APEA Predictor Exam Questions and 100% Correct Answers
with Rationales – High-Yield 360 Q&A
1. A 32-year-old woman presents with sudden right lower quadrant pain, nausea, and
low-grade fever. Exam shows rebound tenderness. Most likely diagnosis?
A) Ovarian cyst rupture
B) Acute appendicitis
C) Ectopic pregnancy
D) Pelvic inflammatory disease
Correct Answer: B) Acute appendicitis
Rationale: Classic RLQ pain with rebound tenderness and systemic symptoms indicates
appendicitis. Other options may mimic, but location and signs point to appendicitis.
2. A 10-year-old child has fever, sore throat, and sandpaper-like rash on trunk.
Causative organism?
A) Staphylococcus aureus
B) Group A Streptococcus
C) Haemophilus influenzae
D) Epstein-Barr virus
Correct Answer: B) Group A Streptococcus
Rationale: Scarlet fever is caused by Group A Streptococcus; features include
pharyngitis, fever, and fine erythematous rash.
3. 58-year-old man with type 2 diabetes, polyuria, polydipsia, blurred vision. HbA1c
9.5%. Next step?
A) Observe and recheck labs in 3 months
B) Intensify glycemic control with lifestyle and meds
C) Start antibiotics
,D) Schedule cardiac stress test
Correct Answer: B) Intensify glycemic control with lifestyle and meds
Rationale: HbA1c >9% indicates poor control; therapy must be intensified.
4. 25-year-old woman, 2 weeks postpartum, sudden dyspnea and pleuritic chest pain.
Most urgent consideration?
A) Asthma exacerbation
B) Pulmonary embolism
C) Pneumonia
D) Myocardial infarction
Correct Answer: B) Pulmonary embolism
Rationale: Postpartum hypercoagulability + sudden dyspnea = high risk for PE.
5. 6-year-old with fever, cough, coarse crackles, WBC 15,000/mm³. Empiric antibiotic for
community-acquired pneumonia?
A) Azithromycin
B) Amoxicillin
C) Ciprofloxacin
D) Trimethoprim-sulfamethoxazole
Correct Answer: B) Amoxicillin
Rationale: First-line empiric therapy in healthy children is amoxicillin.
6. 70-year-old man with crushing chest pain radiating to jaw, sweating, nausea. ECG
shows ST elevation in leads II, III, aVF. Next step?
A) Administer sublingual nitroglycerin and discharge
,B) Emergent PCI
C) Oral beta-blocker only
D) Schedule stress test next week
Correct Answer: B) Emergent PCI
Rationale: ST-elevation MI (inferior wall) requires immediate reperfusion via PCI.
7. 45-year-old woman presents with fatigue, cold intolerance, constipation, and dry skin.
Labs show high TSH, low T4. Diagnosis?
A) Hyperthyroidism
B) Hypothyroidism
C) Cushing syndrome
D) Addison disease
Correct Answer: B) Hypothyroidism
Rationale: Classic symptoms with lab findings indicate primary hypothyroidism.
8. 22-year-old college student presents with dysuria, frequency, and urgency. Urine dip
shows leukocyte esterase positive. Most likely diagnosis?
A) Acute pyelonephritis
B) Cystitis
C) Interstitial nephritis
D) Urethral stricture
Correct Answer: B) Cystitis
Rationale: Young female with dysuria and frequency, no systemic symptoms, consistent
with uncomplicated urinary tract infection.
, 9. A 60-year-old man with COPD develops worsening dyspnea, purulent sputum, and
fever. Best empiric antibiotic?
A) Amoxicillin
B) Levofloxacin
C) Vancomycin
D) Azithromycin
Correct Answer: B) Levofloxacin
Rationale: COPD exacerbation with suspected bacterial infection often requires
respiratory fluoroquinolone coverage.
10. 5-year-old child with sudden onset of difficulty breathing, inspiratory stridor, drooling,
and fever. Most likely diagnosis?
A) Croup
B) Epiglottitis
C) Asthma
D) Bronchiolitis
Correct Answer: B) Epiglottitis
Rationale: Drooling, stridor, and rapid onset suggest epiglottitis; airway management is
priority.
11. 28-year-old pregnant woman at 32 weeks presents with headache, visual changes,
and BP 160/110 mmHg. Most likely diagnosis?
