1|Page
APEA Pre-Predictor 2026-2027 BANK QUESTIONS WITH
DETAILED VERIFIED ANSWERS EXAM QUESTIONS WILL
COME FROM HERE (100% CORRECT ANSWERS A+ GRADED
1. A 55-year-old male with a history of hypertension and hyperlipidemia
presents with a sudden onset of severe, "tearing" chest pain radiating
to his back. His blood pressure is 170/90 mmHg in the right arm and
130/80 mmHg in the left arm. What is the most likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Answer: C
Explanation: The classic presentation of aortic dissection is severe,
tearing chest pain that radiates to the back. A blood pressure
differential of more than 20 mmHg between arms is a key physical
finding, resulting from compromise of the aortic arch branches.
Myocardial infarction pain is typically described as crushing pressure
and does not usually cause a pulse or blood pressure differential.
Pulmonary embolism causes pleuritic pain and dyspnea, while
pericarditis pain is sharp, pleuritic, and improves with leaning forward.
,2|Page
2. A 24-year-old woman presents with a 3-day history of dysuria,
urinary frequency, and suprapubic pain. She is afebrile and has no
costovertebral angle tenderness. Urinalysis shows positive leukocyte
esterase and nitrites. What is the first-line antibiotic for uncomplicated
cystitis in this patient?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. Azithromycin
Answer: B
Explanation: Nitrofurantoin, trimethoprim-sulfamethoxazole (if local
resistance is less than 20%), and fosfomycin are first-line agents for
acute uncomplicated cystitis. Fluoroquinolones like ciprofloxacin are
not first-line due to concerns about adverse effects and resistance.
Amoxicillin has high resistance rates, and azithromycin is not indicated
for UTIs.
3. A 72-year-old woman reports a gradual decline in vision in both eyes,
describing it as "looking through a foggy window." She also reports
increased glare when driving at night. Fundoscopic examination is
difficult due to a loss of the red reflex. Which condition is most likely?
A. Macular degeneration
B. Glaucoma
C. Cataract
D. Diabetic retinopathy
,3|Page
Answer: C
Explanation: The gradual, painless, progressive vision loss with glare
and a diminished red reflex is classic for cataracts. Age-related macular
degeneration causes central vision loss and distortion
(metamorphopsia), but the red reflex is typically present. Glaucoma is
often asymptomatic initially or presents with peripheral vision loss.
Diabetic retinopathy is associated with dot-blot hemorrhages and
neovascularization on fundoscopic exam.
4. A 4-day-old infant is brought in for a well-child check. The mother is
breastfeeding and concerned that the baby's skin has a yellow hue. The
infant is feeding well and having 6 wet diapers a day. The jaundice is
confined to the face and upper chest. What is the most likely type of
jaundice?
A. Pathologic jaundice
B. Physiologic jaundice
C. Breast milk jaundice
D. Biliary atresia jaundice
Answer: B
Explanation: Physiologic jaundice typically appears after the first 24
hours of life, peaks around days 3-5, and is usually unconjugated and
benign. It does not extend past the umbilicus in mild cases. Pathologic
jaundice appears within the first 24 hours. Breast milk jaundice typically
has a later onset (after day 5-7). Biliary atresia would present with pale
stools and dark urine, with a conjugated hyperbilirubinemia.
, 4|Page
5. A patient with well-controlled asthma on a low-dose inhaled
corticosteroid (ICS) presents for a routine follow-up. According to the
stepwise approach to asthma management, which of the following is
the preferred step-up therapy if control is lost?
A. Add a long-acting beta-agonist (LABA) to the low-dose ICS
B. Switch to a high-dose ICS alone
C. Add a short-acting beta-agonist (SABA) daily
D. Start oral corticosteroids immediately
Answer: A
Explanation: In the stepwise approach, if low-dose ICS is not sufficient,
the preferred step is to add a LABA to a low-dose ICS, often in a single-
inhaler combination. This addresses both inflammation and
bronchoconstriction more effectively than increasing the ICS dose
alone. Daily SABA use is not recommended for maintenance. Oral
corticosteroids are reserved for severe exacerbations or Step 6
treatment.
6. A 65-year-old man with a 40-pack-year smoking history presents with
exertional dyspnea, chronic cough with scant sputum, and a barrel-
shaped chest. Pulmonary function tests are likely to show which
pattern?
