The Audio PANCE and PANRE Physician Assistant Board Review Podcast http://podcast.thepalife.com Multiple Choice Physician Assistant Board Review and Rotation Exam Questions on the Go – Listen and Learn Mon, 14 Sep 2020 15:06:56 +0000 en-US hourly 1 http://podcast.thepalife.com/wp-content/uploads/2017/04/cropped-The-Audio-PANCE-and-PANRE-512x512-32x32.jpg The Audio PANCE and PANRE Physician Assistant Board Review Podcast http://podcast.thepalife.com 32 32 The Audio PANCE and PANRE is an audio Board and Rotation Review Series that includes ten Multiple Choice PANCE and PANRE Board Review Questions in Each Episode. Now you can study for your PANCE, PANRE, and End or Rotation Exams in the gym, in the car, on a run, or while relaxing on the beach. This free series is limited to every other episode. To download the complete series join Smarty PANCE at https://smartypance.com/sign-up/ The Physician Assistant Life | Smarty PANCE clean The Physician Assistant Life | Smarty PANCE stephen@smartypance.com stephen@smartypance.com (The Physician Assistant Life | Smarty PANCE) The PA Life, INC Multiple Choice Physician Assistant Board and Rotation Review Questions on the Go - Listen and Learn The Audio PANCE and PANRE Physician Assistant Board Review Podcast http://podcast.thepalife.com/wp-content/uploads/powerpress/THE_AUDIO_PANCE_AND_PANRE_ACADEMY_PODCAST.png http://podcast.thepalife.com TV-G 78572745 Podcast Episode 85: Ten Mixed Multiple Choice PANCE and PANRE Board Review Questions http://podcast.thepalife.com/episode-85/ Mon, 14 Sep 2020 14:49:26 +0000 http://podcast.thepalife.com/?p=394 http://podcast.thepalife.com/episode-85/#respond http://podcast.thepalife.com/episode-85/feed/ 0 <p>Welcome to episode 85 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet). Special from today’s episode: Download your copy of the Free Trello Smarty PANCE NCCPA™ Blueprint […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/episode-85/">Podcast Episode 85: Ten Mixed Multiple Choice PANCE and PANRE Board Review Questions</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Podcast Episode 85_ The Audio PANCE and PANRE PA Board Review PodcastWelcome to episode 85 of the Audio PANCE and PANRE PA Board Review Podcast.

Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

Special from today’s episode:

This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprints. 

Below you will find an interactive exam to complement the podcast.

Below you will find an interactive exam to complement the podcast.

The Audio PANCE/PANRE and EOR PA Board Review Podcast

I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

Listen Carefully Then Take The Practice Exam

If you can’t see the audio player click here to listen to the full episode.

Podcast Episode 85: Ten MIXED PANCE and PANRE Board Review Questions

The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member, you will be able to log in and view this interactive video lesson.

1. A 14-hour-old boy has failed to pass stool and is vomiting greenish fluid. He was born at 40 weeks gestation with no complications during delivery or pregnancy. His temperature is 97.6°F (36.4°C), blood pressure is 64/34 mmHg, pulse is 140/min, respirations are 33/min, and oxygen saturation is 98% on room air. The child is currently breastfeeding and appears irritable. Physical exam is notable for a distended and non-tender abdomen. The rectal exam is unremarkable. An abdominal radiograph demonstrates distended loops of bowel. What is the most likely diagnosis?

  1. Cystic fibrosis
  2. Hirschsprung disease
  3. Jejunal atresia
  4. Pyloric stenosis
  5. Tracheoesophageal fistula
Click here to see the answer

Answer: A. Cystic fibrosis

Cystic fibrosis (CF) commonly presents with meconium ileus, characterized by bilious vomiting, distended loops of bowel on radiography, and failure to pass meconium. CF is an autosomal recessive disease and is common in Caucasians. Neonates with CF commonly present with failure to thrive, respiratory compromise, and meconium ileus. In meconium ileus, abnormally thick meconium results in bowel obstruction, perforation, or volvulus. CF is diagnosed by the sweat chloride test or genetic testing. Radiography in ileus can demonstrate distended loops of bowel from the obstruction.

  • Hirschsprung disease would present with abdominal pain with chronic constipation. There would be an absence of stool in the rectal vault on rectal exam and a positive squirt sign on physical exam (expulsion of stool/flatus on rectal exam).
  • Jejunal atresia is characterized by the “triple bubble” sign on abdominal radiographs as well as bilious vomiting.
  • Pyloric stenosis presents with non-bilious and projectile vomiting with a palpable mass on abdominal exam. This diagnosis can be confirmed with an ultrasound. The patient should first be rehydrated and have their electrolytes repleted prior to imaging.
  • Tracheoesophageal fistula presents with coughing and choking with feeding. This breastfeeding and asymptomatic child in terms of his respiratory status suggests against this.

Review NCCPA Blueprint Topic: Cystic fibrosis

2. A 34-year-old female presents to her ophthalmologist with 6 hours of blurry vision in her right eye. She reports severe pain with eye movement that has not been relieved with NSAIDs. She feels that she has been generally healthy all her life, although she does note one week of right arm weakness during the previous year that resolved without treatment. On exam, she has no noted ocular secretions. On her fundal exam, you note blurred borders on the optic disc. Which of the following additional findings is likely to be present in this patient?

  1. Polycythemia
  2. Elevated IgG in the cerebrospinal fluid (CSF)
  3. Multiple areas of periventricular hyperintensity on T2 FLAIR imaging
  4. Subdural hematoma
  5. Small, punctate hypointensities on gradient-echo MR
Click here to see the answer

The answer is B. Elevated IgG in the cerebrospinal fluid (CSF)

This patient’s clinical presentation is consistent with multiple sclerosis (MS), which is associated with an elevated IgG in the CSF.

MS is associated with oligoclonal bands on CSF evaluation in 80% of cases. The bands result from IgG overproduction, likely as a result of the autoimmune processes that occur in MS. Patients with MS frequently present first with symptoms of optic neuritis, which include loss of vision or blurry vision (usually unilateral), with severe pain with eye movement. The prognosis of MS differs drastically from patient to patient, but most commonly has a relapsing-remitting course.

Incorrect Answers:

  • Mononuclear pleocytosis, not polycythemia, is associated with MS.
  • MS plaque is hyperintense, not hypointense, on T2 FLAIR.
  • MS is not associated with subdural hematomas. In addition, a subdural hematoma would be unusual in this young patient without a history of trauma.
  • Small, punctate hypointensities on gradient-echo MRI is typical of diffuse axonal injury, which would be unlikely in this patient without a history of trauma.

Review NCCPA Blueprint Topic: Multiple sclerosis (ReelDx + Lecture)

3. A 43-year-old man is brought to the emergency department after having a seizure. His wife states that the patient has been struggling with alcohol abuse and has recently decided to “quit once and for all”. Physical exam is notable for a malnourished patient responsive to verbal stimuli. He has moderate extremity weakness, occasional palpitations, and brisk deep tendon reflexes (DTRs). EKG demonstrates normal sinus rhythm and a prolonged QT interval. What nutritional deficiency most likely contributed to these findings?

  1. Potassium
  2. Calcium
  3. Folate
  4. Magnesium
  5. Vitamin D
Click here to see the answer

The answer is D. Magnesium

This patient in this vignette demonstrates a constellation of findings related to the complications of hypomagnesemia. Although alcohol withdrawal may present with seizures, the constellation of brisk DTRs, weakness, and prolonged QT suggest hypomagnesemia. The treatment for this patient will be multi-faceted, with magnesium repletion a necessity.

Hypomagnesemia (<1.5 mg/dL) is a potentially serious condition that may be difficult to recognize due to non-specific manifestations. Mild signs of hypomagnesemia include: generalized weakness, fatigue, nausea and vomiting. As deficiency progresses patients may complain of numbness, cramping, and dysphagia. Physical exam findings may reveal increased DTRs and fasciculations. If hypomagnesemia is acute in onset and/or severe, patients may develop altered mental status, seizures, or cardiac conduction abnormalities. Low magnesium levels also have the potential to affect other electrolyte levels. In patients with hypomagnesemia it is not uncommon to see hypokalemia (K+ conductance changes increasing renal losses) and hypocalcemia (due to PTH resistance).

Incorrect Answers:

  • This patient is likely hypokalemic secondary to hypomagnesemia. In fact, hypokalemia may contribute to the EKG findings. If the patient is solely hypokalemic, without any other electrolyte disturbances, DTRs will be decreased rather than increased.
  • A patient with hypocalcemia may present in the same fashion as this patient (altered mental status, seizures, increased DTRs, and prolonged QT). While hypomagnesemia can lead to hypocalcemia, it is important to understand that a deficiency in magnesium itself can independently cause neuromuscular abnormalities. Seeing as this patient is malnourished and a chronic alcoholic, magnesium deficiency is the likely etiology.
  • Folate deficiency is common in chronic alcoholics. It typically presents with macrocytic anemia without neurological complications
  • Vitamin D deficiency is often asymptomatic but may present with signs of osteomalacia in adults and rickets in children.

Review NCCPA Blueprint Topic: Fluid and Electrolyte Disorders (PEARLS)

4. A 17-year-old female presents to her physician’s office after noticing a round lump in her left breast 2 months ago. She reports that the lump seemed to enlarge and became tender just preceding her last 2 menses. It is otherwise painless, and the patient denies any discharge or skin changes. She has no past medical history but her grandmother, age 72, was just diagnosed with invasive ductal carcinoma of the breast. The patient is an avid softball player at her high school and denies alcohol, smoking, or illicit drug use. On exam, the breasts appear symmetric and normal. A 3-cm round, mobile mass is palpated in the upper outer quadrant of the left breast. There is slight tenderness to deep palpation of the mass. There is no axillary lymphadenopathy on either side. Which of the following is the most likely outcome of this patient’s condition?

  1. This mass will likely require excision
  2. This mass will decrease in size if the patient starts oral contraceptives
  3. This mass slightly increases this patient’s risk of breast cancer in the future
  4. This mass will most likely decrease in size or disappear over time
  5. If this mass grows rapidly to greater than 5 cm, radiation and chemotherapy are indicated
Click here to see the answer

The answer is D. This mass will most likely decrease in size or disappear over time

This patient is a young female with a round, mobile mass that seems to respond to hormonal fluctuations, most likely a fibroadenoma, a benign mass common in reproductive-aged women. In adolescents, the majority of lesions will diminish or completely resolve over time, so only reassurance and observation are required. 

Classic fibroadenomas are relatively small (2-3 cm in size), in the upper outer quadrant of one or both breasts, and feel rubbery to palpation. They are generally painless but may become tender around the time of menses, as in this patient. There should be no skin changes, breast drainage, or lymphadenopathy. For an adolescent patient without concerning features or strong family history of premenopausal breast cancer in multiple first-degree relatives, there is no increased risk of malignancy from fibroadenomas. Fat necrosis is also a possible diagnosis in this softball player, as many patients do not recall a specific inciting trauma. However, given that the mass has been present for 2 months and undergoes hormonal changes, fibroadenoma is still the most likely diagnosis. Either way, the mass should eventually resolve and ultrasound is only indicated if the patient is older or there is persistence or change in the mass (Illustration A). Ultrasound is preferred in young women due to high breast density and the radiosensitivity of their tissues, but if the patient is over 35, mammography may also be performed. It would show a “popcorn” appearance (Illustration B). Upon confirmation of the diagnosis, either by imaging findings or core needle biopsy, surgical excision can be performed only if the patient experiences significant symptoms. Otherwise, routine follow-up is sufficient.

Incorrect Answers:

  • Excision is usually not required for fibroadenomas given that they are not associated with increased risk of malignancy. If a patient feels the symptoms are too bothersome, surgical resection can be performed. If the diagnosis is called into question due to persistence or growth and there is concern for malignancy, excision may be required after imaging and biopsy are performed.
  • Oral contraceptives containing estrogen may increase, not decrease, the size of the fibroadenoma. Since these tumors are hormonally receptive, they often grow and become tender around the time of menses, during pregnancy, and with estrogen administration (as in an OCP). For this reason, they also typically regress in menopause.
  • Breast cancer risk is not increased by fibroadenomas, especially ones that are simple (no skin changes, drainage, lymphadenopathy, etc.), as in this patient. This patient’s family history of postmenopausal breast cancer in a second degree relative does put her at minimally higher risk of breast cancer, but this is unrelated to her fibroadenoma.
  • A rapid growth to over 5 cm suggests that the mass is actually not a fibroadenoma but a phyllodes tumor (Illustration C). This is a rare neoplasm that can be benign or malignant, and although most phyllodes tumors occur in older women, they have been reported in patients as young as 10 years old. They are known for their rapid increase in size within weeks and any such growth should be evaluated with ultrasound and core needle biopsy (and mammography if the patient is over 35). Given the malignant potential, wide local excision is the standard of care. Chemotherapy and radiation are generally not indicated as effectiveness is unclear.

Review NCCPA Blueprint Topic: Fibroadenoma

5. A 26-year-old monogamous female presents with cyclic pelvic pain that has been increasing over the last 6 months. She complains of significant dysmenorrhea and dyspareunia. She uses condoms for birth control. On physical examination, her uterus is retroverted and non-mobile, and she has a palpable adnexal mass on the left side. Her serum pregnancy test is negative. Which of the following is the most likely diagnosis?

  1. Ovarian cancer
  2. Endometriosis
  3. Functional ovarian cyst
  4. Pelvic inflammatory disease
Click here to see the answer

The answer is B. Endometriosis

With endometriosis, the uterus is often fixed and retroflexed in the pelvis. The palpable mass is an endometrioma or “chocolate cyst”. The patient with endometriosis also often has dysmenorrhea, dyspareunia, and dyschezia.

Incorrect answers:

  • It is important to consider ovarian cancer in a patient with a pelvic mass however, ovarian cancer usually occurs in older women over age 55 and patients are often asymptomatic until the disease is more advanced
  • Functional ovarian cysts occur from ovulation and usually are not symptomatic.
  • With PID the patient will have abdominal tenderness, adnexal tenderness, cervical motion tenderness, and elevated temperature.

Review NCCPA Blueprint Topic: Endometriosis (Lecture)

6.  A healthy 29-year-old woman at 30-weeks gestational age has gained 35lbs since becoming pregnant. She complains of several weeks of bilateral numbness and tingling of her palms, thumbs, index, and middle fingers that is worse at night. She also notes weakness gripping objects at the office. Which nerve is most likely affected?

  1. Median nerve
  2. Ulnar nerve
  3. Radial nerve
  4. Axillary nerve
  5. Anterior interosseous nerve
Click here to see the answer

The answer is A. Median nerve

This clinical presentation is consistent with carpal tunnel syndrome (CTS), the most common entrapment neuropathy, caused by compression of the median nerve as it travels under the flexor retinaculum. During pregnancy, increased edema causes a narrowing of the carpal tunnel, which predisposes the entrapment of the median nerve. The median nerve is responsible for sensory and motor distribution of the thumb, index, middle and radial half of the ring finger. Hallmark symptoms of CTS include numbness and paresthesias in the median nerve distribution. Weakness and atrophy of the thenar muscles may be evident if CTS is left untreated.

Incorrect Answers:

  • The ulnar nerve supplies sensory innervation to the 5th digit and the medial half of the 4th digit and motor innervation of the forearm flexors, and several intrinsic muscles of the hand. The ulnar nerve is most commonly injured at the elbow as it courses adjacent to the humeral medial epicondyle or it may be compressed between the two heads of the flexor carpi ulnaris muscles (cubital tunnel syndrome).
  • The radial nerve supplies the medial, lateral, long heads of the triceps brachii, 12 muscles in the posterior compartment of the forearm and the associated joints and overlying skin. Radial nerve injury may result from spiral fracture of the midshaft of the humerus and result in “wrist drop”
  • The axillary nerve supplies the deltoid, teres minor, and the long head of the triceps brachii. Axillary nerve injury may result from dislocation of the head of the humerus
  • The anterior interosseous nerve branch of the median nerve supplies the deep muscles on the anterior of the forearm. This includes the flexor pollicis longus, pronator quadratus, and the radial half of flexor digitorum profundus

Review NCCPA Blueprint Topic: Carpal Tunnel Syndrome

7. A 55-year-old female comes to the ED complaining of moderate right eye pain, headache, and acute onset of blurry vision, which she describes as colored halos around lights. She was watching a movie at home with her husband about an hour ago when the pain began. On the physical exam of her right eye, her pupil is mid-dilated and unresponsive to light. Her right eyeball is firm to pressure. Intraocular pressure (IOP) measured with a tonometer is elevated at 36mmHg. Which of the following is the most appropriate emergency treatment?

  1. Timolol ophthalmic solution
  2. Epinephrine ophthalmic solution
  3. Laser peripheral iridotomy
  4. Anti-cholinergic ophthalmic solution
  5. NSAID ophthalmic solution
Click here to see the answer

Answer: A. Timolol ophthalmic solution

Acute angle-closure glaucoma, also known as narrow-angle glaucoma, presents with sudden onset blurry vision, hardened eyeball, and increased IOP. First-line emergency treatment includes alpha 2 selective adrenergic agonists, beta-blockers, or carbonic anhydrase inhibitors. Acute angle-closure glaucoma is caused by relative pupillary block of aqueous humor as it flows from the posterior to the anterior chamber through the iris-lens channel (the canal of Schlemm). Sudden attacks are more likely to occur when the pupil is partially dilated, for example, being in a darkened room such as a movie theater, or when eye drops are taken that dilate the pupil. If not treated immediately, it can damage the optic nerve and result in permanent vision loss within hours. Risk factors include certain medications (dilating drops, anticholinergic, antidepressants).

Incorrect Answers:

  • Epinephrine would cause pupil dilation which would worsen acute angle glaucoma.
  • Laser peripheral iridotomy is an appropriate and definitive treatment for acute angle glaucoma in the post-acute phase of treatment once IOP is controlled.
  • Anticholinergics would cause pupil dilation which would worsen acute angle glaucoma
  • NSAID ophthalmic solution can theoretically worsen acute angle glaucoma because of its anti-prostaglandin effect.

