American Podiatric Medical Licensing Examination Part I Practice Test

APMLE exam Format | Course Contents | Course Outline | exam Syllabus | exam Objectives

The Part I examination samples the candidates knowledge in the basic science areas of General Anatomy, including embryology, histology, genetics, and geriatrics; Lower Extremity Anatomy; Biochemistry; Physiology; Microbiology and Immunology; Pathology; and Pharmacology. A separate Candidate Information Bulletin for the Part I exam is available online at killexams.com

The Part II written examination samples the candidates knowledge in the clinical areas of Medicine; Radiology; Orthopedics, Biomechanics and Sports Medicine; Anesthesia and Surgery; and Community Health, Jurisprudence, and Research. A separate Candidate Information Bulletin for the Part II written exam is available online at killexams.com Performance on the Part II written examination does not impact eligibility for the Part II CSPE.

The Part II Clinical Skills Patient Encounter (Part II CSPE) assesses proficiency in podiatric clinical tasks needed to enter residency. Candidates will be expected to perform a focused physical examination including podiatric and general medicine physical exam maneuvers appropriate for each patient presentation. Podiatric and general medical knowledge, verbal and written communication, and interpersonal skills will be assessed in each exam form. Performance on the Part II CSPE does not impact eligibility for the Part II written examination.

The Part III examination is designed to determine whether a candidates knowledge and clinical skills are adequate for safe, unsupervised practice. The Part III examination samples the candidates clinical skills in evaluating, diagnosing, and treating patients. Examples of the application of knowledge may be measured through photographs, radiographs and case presentations. A separate Candidate Information Bulletin for the Part III exam is available online at killexams.com

Part I and II
Podiatric Medical College Faculty submit questions (with accompanying references) to Prometric.
The pool of questions (items) are reviewed by a panel of practicing podiatric physicians and two podiatric medical school faculty in each content area.
The primary responsibility of the faculty is clarity and a current reference check.
The primary responsibility of the DPM members is what is the relationship between the item and the tasks performed by a DPM in practice-
priority with regard importance in practice.
estimated difficulty-Is it easy, medium or hard-
For Part I, the questions (items) also are reviewed by a content specialist in one of the basic sciences for accuracy and currency. This individual is a medical school faculty member.
Prometric assembles the test from approved questions according to the content specification.
Part III
Items are written and reviewed by panels of DPM practitioners who have been trained how to prepare effective test items. A second panel of DPMs reviews each form of the test before it is published.

Post Test Administration
Double Scoring Ensures Accuracy
At the examinee level, each computer-based test undergoes two independent scorings. Each test is first scored at the testing site and subsequently rescored when the data arrive back at Prometric. If scores do not match exactly, the examinees record is held until the results can be reconciled. Irregularities that may have occurred at the testing site are also noted and any examinees who may have experienced irregular testing conditions at the test site (such as hardware or software failures or power interruptions) receive a thorough review of their responses. Scores for these examinees are not released until all irregular conditions are given consideration and resolution processing rules are applied fairly to ensure equity in the test administration process.

Item Analysis
Each item is statistically analyzed to determine how many candidates answered correctly and whether the item discriminated between the high and low scoring candidates (the high scoring candidates answered correctly and the low scoring candidates did not). If the item is “flagged”, content experts review each of the flagged items for accuracy.

Deans Report
At the conclusion of the above analyses and after the scores are mailed to the candidates, each dean receives a report, which compares the performance for first time candidates at that school with the national examination data.

Score Reliability
Reliability refers to the consistency of test scores, the consistency with which candidates are classified as either passing or failing, and the degree to which test scores are free from errors of measurement. Errors of measurement result from factors not related to the test, factors such as fatigue or heightened attention, personal interests and other characteristics not related to the test. A persons score will not be perfectly consistent from one occasion to the next as a result of measurement error.

Determination of Passing Scores
The National Board and its test consultant, Prometric, use a widely-accepted criterion-referenced approach to determine passing scores known as the Angoff Method. The important feature of criterion-referenced standard setting is that it is based on an expected level of competence regardless of how many candidates in a particular group pass or fail. This is distinguished from a norm-referenced approach in which a set proportion of test takers fall above or below the passing score.

