, x a. xTadalafil x(Cialis) xmay xbe xused xat xa xdose xof x2.5 xmg xdaily xif xsexual xactivity xwill
xtake xplace xtwo xor xmore xtimes xper xweek.
b. Vardenafil x(Levitra), x5 xmg, xmay xbe xtaken xwith xa xhigh-fat xmeal xfour xhours xbefore
xsexual xactivity
c. Sildenafil x(Viagra), x50 xmg, xmay xbe xtaken xone xhour xbefore xsexual xactivity xas
xlong xas xthe xpatient xhas xa xresting xblood xpressure xbelow x170/110 xmm xHg
d. Avanafil x(Stendra) xis xrecommended xat x50 xmg xfor xall xpatients, xand xmay xbe xtaken
x30 xminutes xbefore xsexual xactivity. x- xCORRECT xANSWER-a. xTadalafil x(Cialis) xmay
xbe xused xat xa xdose xof x2.5 xmg xdaily xif xsexual xactivity xwill xtake xplace xtwo xor xmore
xtimes xper xweek.
Which xof xthe xfollowing xis xNOT xpart xof xVirchow's xTriad?
a. Hypercoagulability
xb. xDamage xto xendothelial xcells
xc. xSympathetic xtone
xd. xTurbulent xblood xflow x- xCORRECT xANSWER-c. xSympathetic xtone
Virchow's xtriad xis xa xmethod xof xdescribing xthe xthree xmain xfactors xthat xlead xto xa
x thrombosis x-- xsympathetic xtone xis xnot xone xof xthose xand xdoesn't xaffect xblood
xclotting. xHypercoagulability xdoes xlead xto xclotting, xincluding xmalignancy, xtrauma,
xsepsis, xand xthrombophilia. xEndothelial xcell xdamage xis xpart xof xVirchow's xtriad xbc xit
xcauses xblood xto xclot xby xpromoting xplatelet xadherence xto xthe xwall xof xthe xvessels;
xvascular xwall xinjury xis xthe xsecond xaspect xof xVirchow's xtriad. xLastly, xturbulent xblood
xflow xis xa xconstituent xof xcirculatory xstasis xthe xthird xcomponent xof xthe xtriad, xwhich
xcan xbe xcaused xby xatrial xfibrillation, xvenous xobstruction, xand xventricular xdysfunction
A xpatient xwith xkidney xstones xalso xpresents xwith xhypercalcemia xand xmental
xconfusion. xThe xpractitioner xshould xevaluate xthe xpatient xfor xwhich xof xthe xfollowing?
a. Cushing xSyndrome
b. Conn's xSyndrome
c. Hyperparathyroidism
d. Addison's xdisease x- xCORRECT xANSWER-c. xHyperparathyroidism
Which xof xthe xfollowing xstatements xis xtrue xregarding xcontraceptives?
a. Because xoral xcontraceptives xmay xcause xharm xto xthe xfetus, xthey xare
xpregnancy xcategory xX xdrugs xin xpregnancy.
b. Oral xcontraceptives xare xlinked xto xthe xpromotion xof xovarian, xendometrial, xand
xbreast xcancer.
c. By xincreasing xangiotensin xand xaldosterone, xoral xcontraceptives xmay xincrease
xblood xpressure.
xd. xOral xcontraceptives xmay xreduce xthe xeffects xof xtheophylline, xbenzodiazepines,
xand xtricyclic xantidepressants x- xCORRECT xANSWER-c. xBy xincreasing xangiotensin
xand xaldosterone, xoral xcontraceptives xmay xincrease xblood xpressure.
estrogen xpromotes xaldosterone xproduction= xsodium xretention x& xHTN. xAlso xbelieved
xstimulates xhepatic xproduction xof xangiotensinogen, xaffecting xrenal xsystem xvia
xelevated
