SPEX Cheat Sheet 2026

The 30 highest-yield SPEX facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which statistical index is most appropriate for evaluating the clinical significance of treatment change in an individual client? → Reliable Change Index (RCI)
2. Which finding on ultrasound is most consistent with acute cholecystitis? → Gallbladder wall thickening with a positive Murphy's sign on US
3. What is the value of continuing education in pediatrics for SPEX professionals? → It keeps professionals current with evolving standards and practices
4. What is the most important professional competency for SPEX certification in emergency medicine? → Deep knowledge combined with practical application skills
5. Which professional attribute is most valued in neurology within the SPEX field? → Accountability and commitment to standards
6. Which intervention is classified as tertiary prevention? → Cardiac rehabilitation after myocardial infarction
7. In Hartmann's procedure for perforated sigmoid diverticulitis, which of the following best describes the operation? → Sigmoid resection, end colostomy, and oversewn rectal stump
8. A community health department investigates a cluster of hepatitis A cases linked to a single restaurant. This is best classified as which type of outbreak? → Point source outbreak
9. A physician prescribes digoxin for heart failure. Which electrolyte abnormality potentiates digoxin toxicity? → Hypokalemia
10. According to APA ethical guidelines, informed consent for psychological services must include which of the following elements? → Nature and course of treatment, risks and benefits, and alternatives to treatment
11. Which finding is MOST specific for systemic lupus erythematosus (SLE)? → Anti-double-stranded DNA (anti-dsDNA) antibody
12. What is the mechanism of resistance when bacteria produce beta-lactamase enzymes? → They hydrolyze the beta-lactam ring
13. Which of the following is a contraindication to thrombolytics in pulmonary embolism? → Recent intracranial surgery within 3 months
14. In SPEX practice, what is the best approach to quality improvement in obstetrics and gynecology? → Use data-driven methods with measurable outcomes
15. According to USPSTF guidelines, at what age should average-risk adults begin colorectal cancer screening? → 45 years
16. In the ABCDE criteria for evaluating suspicious skin lesions for melanoma, what does the 'E' stand for? → Evolution or change over time
17. A 40-year-old woman with stage IIIC endometrial cancer (papillary serous histology) is status post-hysterectomy. What adjuvant therapy is most appropriate? → Chemotherapy plus external beam radiation
18. What is the value of continuing education in psychiatry for SPEX professionals? → It keeps professionals current with evolving standards and practices
19. A patient with a GFR of 28 mL/min requires contrast-enhanced CT. Which strategy best minimizes the risk of contrast-induced nephropathy? → Prehydrate with IV normal saline and use the lowest effective iodine dose
20. Under HIPAA, which situation allows a pharmacist to disclose patient health information without authorization? → A law enforcement officer presents a valid court order
21. Which test is used intraoperatively to verify bile duct patency and identify retained stones during cholecystectomy? → Intraoperative cholangiogram (IOC)
22. The ALARA principle in radiation protection stands for: → As Low As Reasonably Achievable
23. Which of the following vaccines is recommended annually for all adults regardless of age? → Influenza vaccine
24. Which of the following best describes the hierarchy of controls for occupational hazards, from most to least preferred? → Elimination → substitution → engineering → administrative → PPE
25. On a Tc-99m bone scan, a 'superscan' pattern is characterized by: → Diffusely increased skeletal uptake with absent or faint renal activity
26. Which opioid analgesic has the highest oral bioavailability and is least affected by first-pass metabolism? → Methadone
27. Which drug used for type 2 diabetes carries the highest risk of hypoglycemia when used as monotherapy? → Glipizide
28. Which of the following is a recognized criterion for diagnosing metabolic syndrome according to the ATP III guidelines? → Fasting glucose ≥ 110 mg/dL
29. Which approach best demonstrates mastery of neurology in SPEX practice? → Applying principles to novel situations with sound judgment
30. What is the value of continuing education in family medicine for SPEX professionals? → It keeps professionals current with evolving standards and practices