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Question: 290
Signs and symptoms of hemolytic transfusion reactions include:
A. Hypothermia
B. Hypertension
C. Polyuria
D. Abnormal bleeding
Answer: D
Signs and symptoms of hemolytic transfusion reactions include abnormal
bleeding. Other symptoms of a hemolytic transfusion reaction include fever,
chills, and pain and heat at the infusion site, as well as respiratory distress,
anxiety, hypotension, and oliguria. During surgery, a hemolytic transfusion
reaction can manifest as abnormal bleeding.
Question: 291
A patient suspected of having a hemolytic transfusion reaction should be managed
with:
A. Removal of nonessential foreign body irritants, e.g., Foley catheter
B. Fluid restriction
C. Steroids
D. Fluids and mannitol
Answer: D
A patient suspected of having a hemolytic transfusion reaction should be managed
with fluids and mannitol. Hemolytic transfusion reactions lead to hypotension and
oliguria. The increased hemoglobin in the plasma will be cleared via the kidneys,
which leads to hemoglobinuria.
Question: 292
Which of the following characteristics in a patient might increase the risk of a
wound infection?
A. History of colon surgery
B. Hypertension
C. Male sex
D. Receipt of chemotherapy
Answer: D
A characteristic in a patient that might increase the risk of a wound infection is
receipt of chemotherapy. Decreasing the bacterial inoculum and virulence by
limiting the patient"s prehospital stay, clipping the operative site in the operating
room, administering perioperative antibiotics (within a 24-h period surrounding
operation) with an appropriate antimicrobial spectrum, treating remote infections,
avoiding breaks in technique, using closed drainage systems (if needed at all) that
exit the skin away from the surgical incision, and minimizing the duration of the
operation have all been shown to decrease postoperative infection.
Question: 293
Signs and symptoms associated with early sepsis include:
A. Respiratory acidosis
B. Decreased cardiac output
C. Hypoglycemia
D. Cutaneous vasodilation
Answer: D
Signs and symptoms associated with early sepsis include cutaneous vasodilation.
A changing mental status, tachypnea that leads to respiratory alkalosis, and
flushed skin are often the earliest manifestations of sepsis.
Question: 294
Hypocalcemia is associated with:
A. Acidosis
B. Shortened QT interval
C. Hypomagnesemia
D. Myocardial irritability
Answer: C
Hypocalcemia is associated with hypomagnesemia. Hypocalcemia is also
associated with a prolonged QT interval and may be aggravated by both
hypomagnesemia and alkalosis.
Question: 295
Which of the following inhalation anesthetics accumulates in air-filled cavities
during general anesthesia?
A. Diethyl ether
B. Nitrous oxide
C. Halothane
D. Methoxyflurane
Answer: B
The inhalation anesthetic that accumulates in air-filled cavities during general
anesthesia is nitrous oxide. Nitrous oxide (N2O) has a low solubility compared
with other inhalation anesthetics. Its blood:gas partition coefficient is 0.47 and it
is 30 times more soluble in blood than is nitrogen (N2).
Question: 296
Dopamine is a frequently used drug in critically ill patients because:
A. At high doses, it increases splanchnic flow
B. At high doses, it increases coronary flow
C. At low doses, it decreases heart rate
D. At low doses, it lowers peripheral resistance
Answer: B
Dopamine is a frequently used drug in critically ill patients because at high doses,
it increases coronary flow. In low doses (1-5 mg/kg/min), dopamine affects
primarily the dopaminergic receptors. Activation of these receptors causes
vasodilation of the renal and mesenteric vasculature and mild vasoconstriction of
the peripheral bed, which thereby redirects blood flow to kidneys and bowel.
Question: 297
During blood transfusion, clotting of transfused blood is associated with:
A. ABO incompatibility
B. Minor blood group incompatibility
C. Rh incompatibility
D. Transfusion through Ringer"s lactate
Answer: D
During blood transfusion, clotting of transfused blood is associated with
transfusion through Ringer"s lactate. Calcium-containing solutions such as
Ringer"s lactate cause clotting within the intravenous line rather than hemolysis
and may lead to pulmonary embolism.
Question: 298
The etiologic factor implicated in the development of pulmonary insufficiency
following major nonthoracic trauma is:
A. Aspiration
B. Atelectasis
C. Fat embolism syndrome
D. Fluid overload
Answer: C
The etiologic factor implicated in the development of pulmonary insufficiency
following major nonthoracic trauma is fat embolism syndrome. Post-traumatic
pulmonary insufficiency in the absence of significant thoracic trauma has been
attributed to a wide variety of etiologic agents, including aspiration, simple
atelectasis, lung contusion, fat embolism, pneumonia, pneumothorax, pulmonary
edema, and pulmonary thromboembolism.
Question: 299
Signs and symptoms of unsuspected Addison"s disease include:
A. Hypothermia
B. Hypokalemia
C. Hyperglycemia
D. Hyponatremia
Answer: D
Signs and symptoms of unsuspected Addison"s disease include hyponatremia.
Other clinical manifestations of adrenocortical insufficiency include
hyperkalemia, hyponatremia, hypoglycemia, fever, weight loss, and dehydration.
Question: 300
Treatment for clostridial myonecrosis (gas gangrene) includes which of the
following measures?
A. Administration of an antifungal agent
B. Administration of antitoxin
C. Wide debridement
D. Administration of hyperbaric oxygen
Answer: C
Treatment for clostridial myonecrosis (gas gangrene) includes wide debridement.
Necrotizing skin and soft tissue infections may produce insoluble gases
(hydrogen, nitrogen, methane) through anaerobic bacterial metabolism.

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