A. Reduced FEV1/FVC ratio that normalizes after bronchodilator
B. Reduced FEV1/FVC ratio that does not normalize after
bronchodilator
C. Normal FEV1/FVC ratio with reduced FVC
D. Increased FEV1/FVC ratio
APEA Pre-Predictor 2026-2027 BANK QUESTIONS WITH
DETAILED VERIFIED ANSWERS EXAM QUESTIONS WILL
COME FROM HERE (100% CORRECT ANSWERS A+ GRADED
1. A 55-year-old male with a history of hypertension and hyperlipidemia
presents with a sudden onset of severe, "tearing" chest pain radiating
to his back. His blood pressure is 170/90 mmHg in the right arm and
130/80 mmHg in the left arm. What is the most likely diagnosis?
A. Acute myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pericarditis
Answer: C
Explanation: The classic presentation of aortic dissection is severe,
tearing chest pain that radiates to the back. A blood pressure
differential of more than 20 mmHg between arms is a key physical
finding, resulting from compromise of the aortic arch branches.
Myocardial infarction pain is typically described as crushing pressure
and does not usually cause a pulse or blood pressure differential.
Pulmonary embolism causes pleuritic pain and dyspnea, while
pericarditis pain is sharp, pleuritic, and improves with leaning forward.
,2|Page
2. A 24-year-old woman presents with a 3-day history of dysuria,
urinary frequency, and suprapubic pain. She is afebrile and has no
costovertebral angle tenderness. Urinalysis shows positive leukocyte
esterase and nitrites. What is the first-line antibiotic for uncomplicated
cystitis in this patient?
A. Ciprofloxacin
B. Nitrofurantoin
C. Amoxicillin
D. Azithromycin
Answer: B
Explanation: Nitrofurantoin, trimethoprim-sulfamethoxazole (if local
resistance is less than 20%), and fosfomycin are first-line agents for
acute uncomplicated cystitis. Fluoroquinolones like ciprofloxacin are
not first-line due to concerns about adverse effects and resistance.
Amoxicillin has high resistance rates, and azithromycin is not indicated
for UTIs.
3. A 72-year-old woman reports a gradual decline in vision in both eyes,
describing it as "looking through a foggy window." She also reports
increased glare when driving at night. Fundoscopic examination is
difficult due to a loss of the red reflex. Which condition is most likely?
A. Macular degeneration
B. Glaucoma
C. Cataract
D. Diabetic retinopathy
,3|Page
Answer: C
Explanation: The gradual, painless, progressive vision loss with glare
and a diminished red reflex is classic for cataracts. Age-related macular
degeneration causes central vision loss and distortion
(metamorphopsia), but the red reflex is typically present. Glaucoma is
often asymptomatic initially or presents with peripheral vision loss.
Diabetic retinopathy is associated with dot-blot hemorrhages and
neovascularization on fundoscopic exam.
4. A 4-day-old infant is brought in for a well-child check. The mother is
breastfeeding and concerned that the baby's skin has a yellow hue. The
infant is feeding well and having 6 wet diapers a day. The jaundice is
confined to the face and upper chest. What is the most likely type of
jaundice?
A. Pathologic jaundice
B. Physiologic jaundice
C. Breast milk jaundice
D. Biliary atresia jaundice
Answer: B
Explanation: Physiologic jaundice typically appears after the first 24
hours of life, peaks around days 3-5, and is usually unconjugated and
benign. It does not extend past the umbilicus in mild cases. Pathologic
jaundice appears within the first 24 hours. Breast milk jaundice typically
has a later onset (after day 5-7). Biliary atresia would present with pale
stools and dark urine, with a conjugated hyperbilirubinemia.
, 4|Page
5. A patient with well-controlled asthma on a low-dose inhaled
corticosteroid (ICS) presents for a routine follow-up. According to the
stepwise approach to asthma management, which of the following is
the preferred step-up therapy if control is lost?
A. Add a long-acting beta-agonist (LABA) to the low-dose ICS
B. Switch to a high-dose ICS alone
C. Add a short-acting beta-agonist (SABA) daily
D. Start oral corticosteroids immediately
Answer: A
Explanation: In the stepwise approach, if low-dose ICS is not sufficient,
the preferred step is to add a LABA to a low-dose ICS, often in a single-
inhaler combination. This addresses both inflammation and
bronchoconstriction more effectively than increasing the ICS dose
alone. Daily SABA use is not recommended for maintenance. Oral
corticosteroids are reserved for severe exacerbations or Step 6
treatment.
6. A 65-year-old man with a 40-pack-year smoking history presents with
exertional dyspnea, chronic cough with scant sputum, and a barrel-
shaped chest. Pulmonary function tests are likely to show which
pattern?
A. Reduced FEV1/FVC ratio that normalizes after bronchodilator
B. Reduced FEV1/FVC ratio that does not normalize after
bronchodilator
C. Normal FEV1/FVC ratio with reduced FVC
D. Increased FEV1/FVC ratio
