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Apea Pre-Predictor Actual Exam 2025/2026 Questions
And Detailed Answers
A 70-year-old woman is brought to your attention by her
family because of the slowly progressive gait disorder, the
impairment of mental function, and urinary incontinence.
About 1 year ago, she started having weakness and
tiredness in her legs, followed by unsteadiness; her steps
became shorter and shorter, and she also experienced
unexplained backward falls. She is becoming emotionally
indifferent, inattentive, and her actions and thinking have
became "dull". Over the past month, she has started
having urinary urgency and involuntary leaking of urine.
What is most likely the best method of treating the
patient's urinary problems? - ANSWER-
Ventriculoperitoneal shunt
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A 5-month-old male infant presents after a seizure
involving all 4 limbs. His mother tells you that he was born
full term without any complications, and he was well until 2
days ago when he developed a fever. He vomited multiple
times yesterday and was irritable. He was given antipyretic
medication for his fever. He has no known allergies. On
physical exam, his temperature is 102.7 F, and his pulse is
154/min; BP is 90/50 mmHg, and RR is 20/min. He is
lethargic, pale, and focal neurological deficits are present.
His anterior fontanel is bulging. You suspect that he has
bacterial meningitis. After drawing blood samples for
investigations, what is the most appropriate next step? -
ANSWER-intravenous empirical antibiotics
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A 12-year-old girl presents with a 3-day history of
progressive dysarthria, dysphagia, and weakness. The
patient was well until 3 days prior to admission to the
hospital; at that time, she developed the onset and
subsequent gradual worsening of dysarthria. She
attributed the dysarthria to a sore throat that she had had
about 2 weeks earlier. 3 days prior to admission, she also
had the onset of mild dysphagia; it mostly occurred with
liquids. 24 hours prior to admission, she developed
weakness in both upper extremities, which increased and
began to involve the lower extremities. This limb weakness
was neither worsened by activity nor improved by rest. A
nerve conduction study reveals a moderate degree of
mostly motor demyelinating peripheral neuropathy, highly
suggestive of Guillain- Barre. What statement best
, 4|Page
describes the patient's prognosis? - ANSWER-Her rapidly
evolving clinical course indicates a poor prognosis
A 45-year-old African American man with no significant
past medical history presents with a 1-hour history of left
retroorbital headache. It is described as excruciating,
stabbing, sharp, and lancinating; it is rated as severe in
intensity. He denies any preceding infections, nausea,
vomiting, photophobia, or osmophobia; he also denies
fever, chills, stiff neck, focal weakness, numbness, tingling,
vision, hearing, gait, or speech changes. He recalls a
similar episode several months ago; it lasted about a
week, and it dissipated without complications. His physical
exam is remarkable for painful distress, lacrimation with
conjunctival injection, nasal congestion, rhinorrhea, left
Apea Pre-Predictor Actual Exam 2025/2026 Questions
And Detailed Answers
A 70-year-old woman is brought to your attention by her
family because of the slowly progressive gait disorder, the
impairment of mental function, and urinary incontinence.
About 1 year ago, she started having weakness and
tiredness in her legs, followed by unsteadiness; her steps
became shorter and shorter, and she also experienced
unexplained backward falls. She is becoming emotionally
indifferent, inattentive, and her actions and thinking have
became "dull". Over the past month, she has started
having urinary urgency and involuntary leaking of urine.
What is most likely the best method of treating the
patient's urinary problems? - ANSWER-
Ventriculoperitoneal shunt
,2|Page
A 5-month-old male infant presents after a seizure
involving all 4 limbs. His mother tells you that he was born
full term without any complications, and he was well until 2
days ago when he developed a fever. He vomited multiple
times yesterday and was irritable. He was given antipyretic
medication for his fever. He has no known allergies. On
physical exam, his temperature is 102.7 F, and his pulse is
154/min; BP is 90/50 mmHg, and RR is 20/min. He is
lethargic, pale, and focal neurological deficits are present.
His anterior fontanel is bulging. You suspect that he has
bacterial meningitis. After drawing blood samples for
investigations, what is the most appropriate next step? -
ANSWER-intravenous empirical antibiotics
,3|Page
A 12-year-old girl presents with a 3-day history of
progressive dysarthria, dysphagia, and weakness. The
patient was well until 3 days prior to admission to the
hospital; at that time, she developed the onset and
subsequent gradual worsening of dysarthria. She
attributed the dysarthria to a sore throat that she had had
about 2 weeks earlier. 3 days prior to admission, she also
had the onset of mild dysphagia; it mostly occurred with
liquids. 24 hours prior to admission, she developed
weakness in both upper extremities, which increased and
began to involve the lower extremities. This limb weakness
was neither worsened by activity nor improved by rest. A
nerve conduction study reveals a moderate degree of
mostly motor demyelinating peripheral neuropathy, highly
suggestive of Guillain- Barre. What statement best
, 4|Page
describes the patient's prognosis? - ANSWER-Her rapidly
evolving clinical course indicates a poor prognosis
A 45-year-old African American man with no significant
past medical history presents with a 1-hour history of left
retroorbital headache. It is described as excruciating,
stabbing, sharp, and lancinating; it is rated as severe in
intensity. He denies any preceding infections, nausea,
vomiting, photophobia, or osmophobia; he also denies
fever, chills, stiff neck, focal weakness, numbness, tingling,
vision, hearing, gait, or speech changes. He recalls a
similar episode several months ago; it lasted about a
week, and it dissipated without complications. His physical
exam is remarkable for painful distress, lacrimation with
conjunctival injection, nasal congestion, rhinorrhea, left
