PAEA EOC & SUMMATIVE EXAM
VERSION 1 2025 QUESTIONS AND
CORRECT DETAILED ANSWERS 2025
(VERIFIED ANSWERS) PLUS RATIONALES
1. A 22-year-old male presents with fever, headache, and a petechial
rash. He is lethargic and photophobic. What is the most appropriate
next step in management?
A. Start acyclovir
B. Perform lumbar puncture after starting empiric antibiotics
C. Order CT scan without contrast
D. Begin corticosteroids only
Empiric antibiotics must be started before lumbar puncture in
suspected bacterial meningitis to reduce mortality. Delay in antibiotics
can worsen outcomes, especially if meningitis is caused by Neisseria
meningitidis.
,2. A 45-year-old woman has RUQ pain, fever, and leukocytosis.
Ultrasound reveals gallbladder wall thickening and gallstones. What is
the most likely diagnosis?
A. Choledocholithiasis
B. Acute pancreatitis
C. Acute cholecystitis
D. Biliary dyskinesia
Acute cholecystitis typically presents with RUQ pain, fever,
leukocytosis, and ultrasonographic evidence of gallstones with
gallbladder wall thickening and Murphy’s sign.
3. A 63-year-old man with a 45-pack-year smoking history presents
with hematuria. What is the most appropriate initial diagnostic test?
A. Renal biopsy
B. Cystoscopy
C. Abdominal MRI
D. Urethral swab
Cystoscopy is the gold standard for evaluating hematuria in older
adults, especially with a history of smoking, due to high risk of bladder
cancer.
, 4. A child presents with barking cough, inspiratory stridor, and a
steeple sign on X-ray. What is the best treatment?
A. Antibiotics
B. Heliox therapy
C. Dexamethasone and racemic epinephrine
D. Bronchodilators
Croup (laryngotracheitis) is managed with corticosteroids and
nebulized epinephrine to reduce airway inflammation and edema.
5. A 25-year-old woman has symmetric joint stiffness worse in the
morning and elevated ESR. What is the first-line treatment?
A. Methotrexate
B. Prednisone
C. Acetaminophen
D. Hydroxychloroquine
Methotrexate is the initial DMARD of choice for rheumatoid arthritis
due to its proven efficacy in halting disease progression.
6. Which of the following antibiotics is most appropriate for
outpatient treatment of community-acquired pneumonia in a healthy
VERSION 1 2025 QUESTIONS AND
CORRECT DETAILED ANSWERS 2025
(VERIFIED ANSWERS) PLUS RATIONALES
1. A 22-year-old male presents with fever, headache, and a petechial
rash. He is lethargic and photophobic. What is the most appropriate
next step in management?
A. Start acyclovir
B. Perform lumbar puncture after starting empiric antibiotics
C. Order CT scan without contrast
D. Begin corticosteroids only
Empiric antibiotics must be started before lumbar puncture in
suspected bacterial meningitis to reduce mortality. Delay in antibiotics
can worsen outcomes, especially if meningitis is caused by Neisseria
meningitidis.
,2. A 45-year-old woman has RUQ pain, fever, and leukocytosis.
Ultrasound reveals gallbladder wall thickening and gallstones. What is
the most likely diagnosis?
A. Choledocholithiasis
B. Acute pancreatitis
C. Acute cholecystitis
D. Biliary dyskinesia
Acute cholecystitis typically presents with RUQ pain, fever,
leukocytosis, and ultrasonographic evidence of gallstones with
gallbladder wall thickening and Murphy’s sign.
3. A 63-year-old man with a 45-pack-year smoking history presents
with hematuria. What is the most appropriate initial diagnostic test?
A. Renal biopsy
B. Cystoscopy
C. Abdominal MRI
D. Urethral swab
Cystoscopy is the gold standard for evaluating hematuria in older
adults, especially with a history of smoking, due to high risk of bladder
cancer.
, 4. A child presents with barking cough, inspiratory stridor, and a
steeple sign on X-ray. What is the best treatment?
A. Antibiotics
B. Heliox therapy
C. Dexamethasone and racemic epinephrine
D. Bronchodilators
Croup (laryngotracheitis) is managed with corticosteroids and
nebulized epinephrine to reduce airway inflammation and edema.
5. A 25-year-old woman has symmetric joint stiffness worse in the
morning and elevated ESR. What is the first-line treatment?
A. Methotrexate
B. Prednisone
C. Acetaminophen
D. Hydroxychloroquine
Methotrexate is the initial DMARD of choice for rheumatoid arthritis
due to its proven efficacy in halting disease progression.
6. Which of the following antibiotics is most appropriate for
outpatient treatment of community-acquired pneumonia in a healthy