Review NCCPA Blueprint Topic: Glaucoma (Lecture)

8. A 68-year-old woman presents to your office for her annual check-up. Her vitals are HR 85, T 98.8 F, RR 16, BP 125/70. She has a history of smoking 1 pack a day for 35 years but states she quit five years ago. She had her last pap smear at age 64 and states all of her pap smears have been normal. She had her last colonoscopy at age 62, which was also normal. Which is the following is the next best test for this patient?

  1. Abdominal ultrasound
  2. Chest CT scan
  3. Pap smear
  4. Colonoscopy
  5. Chest radiograph
Click here to see the answer

The answer is B: Chest CT scan

The patient presents between the ages of 55 and 80 and has quit smoking within the last 15 years. She should undergo an annual low dose chest CT scan for lung cancer screening.

Cigarette smoking is the leading cause of preventable death in the United States and significantly contributes to deaths from cancer along with cardiovascular and pulmonary diseases. Smoking not only harms adults but also results in the deaths of about 1,000 infants annually. The USPSTF report on the guidelines for lung cancer screening states that age, total cumulative exposure to tobacco smoke, and years since quitting smoking are the most important risk factors for lung cancer. They report that annual screening for lung cancer with low-dose CT in a defined population of high-risk persons can prevent a substantial number of lung cancer–related deaths as evidenced by large randomized controlled trials.

Incorrect Answers:

  • An abdominal ultrasound is recommended for men between the ages of 65 and 75 who have ever smoked, but this recommendation does not hold for women
  • The patient does not require a pap smear because she is older than 65 and does not have a history of cervical or endometrial malignancy, and all of her previous pap smears have been negative.
  • The patient should next get her colonoscopy at age 72 since her last colonoscopy was at age 62 and was normal
  • The patient does not have any acute respiratory or pulmonary problems and therefore does not need a chest radiograph

Review NCCPA Blueprint Topic: Substance-related and addictive disorders (ReelDx)

9. A 22-year-old man presents to the emergency room complaining of pain upon urination and a watery discharge from his penis. It started a few days ago and has been getting progressively worse. His temperature is 98.0°F (36.7°C), blood pressure is 122/74 mmHg, pulse is 83/min, respirations are 14/min, and oxygen saturation is 98% on room air. Physical exam is notable for a tender urethra with discharge. Gram stain of the discharge is negative for bacteria but shows many neutrophils. Which of the following is the most likely infectious etiology of this patient’s symptoms?

  1. Chlamydia trachomatis
  2. Escherichia coli
  3. Neisseria gonorrhoeae
  4. Staphylococcus saprophyticus
  5. Trichomonas vaginalis
Click here to see the answer

The answer is A. Chlamydia trachomatis

This patient is presenting with a tender urethra with a discharge and a negative Gram stain suggesting a diagnosis of urethritis from Chlamydia trachomatis.

Urethritis in men presents with dysuria and urethral discharge with numerous neutrophils on urethral swab. Urethritis in men is most commonly caused by 2 categories of sexually transmitted infections. In gonococcal urethritis, patients present with purulent discharge and gram-negative diplococci on Gram stain, with N. gonorrhoeae as the offending agent. In nongonococcal urethritis, patients present with watery discharge which shows no bacteria on Gram stain (it is intracellular). Chlamydia is the most common offending agent in nongonococcal urethritis and is the most common cause of urethritis overall. Azithromycin is a good choice for the treatment of nongonococcal urethritis because it covers Chlamydia and other common causative organisms. It is often given with ceftriaxone which offers double coverage for N. gonorrhoeae.

Incorrect Answers

  • Escherichia coli is the most common cause of cystitis which presents with dysuria and leukocytes, bacteria, and nitrites on urinalysis. TMP-SMX is a first-line agent for the treatment of uncomplicated cystitis.
  • Neisseria gonorrhoeae is the most common cause of gonococcal urethritis which presents with a purulent urethral discharge and gram-negative diplococci on Gram stain. Ceftriaxone (a single injection) is the most common treatment for gonococcal urethritis. Ceftriaxone would be appropriate if the patient presented with purulent urethral discharge and a supportive Gram stain. Patients treated for gonococcal urethritis are generally treated for a Chlamydia trachomatis infection since there is a high rate of co-infection.
  • Staphylococcus saprophyticus is a common cause of UTI in young and sexually active women. It is still less common a cause of a UTI when compared to Escherichia coli.
  • Trichomonas vaginalis is a less common cause of male urethritis. It can present with pruritus but with less specific symptoms when compared to women with this condition. If the patient did not respond to antibiotics, this diagnosis could be suspected. Metronidazole is the treatment of choice.

Review NCCPA Blueprint Topic: Chlamydia (Lecture)

10. A 6-year-old boy is admitted with a one-week history of diarrhea, which was sometimes bloody and originally began after a birthday party. He has become lethargic and has not been eating or drinking. His vital signs are as follows: T 38.5 C, HR 135, BP 82/54. Physical examination is significant for petechiae on his legs and diffuse abdominal tenderness to palpation. Lab-work shows BUN 72 mg/dL, creatinine 8.1 mg/dL, and platelet count < 10,000. PT and PTT are within normal limits. Which of the following would be expected on a peripheral blood smear?

  1. Rouleaux formation
  2. Fragmented red blood cells
  3. Spur cells
  4. Giant platelets
  5. No abnormalities
Click here to see the answer

The answer is B. Fragmented red blood cells

The boy in this vignette most likely has hemolytic uremic syndrome (HUS), which is characterized by microangiopathic hemolytic anemia with schistocytes.

HUS usually occurs in children and is caused by an E. coli 0157:H7 infection. The classic presentation follows an acute diarrheal illness. HUS is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal failure. The presentation is similar to thrombotic thrombocytopenic purpura (TTP) but without the fever and neurologic symptoms. The key differentiating factor, in this case, is diarrhea + elevated BUN. Keep in mind that in HUS uremia is elevated to a greater extent than TTP. On the other hand, TTP presents with more neurologic signs, and will not be preceded by diarrhea on the PANCE exam.

Incorrect Answers:

  • Rouleaux (stacked RBCs) are seen most notably in multiple myeloma. As well as many other hyperviscosity syndromes. This finding is highly non-specific.
  • Spur cells are seen with liver disease.
  • Giant platelets are seen in idiopathic thrombocytopenic purpura (ITP) as well as Bernard-Soulier syndrome.
  • Schistocytes would be expected in HUS.

Review NCCPA Blueprint Topic: Infectious Diarrhea (ReelDx + Lecture)

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Welcome to episode 85 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet). Welcome to episode 85 of the Audio PANCE and PANRE PA Board Review Podcast.
Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).
Special from today’s episode:

* Download your copy of the Free Trello Smarty PANCE NCCPA™ Blueprint Study Plan
* Make the Audio PANCE and PANRE an Alexa Skill

This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprints. 
Below you will find an interactive exam to complement the podcast.
Below you will find an interactive exam to complement the podcast.
The Audio PANCE/PANRE and EOR PA Board Review Podcast
I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz, and download more resources below.

Listen Carefully Then Take The Practice Exam
If you can’t see the audio player click here to listen to the full episode.
Podcast Episode 85: Ten MIXED PANCE and PANRE Board Review Questions
The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member, you will be able to log in and view this interactive video lesson.
1. A 14-hour-old boy has failed to pass stool and is vomiting greenish fluid. He was born at 40 weeks gestation with no complications during delivery or pregnancy. His temperature is 97.6°F (36.4°C), blood pressure is 64/34 mmHg, pulse is 140/min, respirations are 33/min, and oxygen saturation is 98% on room air. The child is currently breastfeeding and appears irritable. Physical exam is notable for a distended and non-tender abdomen.]]>
The Physician Assistant Life | Smarty PANCE 23:14 394
Cardiac Pharmacology Part One: The Audio PANCE and PANRE Episode 84 http://podcast.thepalife.com/cardiac-pharmacology-part-one-the-audio-pance-and-panre-episode-84/ Tue, 11 Aug 2020 17:04:16 +0000 http://podcast.thepalife.com/?p=391 http://podcast.thepalife.com/cardiac-pharmacology-part-one-the-audio-pance-and-panre-episode-84/#respond http://podcast.thepalife.com/cardiac-pharmacology-part-one-the-audio-pance-and-panre-episode-84/feed/ 0 <p>Welcome to episode 84 of the Audio PANCE and PANRE PA Board Review Podcast Today we welcome back PA board review expert Joe Gilboy PA-C as he covers the exceptionally important topic of cardiac pharmacology. Below you will find a downloadable audio version of this podcast as well as links to resources mentioned in today’s episode. […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/cardiac-pharmacology-part-one-the-audio-pance-and-panre-episode-84/">Cardiac Pharmacology Part One: The Audio PANCE and PANRE Episode 84</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Cardiac Pharmacology - The Audio PANCE and PANRE Board Review Podcast Episode 84Welcome to episode 84 of the Audio PANCE and PANRE PA Board Review Podcast

Today we welcome back PA board review expert Joe Gilboy PA-C as he covers the exceptionally important topic of cardiac pharmacology.

Below you will find a downloadable audio version of this podcast as well as links to resources mentioned in today’s episode. Members of Smarty PANCE can sign in and listen to the second half of Joe’s lecture as well as part two of this high-yield cardiac pharmacology lecture series by clicking here.

Not a Smarty PANCE member? You can gain instant access to this lecture as well as all the Smarty PANCE resources instantly by clicking here.

From today’s episode:

The Audio PANCE and PANRE Board Review Podcast Episode 84: Cardiac Pharmacology

I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

If you can’t see the audio player click here to listen to the full episode.

Looking for all the podcast episodes?

This FREE podcast series is often limited to every other episode, you can download and enjoy the complete audio series by becoming a Smarty PANCE member.

Additional Resources

This Podcast is available on all platforms

Just search for “The Audio PANCE and PANRE” in your favorite podcasting program or use the following links.

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the PANCE Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t, and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on Smarty PANCE.

2020 Interactive NCCPA PANCE Content Blueprint

Download for PANCE Download for PANRE

The post Cardiac Pharmacology Part One: The Audio PANCE and PANRE Episode 84 appeared first on The Audio PANCE and PANRE.

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Welcome to episode 84 of the Audio PANCE and PANRE PA Board Review Podcast Today we welcome back PA board review expert Joe Gilboy PA-C as he covers the exceptionally important topic of cardiac pharmacology. Welcome to episode 84 of the Audio PANCE and PANRE PA Board Review Podcast
Today we welcome back PA board review expert Joe Gilboy PA-C as he covers the exceptionally important topic of cardiac pharmacology.
Below you will find a downloadable audio version of this podcast as well as links to resources mentioned in today’s episode. Members of Smarty PANCE can sign in and listen to the second half of Joe’s lecture as well as part two of this high-yield cardiac pharmacology lecture series by clicking here.
Not a Smarty PANCE member? You can gain instant access to this lecture as well as all the Smarty PANCE resources instantly by clicking here.
From today’s episode:

* To listen to the second half of this lecture as well as cardiac pharmacology part 2 with Joe Gilboy sign in to Smarty PANCE then click here.
* Listen to Joe’s previous podcast episodes:

* How to Answer The Hardest PANCE and PANRE Test Questions Part 1
* How to Answer Tricky PANCE and PANRE Test Questions Part 2
* How to Study for Your PANCE
* Podcast Episode 65: Hepatitis B Breakdown


* Content Blueprint PANCE/PANRE Review Course and EOR (Rotation) Courses

The Audio PANCE and PANRE Board Review Podcast Episode 84: Cardiac Pharmacology
I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

* You can download and listen to past FREE episodes here, on iTunes, Spotify, Google Play Music, Stitcher, or just search “The Audio PANCE and PANRE” in your favorite podcast listening app.

If you can’t see the audio player 49:57 391
How to Answer Tricky PANCE and PANRE Test Questions Part 2: Podcast Episode 83 http://podcast.thepalife.com/how-to-answer-tricky-pance-and-panre-test-questions-part-2-podcast-episode-83/ Tue, 09 Jun 2020 18:43:12 +0000 http://podcast.thepalife.com/?p=385 http://podcast.thepalife.com/how-to-answer-tricky-pance-and-panre-test-questions-part-2-podcast-episode-83/#respond http://podcast.thepalife.com/how-to-answer-tricky-pance-and-panre-test-questions-part-2-podcast-episode-83/feed/ 0 <p>In this second podcast of the series, Joe Gilboy PA-C discusses tips for answering tricky PANCE and PANRE test questions that make answering even the most difficult PANCE Board review questions a breeze</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/how-to-answer-tricky-pance-and-panre-test-questions-part-2-podcast-episode-83/">How to Answer Tricky PANCE and PANRE Test Questions Part 2: Podcast Episode 83</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Welcome to episode 83 of the Audio PANCE and PANRE PA Board Review Podcast

Join me as we welcome Joe Gilboy PA-C back again to cover best practices that make answering even the toughest PANCE and PANRE Board review questions (and EOR exam questions) a breeze!

Below you will find interactive audio with clips covering the most important points. It’s a perfect companion to the podcast.

From today’s episode:

The Audio PANCE and PANRE Board Review Podcast Episode 83: How to Answer PANCE and PANRE Test Questions Part 2

I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

If you can’t see the audio player click here to listen to the full episode.

Audio clips from today’s episode

Here are selected audio tips from today’s episode covering the most important points.

How to answer: “What is the most accurate test (what is the gold standard)?”

How to answer “What would you like to do next?” or “What is the next step?”

How to answer: “What’s the most likely answer/diagnosis – which one fits best?” (the simplest answer always wins)

In other words, if something carries 51% weight versus 49% weight, the 51% weight wins.

How to answer: “What is the most common etiology?”

How to answer: “What is second-line therapy?”

Looking for all the podcast episodes?

This FREE podcast series is often limited to every other episode, you can download and enjoy the complete audio series by becoming a Smarty PANCE member.

Additional Resources

This Podcast is also available on iOS and Android

  1. iTunes: The Audio PANCE and PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher
  3. Google Play: The Audio PANCE and PANRE Podcast Google Play

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the PANCE Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t, and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on Smarty PANCE.

2020 Interactive NCCPA PANCE Content Blueprint

Download for PANCE Download for PANRE

The post How to Answer Tricky PANCE and PANRE Test Questions Part 2: Podcast Episode 83 appeared first on The Audio PANCE and PANRE.

]]> In this second podcast of the series, Joe Gilboy PA-C discusses tips for answering tricky PANCE and PANRE test questions that make answering even the most difficult PANCE Board review questions a breeze Welcome to episode 83 of the Audio PANCE and PANRE PA Board Review Podcast
Join me as we welcome Joe Gilboy PA-C back again to cover best practices that make answering even the toughest PANCE and PANRE Board review questions (and EOR exam questions) a breeze!
Below you will find interactive audio with clips covering the most important points. It’s a perfect companion to the podcast.
From today’s episode:

* Listen to Joe’s previous podcast episodes:

* How to Answer The Hardest PANCE and PANRE Test Questions: Podcast Episode 82
* How to Study for Your PANCE: Podcast Episode 79
* Podcast Episode 65: Hepatitis B Breakdown


* Start with high-quality PANCE practice questions in tutor mode
* Content Blueprint PANCE/PANRE Review Course and EOR (Rotation) Courses

The Audio PANCE and PANRE Board Review Podcast Episode 83: How to Answer PANCE and PANRE Test Questions Part 2
I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz, and download more resources below.

If you can’t see the audio player click here to listen to the full episode.
Audio clips from today’s episode
Here are selected audio tips from today’s episode covering the most important points.
How to answer: “What is the most accurate test (what is the gold standard)?”
How to answer “What would you like to do next?” or “What is the next step?”
How to answer: “What’s the most likely answer/diagnosis – which one fits best?” (the simplest answer always wins)
In other words, if something carries 51% weight versus 49% weight, the 51% weight wins.
How to answer: “What is the most common eti...]]>
The Physician Assistant Life | Smarty PANCE 22:49 385 How to Answer The Hardest PANCE/PANRE Test Questions: Podcast Episode 82 http://podcast.thepalife.com/how-to-answer-the-hardest-pance-panre-test-questions-podcast-episode-82/ Tue, 31 Mar 2020 19:32:48 +0000 http://podcast.thepalife.com/?p=378 http://podcast.thepalife.com/how-to-answer-the-hardest-pance-panre-test-questions-podcast-episode-82/#respond http://podcast.thepalife.com/how-to-answer-the-hardest-pance-panre-test-questions-podcast-episode-82/feed/ 0 <p>In this podcast episode, Joe Gilboy PA-C discusses best practices for answering hard PANCE and PANRE test questions that make answering even the toughest NCCPA PANCE Board review questions a breeze</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/how-to-answer-the-hardest-pance-panre-test-questions-podcast-episode-82/">How to Answer The Hardest PANCE/PANRE Test Questions: Podcast Episode 82</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> How to Answer Hard PANCE and PANRE Test QuestionsWelcome to episode 82 of the Audio PANCE and PANRE PA Board Review Podcast

Join me as we welcome Joe Gilboy PA-C back again to cover best practices that make answering even the toughest PANCE and PANRE Board review questions (and EOR exam questions) a breeze!

Below you will find interactive audio breaking down each question. It’s a perfect companion to the podcast.

Special from today’s episode:

The Audio PANCE and PANRE Board Review Podcast Episode 82: How to Answer The Hardest PANCE/PANRE Test Questions

I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

If you can’t see the audio player click here to listen to the full episode.

Questions we break down in this episode:

The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website

Question 1: Developing good test-taking habits

1. 10-year-old boy presents to the emergency department complaining of sudden onset lightheadedness and chest discomfort, vital signs, 98.6, heart rate of 205, respiratory rate of 30 and 98% oxygen saturation, his EKG demonstrated sinus tachycardia with no p waves. What is the most likely diagnosis?