A) Gestational hypertension
B) Preeclampsia with severe features
C) Eclampsia
D) Chronic hypertension
Correct Answer: B) Preeclampsia with severe features
with Rationales – High-Yield 360 Q&A
1. A 32-year-old woman presents with sudden right lower quadrant pain, nausea, and
low-grade fever. Exam shows rebound tenderness. Most likely diagnosis?
A) Ovarian cyst rupture
B) Acute appendicitis
C) Ectopic pregnancy
D) Pelvic inflammatory disease
Correct Answer: B) Acute appendicitis
Rationale: Classic RLQ pain with rebound tenderness and systemic symptoms indicates
appendicitis. Other options may mimic, but location and signs point to appendicitis.
2. A 10-year-old child has fever, sore throat, and sandpaper-like rash on trunk.
Causative organism?
A) Staphylococcus aureus
B) Group A Streptococcus
C) Haemophilus influenzae
D) Epstein-Barr virus
Correct Answer: B) Group A Streptococcus
Rationale: Scarlet fever is caused by Group A Streptococcus; features include
pharyngitis, fever, and fine erythematous rash.
3. 58-year-old man with type 2 diabetes, polyuria, polydipsia, blurred vision. HbA1c
9.5%. Next step?
A) Observe and recheck labs in 3 months
B) Intensify glycemic control with lifestyle and meds
C) Start antibiotics
,D) Schedule cardiac stress test
Correct Answer: B) Intensify glycemic control with lifestyle and meds
Rationale: HbA1c >9% indicates poor control; therapy must be intensified.
4. 25-year-old woman, 2 weeks postpartum, sudden dyspnea and pleuritic chest pain.
Most urgent consideration?
A) Asthma exacerbation
B) Pulmonary embolism
C) Pneumonia
D) Myocardial infarction
Correct Answer: B) Pulmonary embolism
Rationale: Postpartum hypercoagulability + sudden dyspnea = high risk for PE.
5. 6-year-old with fever, cough, coarse crackles, WBC 15,000/mm³. Empiric antibiotic for
community-acquired pneumonia?
A) Azithromycin
B) Amoxicillin
C) Ciprofloxacin
D) Trimethoprim-sulfamethoxazole
Correct Answer: B) Amoxicillin
Rationale: First-line empiric therapy in healthy children is amoxicillin.
6. 70-year-old man with crushing chest pain radiating to jaw, sweating, nausea. ECG
shows ST elevation in leads II, III, aVF. Next step?
A) Administer sublingual nitroglycerin and discharge
,B) Emergent PCI
C) Oral beta-blocker only
D) Schedule stress test next week
Correct Answer: B) Emergent PCI
Rationale: ST-elevation MI (inferior wall) requires immediate reperfusion via PCI.
7. 45-year-old woman presents with fatigue, cold intolerance, constipation, and dry skin.
Labs show high TSH, low T4. Diagnosis?
A) Hyperthyroidism
B) Hypothyroidism
C) Cushing syndrome
D) Addison disease
Correct Answer: B) Hypothyroidism
Rationale: Classic symptoms with lab findings indicate primary hypothyroidism.
8. 22-year-old college student presents with dysuria, frequency, and urgency. Urine dip
shows leukocyte esterase positive. Most likely diagnosis?
A) Acute pyelonephritis
B) Cystitis
C) Interstitial nephritis
D) Urethral stricture
Correct Answer: B) Cystitis
Rationale: Young female with dysuria and frequency, no systemic symptoms, consistent
with uncomplicated urinary tract infection.
, 9. A 60-year-old man with COPD develops worsening dyspnea, purulent sputum, and
fever. Best empiric antibiotic?
A) Amoxicillin
B) Levofloxacin
C) Vancomycin
D) Azithromycin
Correct Answer: B) Levofloxacin
Rationale: COPD exacerbation with suspected bacterial infection often requires
respiratory fluoroquinolone coverage.
10. 5-year-old child with sudden onset of difficulty breathing, inspiratory stridor, drooling,
and fever. Most likely diagnosis?
A) Croup
B) Epiglottitis
C) Asthma
D) Bronchiolitis
Correct Answer: B) Epiglottitis
Rationale: Drooling, stridor, and rapid onset suggest epiglottitis; airway management is
priority.
11. 28-year-old pregnant woman at 32 weeks presents with headache, visual changes,
and BP 160/110 mmHg. Most likely diagnosis?
A) Gestational hypertension
B) Preeclampsia with severe features
C) Eclampsia
D) Chronic hypertension
Correct Answer: B) Preeclampsia with severe features
