APEA 3P HIGH STAKES QUESTION SET WITH
RATIONALES AND PATIENT ASSESSMENT,
DIAGNOSIS, AND MANAGEMENT REVIEW 2026
◉ Munchausen Syndrome By Proxy.
Answer: A caregiver making up or causing an illness or injury in a
person under his or her care.
◉ Symptoms of depression.
Answer: Side effect of medications such as serotonin and
norepinephrine.
◉ Lesion characteristics.
Answer: A dark raised and asymmetric lesion with irregular border
is indicative of melanoma.
◉ Puffiness of the eyes.
Answer: Dull puffiness of the eyes pronounced not pitting
periorbital edema suggests nephrotic syndrome.
◉ Prophylactic medication for migraines.
,Answer: Amitriptyline (Elavil) is considered off-label use for
prophylactic treatment of migraines.
◉ Scaling on the scalp.
Answer: Areas of scaling on the scalp with round patches of alopecia
are consistent with tinea capitis.
◉ Combined hormonal contraceptive contraindications.
Answer: Contraindicated in women older than 45, breastfeeding,
smoking, hypertension, diabetes, or history of stroke.
◉ Bloody nipple discharge.
Answer: Bloody spontaneous discharge from the right nipple
indicates the need for further evaluation.
◉ Rho (D) immunoglobulin administration.
Answer: Rh negative women should receive Rho (D)
immunoglobulin at 28 weeks' gestation.
◉ Mean corpuscular volume (MCV).
Answer: MCV describes the size of the RBCs; small-sized RBCs result
in a lower MCV, while larger RBCs result in a higher MCV.
, ◉ Avoided medication for headache prophylaxis.
Answer: Venlafaxine (Effexor) should be avoided due to serious side
effects.
◉ Prostaglandin E1 (PG1) mechanism.
Answer: Maintains patency of the great arteries in a patient with
transposition of the great arteries.
◉ Calf pain in peripheral artery disease.
Answer: A dull pain or cramp describes lower extremity calf pain
associated with peripheral artery disease.
◉ Hyperprolactinemia symptoms.
Answer: Typical symptoms include infertility, oligomenorrhea, or
amenorrhea in premenopausal women.
◉ Asthma treatment.
Answer: Short-acting bronchodilators are used to relieve acute
wheezing in asthma patients.
◉ Shingles vaccine.
Answer: The shingles (herpes zoster) vaccine reduces the risk for
infection with the virus that causes painful localized blistering rash.
RATIONALES AND PATIENT ASSESSMENT,
DIAGNOSIS, AND MANAGEMENT REVIEW 2026
◉ Munchausen Syndrome By Proxy.
Answer: A caregiver making up or causing an illness or injury in a
person under his or her care.
◉ Symptoms of depression.
Answer: Side effect of medications such as serotonin and
norepinephrine.
◉ Lesion characteristics.
Answer: A dark raised and asymmetric lesion with irregular border
is indicative of melanoma.
◉ Puffiness of the eyes.
Answer: Dull puffiness of the eyes pronounced not pitting
periorbital edema suggests nephrotic syndrome.
◉ Prophylactic medication for migraines.
,Answer: Amitriptyline (Elavil) is considered off-label use for
prophylactic treatment of migraines.
◉ Scaling on the scalp.
Answer: Areas of scaling on the scalp with round patches of alopecia
are consistent with tinea capitis.
◉ Combined hormonal contraceptive contraindications.
Answer: Contraindicated in women older than 45, breastfeeding,
smoking, hypertension, diabetes, or history of stroke.
◉ Bloody nipple discharge.
Answer: Bloody spontaneous discharge from the right nipple
indicates the need for further evaluation.
◉ Rho (D) immunoglobulin administration.
Answer: Rh negative women should receive Rho (D)
immunoglobulin at 28 weeks' gestation.
◉ Mean corpuscular volume (MCV).
Answer: MCV describes the size of the RBCs; small-sized RBCs result
in a lower MCV, while larger RBCs result in a higher MCV.
, ◉ Avoided medication for headache prophylaxis.
Answer: Venlafaxine (Effexor) should be avoided due to serious side
effects.
◉ Prostaglandin E1 (PG1) mechanism.
Answer: Maintains patency of the great arteries in a patient with
transposition of the great arteries.
◉ Calf pain in peripheral artery disease.
Answer: A dull pain or cramp describes lower extremity calf pain
associated with peripheral artery disease.
◉ Hyperprolactinemia symptoms.
Answer: Typical symptoms include infertility, oligomenorrhea, or
amenorrhea in premenopausal women.
◉ Asthma treatment.
Answer: Short-acting bronchodilators are used to relieve acute
wheezing in asthma patients.
◉ Shingles vaccine.
Answer: The shingles (herpes zoster) vaccine reduces the risk for
infection with the virus that causes painful localized blistering rash.