  1. A-fib
  2. A-flutter
  3. Atrioventricular reentry tachycardia
  4. V-tach

Steps to answering this question

Question 2: Choosing between two good answers

2. A 60-year-old woman with a history of hypertension, dyslipidemia, and coronary heart disease was sent to the emergency room from her primary care physician’s office for a heart rate of 40. She has no complaints, except for mild fatigue. Medications include metoprolol, atorvastatin, lisinopril, and baby aspirin. Her EKG reveals sinus bradycardia and her physical exam is normal. Which of the following is the most appropriate next step and management?

  1. Atropine
  2. Make a medication adjustment
  3. Schedule for a temporary pacemaker
  4. Watchful waiting

Steps to answering this question

Question 3: The long test question

3. A 32-year-old previously healthy man comes to ER with a four-hour history of palpitations. He denies chest pain, shortness of breath or history of similar palpitations. He does admit to heavy alcohol use in the past week drinking one pint of vodka and 24 packs of beer each day in the ED his vital signs of blood pressure 135/75, heart rate of 115, respiratory rate of 14, and oxygen saturation of 98% on room air. He’s got an irregularly irregular rhythm heard on auscultation and EKG shows atrial fibrillation. What is the next step in management?

  1. Chemical conversion
  2. Observation
  3. Rate control
  4. Synchronized cardioversion

Steps to answering this question:

Question 4: The short question with long answer choices

4. Which of the following patients should be classified as having unstable angina?

  1. A 51-year-old woman who has chest pain three days ago, but is now chest pain-free, is found to have a positive troponin with q waves in II, III, and aVF without ST-segment elevation
  2. A 55-year-old woman with a history of hypertension, but no prior cardiac disease who complains of one episode of chest pain that began while pushing her grocery cart and lasted 30 minutes
  3. A 65-year-old male with a known history of coronary artery disease who gets chest pain and shortness of breath every time he climbs the steps to his bedroom
  4. A 71-year-old man who underwent a coronary cardiac catheterization one month ago for early morning chest pain but shows minimal coronary artery disease with no fixed lesions presents with recurrent early morning chest pain that is relieved with nitroglycerin

Steps to answering this question:

Looking for all the podcast episodes?

This FREE podcast series is often limited to every other episode, you can download and enjoy the complete audio series by becoming a Smarty PANCE member.

Additional Resources

This Podcast is also available on iOS and Android

  1. iTunes: The Audio PANCE and PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher
  3. Google Play: The Audio PANCE and PANRE Podcast Google Play

itunes_logo-1

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the PANCE Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t, and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on Smarty PANCE.

2020 Interactive NCCPA PANCE Content Blueprint

Download for PANCE Download for PANRE

The post How to Answer The Hardest PANCE/PANRE Test Questions: Podcast Episode 82 appeared first on The Audio PANCE and PANRE.

]]>
In this podcast episode, Joe Gilboy PA-C discusses best practices for answering hard PANCE and PANRE test questions that make answering even the toughest NCCPA PANCE Board review questions a breeze Welcome to episode 82 of the Audio PANCE and PANRE PA Board Review Podcast
Join me as we welcome Joe Gilboy PA-C back again to cover best practices that make answering even the toughest PANCE and PANRE Board review questions (and EOR exam questions) a breeze!
Below you will find interactive audio breaking down each question. It’s a perfect companion to the podcast.
Special from today’s episode:

* Listen to Joe’s previous podcast episodes:

* How to Study for Your PANCE: Podcast Episode 79
* Podcast Episode 65: Hepatitis B Breakdown


* Start with high-quality questions in tutor mode (untimed with hints on we have a TON on Smarty PANCE)
* Poem “lockdown“ by Brother Richard Hendrick
* Content Blueprint Review Course and EOR Courses

The Audio PANCE and PANRE Board Review Podcast Episode 82: How to Answer The Hardest PANCE/PANRE Test Questions
I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz, and download more resources below.

If you can’t see the audio player click here to listen to the full episode.
Questions we break down in this episode:
The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website
Question 1: Developing good test-taking habits
1. 10-year-old boy presents to the emergency department complaining of sudden onset lightheadedness and chest discomfort, vital signs, 98.6, heart rate of 205, respiratory rate of 30 and 98% oxygen saturation, his EKG demonstrated sinus tachycardia with no p waves. What is the most likely diagnosis?

* A-fib
* A-flutter
]]>
The Physician Assistant Life | Smarty PANCE 27:50 378
Podcast Episode 81: Internal Medicine EOR Cardiology Questions http://podcast.thepalife.com/podcast-episode-81-internal-medicine-eor-cardiology-questions/ Mon, 23 Mar 2020 15:15:19 +0000 http://podcast.thepalife.com/?p=375 http://podcast.thepalife.com/podcast-episode-81-internal-medicine-eor-cardiology-questions/#respond http://podcast.thepalife.com/podcast-episode-81-internal-medicine-eor-cardiology-questions/feed/ 0 <p>Welcome to episode 81 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten internal medicine rotation EOR content blueprint questions from the Smarty PANCE physician assistant board and rotation review website. Special from today’s episode: Check out the new Smarty PANCE Internal Medicine Rotation (EOR) Review Course Download […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/podcast-episode-81-internal-medicine-eor-cardiology-questions/">Podcast Episode 81: Internal Medicine EOR Cardiology Questions</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Episode 81 episode 81 Ten PAEA Internal Medicine Rotation Exam (EOR) QuestionsWelcome to episode 81 of the Audio PANCE and PANRE PA Board Review Podcast.

Join me as I cover ten internal medicine rotation EOR content blueprint questions from the Smarty PANCE physician assistant board and rotation review website.

Special from today’s episode:

Below you will find an interactive exam to complement the podcast.

The Audio PANCE/PANRE and EOR PA Board Review Podcast

I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

Listen Carefully Then Take The Practice Exam

If you can’t see the audio player click here to listen to the full episode.

Podcast Episode 81: Ten Internal Medicine EOR Cardiology Questions

The following questions are linked to PAEA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.

1. 55-year-old woman is admitted to the hospital because she has shortness of breath and pain on both sides of her chest with deep breathing which has worsened over the past 5 days. In recent weeks, she has been feeling fatigued and has had low-grade fevers and night sweats, and was found to have a new cardiac murmur on examination. Her temperature is 38.1°C (100.6°F), pulse is 106/min, respirations are 26/min, and blood pressure is 136/88 mm Hg. She appears diaphoretic and is in mild respiratory distress. Cardiac auscultation reveals a faint systolic murmur heard over the lower left sternal border. Her neck veins are distended and abdominal examination shows hepatomegaly. Which of the following is the most likely cause of her clinical presentation?

A. Fat embolism
B. Infective endocarditis
C. Myocardial infarction
D. Rheumatic fever
E. Small cell lung cancer

Click here to see the answer

Answer: B, Infective endocarditis

Infective endocarditis (IE) is an infection of the endocardial surfaces of the heart, most commonly the heart valves. IE occurs when a microorganism begins to invade the heart valves causing an inflammatory reaction that damages the valve – sometimes leading to stenosis and sometimes leading to regurgitation. This patient developed a new cardiac murmur in recent weeks that is described as a faint systolic murmur heard over the lower left sternal border. This is most consistent with tricuspid regurgitation. She also has distended neck veins and hepatomegaly, both of which suggest right-sided heart failure which can result from tricuspid regurgitation. Small infectious emboli can break away from the primary lesion on the tricuspid valve and go into the pulmonary vasculature causing shortness of breath and pleuritic chest pain. Most cases of IE are caused by Staphylococcus aureus and Viridans streptococci, and diagnosis is confirmed by obtaining multiple blood cultures that show that there is continuous bacteremia.

  • Fat embolism to the pulmonary circulation almost always occurs with major trauma, including surgical procedures like intramedullary nailing of long bones. Fat emboli can occlude the microvasculature, triggering a systemic inflammatory response. The woman did not have recent trauma, and a fat embolism would not explain her cardiac murmur.
  • Clinical presentation of myocardial infarction most often includes substernal crushing chest pain, radiation of pain to the arms, left shoulder, back, neck, and jaw, as well as shortness of breath, anxiety, and fatigue. A myocardial infarction would not explain her developing a new cardiac murmur in recent weeks.
  • Rheumatic fever is an autoimmune inflammatory process that develops as a sequela of streptococcal infection. Clinical manifestations include polyarthritis, carditis, erythema marginatum, chorea, and subcutaneous nodules. Rheumatic fever can cause some of the symptoms seen in this case, but the acute onset makes this option less likely.
  • Although small cell lung cancer can present with pulmonary symptoms and low grade fevers, it wouldn’t easily explain her new cardiac murmur or the signs of right-sided heart failure.

Review PAEA EOR Blueprint Pearls With Links to Topic Lesson: Internal Medicine Rotation: Cardiovascular (PEARLS) ⇒ Endocarditis

2. A 54-year-old man comes to the emergency department following a four-day history of left-sided chest pain and shortness of breath. One week ago, he experienced upper respiratory symptoms along with myalgias and general fatigue. He has no known past medical history. He has not traveled outside the US. His temperature is 38.1°C (100.6°F), pulse is 104/min, respirations are 17/min, oxygen saturation is 94% on room air, and blood pressure is 100/72 mm Hg. Physical examination shows an ill-appearing man with bibasilar rales, jugular venous distention of 11 cm with no murmurs, rubs, or gallops, and 1+ bilateral pitting edema of the lower extremities. His labs are within normal limits and his blood cultures are negative. An echocardiogram shows an ejection fraction of 35%. Which of the following is the most likely cause of this patient’s condition?

A. Adenovirus
B. Coxsackie A virus
C. Staphylococcus aureus
D. Corynebacterium diphtheriae

Click here to see the answer

The answer is A. Adenovirus

Myocarditis in the United States is most commonly caused by a viral infection, typically adenovirus, coxsackie B, parvovirus B19, or others. It often presents with systemic symptoms such as fatigue and chest pain, but may cause sudden death.

  • Though coxsackie B virus is one of the most common causal pathogens of acute myocarditis, Coxsackie A causes herpangina, aseptic meningitis, and hand, foot, and mouth disease.
  • Staphylococcus aureus is a common cause of bacterial endocarditis, not myocarditis. Endocarditis is more likely to present with a new murmur and signs of distant emboli such as nail-bed hemorrhage and Janeway lesions.
  • Corynebacterium diphtheriae is the causal agent of diphtheria, which may involve myocarditis. However, the patient would then most likely have other symptoms of the disease, including pseudomembranous pharyngitis, lymphadenopathy, or an arrhythmia.

Review PAEA EOR Blueprint Pearls With Links to Topic Lesson: Internal Medicine Rotation: Cardiovascular (PEARLS)Myocarditis

3. A 42-year-old woman comes to the emergency department because of chest pain, dyspnea, and lightheadedness. She recently recovered from a presumed viral upper respiratory infection and has a 10-year history of systemic lupus erythematosus. Physical examination shows a decrease in systolic blood pressure by 20 mm Hg during inspiration. An ECG is shown here. Which of the following is the most likely diagnosis?

A. Aortic dissection
B. Tricuspid regurgitation
C. Pericardial effusion
D. Aortic stenosis
E. Mitral stenosis

Click here to see the answer

The answer is C. Pericardial effusion

Pericardial effusions are associated with a variety of causes, including autoimmune disorders and infectious pericarditis. If pericardial effusion leads to cardiac tamponade, patients may have pulsus paradoxus, or a decrease in systolic blood pressure during inspiration of more than 10 mm Hg. Certain ECG findings are characteristic for pericardial effusion. In particular, electrical alternans (shown by arrows) is highly specific for pericardial effusion (usually in association with cardiac tamponade) but not particularly sensitive. This pattern, characterized by beat-to-beat changes in the QRS axis in the limb and precordial leads, is caused by swinging of the heart within the accumulated pericardial fluid. Other common findings on ECG include sinus tachycardia and low QRS voltage.

  • Patients with aortic dissection classically present with a tearing or ripping pain in the chest or back and may have a significant variation in systolic blood pressure between arms (not across respirations).
  • The severity of tricuspid regurgitation varies widely, ranging from asymptomatic disease to symptoms of right-sided heart failure (hepatosplenomegaly, ascites, peripheral edema).
  • Patients with aortic stenosis, the most common cause of left ventricular outflow obstruction, typically present with exertional dizziness or angina. In end-stage disease, symptoms may progress to heart failure.
  • Mitral stenosis obstructs the flow of blood from the left atrium to the left ventricle and typically manifests as exertional dyspnea and decreased exercise tolerance.

Review PAEA EOR Blueprint Pearls With Links to Topic Lesson: Internal Medicine Rotation: Cardiovascular (PEARLS) ⇒ Pericarditis

4. A 57-year-old man comes to the emergency department because of intermittent, severe leg pain in both his calves for 2 weeks. He has a history of untreated high blood pressure, diabetes, and high cholesterol. For the past 3 years, the pain started after walking three blocks and only going away upon resting. In the past 2 weeks, he has had the same pain at rest. His temperature is 36.5°C (97.7°F), pulse is 78/min, respirations are 17/min, and blood pressure is 160/89 mm Hg. Examination shows both calves are atrophied and there is a paucity of hair, but no swelling or discoloration. Additionally, his lower calves are cool to the touch and dusky in appearance. Doppler ultrasound shows perfusion to both feet, and blood pressures of 35/20 mm Hg in the posterior tibial artery are obtained bilaterally. Which of the following is most appropriate next step in management?

A. Immediate high-dose statin therapy
B. Immediately consult vascular surgery
C. Intravenous alteplase
D. Pain control and discharge; refer to vascular surgery as an outpatient
E. Rest, elevate, and compress the affected leg

Click here to see the answer

The answer is B. Immediately consult vascular surgery

Peripheral vascular disease with intermittent claudication and signs of decreased perfusion should be examined using Doppler ultrasound and the ankle-brachial index (ABI). An ABI of <0.41 is grounds for the immediate surgical consultation.

  • Statin therapy has shown to be effective in treating intermittent claudication. However, this intervention is appropriate only when the patient is deemed to be stable, and the risk of limb ischemia has been addressed.
  • Alteplase (tPa) has been used to treat intermittent claudication, but its use is outside the scope of the emergency room. Treatments initiated in the emergency department are unfractionated heparin, aspirin, pain control, and positioning of the leg to maintain perfusion.
  • The patient has significant impairment of perfusion to his legs. Discharge and vascular surgery follow-up as an outpatient would be inappropriate and likely to result in morbidity or mortality.
  • While this leg should be rested, compression and elevation are the opposite of what is needed. These therapies will further decrease the blood flow to the leg and put the patient at increased risk of complications.

Review PAEA EOR Blueprint Pearls With Links to Topic Lesson: Internal Medicine Rotation: Cardiovascular (PEARLS)Peripheral vascular disease

5.  A 6-year-old boy comes to the pediatric clinic because of 4 weeks of fatigue and shortness of breath. His medical history is notable for poor follow-up with yearly check-ups, but his mother notes that he has been fairly healthy for the duration of his life, except for a “bad sore throat that needed antibiotics” about 6 months ago. On examination, the boy appears fatigued, but is appropriately oriented and responsive, and is generally non-toxic appearing. He is afebrile. Cardiac examination is notable for a widely split S2, a quiet S1, and point of maximum impulse displaced to the left. Which of the following is the next best step in the management of this patient?
Elimination tool

A. Digoxin
B. Long-term penicillin
C. Short-term course of clindamycin
D. Reassurance & routine care
E. Intramuscular ceftriaxone

Click here to see the answer

The answer is B. Long-term penicillin

Rheumatic heart disease is caused by autoimmune cross-reactivity following a Streptococcal infection. Development of antibody-mediated mitral valve damage is common. Long-term penicillin is suitable for acute treatment and prophylaxis from complications.

  • Digoxin is a purified cardiac glycoside that is typically used in the treatment of various heart conditions, such as atrial fibrillation, atrial flutter, and heart failure that cannot be controlled by other medication. It is not recommended for use in rheumatic fever.
  • Clindamycin is an antibiotic used to treat middle ear infections, bone or joint infections, pelvic inflammatory disease, strep throat, pneumonia, and endocarditis. Clindamycin is typically used as endocarditis prophylaxis for patients that are already receiving penicillin for secondary rheumatic fever prophylaxis.
  • This patient is suffering from rheumatic fever, which can lead to rheumatic heart disease. This can cause significant carditis which manifests as congestive heart failure.
  • Ceftriaxone is an antibiotic used to treat numerous bacterial infections, such as pneumonia, ear infections, skin infections, urinary tract infection, and meningitis. It is not used in the treatment of rheumatic fever.

Review PAEA EOR Blueprint Pearls With Links to Topic Lesson: Internal Medicine Rotation: Cardiovascular (PEARLS)Rheumatic heart disease

6. A 35-year-old woman, gravida 2, para 1, comes to the office because of her first prenatal visit at 12 weeks’ gestation. She has no current concerns, and her first child was born without complications. She has a history of long-standing untreated hypertension. Her temperature is 36.5°C (97.7°F), pulse is 78/min, respirations are 17/min, and blood pressure is 150/89 mm Hg. Which of the following medications would most likely be appropriate as initial treatment?

A. Atenolol
B. Hydrochlorothiazide
C. Labetalol
D. Lisinopril
E. Losartan

Click here to see the answer

The answer is C. Labetalol

Chronic hypertension in pregnancy can be treated with some medications and labetalol is recommended as a first-line therapy for treatment of hypertension during pregnancy. Angiotensin-converting enzymes (ACE) inhibitors and angiotensin II receptor blockers (ARBs) should be avoided.

