Alvon
PAEA EOC EXAM 2025
1. A 62-year-old man presents with sudden-onset chest pain radiating to his left arm.
His ECG shows ST-segment elevations in leads II, III, and aVF. What is the most
appropriate next step?
A. Administer IV labetalol
B. Order a D-dimer
C. Activate cardiac catheterization lab
D. Start high-dose steroids
Answer: C. Activate cardiac catheterization lab
Rationale: ST-elevation in II, III, and aVF indicates an inferior wall MI. Emergent
revascularization via PCI is the standard of care.
2. A 34-year-old woman presents with fever, cervical lymphadenopathy, sore throat,
and fatigue. A heterophile antibody test is positive. What complication is most likely
if she resumes contact sports too early?
A. Hemolytic anemia
B. Splenic rupture
C. Rheumatic fever
D. Peritonsillar abscess
Answer: B. Splenic rupture
Rationale: Infectious mononucleosis (EBV) can cause splenomegaly, increasing the
risk of rupture during physical activity.
3. Which of the following medications is contraindicated in pregnancy due to
teratogenicity?
A. Labetalol
B. Methyldopa
C. Valproic acid
D. Amoxicillin
,Alvon
Answer: C. Valproic acid
Rationale: Valproic acid is associated with neural tube defects and other congenital
malformations.
4. A 45-year-old man has worsening dyspnea, bilateral lower extremity edema, and
an S3 heart sound. What is the most likely diagnosis?
A. Pulmonary embolism
B. Congestive heart failure
C. COPD exacerbation
D. Constrictive pericarditis
Answer: B. Congestive heart failure
Rationale: Classic signs of CHF include dyspnea, edema, and an S3 gallop due to fluid
overload.
5. A 25-year-old woman presents with right lower quadrant pain and rebound
tenderness. Urine pregnancy test is negative. What is the next best diagnostic step?
A. Abdominal X-ray
B. CT abdomen and pelvis
C. Transvaginal ultrasound
D. Colonoscopy
Answer: B. CT abdomen and pelvis
Rationale: In non-pregnant women with suspected appendicitis, CT scan is the
diagnostic tool of choice.
6. A 4-year-old presents with a barking cough and inspiratory stridor. What is the
most likely diagnosis?
A. Epiglottitis
B. Asthma
C. Croup (laryngotracheobronchitis)
,Alvon
D. Foreign body aspiration
Answer: C. Croup (laryngotracheobronchitis)
Rationale: Croup is characterized by a barking cough, stridor, and is usually caused by
parainfluenza virus.
7. What is the first-line treatment for a patient diagnosed with generalized anxiety
disorder (GAD)?
A. Benzodiazepines
B. Beta-blockers
C. Buspirone
D. SSRIs
Answer: D. SSRIs
Rationale: SSRIs are the first-line pharmacologic treatment for GAD due to favorable
safety and efficacy profiles.
8. A 60-year-old man presents with jaundice, pruritus, and weight loss. Imaging
shows a mass at the head of the pancreas. What is the most likely diagnosis?
A. Pancreatic adenocarcinoma
B. Chronic pancreatitis
C. Cholecystitis
D. Hepatitis C
Answer: A. Pancreatic adenocarcinoma
Rationale: A pancreatic head mass causing obstructive jaundice suggests pancreatic
cancer.
9. Which of the following vaccines is contraindicated in an HIV-positive patient with a
CD4 count <200 cells/mm³?
A. Pneumococcal vaccine
B. Influenza (inactivated)
, Alvon
C. MMR
D. Hepatitis B
Answer: C. MMR
Rationale: MMR is a live attenuated vaccine and is contraindicated in
immunocompromised patients.
10. A newborn fails to pass meconium within 48 hours of life and has abdominal
distension. What is the most likely diagnosis?
A. Pyloric stenosis
B. Meconium ileus
C. Hirschsprung disease
D. Duodenal atresia
Answer: C. Hirschsprung disease
Rationale: Delayed meconium passage and distension are classic signs of
Hirschsprung disease.
11. What is the most likely causative organism in a patient with cellulitis and a
puncture wound through a tennis shoe?
A. Streptococcus pyogenes
B. Staphylococcus aureus
C. Pseudomonas aeruginosa
D. Clostridium perfringens
Answer: C. Pseudomonas aeruginosa
Rationale: Pseudomonas is commonly found in warm, moist environments like tennis
shoes.
12. A 30-year-old woman with type 1 diabetes presents with abdominal pain,
nausea, and confusion. Labs show elevated glucose and positive serum ketones.
What is the initial management?
