APEA PRE PREDICTOR ULTIMATE
EXAM 150 QUESTIONS AND 100%
VERIFIED ANSWERS WITH
DETAILED RATIONALES 2025-2026
A 37-year-old man fell from a ladder as he
finished hanging the Christmas lights on his
house. The right side of his head hit the alley
cement, and he lost consciousness for about 1
minute; he woke up with a headache, but he
had no other complaints. A few hours later, the
patient is brought to the emergency room by his
neighbor because of an intense headache,
confusion, and left hand hemiparesis. On
examination, the patient has a bruise located
,over the right temporal region, mydriasis, and
right deviation of the right eye, papilledema,
and left extensor plantar response. An
emergency CT scan of the head without
contrast reveals a lens-shaped hyper-density
under the right temporal bone with mass effect
and edema. What is the most likely diagnosis?
<answer>Epidural hematoma
A 1-year-old boy presents with increasing
lethargy. He is barely responsive, and his
parents deny any trauma or injury. What is the
most common cause of nontraumatic altered
levels of consciousness? <answer>Infection
A 44-year-old man starts to notice that his
eyelids are drooping. Some time afterwards, his
jaw becomes weak. He has difficulty swallowing
and also experiences weakness in his limbs. He
is quite embarrassed when he eats because he
must use his hand to help support his jaw. His
weakness gets progressively worse. Finally, he
seeks medical attention. His physical
examination demonstrates the weakness in his
limbs; however, no sensory defects are present.
,A Tensilon test is done and is positive. His
doctor is concerned about an associated
malignancy. What is the underlying pathology of
this disease? <answer>Antibodies to the
acetylcholine receptor
A 31-year-old woman presents with a purpural
rash covering her arms, legs, and abdomen.
She also has fever, chills, nausea, abdominal
tenderness, tachycardia, and generalized
myalgias. Prior to the development of the rash,
the patient noted that she had a headache,
cough, and sore throat. Laboratory studies were
positive for Gram-negative diplococci in the
blood, along with thrombocytopenia and an
elevation in PMNs. Urinalysis showed blood,
protein, and casts. The patient denies any
foreign travel and does not have any sick
contacts. However, she does work part time as
a nurse in a local hospital. The patient is
diagnosed with Meningococcemia; she is
admitted to the hospital and placed in
respiratory isolation. What major course of
therapy should this patient receive?
<answer>Antibiotics
, A 54-year-old man presents after having a
generalized seizure. The patient is HIV positive,
but he has been unable to afford antiretroviral
therapy since losing his job 2 years ago. Other
than cachexia, the physical exam is
unremarkable. Upon further inquiry, the patient
also notes that he has become short- tempered
and hypercritical; at times, he seems confused.
An MRI of the brain is performed, and it reveals
several cortical ring-enhancing lesions.
<answer>Toxoplasma encephalitis
In myasthenia gravis, weakness is a result of
insufficient acetylcholine transmission at the
neuromuscular junction; however, weakness
can also occur with overdosing of the
cholinergic medications used to treat
myasthenia. What symptom helps differentiate
a myasthenic crisis from a cholinergic crisis?
<answer>Muscle fasciculations
A 74-year-old man presents after his wife
witnessed him grab his head in pain and fall to
the floor. He has not regained consciousness.
EXAM 150 QUESTIONS AND 100%
VERIFIED ANSWERS WITH
DETAILED RATIONALES 2025-2026
A 37-year-old man fell from a ladder as he
finished hanging the Christmas lights on his
house. The right side of his head hit the alley
cement, and he lost consciousness for about 1
minute; he woke up with a headache, but he
had no other complaints. A few hours later, the
patient is brought to the emergency room by his
neighbor because of an intense headache,
confusion, and left hand hemiparesis. On
examination, the patient has a bruise located
,over the right temporal region, mydriasis, and
right deviation of the right eye, papilledema,
and left extensor plantar response. An
emergency CT scan of the head without
contrast reveals a lens-shaped hyper-density
under the right temporal bone with mass effect
and edema. What is the most likely diagnosis?
<answer>Epidural hematoma
A 1-year-old boy presents with increasing
lethargy. He is barely responsive, and his
parents deny any trauma or injury. What is the
most common cause of nontraumatic altered
levels of consciousness? <answer>Infection
A 44-year-old man starts to notice that his
eyelids are drooping. Some time afterwards, his
jaw becomes weak. He has difficulty swallowing
and also experiences weakness in his limbs. He
is quite embarrassed when he eats because he
must use his hand to help support his jaw. His
weakness gets progressively worse. Finally, he
seeks medical attention. His physical
examination demonstrates the weakness in his
limbs; however, no sensory defects are present.
,A Tensilon test is done and is positive. His
doctor is concerned about an associated
malignancy. What is the underlying pathology of
this disease? <answer>Antibodies to the
acetylcholine receptor
A 31-year-old woman presents with a purpural
rash covering her arms, legs, and abdomen.
She also has fever, chills, nausea, abdominal
tenderness, tachycardia, and generalized
myalgias. Prior to the development of the rash,
the patient noted that she had a headache,
cough, and sore throat. Laboratory studies were
positive for Gram-negative diplococci in the
blood, along with thrombocytopenia and an
elevation in PMNs. Urinalysis showed blood,
protein, and casts. The patient denies any
foreign travel and does not have any sick
contacts. However, she does work part time as
a nurse in a local hospital. The patient is
diagnosed with Meningococcemia; she is
admitted to the hospital and placed in
respiratory isolation. What major course of
therapy should this patient receive?
<answer>Antibiotics
, A 54-year-old man presents after having a
generalized seizure. The patient is HIV positive,
but he has been unable to afford antiretroviral
therapy since losing his job 2 years ago. Other
than cachexia, the physical exam is
unremarkable. Upon further inquiry, the patient
also notes that he has become short- tempered
and hypercritical; at times, he seems confused.
An MRI of the brain is performed, and it reveals
several cortical ring-enhancing lesions.
<answer>Toxoplasma encephalitis
In myasthenia gravis, weakness is a result of
insufficient acetylcholine transmission at the
neuromuscular junction; however, weakness
can also occur with overdosing of the
cholinergic medications used to treat
myasthenia. What symptom helps differentiate
a myasthenic crisis from a cholinergic crisis?
<answer>Muscle fasciculations
A 74-year-old man presents after his wife
witnessed him grab his head in pain and fall to
the floor. He has not regained consciousness.