  • Atenolol is a β-blocker medication, which decreases blood pressure by decreasing heart rate and stroke volume. It is contraindicated in pregnancy because it has been associated with fetal growth restriction. β-blockers considered safe in pregnancy are metoprolol and labetalol.
  • Hydrochlorothiazide is a thiazide diuretic which decreases blood pressure via volume depletion. Diuretics do not cause fetal malformations but are generally avoided in pregnancy, as they prevent the physiologic volume expansion seen in normal pregnancy. They may be used in states of volume-dependent hypertension, such as renal or cardiac disease.
  • Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor which decreases blood pressure through inhibition of the renin-angiotensin-aldosterone system. ACE inhibitors and the closely related angiotensin-receptor blockers are contraindicated in pregnancy because of the risk of birth defects including renal dysgenesis and oligohydramnios.
  • Losartan is an angiotensin II receptor blocker (ARB) which decreases blood pressure through inhibition of the renin-angiotensin-aldosterone system. ARBs and the closely related angiotensin converting enzyme (ACE) inhibitors are contraindicated in pregnancy because of the risk of birth defects including renal dysgenesis and oligohydramnios.

Review PAEA EOR Blueprint Pearls With Links to Topic Lesson: Internal Medicine Rotation: Cardiovascular (PEARLS) ⇒ Hypertension

7. A 42-year-old man comes to the office for a routine check-up. Medical history includes diabetes mellitus and a long history of smoking. Family history includes coronary artery disease. Temperature is 36.5°C (97.7°F), pulse is 78/min, respirations are 17/min, and blood pressure is 160/89 mm Hg. A repeat blood pressure taken 2 days later shows 143/88 mm Hg. Which of the following is most likely the best initial therapy?

A. Enalapril
B. Furosemide
C. Hydrochlorothiazide
D. Metoprolol
E. Nifedipine

Click here to see the answer

Answer: A. Enalapril

Hypertension in the setting of diabetes should be treated, with a goal systolic blood pressure of <130 mm Hg. The best first choice of medication is an angiotensin-converting enzyme inhibitor (ACEi).

Incorrect Answers:

  • Furosemide is a loop diuretic that can be used to treat hypertension but it is not a first line agent. Unlike ACE inhibitors, loop diuretics have no renoprotective qualities and therefore are a worse initial choice in a hypertensive diabetic patient.
  • Hydrochlorothiazide is a thiazide diuretic and a first-line agent for the treatment of hypertension in non-diabetic patients. It is relatively contraindicated in diabetes because it has the potential adverse effect of hyperglycemia. It may also precipitate attacks of gout by increasing uric acid concentrations.
  • Metoprolol is a β-blocker that is used for the treatment of hypertension but is not a first line treatment. Also, β-blocker are contraindicated in asthma, as well as in diabetic patients due to its potential to mask signs of low blood sugar.
  • Nifedipine is a calcium channel blocker that is used in the treatment of hypertension but it is not a first line therapy. It has no renoprotective effects, and commonly causes peripheral edema as an unwanted adverse effect.

Review PAEA EOR Blueprint Pearls With Links to Topic Lesson: Internal Medicine Rotation: Cardiovascular (PEARLS)Hypertension

8. A 45-year-old obese Caucasian gentleman arrives at your clinic for a routine check-up after having some blood work done during a workplace health screening. He is found to have an LDL cholesterol level of 550 mg/dL. He states that his father and brother had high cholesterol and both died at a young age from a heart attack. He has a follow-up appointment with his cardiologist because of some occasional chest pain and abnormalities seen on his EKG. Additionally, you notice that he has well-demarcated yellow deposits around his eyes. He is started on high dose statin and his LDL at 12 weeks is 350 mg/dL. What is the next best step in this patient’s management?

A. Continue high dose statin, the patient’s LDL is at goal
B. Add niacin 100 mg three times daily
C. Add ezetimibe (Zetia) 10 mg daily
D. Add a PCSK9 inhibitor
E. Refer to a lipid specialist

Click here to see the answer

The answer is C: add ezetimibe 10 mg

If LDL-C is not at goal after 6-12 weeks the next best step for the treatment of familial hypercholesterolemia is to add ezetimibe 10 mg daily and check again in 6-12 weeks. If at that time the patient’s LDL is still not at goal (ideally < 150) refer to lipid specialist to consider adding a PCSK9 inhibitor.

Pearls

  • Familial hypercholesterolemia (FH) is the most common autosomal dominant genetic disease. The clinical syndrome (phenotype) is characterized by extremely elevated levels of low-density lipoprotein cholesterol (LDL-C) and a propensity to early-onset atherosclerotic cardiovascular disease. In general, homozygotes manifest the disease at a much earlier age than heterozygotes and the disease is more severe.
  • Homozygous FH patients are rare and have an estimated prevalence of approximately 1:300,000 to 1:400,000
  • Heterozygous FH is estimated to occur in 1 in 200 to 250 individuals in the United States.
  • It is estimated that about 7 percent of American adults have an untreated lipoprotein cholesterol ≥190 mg/dL but only 1.7 percent carry an FH mutation
  • Patients with undiagnosed homozygous familial hypercholesterolemia (FH) develop severe, premature, atherosclerotic cardiovascular disease and die before age 20 in many cases.
  • In patients with a negative or unknown family history, an untreated LDL-C level of ≥190 mg/dL (4.9 mmol/L) suggests FH. This value is greater than the 90th percentile for age and sex.

Diagnosis

  • The diagnosis of heterozygous familial hypercholesterolemia (FH) is made with genetic testing or clinical criteria. A causative mutation in the LDLR, APOB, or PCSK9 gene(s) secures this diagnosis
  • When genetic testing is not available or not felt to be necessary, you can use the Dutch Lipid Clinic Network criteria, which assigns points based on low-density lipoprotein cholesterol (LDL-C) levels, personal history of early atherosclerotic cardiovascular disease (ASCVD), family history of early ASCVD, or high cholesterol in a first-degree relative, and personal and physical examination finding

Treatment

  • Patients with homozygous familial hypercholesterolemia (FH) – intensive LDL-C lowering, which targets a minimal value of <150 mg/dL (3.9 mmol/L)
  • In addition to a high-dose statin (atorvastatin 80 mg daily or rosuvastatin 40 mg daily), most homozygous patients will require additional therapies such as ezetimibe, a PCSK9 inhibitor, or potentially LDL-C apheresis

Review PAEA EOR Blueprint Pearls With Links to Topic Lesson: Internal Medicine Rotation: Cardiovascular (PEARLS)Hyperlipidemia

9. A 65-year-old man comes to the emergency department because of progressive dyspnea, coughing, and orthopnea. The patient says that over the past 2 months he has been feeling fatigued with ordinary physical activity. His medical history is relevant for dyslipidemia, type II diabetes mellitus, and a posterior myocardial infarction 4 months ago. Auscultatory findings reveal a pansystolic murmur over the mitral area. His temperature is 37.5°C (99.5°F), pulse is 90/min, respirations are 17/min, blood pressure is 120/90 mm Hg, and pulse oximetry on room air shows an oxygen saturation of 95%.  This patient most likely has which of the following conditions?

A. Aortic stenosis
B. Aortic valve regurgitation
C. Mitral valve regurgitation
D. Mitral valve stenosis
E. Pulmonary stenosis

Click here to see the answer

The answer is C. Mitral valve regurgitation

Mitral valve regurgitation is defined as an incompetent closure of the mitral valve. Classically patients will present with a pansystolic heart murmur over the mitral area. Posterior myocardial infarction is the second most common cause of mitral valve regurgitation. Mitral valve regurgitation is characterized by an incompetent closure of the mitral valve. This condition causes retrograde blood flow into the left atrium during systole. The most common cause of mitral regurgitation is mitral valve prolapse, followed by a dysfunction of the posteromedial papillary muscle due to posterior myocardial infarction. Other causes may include, endocarditis or stretching of the mitral valve ring.

  • Aortic stenosis is the reduction of the valvular orifice (<2 cm) with left ventricular outflow obstruction. Patients with aortic stenosis present with chest pain, syncopal episodes, and dyspnea. Here, the patient has progressive dyspnea (NYHA II), and a pansystolic murmur (mitral area), which relates to mitral valve regurgitation
  • Aortic valve regurgitation (AOR) is described as an inefficient closure of the aortic valve leading to a retrograde blood flow into the left ventricle during diastole. Patients will present with a wide pulse pressure (Corrigan hammer pulse) or an Austin-Flint murmur (severe), none of which are present in this case.
  • Mitral valve stenosis (MVS) is the reduction of the mitral valve orifice (<2.5cm). The left atrium becomes dilated and hypertrophied because of increased work of the left atrium. Patients with MVS present with dyspnea, rust-colored sputum, atrial fibrillation, and a diastolic heart murmur (diastolic rumble and opening snap).
  • Pulmonary stenosis is an uncommon valvular lesion. It is commonly associated with congenital heart disease and carcinoid heart disease. Patients present a systolic ejection murmur in the left second intercostal space.

Review PAEA EOR Blueprint Pearls With Links to Topic Lesson: Internal Medicine Rotation: Cardiovascular (PEARLS)Valvular heart disease

10. A 43-year-old man with a history of rheumatic fever comes to the primary care clinic for a check up. Cardiac examination reveals a late systolic crescendo murmur with midsystolic click best heard over the apex and loudest just before S2. Which of the following maneuvers will cause an earlier onset of the click/murmur?

A. Inspiration
B. Rapid squatting
C. Standing
D. Hand grip
E. Left lateral cubital position

Click here to see the answer

The answer is C. Standing

The ‘click’ of mitral valve prolapse, caused by the tightening of the chordae tendinae, moves closer to S2 with increased preload. Increased preload causes the left ventricle to stretch, as a result, the chordae tendinae are stretched as well. This makes it harder for the mitral valve to prolapse until the ventricles shrink enough to allow the chordae tendinae to let the mitral valve prolapse. Since there is more blood in the ventricles, it takes them longer to pump it out and shrink to a point at which MVP can occur, hence it occurs later in systole. Thus, the click will get closer to S2 with increased preload. Hand grip, rapid squatting, and inspiration all increase preload. Standing decreases preload and will cause an earlier onset of the click.

  • The click of mitral valve prolapse is heard closer to S2 in the event of increased preload. Preload is increased by hand grip, squatting and inspiration.
  • Placing the patient in the left lateral cubitus position will not affect preload and will have no effect on the timing of the click in mitral valve prolapse.

Review PAEA EOR Blueprint Pearls With Links to Topic Lesson: Internal Medicine Rotation: Cardiovascular (PEARLS) ⇒ Heart murmurs

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Resources and Links From The Show

This Podcast is also available on iOS and Android

  1. iTunes: The Audio PANCE and PANRE Podcast iTunes
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  3. Google Play: The Audio PANCE and PANRE Podcast Google Play

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Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the PANCE Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t, and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on Smarty PANCE.

2020 Interactive NCCPA PANCE Content Blueprint

Download for PANCE Download for PANRE

The post Podcast Episode 81: Internal Medicine EOR Cardiology Questions appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 81 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten internal medicine rotation EOR content blueprint questions from the Smarty PANCE physician assistant board and rotation review website. Welcome to episode 81 of the Audio PANCE and PANRE PA Board Review Podcast.
Join me as I cover ten internal medicine rotation EOR content blueprint questions from the Smarty PANCE physician assistant board and rotation review website.
Special from today’s episode:

* Check out the new Smarty PANCE Internal Medicine Rotation (EOR) Review Course
* Download your Free Trello Smarty PANCE PAEA Internal Medicine EOR Tracking Template
* Take the FREE Internal Medicine Rotation Cardiovascular Practice Exam
* View the interactive Smarty PANCE Internal Medicine Rotation (EOR) Topic List

Below you will find an interactive exam to complement the podcast.
The Audio PANCE/PANRE and EOR PA Board Review Podcast
I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download more resources below.

Listen Carefully Then Take The Practice Exam
If you can’t see the audio player click here to listen to the full episode.
Podcast Episode 81: Ten Internal Medicine EOR Cardiology Questions
The following questions are linked to PAEA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.
1. 55-year-old woman is admitted to the hospital because she has shortness of breath and pain on both sides of her chest with deep breathing which has worsened over the past 5 days. In recent weeks, she has been feeling fatigued and has had low-grade fevers and night sweats, and was found to have a new cardiac murmur on examination. Her temperature is 38.1°C (100.6°F), pulse is 106/min, respirations are 26/min, and blood pressure is 136/88 mm Hg. She appears diaphoretic and is in mild respiratory distress.]]>
The Physician Assistant Life | Smarty PANCE 28:09 375
How to Study for Your PANCE: Podcast Episode 79 http://podcast.thepalife.com/how-to-study-for-your-pance-podcast-episode-79/ Mon, 02 Mar 2020 21:41:53 +0000 http://podcast.thepalife.com/?p=367 http://podcast.thepalife.com/how-to-study-for-your-pance-podcast-episode-79/#respond http://podcast.thepalife.com/how-to-study-for-your-pance-podcast-episode-79/feed/ 0 <p>Podcast Episode 79: How to Study for Your PANCE Welcome to episode 79 of the Audio PANCE and PANRE PA Board Review Podcast. In this episode 35-year PA veteran and PANCE/PANRE board review expert Joe Gilboy PA-C shares his top tips on how to best prepare for the Physician Assistant National Certification Exam Special Links […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/how-to-study-for-your-pance-podcast-episode-79/">How to Study for Your PANCE: Podcast Episode 79</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Podcast Episode 79 How To Study For Your PANCE with Joe Gilboy PA-C

Podcast Episode 79: How to Study for Your PANCE

Welcome to episode 79 of the Audio PANCE and PANRE PA Board Review Podcast.

In this episode 35-year PA veteran and PANCE/PANRE board review expert Joe Gilboy PA-C shares his top tips on how to best prepare for the Physician Assistant National Certification Exam

Special Links From Today’s Episode:

The Audio PANCE and PANRE Physician Assistant Board Review Podcast

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of Smarty PANCE.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE

I will be releasing new episodes every few weeks. Smarty PANCE is discounted, so sign up now.

Table of Contents and Key Points from this episode:

  1. Start Preparing One Year Before Your Exam Date
  2. Consider Forming a Study Group
  3. Print out the Blueprint
  4. Jot Down Quick Notes From Memory
  5. The Simple Answer Is Usually The Correct Answer
  6. In a 51/49 Split Choose The 51%
  7. Look For The Hook!
  8. Control Your X-Factors: I.E., Don’t Add Stress Where You Don’t Need It
  9. Practice Your Questions In Tutor Mode
  10. Correct Yourself in Real-Time
  11. Only Start Timing Yourself Towards The End
  12. Only Use High-Quality Questions
  13. Do 20-25 Questions Max Per Day
  14. The Best Textbooks for PANCE Prep
  15. The Best Websites for PANCE Prep
  16. Summary and Recommendations

Podcast Transcript and Timestamps

If you can’t see the audio player click here to listen to the full episode.

0:00

Welcome, PA, world. My name is Joe Gilboy, PA-C. I work with Stephen Pasquini with the smarty PANCE website.

Today’s podcast is going to be on how to prepare for the PANCE, which is a very big subject and a very important subject to a lot of you guys out there. So come on guys, let’s get this game roll, and let’s learn how to prepare for the PANCE.

0:33

Hello, PA podcast world. My name is Joe Gilbert. I’ve been a PA for about 35 years, with all my time being in the emergency room.

I’m a graduate of the Duke University PA program from 1984. I started helping students prepare for the PANCE and PANRE starting in 1990. So, as you can imagine, I’ve had a lot of students come through my hands. The answer is greater than 10,000. I’ve taught in several schools here in California I teach at several schools in Nevada. I also help in Tennessee. I help in Ohio, I help in Georgia, so I am around in a lot of different places, but for today, let’s get you ready to take the PANCE. So I know a lot of ways to get students prepared. So, let’s start.

1:14

So, today’s podcast is actually going to be on how to prepare for the PANCE. So before we get going into the very specifics, let’s look at so just come some basic guidelines as a student as you’re getting ready to take the PANCE. So, the first thing that we need to actually do is study! I now I know this sounds a little oxymoronic, but you’d be surprised how many students I’ve met along the way, do really well in PA school, you know, they do well in their grades they do well in their End of Rotation Exams, they feel like they don’t need to study. This couldn’t be farther from the truth.

1:44

Start Preparing One Year Before Your Exam Date

So usually what I tell most students to do is start preparing for this exam literally about a year before it comes. What you don’t understand and what’s coming is that when you get towards the end of your PA school, you’re going to be so burned out is just amazing how burned out you’ll be, and you’ll see that especially when you go out on rotations and come back for maybe your callback week, or maybe End of Rotation Exam or some kind of maybe specific lecture, and I can guarantee you on that first day back, when you’ve been gone on rotations, it’s like pulling teeth, you’re like, oh, I’m back in this room, again, that I’ve spent so much of my life, I don’t want to be here. And it’s like, your mind’s just not ready for it. So, what I tell my students to do, instead of trying to cram this all in at the end, play it out.

2:28

So basically, about a year before, start getting ready for this. So what I tell most people to do study. Now, one of the questions that commonly comes up is how much do I study? And at most, most people, I tell them, if you can get up to like maybe two hours or three hours a day, that’s great. Max is four. So you’ll see there’s a lot of studies out there that will show that if you take a human being and actually get them studying for more than about three hours, three and a half hours they do not retain and then things get a little frustrating. So two to three hours if you can, no more than four. And of course, you know, always give yourself a day off.

3:13

The other thing about studying is the worst place to study. Yeah, where are you going to study guys home? And so what you have to understand is that when you’re studying, you actually need stimulus free. So your cell phone is off. Now I know this is a big one for most of you young millennials out there; you’re going “what, I have to turn it off?” That’s right. Don’t worry; the world will keep revolving with the cell phone off. But one of the things they’ve done there’s a lot of studies out there showing that when a cell phone is on, literally 15% of your brain is waiting for that thing to go off. I need that 15% of the brain getting ready for the PANCE, and at the end of the day, guys, there’s no cell message or text messages that’s that important. They can always call 911. So again, just make sure your cell phone is off. This is a big thing to really keep in the back your head.