PAEA EOC EXAM 2025
1. A 62-year-old man presents with sudden-onset chest pain radiating to his left arm.
His ECG shows ST-segment elevations in leads II, III, and aVF. What is the most
appropriate next step?
A. Administer IV labetalol
B. Order a D-dimer
C. Activate cardiac catheterization lab
D. Start high-dose steroids
Answer: C. Activate cardiac catheterization lab
Rationale: ST-elevation in II, III, and aVF indicates an inferior wall MI. Emergent
revascularization via PCI is the standard of care.
2. A 34-year-old woman presents with fever, cervical lymphadenopathy, sore throat,
and fatigue. A heterophile antibody test is positive. What complication is most likely
if she resumes contact sports too early?
A. Hemolytic anemia
B. Splenic rupture
C. Rheumatic fever
D. Peritonsillar abscess
Answer: B. Splenic rupture
Rationale: Infectious mononucleosis (EBV) can cause splenomegaly, increasing the
risk of rupture during physical activity.
3. Which of the following medications is contraindicated in pregnancy due to
teratogenicity?
A. Labetalol
B. Methyldopa
C. Valproic acid
D. Amoxicillin
,Alvon
Answer: C. Valproic acid
Rationale: Valproic acid is associated with neural tube defects and other congenital
malformations.
4. A 45-year-old man has worsening dyspnea, bilateral lower extremity edema, and
an S3 heart sound. What is the most likely diagnosis?
A. Pulmonary embolism
B. Congestive heart failure
C. COPD exacerbation
D. Constrictive pericarditis
Answer: B. Congestive heart failure
Rationale: Classic signs of CHF include dyspnea, edema, and an S3 gallop due to fluid
overload.
5. A 25-year-old woman presents with right lower quadrant pain and rebound
tenderness. Urine pregnancy test is negative. What is the next best diagnostic step?
A. Abdominal X-ray
B. CT abdomen and pelvis
C. Transvaginal ultrasound
D. Colonoscopy
Answer: B. CT abdomen and pelvis
Rationale: In non-pregnant women with suspected appendicitis, CT scan is the
diagnostic tool of choice.
6. A 4-year-old presents with a barking cough and inspiratory stridor. What is the
most likely diagnosis?
A. Epiglottitis
B. Asthma
C. Croup (laryngotracheobronchitis)
,Alvon
D. Foreign body aspiration
Answer: C. Croup (laryngotracheobronchitis)
Rationale: Croup is characterized by a barking cough, stridor, and is usually caused by
parainfluenza virus.
7. What is the first-line treatment for a patient diagnosed with generalized anxiety
disorder (GAD)?
A. Benzodiazepines
B. Beta-blockers
C. Buspirone
D. SSRIs
Answer: D. SSRIs
Rationale: SSRIs are the first-line pharmacologic treatment for GAD due to favorable
safety and efficacy profiles.
8. A 60-year-old man presents with jaundice, pruritus, and weight loss. Imaging
shows a mass at the head of the pancreas. What is the most likely diagnosis?
A. Pancreatic adenocarcinoma
B. Chronic pancreatitis
C. Cholecystitis
D. Hepatitis C
Answer: A. Pancreatic adenocarcinoma
Rationale: A pancreatic head mass causing obstructive jaundice suggests pancreatic
cancer.
9. Which of the following vaccines is contraindicated in an HIV-positive patient with a
CD4 count <200 cells/mm³?
A. Pneumococcal vaccine
B. Influenza (inactivated)
, Alvon
C. MMR
D. Hepatitis B
Answer: C. MMR
Rationale: MMR is a live attenuated vaccine and is contraindicated in
immunocompromised patients.
10. A newborn fails to pass meconium within 48 hours of life and has abdominal
distension. What is the most likely diagnosis?
A. Pyloric stenosis
B. Meconium ileus
C. Hirschsprung disease
D. Duodenal atresia
Answer: C. Hirschsprung disease
Rationale: Delayed meconium passage and distension are classic signs of
Hirschsprung disease.
11. What is the most likely causative organism in a patient with cellulitis and a
puncture wound through a tennis shoe?
A. Streptococcus pyogenes
B. Staphylococcus aureus
C. Pseudomonas aeruginosa
D. Clostridium perfringens
Answer: C. Pseudomonas aeruginosa
Rationale: Pseudomonas is commonly found in warm, moist environments like tennis
shoes.
12. A 30-year-old woman with type 1 diabetes presents with abdominal pain,
nausea, and confusion. Labs show elevated glucose and positive serum ketones.
What is the initial management?
