APEA 3P Exam Predictor
Exam100% (Best
Predictor Exam (A+ Free
1. A 72-year-old man with long-standing hypertension presents with a bruit over the
renal artery. His blood pressure remains elevated despite three medications. What
diagnostic test is MOST appropriate?
A. CT abdomen without contrast
B. MRI of the kidneys
C. Renal artery duplex ultrasound
D. PET scan
Correct Answer: C — Renal artery duplex ultrasound
Rationale:
First-line screening for renal artery stenosis is a duplex ultrasound. CT angiography
or MRA may be next if suspicion remains high.
2. A 19-year-old college student has dysuria, suprapubic discomfort, and positive
nitrites on urine dipstick. She denies flank pain or fever. First-line treatment?
A. Ciprofloxacin 500 mg BID x 3 days
B. Nitrofurantoin 100 mg BID x 5 days
,C. Amoxicillin 875 mg BID x 7 days
D. TMP-SMX DS BID x 1 day
Correct Answer: B — Nitrofurantoin
Rationale:
Uncomplicated cystitis → nitrofurantoin or TMP-SMX (if local resistance <20%).
Fluoroquinolones avoided for routine UTI.
3. A patient with COPD presents with increased dyspnea, purulent sputum, and
wheezing. O2 sat is 92%. What is the MOST appropriate treatment addition?
A. Oral antibiotics
B. ICS-LABA
C. Oral prednisone
D. Nebulized saline
Correct Answer: C — Oral prednisone
Rationale:
COPD exacerbation → systemic steroids + consider antibiotics if purulent sputum
and increased dyspnea.
4. A 54-year-old woman presents with sudden unilateral tearing eye pain, blurred
vision, and halos around lights. Pupil is fixed and mid-dilated. What is the diagnosis?
A. Bacterial conjunctivitis
B. Angle-closure glaucoma
C. Open-angle glaucoma
D. Iritis
Correct Answer: B — Angle-closure glaucoma
,Rationale:
Acute, painful, vision-threatening condition; requires emergent ophthalmology.
5. A 60-year-old smoker has an asymmetric, hard, non-tender cervical lymph node
that has persisted for 6 weeks. Next step?
A. Prescribe antibiotics
B. CT neck with contrast
C. Reassure and monitor
D. CBC with differential
Correct Answer: B — CT neck with contrast
Rationale:
Suspicious lymph node → imaging + biopsy. Smoking ↑ risk for head/neck cancers.
6. A 5-year-old with a “barking cough,” inspiratory stridor, and steeple sign on X-ray
most likely has:
A. Epiglottitis
B. Croup
C. Asthma
D. Bronchiolitis
Correct Answer: B — Croup
Rationale:
Barking cough + inspiratory stridor + parainfluenza virus.
7. Before prescribing lisinopril for hypertension, what baseline lab is required?
, A. Lipid panel
B. Hemoglobin A1C
C. Serum creatinine & potassium
D. ESR
Correct Answer: C — Serum creatinine & potassium
Rationale:
ACE inhibitors can cause hyperkalemia and affect renal function.
8. A patient taking simvastatin reports severe muscle pain and dark urine. Next step?
A. Increase hydration
B. Check CK level
C. Reduce dose
D. Add ezetimibe
Correct Answer: B — Check CK level
Rationale:
Signs of rhabdomyolysis; statins must be held.
9. A 22-year-old woman has malar rash, joint pain, and fatigue. Which test is MOST
specific?
A. ESR
B. ANA
C. Anti–dsDNA
D. RF
Correct Answer: C — Anti–dsDNA
Exam100% (Best
Predictor Exam (A+ Free
1. A 72-year-old man with long-standing hypertension presents with a bruit over the
renal artery. His blood pressure remains elevated despite three medications. What
diagnostic test is MOST appropriate?
A. CT abdomen without contrast
B. MRI of the kidneys
C. Renal artery duplex ultrasound
D. PET scan
Correct Answer: C — Renal artery duplex ultrasound
Rationale:
First-line screening for renal artery stenosis is a duplex ultrasound. CT angiography
or MRA may be next if suspicion remains high.
2. A 19-year-old college student has dysuria, suprapubic discomfort, and positive
nitrites on urine dipstick. She denies flank pain or fever. First-line treatment?
A. Ciprofloxacin 500 mg BID x 3 days
B. Nitrofurantoin 100 mg BID x 5 days
,C. Amoxicillin 875 mg BID x 7 days
D. TMP-SMX DS BID x 1 day
Correct Answer: B — Nitrofurantoin
Rationale:
Uncomplicated cystitis → nitrofurantoin or TMP-SMX (if local resistance <20%).
Fluoroquinolones avoided for routine UTI.
3. A patient with COPD presents with increased dyspnea, purulent sputum, and
wheezing. O2 sat is 92%. What is the MOST appropriate treatment addition?
A. Oral antibiotics
B. ICS-LABA
C. Oral prednisone
D. Nebulized saline
Correct Answer: C — Oral prednisone
Rationale:
COPD exacerbation → systemic steroids + consider antibiotics if purulent sputum
and increased dyspnea.
4. A 54-year-old woman presents with sudden unilateral tearing eye pain, blurred
vision, and halos around lights. Pupil is fixed and mid-dilated. What is the diagnosis?
A. Bacterial conjunctivitis
B. Angle-closure glaucoma
C. Open-angle glaucoma
D. Iritis
Correct Answer: B — Angle-closure glaucoma
,Rationale:
Acute, painful, vision-threatening condition; requires emergent ophthalmology.
5. A 60-year-old smoker has an asymmetric, hard, non-tender cervical lymph node
that has persisted for 6 weeks. Next step?
A. Prescribe antibiotics
B. CT neck with contrast
C. Reassure and monitor
D. CBC with differential
Correct Answer: B — CT neck with contrast
Rationale:
Suspicious lymph node → imaging + biopsy. Smoking ↑ risk for head/neck cancers.
6. A 5-year-old with a “barking cough,” inspiratory stridor, and steeple sign on X-ray
most likely has:
A. Epiglottitis
B. Croup
C. Asthma
D. Bronchiolitis
Correct Answer: B — Croup
Rationale:
Barking cough + inspiratory stridor + parainfluenza virus.
7. Before prescribing lisinopril for hypertension, what baseline lab is required?
, A. Lipid panel
B. Hemoglobin A1C
C. Serum creatinine & potassium
D. ESR
Correct Answer: C — Serum creatinine & potassium
Rationale:
ACE inhibitors can cause hyperkalemia and affect renal function.
8. A patient taking simvastatin reports severe muscle pain and dark urine. Next step?
A. Increase hydration
B. Check CK level
C. Reduce dose
D. Add ezetimibe
Correct Answer: B — Check CK level
Rationale:
Signs of rhabdomyolysis; statins must be held.
9. A 22-year-old woman has malar rash, joint pain, and fatigue. Which test is MOST
specific?
A. ESR
B. ANA
C. Anti–dsDNA
D. RF
Correct Answer: C — Anti–dsDNA