4:00

Consider Forming a Study Group

The other thing sometimes people like to work together and groups. Groups are great. Study groups work well; just the key thing to a study group is that as you’re in the group, you have to teach the other student, maybe about a subject. And you see when you’re a teacher, you have to know a subject twice, once for your own knowledge, but second to be able to present it that knowledge to another person. So study groups do work.

4:09

Print out the Blueprint

The other thing I tell people to do is print out the PANCE blueprint. It’s pretty extensive and pretty large if you’ve ever seen it, it’s a very large extensive blueprint. And what I tell people to do, so go the NCCPA website, print out the blueprint.

2020 Interactive NCCPA PANCE Content Blueprint

 

Download for PANCE Download for PANRE

4:33

Jot Down Quick Notes From Memory

Then what you do, it’s like, let’s say you get to your cardiovascular and let’s say it says mitral stenosis. So, what I tell my students to do is actually physically write down the word mitral stenosis, and then just jog down some quick notes about things that you memorize in school, and you’re like, I think I remember opening snap. I think I remember rheumatic fever. I think I remember somebody Jones, Jone’s criteria. Jones something, I remember and then stop. And then at that moment, what you do is you start reading up on other things about the Jones criteria. So, in other words, you write more notes to help you out and stuff like that. And this is one of the things that I tell a lot of students to do. Because believe it or not, when you write something down, you know, it’s twice, once for thought, second for motor. For example, just to show you how your brain works, and I know you did this in PA school, you wrote down a note, maybe like, on your one note on your computer, or maybe you wrote it down on a handout that you’re given. You took the test. There you were on the test going. What was it again? I wrote about Jone’s criteria? God, I can’t remember this question. I know I wrote it down somewhere, but I can’t remember. And as soon as the test is over, you walk outside, and you know exactly where it is on your notes. It is in the upper right-hand corner of circle than pink. Welcome to your Brain, you wrote it down once for thought and then second for motor. So when we do this, we actually locking it. I’m not saying that we need to write a dissertation on mitral stenosis, what I’m really saying to you is that just write down some quick notes and try to make this more kind of like thought friendly, like, hey, this is what I remember. And this is what makes sense. And then you read up on the Jones criteria like That’s right. Fevers, minor, even though I want to make it major and things like that. So that tends to work out really well with my students.

6:28

The Simple Answer Is Usually The Correct Answer

The other thing that we’re going to do, and I’ll try to help you guys out, is with the ambiguous questions. Who got into a test, you’re taking the test? And you were choosing between A and B. And you were like, I think it’s A I think it’s B thing? It’s A I think it’s B. And so, there was this ambiguous question, and you couldn’t figure out which was the right answer. So you felt like you’re in this what I call ambiguous 50/50 game. So when we play the ambiguous 50/50 game, there are a couple things you need to do. Just a little test-taking technique that works all the time. One, keep it simple. The simple answer is usually the correct answer one more time; the simple answer is usually the correct answer.

7:06

The Answer That Weighs Just a Little Bit More Than The Other is Your Answer (In a 51/49 Split Take the 51%)

If one answer outweighs the other, even if it’s to a 51/49 edge. In other words, 51% of the time is right here. 49% of the time, it’s right there. What do I take? The 51! So, it only takes 1% to push me over. So one more time. Keep it simple. And the one that weighs just a little bit more than the other? That’s your answer.

7:30

Look for the Hook!

Every now and then, what you’ll see is that student’s kind of miss like a little, like a little piece of the word up in the question. In other words, most likely, at least likely first line, second line. So again, as we go through test questions, we have to be really alert about all the various words they use. And remember at the end of the question is what I call the hook. So sometimes what students will do is they’ll read the last line of the question, so we’ll just say, you know, there’s a question, and it says, What’s the most likely treatment. So as you go to the question, you realize this is what it’s asking for is a treatment. So the whole time you read the question like, so what’s going to be the treatment for this patient? Maybe it’s a CHF, pneumonia, whatever it may be. So again, another test-taking technique that kind of works pretty well. Yeah, try saying that five times fast.

8:21

Control Your X-Factors: i.e., Don’t Add Stress Where You Don’t Need It

The other thing that I tell students to do, and hopefully this, this handout will also be up there on the smarty PANCE website on how to prepare the seven major points, which is what we’re going over is to control your x-factors. This is huge. Guys. If I had to put my 30 years of teaching students into a paragraph, oh, this is it. So when I say control your x-factors, what I’m saying to you is this is that as you get ready to take this PANCE, don’t change your emotional or social wellbeing at all. Now granted, you can’t prevent certain things from coming like a death in the family and illness, things like that. But don’t create chaos is what I always tell my students because PA school is chaotic enough; the last thing you need to do is create more chaos. So don’t try to change your relationships during PA school, just play them out. Don’t try to change your surroundings, don’t buy anything big. I mean, come on, guys, every single one of you guys is in debt. So, going out and buying a Tesla is not the smartest thing to do before the PANCE because now you’re kind of worried about how am I going to pay for this Tesla. And I always tell people, this is you know, in other words, don’t add stress to your life. This is what I’m really trying to get at. Try to make this as stress-free as possible.

9:34

Practice Your Questions in Tutor Mode

The last thing, the number seven-point that I’m always trying to make to my students, practice your questions in tutor mode. This is big. This is huge. And if all this thing in the podcast I hope remember is this point, you see guys; our brain is much more like a dog than you know. In other words, we need to be corrected in real-time. For example, there’s this world called neuroplasticity, just type it in enjoy the ride, guys. Okay, and it pretty much goes like this. you fire it, I wire it. That’s how your brain works. If you fire it, I’ll wire it. But if it’s fired the wrong way, you need to wire it the correct way, in real-time. For example, when your dog pees on the bed, what do you do? You scold him at that moment, but you don’t scold him three hours later. He’s like, going, what do you hit me for? I’m over here chewing my bone, and in other words, you have to correct them in real-time. As humans, we’re the same way.

10:30

Correct Yourself in Real-Time

We need to be corrected in real-time. And so, there’s a lot of studies that have come out here in the world of neuroplasticity and how our brain works like this. So, I kept telling my students to keep it in Tudor mode. Let’s say you get the question wrong. We’re back to mitral stenosis, and for whatever reason, you forget the left lateral decubitus position is the best way to listen to the murmur. So what you do is you stop at that moment. You read up on it, you correct yourself in real-time, and then you go back to the question again. So again, it’s correcting yourself in real-time. This is huge. You have no idea how big this is. But it’s always in Tudor mode

11:05

Only Start Timing Yourself Towards The End

Only towards the end, and I’m talking about the last month before you take the exam, you start timing yourself.

Only Use High-Quality Questions

The other thing to do high-quality questions, one more time, high-quality questions. One of the biggest mistakes students will make they’ll tell you like, yeah, I’m doing 150 questions today. Wrong. What you’re doing is you’re probably going through these questions so fast, you’re probably developing a lot of bad habits.

Do 20-25 Questions Max Per Day

So I tell students to do is 20-25 a day, Max, no, Max, but I want you to do them in a high-quality fashion. I want you to pick apart every single word on that question. I want you to go beyond the question. So they’re asking the question, you know, aortic stenosis. Like I got this. I know the left ventricular hypertrophy, I know It’s a split S2 to I want you to go past the answer. In other words, you got the answer. And you went through it nice and slow. You peeled it apart. It was ambiguous, and you chose 51 verses 49. Practice these good habits because come the day the test, these good habits will rear up and they will help you. Because one of the things I see all the time with my high-risk students, the ones that fail, it’s always the same story. They’re always telling me that they are doing anywhere between the one to 200 questions a day, and I’m like I need you to do 25 high-quality questions a day. In other words, practice good test habits. So when you get to the day of the test, this will help you out the most.

12:42

The Best Textbooks for PANCE Prep

So now, our next topic we’re going to talk about is what are the best textbooks to get ready for the PANCE. About five years ago, I went out and actually bought all the PANCE and PANRE review booklets. I’m a big fan. If I’m going to talk the talk, I’m going to walk the walk, and what I did is it went out to and took a look at all these booklets that you guys are being introduced to. And what I did is I came up with the list of the booklets that I thought was best. Let me frame this statement quite clearly. There is no great book one more time; there is no great book; you will be piecemealing this. They’re all good. Nobody’s great. Each one is good, but each one has its flaws. So there are a lot of good ones out there, but nobody’s Great. So what were the better booklets that I saw out there when I was kind of doing my little research on how to get ready for the PANCE? First, one I came by is the AAPA book. That’s a Comprehensive Review for the Certification and Recertification Examinations for Physician Assistants that you see. It’s good. It’s not great. Some of the information is pretty good, but as you read through it, it’s really hard to find the nugget. Go ahead, look up meningitis, and osteomyelitis. You’ll be spending minutes trying to find out what your most common cause, which IV anabolic do I use? Things like that. So it’s good. It’s not great. Then there’s the Physician Assistant Board Review: Certification and Recertification by James Van Rhee, which is also a good book, but it’s not great. The Davis PA Exam Review book is good. There’s a Kaplan medical PANCE review book that’s good. Lange has gotten really good. So Lange, if you go back in time, 10 years ago, Lange was definitely not the best book that out there. But they got new editors, and they’ve done much, much better and I can only tell you the book is very good and this is the one that’s the Lange Q&A Physician Assistant Examination, Seventh Edition by Rachel Carlson and Albert Simon. It’s gotten very, very good. So highly recommend that one as well.

Read my post: 

The 4 Best PANCE and PANRE Study Guides and Review Books

15:16

PANCE PREP PEARLS

PANCE PREP PEARLS V3A - BEST PA SCHOOL REVIEW BOOKSSo let’s stop right here right now. I can guarantee you, if you’re listening to this podcast, you have this booklet. Make no mistake. It’s a great book, but it’s a reference book, not a study book. One more time, PANCE Prep Pearls. Wonderful reference book, not a good study book. If you don’t believe me, I know you already did this. What did you do? And I’m not begrudging anybody out there in the podcast world, but as students would you do? Okay, so let’s just say you had a GI test on a Monday, and you had a pulmonary test on Wednesday, and you had an ENT test on Friday. What do you do? You pulled out your PANCE Prep Pearls. You looked at the subjects or the objectives you had to do and you just brutally memorize the stuff, did you not you brutally memorize all the stuff at the pulmonary exam, the ENT exam, so you really memorized it off the reference book. Then what happened? I don’t know. By Friday afternoon, I could walk up to you and say, Hey, what is the first-line treatment of choice for pneumonia? Like I have no idea. I don’t even know where I parked. So in other words, you memorized it. It’s in it’s out. So again, it’s a great reference book, but not a good study book. If I had to paint, the student who is going to fail the boards. How would I paint on this one? I know I have your attention now. So who are my high-risk students? Oh, let me tell you what they all have in common. One. They live off a PANCE Prep Pearls. No, that’s the only book they have. They live off a Rosh review. That’s the only database and questions they use, period. And then what ends up happening to them because they had all the stuff memorized. They get a concept question. Some type of concept question shows up, and oh my god, they’re flat-footed. They have no idea which way to go. Because you see if it doesn’t show up as a trigger word of something they memorize and PANCE Prep Pearls. They’re done. And we’ll get to talk about Rosh in a second here about why I think Rosh is good, but again, it’s not great. So again, PANCE Prep Pearls is a wonderful, wonderful reference book. I think it’s great. It’s wonderful. I think Dwayne Williams did a wonderful job on this. But to use it specifically to study for the PANCE. Oh no, not at all. You’re going to get yourself lost.

Cost: $34.70 on Amazon – Version 3 is now divided into two books: part A / part B

17:00

The Best Websites for PANCE Review (PA Easy, Kaplan, Rosh)

When it comes to the website question. There are some database questions out there that are pretty good, and again, I went out there bought them all and there are some good ones some of them can get pretty pricey there’s no doubt about they can get pretty expensive.

PA Easy

So the first one I came across was PA Easy. I like PA Easy; it is quite good on the databank questions with the Lange references was really good, and again, you can put it in tutor mode. And again, I really enjoyed that a lot.

www.paexamprep.com

Kaplan

Kaplan is good, alright, so let’s stop right here. I love Kaplan Don’t get me wrong, but Kaplan, you know, I will say with Kaplan, take it with a grain of salt. Do you ever see some of those questions on Kaplan? They are hard so if you score above 60% or Kaplan, you’re doing great. And I know as students that suddenly you take some you know, cardiovascular exam, you score 62% and you swear that you’re going to you know, not pass the PANCE. That’s not true. Kaplan is a very, very difficult exam bank, but again, just take it with a grain of salt and just understand that some of these questions can be very tough.

www.kaptest.com

Rosh Review

If you’re listening to this podcast, I’d say about 80% of you guys use Rosh Review. Rosh is good, but it’s not great. Let me explain to you why. Who out there in podcast world took a question on Rosh Review, you swore you got it, right? You’re like I know this, this is what I learned in school. And then you went to Rosh Review, and they said no. And then if you look to the right, there is this thing called peer comparison, and you’re gonna find out that wait a second 70% that people got the question wrong. So as a teacher, just let you know that peer comparison over there. So when you do peer comparison, one of the things you should do if you’re a good teacher, your test question should sit around 70/30. This is really what’s called the discretion of a question in the education world. In other words, if a question is presented correctly, 70% of your class should get it right, 30% should get it wrong. That’s pretty much the ballpark. That’s the sweet spot anything hire is obviously good, but anything lower, ends up being a context problem. So when you get below 70%, getting it right. This is context. This isn’t a knowledge base issue with the students. This is a context of the question and otherwise, the question is worded poorly or incorrectly? Who on Rosh, if you have seen peer comparisons below 70/30? Yeah, you’re all shaking your head. Aren’t you going? Yeah, I’ve seen it all the time, Joe. Exactly. That’s my whole point. The other problem with Rosh, some of those questions aren’t even on the blueprint. That’s right. Look it up. You’ll see some of these questions going, who’s this disease? And it’s not even on your blueprint? So again, it’s like, I always tell people stick to the blueprint. This is what you’re going to be held accountable for. You’re not going to be held accountable for some, you know, chemo drug from breast cancer and some crazy side effects. But knowing the breast guidelines and what kind of cell type breast cancer is. Yes, that will be there. But not this other craziness that sometimes you’ll see on Rosh. So again, Rosh, it’s good. It’s not great. Of course, I’m going to push out my personal bias, Smarty PANCE. I think it’s a great website.

www.roshreview.com

20:03

Smarty PANCE

It’s just a treasure trove of information that takes a while to get through, but it’s a treasure trove of information. Wonderful website. And it follows the blueprint. So what I tell people to do is open up your smarty PANCE. There’s your blueprint, right, so let’s just say we’re back to aortic stenosis or mitral stenosis. So there it is, on the smarty PANCE blueprint there it is, you’re like, Okay, I gotta know, mitral stenosis. You open it up there’s an opening snap. Maybe you use another reference to study, and maybe you use the Merck manual? Maybe you’re using Lang, but in other words, you’re using other references to pull this all together? I keep trying to tell you guys; this is piecemeal, nobody’s great. Everybody’s good. So now, with all the information that you have, what would I recommend? Oh, this is what I would tell people to do.

www.smartypance.com

Putting it all together

20:50

One, start studying a year before, keep the stress out of your life. What I’d start doing is start studying. Yes, I would buy smarty PANCE ASAP use the blueprint; there’s my blueprint. This is the information I will be held accountable for, then I’m I looked at other references about maybe a or cynicism or look at PANCE pro tips. Maybe here’s some stuff that I forgot that and maybe I’ll read up on Merck manual or maybe I’ll read up on Lang and I’m going to do my questions how tutor mode? Because what do I need to correct myself in real-time? And that’s exactly what you need to do. So again, tutor mode, correct myself from real-time have all these references, my cell phone is off. I got no stress in my life. And I’m starting to go at it. That’s how you do it guys. That’s the secret sauce. That’s how it goes about. You see, where people go wrong, is they start not studying till the very end, they start memorizing things. They start doing things in test mode, not tutor mode. They’re doing 100 questions a day, not high-quality questions. But if we could just do high-quality questions, start them out a year before, it’s in tutor mode. I got smarty PANCE up and on one side, I’m looking at my blueprint. I got her other resources. Maybe I’m going to spend the afternoon on aortic stenosis. That’s all I’m doing. Sounds good to me. And then the next day, maybe another murmur and start trying to make sense of it all. Not memorize, because you see guys, just as my last little parting comment to you see, guys, the reason the board scores have dropped, and they have nationwide, and for some of these schools, they have dropped like a rock.

22:40

What happened? Well, what they did is a couple of things. One, they took away the buzzwords. So all these little buzzwords that you were used to writing, you know, you know, frothy green discharge, you know, purulent those kinds of things, right? They’re all gone. And now what they did is they made some of these questions, kind of concept questions. Do you know the concept of this issue and that is what I’m really trying to get at and see if you see something and you’ve got a big broad look at it? Now you understand the concept. You didn’t memorize it off PANCE Prep Pearls. You kept to the blueprint. You didn’t go way off base on some crazy Rosh Review that had nothing to do with the blueprint. And you stuck to it. You stick to that and I guarantee you you’re going to do great guys. So in the end of the day, high-quality questions, tutor mode, stick to the blueprint. Keep the stress out of my life. You do that guys, nine times out of 10 you’re going to end up in a very very good area guys. You really will.

So I hope this helps you guys out there in the podcast world. It was really great talking to everybody and I will be talking to you guys real soon. Take care.

Resources and Links From The Show

This Podcast is also available on iOS and Android

  1. iTunes: The Audio PANCE and PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher
  3. Google Play: The Audio PANCE and PANRE Podcast Google Play

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Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

2020 Interactive NCCPA PANCE Content Blueprint

 

Download for PANCE Download for PANRE

The post How to Study for Your PANCE: Podcast Episode 79 appeared first on The Audio PANCE and PANRE.

