APEA 3P HIGH STAKES EXAM STUDY GUIDE LATEST REVIEW
CERTIFIED QUALITY EXAM 2026
Which medication is most commonly associated with
hypoglycemia?
Sulfonylureas i.e. Glyburide, Glipizide, Glimepiride
What does myxedema indicate and what is the clinical
presentation?
Myxedema indicates hypothyroidism. S&S include hypothermia,
thickening of the tongue, disorientation, and swelling of the
face, hands, feet.
Hyperthyroidism S&S
Tachycardia, afib, weight loss, hyperactiivity, heat insensitivity,
moist skin, exophthalmos.
Hyperprolactinemia
Menstrual Dysfunction
Erectile Dysfunction
,Breast Pain
Loss of Libido
Vaginal Dryness
Infertility
Lactation
Hyperandrogenism
High levels of androgens in females
Acne
Seborrhea (Oily/Flaky Skin)
Androgenic Alopecia (hair loss on scalp)
Hirsuitism
Infrequent/Absent menstruation
Can be caused by PCOS
Diabetes Mellitus
A1c over 6.5 or fasting glucose over 126 on 2 separate
occasions
Metformin is first line treatment
,Diabetic Neuropathy
Occurs in distal lower extremities r/t long-term hyperglycemia
S&S include
Parestehsias
Burning
Muscle Weakness
Difficulty with Coordination/Balance
Giardiasis S&S
Foul Smelling Stools
Abdominal Pain
Flatulence which can spread the disease
Bloating/Nausea/Vomiting
Giardiasis Treatment
Metronidazole 250mg TID
Cirrhosis S&S
Coagulopathy
Thrombocytopenia in early stages
, Bleeding Varices
Hepatic Encephalopathy
ALOC and Tremors
Psychiatric - Depression/Anxiety
Arthralgia
Glucose Intolerance
Can be caused by Autoimmune disorders
Hepatitis S&S
Low-grade fever
Malaise
Jaundice
Weight Loss
Joint Pain
Dark Urine
RUQ Pain
Pancytopenia
Enlarged Liver
Elevated ALT/AST, Bilirubin, and Alkaline Phosphate
GERD S&S
Pyrosis (heartburn)
CERTIFIED QUALITY EXAM 2026
Which medication is most commonly associated with
hypoglycemia?
Sulfonylureas i.e. Glyburide, Glipizide, Glimepiride
What does myxedema indicate and what is the clinical
presentation?
Myxedema indicates hypothyroidism. S&S include hypothermia,
thickening of the tongue, disorientation, and swelling of the
face, hands, feet.
Hyperthyroidism S&S
Tachycardia, afib, weight loss, hyperactiivity, heat insensitivity,
moist skin, exophthalmos.
Hyperprolactinemia
Menstrual Dysfunction
Erectile Dysfunction
,Breast Pain
Loss of Libido
Vaginal Dryness
Infertility
Lactation
Hyperandrogenism
High levels of androgens in females
Acne
Seborrhea (Oily/Flaky Skin)
Androgenic Alopecia (hair loss on scalp)
Hirsuitism
Infrequent/Absent menstruation
Can be caused by PCOS
Diabetes Mellitus
A1c over 6.5 or fasting glucose over 126 on 2 separate
occasions
Metformin is first line treatment
,Diabetic Neuropathy
Occurs in distal lower extremities r/t long-term hyperglycemia
S&S include
Parestehsias
Burning
Muscle Weakness
Difficulty with Coordination/Balance
Giardiasis S&S
Foul Smelling Stools
Abdominal Pain
Flatulence which can spread the disease
Bloating/Nausea/Vomiting
Giardiasis Treatment
Metronidazole 250mg TID
Cirrhosis S&S
Coagulopathy
Thrombocytopenia in early stages
, Bleeding Varices
Hepatic Encephalopathy
ALOC and Tremors
Psychiatric - Depression/Anxiety
Arthralgia
Glucose Intolerance
Can be caused by Autoimmune disorders
Hepatitis S&S
Low-grade fever
Malaise
Jaundice
Weight Loss
Joint Pain
Dark Urine
RUQ Pain
Pancytopenia
Enlarged Liver
Elevated ALT/AST, Bilirubin, and Alkaline Phosphate
GERD S&S
Pyrosis (heartburn)