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Podcast Episode 79: How to Study for Your PANCE Welcome to episode 79 of the Audio PANCE and PANRE PA Board Review Podcast. In this episode 35-year PA veteran and PANCE/PANRE board review expert Joe Gilboy PA-C shares his top tips on how to best prepar... In this episode 35-year PA veteran and PANCE/PANRE board review expert Joe Gilboy PA-C shares his top tips on how to best prepare for the Physician Assistant National Certification Exam The Physician Assistant Life | Smarty PANCE clean 40:54 367
Podcast Episode 77: The Audio PANCE and PANRE Board Review Podcast http://podcast.thepalife.com/podcast-episode-77/ Tue, 10 Dec 2019 17:21:04 +0000 http://podcast.thepalife.com/?p=355 http://podcast.thepalife.com/podcast-episode-77/#respond http://podcast.thepalife.com/podcast-episode-77/feed/ 0 <p>Welcome to episode 77 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the Smarty PANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet). Special from today’s episode: Download your copy of the Free Trello Smarty PANCE […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/podcast-episode-77/">Podcast Episode 77: The Audio PANCE and PANRE Board Review Podcast</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p>
Episode 77 The Audio PANCE and PANRE PA Board Review Podcast By The Physician Assistant Life

Welcome to episode 77 of the Audio PANCE and PANRE PA Board Review Podcast.

Join me as I cover ten PANCE and PANRE Board review questions from the Smarty PANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

Special from today’s episode:

This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprints. 

Below you will find an interactive exam to complement the podcast.

The Audio PANCE and PANRE Physician Assistant Board Review Podcast

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

Listen Carefully Then Take The Practice Exam

If you can’t see the audio player click here to listen to the full episode.

Podcast Episode 77: Ten Question PANCE and PANRE Podcast Quiz

The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.

1.  A 10-month-old girl was admitted to the hospital for cardiac catheterization. Her history included cyanosis noted at about 6 weeks of age, increasing over the last 7 months and becoming more severe with crying or physical activity. The chest x-ray demonstrates a “boot-shaped heart.” A presumptive diagnosis of tetralogy of Fallot (TOF) was made on admission. TOF has 4 components, which of the following below is NOT PART of the diagnosis?

A. Pulmonary valve stenosis
B. VSD
C. Overriding aorta
D. Right ventricular hypertrophy
E. ASD

Click here to see the answer

Answer: E, ASD

In 1888, Fallot described a congenital heart defect composed of four characteristics (a) large ventricular septal defect (VSD) (b) right ventricular outflow obstruction (pulmonary valve stenosis) (c) overriding aorta (d) right ventricular hypertrophy. The main characteristic of TOF is cyanosis. Hypercyanotic spells or “tet spells” are paroxysmal episodes in which the cyanosis acutely worsens. Crying, feeding, or defecating can bring on these episodes.

Review NCCPA Blueprint Topic: Tetralogy of Fallot

2. A 65-year-old man presents with pain in his right knee. He says he fell and “banged it up fairly bad” approximately 6 months ago but that it had since recovered spontaneously and provided no further trouble until now. On examination, his temperature is 37.5 °C and his blood pressure is 125/70 mm Hg. He has an inflamed, tender, swollen right knee. No other joints are affected. No other abnormalities are found on physical examination. A plain radiographic examination of the right knee reveals streaking of the surrounding soft tissue with calcium deposits (chondrocalcinosis). What is the definitive diagnostic test of choice for this patient’s disease

A. A plasma level
B. A random urine test
C. A 24-hour urine
D. A synovial fluid analysis
E. Gram stain plus culture and sensitivity

Click here to see the answer

The answer is D: A synovial fluid analysis

A definitive diagnosis of gout is made by demonstrating negatively birefringent, needle-shaped monosodium urate crystals under a polarizing microscope. Although an elevated serum uric acid concentration is often seen in acute gout, it is neither as sensitive nor as specific a test as the demonstration of uric acid crystals in the synovial fluid under a microscope.

Serum uric acid levels can be normal in patients with acute gouty arthritis. The diagnosis of septic arthritis can be ruled out by appropriate Gram stain and culture of the same specimen of synovial fluid obtained for examination with the polarizing microscope.

Review NCCPA Blueprint Topic: Gout and pseudogout (Lecture)

3. What is (are) the major difference(s) between polymyalgia rheumatica (PMR) and polymyositis?

A. Marked proximal muscle weakness in polymyositis
B. Marked proximal muscle tenderness in polymyositis
C. Elevated muscle enzymes such as creatine kinase (CK) in polymyositis
D. a, b, and c

Click here to see the answer

The answer is D: a, b, and c

The differences between Polymyalgia Rheumatica (PMR) and polymyositis on clinical examination are as follows:

  • There is marked weakness associated with proximal muscle pain in polymyositis
  • There is often marked muscle tenderness (versus joint pain in PMR) associated with the proximal muscle pain in polymyositis
  • Laboratory examination reveals elevated muscle enzymes only in polymyositis

Polymyositis Pearls

Polymyositis is an autoimmune-mediated inflammatory destruction of muscles leading to muscle weakness

  • Patients with polymyositis experience proximal symmetric (bilateral) muscle weakness
  • The shoulders and hips are the parts of the body most commonly affected by polymyositis
  • Early fatigue while walking and inability to rise from a seated position

Diagnosis

  • The three autoantibodies anti-Jo-1anti-SRP, and anti-Mi-2, are associated with polymyositis
  • Creatine kinase levels are increased in polymyositis
  • Electromyography can detect regions of dead muscle cells
  • Muscle biopsy can show endomysial inflammation and various stages of necrosis

Treatment

  • Initial treatment of polymyositis  involves suppressing the immune response with corticosteroids
  • Methotrexate is used for long-term immunosuppressive therapy in polymyositis

Review NCCPA Blueprint Topic: Polymyositis (ReelDx + Lecture)

4. Clinical features of botulism include all of the following except

A. Paresthesia
B. Dysphagia
C. Diplopia
D. Fixed/dilated pupils

Click here to see the answer

The answer is A: Paresthesia

Paresthesia is not a feature of botulism while dysphagia, diplopia, and fixed dilated pupils are.

Botulism Pearls

  • Caused by a neurotoxin elaborated by Clostridium botulinum a gram-positive bacillus, which is an anaerobic, spore-forming bacteria
  • Associated with home-canned food products and honey in infants (wait until babies are at least 12 months before introducing honey)
  • Presents with double visiondrooping of eyelids, inability to make facial expressions, and difficulty swallowing
  • Autonomic nervous system effects may cause dry mouth, postural hypotension, nausea, vomiting, and constipation
  • Can lead to complete flaccid paralysis which is deadly if it involves respiratory muscles
  • In infants, symptoms include constipation and generalized weakness, with weak crying, poor feeding, lethargy, and loss of head control (floppy baby syndrome)

Diagnosis

  • Diagnosis is by toxin assays
  • Sometimes electromyography

Treatment

  • Treatment is supportive
  • The greatest threat to life is respiratory impairment and its complications
  • IV botulinum immunoglobulin/heptavalent botulinum antitoxin
  • Correct canning and adequate heating of home-canned food before serving are essential
  • Canned foods showing evidence of spoilage and swollen or leaking cans should be discarded

Review NCCPA Blueprint Topic: Botulism

5. A 59-year-old male complains of “flashing lights behind my eye” followed by a sudden loss of vision, stating that it was “like a curtain across my eye.” He denies trauma. He takes Glucophage for his diabetes mellitus and atenolol for his hypertension. He has no other complaints. On the fundoscopic exam, the retina appears to be out of focus. Which of the following is the most likely diagnosis?

A. Central retinal vein occlusion
B. Retinal artery occlusion
C. Retinal detachment
D. Hyphema

Click here to see the answer

The answer is C: Retinal Detachment

Patients with retinal detachment frequently complain of flashes of light or floaters that occur during traction on the retina as it detaches. This is followed by loss of vision. In small detachments, the retina may appear out of focus, but with larger detachments, a retinal fold may be identified.

  • Central retinal vein and artery occlusion cause painless, variable loss of vision. Exam shows retinal hemorrhages in all quadrants and edema of the optic disk
  • Hyphema is usually associated with trauma and is a collection of blood in the anterior chamber

Retinal Detachment Pearls

  • Retinal detachment is a separation of the neurosensory retina from the underlying retinal pigment epithelium
  • Look for sudden increase or change in floaters along with curtain or veil across the visual field
  • Often is spontaneous, but may have an underlying cause – example recent cataract surgery
  • Myopia (nearsightedness) is a risk factor for the development of retinal detachment
  • Retinal detachment is usually unilateral
  • Retinal detachment usually presents with defects in the peripheral visual field

Diagnosis

  • Diagnosis is by fundoscopy – retinal detachment is visualized as crinkling of retinal tissue and changes in vessel direction
  • Ultrasonography may help determine the presence and type of retinal detachment if it cannot be seen with funduscopy

Treatment

  • Retinal detachment is an ophthalmologic emergency
  • Stay supine (lying face upward) with head turned towards the side of the detached retina
  • Pneumatic retinopexy is a procedure for the management of retinal detachment that involves cryoretinopexy followed by injection of an air bubble in the vitreous

Review NCCPA Blueprint Topic: Retinal detachment (Lecture)

6. The first dose of the combined vaccine of measles, mumps, and rubella (MMR) is usually given at age

A. 12 months
B. 6 weeks
C. Birth
D. 9 months

Click here to see the answer

The answer is A: The first dose of MMR is given at age 12 – 15 months and a second dose at age 4-6 years

Mumps Pearls

Mumps is a viral disease that is part of the paramyxovirus family. It presents with parotitis (painful parotid gland swelling), orchitis, or aseptic meningitis. It is transmitted through respiratory droplets and has an incubation period of 12-14 days

  • Prodrome of fevermalaise, and anorexia
  • Parotid enlargement (usually bilateral but not always synchronous) 24 h later
  • Swelling of submaxillary and submandibular glands
  • Orchitis (usually unilateral) with testicular enlargement two to three times normal size
  • Mumps is the most common cause of pancreatitis in children

Diagnosis

  • During an outbreak, a diagnosis can be made by determining recent exposure and parotitis. Usually, the disease is diagnosed on clinical grounds, and no confirmatory laboratory testing is needed
  • If there is uncertainty about the diagnosis, a test of saliva or blood may be carried out; a newer diagnostic confirmation, using real-time nested (PCR) technology, has also been developed
  • As with any inflammation of the salivary glands, the serum level of the enzyme amylase is often elevated
  • CSF demonstrates increased lymphocytes and decreased glucose 

Treatment

  • There is no available cure for mumps and treatment is supportive
  • Symptoms usually last for 7-10 days and patients are contagious for up to 9 days after onset
  • May need to provide scrotal support if painful or swollen testicle (as in case presentation)
  • MMR vaccine is given at 12-15 months then again at 4-6 years of age

Review NCCPA Blueprint Topic: Mumps

7. A 28-year old sub-fertile woman presents to you on account of dysmenorrhea, deep dyspareunia, dyschezia, and pelvic pain of a few months’ duration. Physical examination revealed nodularity of the uterosacral ligaments, tenderness in the pouch of Douglas, and a fixed retroverted uterus with positive cervical excitation tenderness. What is the most likely diagnosis?

A. Endometriosis
B. Pelvic inflammatory disease
C. Adenomyosis
D. Uterine leiomyoma

The diagnosis is generally made by

A. Detection of increased estrogen levels
B. Endometrial biopsy
C. Pelvic ultrasound
D. Laparoscopy
E. CT of the pelvis

Click here to see the answer

Answer: A, endometriosis, and D Laparoscopy

  • Endometriosis, which is the presence of benign endometrial tissue outside of the uterine cavity typically presents as described in this clinical vignette. Remember the “three d’s” – Dyspareunia, dyschezia (difficulty in defecating) and dysmenorrhea
  • Definitive diagnosis is made by laparoscopy and confirmed with a biopsy
  • Imaging tests (eg, ultrasonography, barium enema, IV urography, CT, MRI) are not specific or adequate for diagnosis. However, they sometimes show the extent of endometriosis and thus can be used to monitor the disorder once it is diagnosed.

Incorrect Answers:

  • Patients with PID may have similar symptoms with endometriosis, but also presents with fever and vaginal discharge
  • Patients with adenomyosis (a condition in which endometrial tissue exists within and grows into the uterine wall) present with uterine mass with or without pressure symptoms and menorrhagia
  • Uterine leiomyomas cause chronic painful bleeding and are common in women in their late thirties and early forties.

Review NCCPA Blueprint Topic: Endometriosis (Lecture)

8. A 45-year-old obese Caucasian gentleman arrives at your clinic for a routine check-up after having some blood work done during a workplace health screening. He is found to have an LDL cholesterol level of 550 mg/dL. He states that his father and brother had high cholesterol and both died at a young age from a heart attack. He has a follow-up appointment with his cardiologist because of some occasional chest pain and abnormalities seen on his EKG. Additionally, you notice that he has well-demarcated yellow deposits around his eyes. He is started on high dose statin and his LDL at 12 weeks is 350 mg/dL. What is the next best step in this patient’s management?

A. Continue high dose statin, the patient’s LDL is at goal
B. Add niacin 100 mg three times daily
C. Add ezetimibe (Zetia) 10 mg daily
D. Add a PCSK9 inhibitor
E. Refer to a lipid specialist

Click here to see the answer

The answer is C: add ezetimibe 10 mg

If LDL-C is not at goal after 6-12 weeks the next best step for the treatment of familial hypercholesterolemia is to add ezetimibe 10 mg daily and check again in 6-12 weeks. If at that time the patient’s LDL is still not at goal (ideally < 150) refer to lipid specialist to consider adding a PCSK9 inhibitor.

Pearls

  • Familial hypercholesterolemia (FH) is the most common autosomal dominant genetic disease. The clinical syndrome (phenotype) is characterized by extremely elevated levels of low-density lipoprotein cholesterol (LDL-C) and a propensity to early-onset atherosclerotic cardiovascular disease. In general, homozygotes manifest the disease at a much earlier age than heterozygotes and the disease is more severe.
  • Homozygous FH patients are rare and have an estimated prevalence of approximately 1:300,000 to 1:400,000
  • Heterozygous FH is estimated to occur in 1 in 200 to 250 individuals in the United States.
  • It is estimated that about 7 percent of American adults have an untreated lipoprotein cholesterol ≥190 mg/dL but only 1.7 percent carry an FH mutation
  • Patients with undiagnosed homozygous familial hypercholesterolemia (FH) develop severe, premature, atherosclerotic cardiovascular disease and die before age 20 in many cases.
  • In patients with a negative or unknown family history, an untreated LDL-C level of ≥190 mg/dL (4.9 mmol/L) suggests FH. This value is greater than the 90th percentile for age and sex.

Diagnosis

  • The diagnosis of heterozygous familial hypercholesterolemia (FH) is made with genetic testing or clinical criteria. A causative mutation in the LDLR, APOB, or PCSK9 gene(s) secures this diagnosis
  • When genetic testing is not available or not felt to be necessary, you can use the Dutch Lipid Clinic Network criteria, which assigns points based on low-density lipoprotein cholesterol (LDL-C) levels, personal history of early atherosclerotic cardiovascular disease (ASCVD), family history of early ASCVD, or high cholesterol in a first-degree relative, and personal and physical examination finding

Treatment

  • Patients with homozygous familial hypercholesterolemia (FH) – intensive LDL-C lowering, which targets a minimal value of <150 mg/dL (3.9 mmol/L)
  • In addition to a high-dose statin (atorvastatin 80 mg daily or rosuvastatin 40 mg daily), most homozygous patients will require additional therapies such as ezetimibe, a PCSK9 inhibitor, or potentially LDL-C apheresis

Review NCCPA Blueprint Topic: Hypercholesterolemia

9. What best describes the time that preeclampsia is commonly seen?

A. Before 18 weeks of pregnancy
B. After 18 weeks of pregnancy
C. After 16 weeks of pregnancy
D. After 20 weeks of pregnancy
E. Before 12 weeks of pregnancy

Click here to see the answer

The answer is D, after 20 weeks of pregnancy

Preeclampsia is a systemic disease characterized by hypertension that is accompanied by proteinuria. Preeclampsia usually begins after the 20th week of gestation; however, it can appear at any time during pregnancy. It occurs most frequently in the final trimester.

Pearls

  • Preeclampsia is a systemic disease characterized by hypertension that is accompanied by proteinuria after the 20th week of gestation.
  • If left untreated, preeclampsia can lead to serious, and even fatal, complications.
  • Risk factors include nulliparity, age younger than 19 or older than 35, obesity, multiple gestations, positive family history, pre-existing hypertension or renal disease, and diabetes mellitus.
  • Eclampsia is defined as the development of seizures in a woman with preeclampsia.

Diagnosis

  • Hypertension with proteinuria
  • Mild Preeclampsia
    • BP 140/90 – 160/110
    • Proteinuria – > 300 mg/24 hours or > +1 on dipstick
  • BP > 160/110
    • Proteinuria > 5g in 24 hours or no urine or 3 +on dipstick
    • ***HELLP SYNDROME – Hemolysis, elevated liver enzymes, and low platelets

Treatment

  • Delivery is the only cure for preeclampsia. The decision to induce depends on the stage of pregnancy and the severity of the disease
  • Patients with preeclampsia without severe symptoms are generally induced into labor after 37 weeks gestation in severe preeclampsia delivery is performed at 24-26 weeks
  • If less than 34 weeks antenatal steroids promote fetal lung development
  • Intravenous magnesium sulfate as seizure prophylaxis)

Review NCCPA Blueprint Topic: PANCE Blueprint Reproductive System (7%)Hypertension disorders in pregnancy

10. A 36-year-old male who is hospitalized because of severe injuries from a motor vehicle accident develops a rapid onset of profound dyspnea. The initial chest x-ray shows a normal heart size with diffuse bilateral infiltrates. A follow-up chest x-ray shows confluent bilateral infiltrates that spare the costophrenic angles. Which of the following is the best clinical intervention for this patient?

A. Tracheal intubation
B. Bilateral chest tube insertion
C. Type-specific packed cells
D. Colloid solutions
E. Provide supplemental oxygen

Click here to see the answer

The answer is A – Tracheal intubation

Tracheal intubation with the lowest level of PEEP is required to maintain the PaO2 above 60 mmHg or SaO2 above 90% in a patient with ARDS

Pearls

Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by fluid collecting in the lungs depriving organs of oxygen

  • The underlying abnormality in ARDS is ⇑ Permeability of alveolar-capillary membranes ⇒ development of protein-rich pulmonary edema (non-cardiogenic pulmonary edema)
  • ARDS can occur in those who are critically ill or who have significant injuries

Three clinical settings account for 75% of ARDS cases:

  • Sepsis syndrome (most common cause)
  • Severe multiple trauma
  • Aspiration of gastric contents (alcoholics), toxic inhalation, near-drowning

People with ARDS have severe shortness of breath and often are unable to breathe on their own without support from a ventilator

  • Occurring 12-24 hours after the precipitating event
  • Tachypnea, pink frothy sputum, crackles

Diagnosis

Chest radiograph shows air bronchograms and bilaterally fluffy infiltrate

  • Normal BNP, pulmonary wedge pressure, left ventricle function and echocardiogram

Treatment

  • Treatment involves identifying and managing underlying precipitation and secondary conditions
  • Tracheal intubation with the lowest level PEEP to maintain PaO2 >60 mmHg or SaO2 >90
  • ARDS is often fatal, the risk increases with age and severity of illness

Review NCCPA Blueprint Topic: PANCE Blueprint Pulmonary (10%) ⇒ Acute respiratory distress syndrome (Lecture)

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Welcome to episode 77 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the Smarty PANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).



Welcome to episode 77 of the Audio PANCE and PANRE PA Board Review Podcast.



Join me as I cover ten PANCE and PANRE Board review questions from the Smarty PANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).



Special from today’s episode:



* Download your copy of the Free Trello Smarty PANCE NCCPA™ Blueprint Study Plan* Follow The Daily PANCE Blueprint on Instagram* Follow The Daily PANCE Blueprint on Facebook



This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprints. 



Below you will find an interactive exam to complement the podcast.



The Audio PANCE and PANRE Physician Assistant Board Review Podcast



I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.



* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.* You can listen to the latest episode, take an interactive quiz and download your results below.



Listen Carefully Then Take The Practice Exam





If you can’t see the audio player click here to listen to the full episode.



Podcast Episode 77: Ten Question PANCE and PANRE Podcast Quiz



The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.



1.  A 10-month-old girl was admitted to the hospital for cardiac catheterization. Her history included cyanosis noted at about 6 weeks of age...]]>
The Physician Assistant Life | Smarty PANCE clean 30:27 355
Podcast Episode 75: Ten FREE PANCE and PANRE Audio Board Review Questions http://podcast.thepalife.com/podcast-episode-75-ten-free-pance-and-panre-audio-board-review-questions/ Thu, 03 Oct 2019 07:01:44 +0000 http://podcast.thepalife.com/?p=350 http://podcast.thepalife.com/podcast-episode-75-ten-free-pance-and-panre-audio-board-review-questions/#respond http://podcast.thepalife.com/podcast-episode-75-ten-free-pance-and-panre-audio-board-review-questions/feed/ 0 <p>Welcome to episode 75 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will be covering ten general board review questions based on the NCCPA PANCE and […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/podcast-episode-75-ten-free-pance-and-panre-audio-board-review-questions/">Podcast Episode 75: Ten FREE PANCE and PANRE Audio Board Review Questions</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p>
Episode 75 The Audio PANCE and PANRE PA Board Review Podcast

Welcome to episode 75 of the Audio PANCE and PANRE PA Board Review Podcast.

Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprints. 

Below you will find an interactive exam to complement the podcast.

The Audio PANCE and PANRE Physician Assistant Board Review Podcast

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

Listen Carefully Then Take The Practice Exam

If you can’t see the audio player click here to listen to the full episode.

Podcast Episode 75: Ten Question PANCE and PANRE Podcast Quiz

The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.

1. A 5-year-old girl is brought to the emergency department after drinking a bottle of drain cleaner. It is unknown how much the child drank. She has a past medical history of Down syndrome and obesity. The patient’s vitals are unremarkable. Physical exam is notable for a child in no acute distress. She is tolerating her oral secretions and is interactive. Inspection of the oropharynx is unremarkable. Which of the following is the appropriate management of this patient?

  1. Dilute hydrochloric acid
  2. Endoscopy
  3. Intubation
  4. Observation
  5. Polyethylene glycol
Click here to see the answer

Answer: B. Endoscopy 

Ingestion of caustic fluids (acid or alkali) such as drain cleaner may lead to esophageal damage and stricture. Any patient presenting after caustic ingestion should have an endoscopy performed between 12 and 24 hours of presentation. Injury due to ingestion of alkaline fluids such as drain/oven cleaner occurs rapidly in the first minutes to hours and is characterized by liquefactive necrosis of the esophageal tissue. Subsequently, esophageal strictures form due to scarring of the affected tissue. Patients should immediately be resuscitated following the ABC’s (airway, breathing, and circulation). Subsequent management involves endoscopy (typically within 12 to 24 hours of ingestion) to assess the extent of the damage and plan any further treatment that may be needed.

Incorrect Answers:

  • Answer 1: Dilute hydrochloric acid or administration of any agent to titrate the ingestion is always contraindicated as this will lead to more tissue damage.
  • Answer 3: Intubation would be indicated if the patient was failing to protect their airway or if they had impending airway loss. This well-appearing patient has no airway concerns.
  • Answer 4: Observation is certainly a part of this patient’s care; however, she must also receive endoscopy to assess for any esophageal/GI tract injury.
  • Answer 5: Polyethylene glycol or whole bowel irrigation has limited indications. It may be used to pass bags of drugs if ingested by a packer/stuffer but would not aid in the management of caustic ingestion.

Review NCCPA Blueprint Topic: Ingestion of toxic substances or foreign bodies

2. A 27-year-old man presents to the emergency department after a motor vehicle collision. The patient was a front seat unrestrained driver in a head-on collision. The patient’s echocardiogram (ECG) is notable only for sinus tachycardia. His temperature is 99.5°F (37.5°C), blood pressure is 107/58 mmHg, pulse is 120/min, respirations are 17/min, and oxygen saturation is 98% on room air. The patient is given 2 liters of Ringer lactate solution and morphine. Initial workup demonstrates that the patient’s pulmonary capillary wedge pressure and troponins are elevated. The patient is currently complaining of chest pain. Physical exam is notable for an uncomfortable young man with bruising over his chest wall. Which of the following is the most likely diagnosis?

  1. Cardiac contusion
  2. Hemorrhage
  3. Myocardial infarction
  4. Pulmonary contusion
  5. Takotsubo cardiomyopathy
Click here to see the answer

Answer: A. Cardiac contusion

This patient is presenting after blunt chest trauma (which is common in motor vehicle accidents) with chest pain, elevated troponins, and an elevated pulmonary capillary wedge pressure suggesting a diagnosis of a cardiac contusion. A cardiac contusion is a blunt injury to the heart which can disrupt the mechanical and electrical function of the heart. There will typically be visible signs of chest trauma such as bruising and the patient will often complain of chest pain and dyspnea. The ECG can be unremarkable, demonstrate sinus tachycardia, or even demonstrate more severe dysrhythmias such as supraventricular tachycardia, atrial fibrillation, and a right bundle branch block. Initial cardiac troponins can be elevated. In the setting of any ECG abnormality or elevated troponins, patients with a suspected diagnosis of a cardiac contusion should be admitted to the hospital and observed until clinically stable with normalization of their troponins.

Incorrect Answers:

  • Answer 2: Hemorrhage would present with hypotension, tachycardia, and a decreased pulmonary capillary wedge pressure. Internal bleeding could be assessed with a FAST exam which assesses for pleural sliding, pericardial fluid and cardiac function, fluid in the hepatorenal and splenorenal recesses, and fluid surrounding the bladder.
  • Answer 3: Myocardial infarction presents with chest pain, shortness of breath, ST elevation on ECG and elevated cardiac troponins. This patient’s elevated troponins are likely secondary to blunt trauma to the heart as he has no risk factors for ischemic heart disease and is young.
  • Answer 4: Pulmonary contusion presents with chest pain, hypoxia, and patchy opacities on chest radiography which may not be initially apparent. Management for a pulmonary contusion is typically supportive in nature and to adequately control the patient’s pain.
  • Answer 5: Takotsubo cardiomyopathy presents with chest pain and dyspnea as well as ST elevation on ECG without reciprocal changes. Global hypokinesis of the heart can be seen on echocardiography and minor elevations in troponins can be present. The typical precipitating event for Takotsubo cardiomyopathy is an emotionally stressful life event and the patient is typically a woman in contrast to this male patient who has a mechanism of injury that supports a diagnosis of a cardiac contusion.

Review NCCPA Blueprint Topic: Chest/Rib Fractures and Trauma

3. A 33-year-old woman presents to her primary care PA for a wellness check-up. She states that recently she has been feeling well other than headaches that occur occasionally, which improve with ibuprofen and rest. She has a past medical history of hypertension and headaches and is currently taking hydrochlorothiazide. Her temperature is 99.2°F (37.3°C), blood pressure is 157/108 mmHg, pulse is 90/min, respirations are 14/min, and oxygen saturation is 98% on room air. Physical exam reveals a young woman who appears healthy. A normal S1 and S2 are auscultated on cardiac exam, and her lungs are clear with good air movement bilaterally. From her previous visit, it was determined that she has an elevated aldosterone and low renin level. Laboratory values are ordered as seen below.

Serum:
Na+: 139 mEq/L
Cl-: 100 mEq/L
K+: 3.7 mEq/L
HCO3-: 29 mEq/L
BUN: 20 mg/dL
Creatinine: 1.1 mg/dL

Which of the following is the most likely diagnosis?

  1. Benign essential hypertension
  2. Cushing syndrome
  3. Narrowing of the renal arteries
  4. Pheochromocytoma
  5. Primary hyperaldosteronism
Click here to see the answer

Answer: E. Primary hyperaldosteronism

This patient is presenting with hypertension refractory to a diuretic with a decreased potassium, a decreased renin level, and an increased aldosterone level suggesting a diagnosis of primary hyperaldosteronism.

Primary hyperaldosteronism occurs when the adrenal gland produces excess aldosterone. Aldosterone has the effect in the kidney of absorbing sodium (and thus water) and wasting potassium and hydrogen. Thus, hyperaldosteronism can lead to hypertension, hypokalemia, and a metabolic alkalosis. In primary hyperaldosteronism, the high blood pressure is detected by the kidney, and thus renin levels are decreased in the setting of an elevated aldosterone.

Incorrect Answers:

  • Answer 1: Benign essential hypertension typically occurs in overweight patients and has no clear underlying cause. It would not be associated with elevated aldosterone levels.
  • Answer 2: Cushing syndrome would be associated with weight gain, limb muscle atrophy, and striae on dermatological exam in the setting of a decreased renin and aldosterone.
  • Answer 3: Narrowing of the renal arteries (renal artery stenosis) would present with refractory hypertension in the setting of an elevated renin and aldosterone level.
  • Answer 4: Pheochromocytoma would present with severe episodic hypertension and headaches secondary to an adrenal mass that releases catecholamines.

Summary: Primary hyperaldosteronism presents with hypertension, a decreased renin and potassium level, a metabolic alkalosis, and an increased aldosterone level.

Review NCCPA Blueprint Topic: Secondary hypertension

4. A 24-year-old man is brought in to the emergency room after being retrieved by firefighters from a burning building. The patient is responding coherently to questions but reports pain secondary to a burn on his leg. He states he also has a headache and feels dizzy. His temperature is 98.5°F (36.9°C), blood pressure is 129/66 mmHg, pulse is 126/min, respirations are 14/min, and oxygen saturation is 99% on room air. Physical exam is notable for a confused young man with dry and flushed skin. The cardiopulmonary exam reveals a normal S1 and S2, as well as clear breath sounds bilaterally. The patient’s neurological exam is within normal limits. Towards the end of his exam, the patient begins vomiting. The dermatologic exam reveals a superficial burn covering 1% of the patient’s body over his right leg. Which of the following is the best next step in management for this patient?

  1. 100% oxygen
  2. CT scan of the head
  3. Hydroxocobalamin
  4. Normal saline
  5. Ondansetron
Click here to see the answer

Answer: A. 100% oxygen

This patient is presenting after being rescued from a fire with confusion, headache, nausea, vomiting, and flushed skin suggesting a diagnosis of carbon monoxide poisoning which should be treated with 100% oxygen.

Carbon monoxide exposure is common in fires and in patients who heat their house with an old-fashioned wood stove. Carbon monoxide binds to hemoglobin with a higher affinity than oxygen thus displacing it leading to symptoms. Carbon monoxide poisoning presents with confusion, headache, altered mental status, nausea, vomiting, and cherry-red skin. Pulse oximetry is often normal in these patients as the device detects hemoglobin bound to oxygen or carbon monoxide similarly. A carboxyhemoglobin level can be obtained to confirm the diagnosis in these patients; however, patients presenting with a clinical picture supportive of carbon monoxide poisoning should be treated with 100% (or hyperbaric) oxygen. Sequelae of carbon monoxide poisoning should be treated supportively, including dantrolene for increased muscle activity or benzodiazepines for seizure activity.

Incorrect Answers:

  • Answer 2: CT scan of the head would be indicated if a patient presented with head trauma followed by altered mental status, nausea, and vomiting. This patient’s neurological abnormalities, as well as his nausea and vomiting, can be explained by his carbon monoxide poisoning.
  • Answer 3: Hydroxocobalamin is the treatment of choice for cyanide poisoning which is also associated with exposure to fires. Patients will present with weakness, malaise, headache, dizziness, nausea, vomiting, and shortness of breath. Though this diagnosis is possible in this patient, a more likely diagnosis both epidemiologically and given his flushed skin is carbon monoxide poisoning. This patient will need empiric treatment for cyanide poisoning, however, a more dire intervention for the most likely diagnosis is putting the patient on oxygen to simultaneously and rapidly improve his respiratory status and treat his carbon monoxide poisoning.
  • Answer 4: Normal saline may be necessary to stabilize this patient’s blood pressure; however, his tachycardia is likely secondary to his pain and a more important initial intervention is stabilizing the patient’s respiratory status including administering oxygen for this patient’s carbon monoxide poisoning.
  • Answer 5: Ondansetron only treats this patient’s symptoms of nausea but does not address their respiratory status which should be treated promptly and prior to treating other concerns.

Summary: The treatment of carbon monoxide poisoning is 100% oxygen.

Review NCCPA Blueprint Topic: Burns (ReelDx)

5. A 42-year-old woman is brought to the emergency department after a motor vehicle accident. She complains of lower back pain and some minor abdominal pain. The patient has a past medical history of obesity and type II diabetes. Her current medications include atorvastatin, metformin, and glyburide. A FAST exam is performed in the trauma bay and does not reveal any signs of intra-abdominal bleeding. Her temperature is 98.2°F (36.8°C), blood pressure is 130/77 mmHg, pulse is 90/min, respirations are 16/min, and oxygen saturation is 99% on room air. Ultrasound findings are notable for multiple gallstones in the gallbladder. The patient is given naproxen. Which of the following is the best next step in management?

  1. CT scan of the abdomen
  2. NPO, IV fluids, and broad-spectrum antibiotics
  3. Perform a cholecystectomy this hospital visit
  4. Schedule an outpatient cholecystectomy
  5. Supportive therapy
Click here to see the answer

Answer: E. Supportive therapy

This patient is presenting with asymptomatic gallstones discovered incidentally. Asymptomatic gallstones do not need to be managed with a cholecystectomy. 

Acute cholecystitis classically presents with right upper quadrant abdominal pain that presents in a fat, fertile, female in her forties. Once the diagnosis is confirmed with ultrasound, “cooling off” of the gallbladder is necessary (keeping the patient NPO and IV fluids) followed by a cholecystectomy that hospital visit. However, if asymptomatic gallstones are discovered incidentally, there is no indication for cholecystectomy. These patients should be managed conservatively.

Incorrect Answers:

  • Answer 1: CT scan of the abdomen is unnecessary as there is no indication to perform a CT scan, in particular when the only finding in this assessment was asymptomatic gallstones on ultrasound. 
  • Answer 2: NPO, IV fluids, and broad spectrum antibiotics is the best initial management of ascending cholangitis. Patients with ascending cholangitis are acutely ill and present with a fever, jaundice, and right upper quadrant tenderness. They require immediate treatment as well as decompression (from interventional radiology), followed by ERCP/cholecystectomy. 
  • Answer 3: Performing a cholecystectomy this hospital visit is the appropriate management of acute cholecystitis. Acute cholecystitis would present with right upper quadrant abdominal pain in an overweight woman after eating a fatty meal. It is not indicated in the management of asymptomatic gallstones. 
  • Answer 4: Scheduling an outpatient cholecystectomy is not necessary as this patient is asymptomatic. Outpatient cholecystectomies are not typically performed in the management of acute cholecystitis as most patients do not comply with outpatient recommendations (avoiding triggers like fatty foods and alcohol) and end up returning to the hospital for another flare before their procedure. In certain compliant patients, it may be a viable option.

Review NCCPA Blueprint Topic: Cholelithiasis (ReelDx + Lecture)

6. A 60-year-old woman presents to the emergency department with dizziness. She states it started this morning when she woke up from bed and was severe causing her to vomit. The episode resolved in 1 minute. The patient has a past medical history of hypertension, diabetes, obesity, and atrial fibrillation treated with warfarin and metoprolol. She recently recovered from a cold a few days ago. Her temperature is 99.0°F (37.2°C), blood pressure is 174/99 mmHg, pulse is 115/min, respirations are 12/min, and oxygen saturation is 98% on room air. Physical exam is notable for a well-appearing woman. Her neurological exam including cranial nerves and gait is within normal limits. The patient is laid flat in the bed which causes an episode of dizziness with notable nystagmus and vomiting. She feels better after 1 minute. The patient’s ECG is within normal limits. Lab values are notable for an INR of 3.5. Which of the following is the most likely etiology of this patient’s symptoms?

  1. Canalithiasis
  2. Increased endolymph production
  3. Inflammation of the vestibular apparatus
  4. Inflammation of the vestibulocochlear apparatus
  5. Vertebrobasilar insufficiency
Click here to see the answer

Answer: A. Canalithiasis

This patient is presenting with intermittent, severe vertigo which is provoked by position changes which is most consistent with benign paroxysmal positional vertigo (BPPV). BPPV is commonly caused by canalithiasis.

Benign paroxysmal positional vertigo (BPPV) is a common form of peripheral vertigo that results from a dislodged piece of otolith (called otoconia when dislodged) causing disturbances in the semicircular canals. The presentation of BPPV involves sudden and episodic vertigo with head movements that lasts for seconds to minutes accompanied by nausea and vomiting. Physical exam will demonstrate a horizontal nystagmus with specific head postures (such as the Dix-Hallpike maneuver). Treatment involves repositioning exercises (such as the Epley maneuver) as well as meclizine or diphenhydramine for symptomatic control.

Incorrect Answers:

  • Answer 2: Increased endolymph production describes Meniere disease which presents with chronic symptoms including hearing loss and ear fullness and intermittent episodes of vertigo. Treatment involves diuretics and salt restriction.
  • Answers 3-4: Inflammation of the vestibular apparatus and the vestibulocochlear apparatus describes vestibular neuritis (sustained/persistent vertigo after a cold) and labyrinthitis (sustained/persistent vertigo and hearing loss after a cold), respectively. This condition will resolve on its own; however, symptoms can be treated with meclizine or diphenhydramine.
  • Answer 5: Vertebrobasilar insufficiency can present with syncope or if there is a hemorrhage/ischemia, may present in an elderly patient with multiple risk factors with sustained and severe vertigo that is sudden onset and associated with dysarthria and dystonia.

Summary: Benign paroxysmal positional vertigo is commonly caused by canalithiasis.

Review NCCPA Blueprint Topic: Vertigo (ReelDx + Lecture)

7. An 18-year-old male presents to his primary care provider with his parents for a sports physical. He was last seen in the clinic several months ago when he was diagnosed with attention deficit hyperactivity disorder (ADHD). He was started on methylphenidate at that time, and the patient now reports improvement in his ability to concentrate in school and at home. He hopes to play baseball in college and has begun lifting weights daily in preparation for baseball season. The patient reports that he eats a healthy diet to fuel his exercise regimen. His parents have no concerns and are pleased with the recent improvement in his grades. On physical exam, the patient has tall stature with average muscle mass for his age. He has no dysmorphic features. His chest has a normal appearance other than mild gynecomastia. The patient has sparse facial hair and a moderate amount of coarse pubic hair that extends across the pubis and spares the medial thighs. His testes are small and firm. Due to the latter, laboratory testing is performed and reveals the following:

  • Follicle-stimulating hormone (FSH): 42 mIU/mL (Reference range: 4-25 mIU/mL)
  • Luteinizing hormone (LH): 38 mIU/mL (Reference range: 6-23 mIU/mL)

Which of the following is the most likely etiology of this patient’s presentation?

  1. Anabolic steroid use
  2. CGG trinucleotide repeat disorder
  3. CTG trinucleotide repeat disorder
  4. Failure of neuronal migration
  5. Meiotic nondisjunction
Click here to see the answer

Answer: E. Meiotic nondisjunction

This patient presents with tall stature, gynecomastia, and small testes with elevated FSH and LH, which suggests a diagnosis of Klinefelter syndrome. Klinefelter syndrome is usually caused by meiotic nondisjunction that results in a 47,XXY genotype.

Klinefelter syndrome is the most common cause of primary hypogonadism. Patients with Klinefelter syndrome present with tall stature, neurocognitive difficulties (ADHD) and features of hypogonadism including gynecomastia, small testes, small phallus, hypospadias, underdeveloped secondary sex characteristics, and cryptorchidism. Patients without hypospadias or cryptorchidism are often not diagnosed until after puberty, when the symptoms of gynecomastia and small testes become more prominent. Because the hypogonadism in Klinefelter syndrome is caused by testicular fibrosis, laboratory results demonstrate a low testosterone and elevated FSH and LH.

Incorrect Answers:

  • Answer 1: Anabolic steroid use causes decreased levels of FSH and LH due to the suppression of GnRH release by the hypothalamus, which in turn suppresses FSH and LH release by the pituitary gland. Anabolic steroid use would not present with signs of hypogonadism.
  • Answer 2: The CGG trinucleotide repeat disorder characterizes Fragile X syndrome. Fragile X presents with macroorchidism rather than hypogonadism, and patients typically have dysmorphic features of a long, narrow face with large ears, prominent forehead, and prominent chin. Fragile X is the most common cause of inherited intellectual disability.
  • Answer 3: The CTG trinucleotide repeat disorder characterizes myotonic dystrophy. Although myotonic dystrophy presents with hypogonadism, patients would also present with symptoms of progressive weakness, such as facial weakness, dysphagia, or hand grip weakness.
  • Answer 4: Failure of neuronal migration characterizes Kallmann syndrome. Kallmann syndrome presents with the classic symptoms of loss of smell and hypogonadism, but patients with Kallmann syndrome have a low FSH and LH.

Summary: Klinefelter syndrome results in primary hypogonadism and presents with tall stature, gynecomastia, small testes, a small phallus, hypospadias, and cryptorchidism.

Review NCCPA Blueprint Topic: Hypogonadism

8. A 65-year-old man presents to the emergency department for sudden weakness. The patient states that he was at home enjoying his morning coffee when his symptoms began. He says that his left arm suddenly felt very odd and weak thus prompting him to come to the ED. The patient has a past medical history of diabetes, COPD, hypertension, anxiety, alcohol abuse, and PTSD. He recently fell off a horse while horseback riding but claims to not have experienced any significant injuries. He typically drinks 5-7 drinks per day and his last drink was yesterday afternoon. His current medications include insulin, metformin, atorvastatin, lisinopril, albuterol, and fluoxetine. His temperature is 99.5°F (37.5°C), blood pressure is 177/118 mmHg, pulse is 120/min, respirations are 18/min, and oxygen saturation is 93% on room air. On physical exam, you note an elderly man who is mildly confused. The cardiopulmonary exam demonstrates bilateral expiratory wheezes and a systolic murmur along the right upper sternal border that radiates to the carotids. Neurological exam reveals cranial nerves II-XII as grossly intact with finger-nose exam mildly abnormal on the left and heel-shin exam within normal limits. The patient has 5/5 strength in his right arm and 3/5 strength in his left arm. The patient struggles to manipulate objects such as a pen with his left hand. The patient is given a dose of diazepam and started on IV fluids. Which of the following is the most likely diagnosis in this patient?

  1. Berry aneurysm rupture
  2. Bridging vein tear
  3. Cerebellar bleeding
  4. Hypertensive encephalopathy
  5. Lacunar stroke
Click here to see the answer

Answer: E. Lacunar stroke

This patient is presenting with risk factors and symptoms suggestive of a diagnosis of a lacunar stroke. 

Lacunar strokes typically occur in patients with risk factors such as hypertension, diabetes, old age, and smoking. The basal ganglia, pons, and subcortical white matter are commonly affected. The pathophysiology occurs secondary to a small penetrating artery occlusion from hypertensive arteriolar sclerosis, lipohyalinosis, or microatheroma formation. Patients present with neurological deficits that can include pure motor hemiparesis, pure sensory stroke, ataxic hemiparesis, or dysarthria-clumsy hand syndrome.

Incorrect Answers:

  • Answer 1: Berry aneurysm rupture describes a subarachnoid hemorrhage that would present with a sudden onset, severe headache.
  • Answer 2: Bridging vein tear describes a subdural hematoma which could present with gradual neurological deficits and altered cognition in the setting of recent trauma in an elderly patient/alcoholic.
  • Answer 3: Cerebellar bleeding would present with ataxic gait and an abnormal finger-nose and heel-shin exam.
  • Answer 4: Hypertensive encephalopathy presents with general CNS dysfunction which can include headache, irritability, nausea/vomiting, disturbances of consciousness, and seizures.

Review NCCPA Blueprint Topic: Stroke (ReelDx + Lecture)

9. A 26-year-old woman presents to the emergency department with abdominal pain. She states that she was walking up the stairs at work when she felt sudden and severe abdominal pain followed by nausea and vomiting. Her past medical history is noncontributory and she is not currently taking any medications. Her temperature is 99.7°F (37.6°C), blood pressure is 122/78 mmHg, pulse is 120/min, respirations are 17/min, and oxygen saturation is 98% on room air. Physical exam is notable for an absence of abdominal tenderness, a left adnexal mass, and left adnexal tenderness. A transvaginal ultrasound demonstrates free fluid surrounding the ovary with edema and the presence of doppler flow. A urinary pregnancy test is negative. The patient’s symptoms persisted after ibuprofen and acetaminophen. Which of the following is the best next step in management?

  1. CT scan of the abdomen
  2. Laparoscopy
  3. Laparotomy
  4. MRI of the pelvis
  5. Observation and serial abdominal exams
Click here to see the answer

Answer: B. Laparoscopy

This patient is presenting with sudden onset abdominal pain, nausea, vomiting, and free fluid around the ovary with normal blood flow which is still concerning for ovarian torsion that should be managed with laparoscopy. Ovarian torsion occurs when the ovary twists around its blood supply causing ischemia and necrosis. Patients are typically young women who experience sudden/severe abdominal or vaginal pain, blood per vagina, a left adnexal mass with adnexal tenderness, and a negative urine pregnancy test. The best initial test is a transvaginal ultrasound with Doppler which can show blood flow to the ovary as well as ovarian enlargement and edema (signs of ischemia). Even in the setting of normal blood flow, torsion is possible as the ovary may twist and untwist. Patients presenting with symptoms concerning for ovarian torsion should be managed with laparoscopy to definitively treat and salvage the ovary.

Incorrect Answers:

  • Answer 1: CT scan of the abdomen would not be necessary as this patient has no abdominal tenderness and has physical exam and ultrasound findings concerning for ovarian torsion which should be managed surgically. 
  • Answer 3: Laparotomy is an open procedure that would be indicated if the patient suddenly decompensated and needed more aggressive management to stop acute bleeding. 
  • Answer 4: MRI of the pelvis would be a very accurate test for diagnosing pelvic pathology; however, it is not necessary in this patient who has a history and findings concerning for ovarian torsion. Performing an MRI would only delay treatment.
  • Answer 5: Observation and serial abdominal exams would be the appropriate management of a patient with abdominal pain with a clear etiology after a CT scan had ruled out any serious pathology. This patient’s likely ovarian torsion should not be observed.

Summary: Ovarian torsion should be treated with laparoscopy. 

Review NCCPA Blueprint Topic: Ovarian torsion

10. A 72-year-old man is brought into the emergency department by emergency medical services. He looks disheveled and states that he is homeless. He has bruising over his arms and legs and states that he does not have a regular source of nutrition. He denies prior medical conditions but states that he still smokes one pack of cigarettes per day. On exam, the patient’s vital signs are normal, but he appears extremely malnourished. His gums are swollen and bleeding and his tongue is unusually smooth. The hair on his arms is pinwheel-shaped. What is the most likely cause?

  1. Iron deficiency
  2. Vitamin B3 deficiency
  3. Vitamin C deficiency
  4. Vitamin B12 deficiency
  5. Vitamin K deficiency
Click here to see the answer

Answer: C. Vitamin C deficiency

An elderly, malnourished, cigarette-smoking male with swollen gums, bruising, and corkscrew hair is most likely suffering from vitamin C deficiency.

Though vitamin C deficiency, or scurvy, is uncommon in the developed world, cases in developing countries still exist. Typically, these cases occur in those who are very old or very young due to the inability to feed themselves properly. Since vitamin C, or ascorbic acid, is found in citrus fruits and green vegetables, deficiency in these foods or consumption of these foods with denatured vitamins (due to over-boiling) can result in deficiency. Those who smoke cigarettes have also been found to be more deficient in vitamin C.

Incorrect Answers:

  • Answer 1: Iron deficiency anemia would most commonly be asymptomatic, and if serious, would present with symptoms of fatigue and shortness of breath. It would not present with glossitis or corkscrew hair.
  • Answer 2: Vitamin B3, or niacin, can present with glossitis, but would typically also have the “3 D’s”: diarrhea, dermatitis, and dementia.
  • Answer 4: Vitamin B12 deficiency can also present with glossitis, but it would also have physical exam signs such as numbness and parasthesias of the extremities along with ataxia.
  • Answer 5: Vitamin K deficiency can present with bleeding and bruising, but it would not present with the other symptoms typically associated with scurvy.

Review NCCPA Blueprint Topic: Hypervitaminosis/hypovitaminosis

[spoiler title=”C

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE

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Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE and PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher
  3. Google Play: The Audio PANCE and PANRE Podcast Google Play
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Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

Download for PANCE Download for PANRE

The post Podcast Episode 75: Ten FREE PANCE and PANRE Audio Board Review Questions appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 75 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).



Welcome to episode 75 of the Audio PANCE and PANRE PA Board Review Podcast.



Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).



This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprints. 



Below you will find an interactive exam to complement the podcast.



The Audio PANCE and PANRE Physician Assistant Board Review Podcast



I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.



* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.* You can listen to the latest episode, take an interactive quiz and download your results below.



Listen Carefully Then Take The Practice Exam





If you can’t see the audio player click here to listen to the full episode.



Podcast Episode 75: Ten Question PANCE and PANRE Podcast Quiz



The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.



1. A 5-year-old girl is brought to the emergency department after drinking a bottle of drain cleaner. It is unknown how much the child drank. She has a past medical history of Down syndrome and obesity. The patient’s vitals are unremarkable. Physical exam is notable for a child in no acute distress. She is tolerating her oral secretions and is interactive. Inspection of the oropharynx is unremarkable. Which of the following is the appropriate management of this patient?



* Dilute hydrochloric acid* Endoscopy* Intubation* Observation* Polyethylene glycol





2. A 27-year-old man presents to the emergency department after a motor vehicle collision.]]>
The Physician Assistant Life | Smarty PANCE clean 35:46 350
Podcast Episode 73: Ten PANCE and PANRE Audio Board Review Questions http://podcast.thepalife.com/podcast-episode-73-ten-pance-and-panre-audio-board-review-questions/ Wed, 14 Aug 2019 10:23:41 +0000 http://podcast.thepalife.com/?p=344 http://podcast.thepalife.com/podcast-episode-73-ten-pance-and-panre-audio-board-review-questions/#respond http://podcast.thepalife.com/podcast-episode-73-ten-pance-and-panre-audio-board-review-questions/feed/ 0 <p>The Audio PANCE and PANRE Physician Assistant Board Review Podcast Welcome to episode 73 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will be […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/podcast-episode-73-ten-pance-and-panre-audio-board-review-questions/">Podcast Episode 73: Ten PANCE and PANRE Audio Board Review Questions</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> The Audio PANCE and PANRE Physician Assistant Board Review Podcast
Episode 73 The Audio PANCE and PANRE Physician Assistant Board Review Podcast

Welcome to episode 73 of the Audio PANCE and PANRE PA Board Review Podcast.

Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprints. 

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

Listen Carefully Then Take The Practice Exam

If you can’t see the audio player click here to listen to the full episode.

Podcast Episode 73: Ten Question PANCE and PANRE Podcast Quiz

The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.

1. A 45-year obese female (BMI=36.7 ) presents to your clinic with a random serum glucose level of 242.  You diagnose the patient with type II diabetes and place her on metformin 500 mg twice daily and ask that she check her glucose first thing in the morning and again late at night. The patient states that her glucose first thing in the morning is 424 and by the evening it is 96.  Which of the following tests would you like to order to confirm your diagnosis?

  1. ACTH level
  2. HgA1C
  3. 24 collection of VMA
  4. Dexamethasone suppression test
  5. Cortisol levels
Click here to see the answer

Answer: D. Dexamethasone suppression test

This patient is presenting with elevated glucose levels in the morning and normal levels at night. This is due to the dawn phenomenon or secreting too much cortisol first thing in the morning which is very common in patients with Cushing syndrome. The diagnostic test of choice for Cushing syndrome is a dexamethasone suppression test. While it is true that the cortisol levels will be elevated this does not diagnose Cushing’s syndrome.

Review NCCPA Blueprint Topic: Cushing’s syndrome

2. A 49-year-old male is admitted to the hospital with a diagnosis of pneumonia. He has had a cough and fever up to 101.2 °F for five days.  The patient states that his cough is productive and he is also complaining of sharp right-sided chest pain. On physical exam, you note diminished breath sounds on the right as well as dullness to percussion.  The chest x-ray demonstrates a right lower lobe infiltrate. Which of the following bacteria would be the most likely cause of this patient’s pneumonia?

  1. Mycoplasma
  2. Pneumococcal
  3. H. Flu
  4. Legionnaires 
  5. Chlamydia
Click here to see the answer

Answer: B. Pneumococcal

Pneumococcal pneumonia is the most common form of pneumonia in an adult that is greater than 40. It usually presents as lobar pneumonia with dullness to percussion and diminished breath sounds. There is also a vaccination available. Mycoplasma is the most common form of pneumonia in young adults and those less than 40.

Review NCCPA Blueprint Topic: Bacterial pneumonia (ReelDx)

3. A 21-year-old male is brought into the emergency room by his fraternity brothers. He appears confused and is agitated. He has a temperature of 100.5 F, horizontal nystagmus, muscular rigidity and at times becomes incredibly combative. His laboratory evaluation shows a CPK level of 8000 and his blood alcohol level is 0. Which of the following drugs most likely explains this patient’s symptoms?

  1. Methamphetamines
  2. LSD
  3. PCP
  4. Ecstasy 
  5. Marijuana
Click here to see the answer

Answer: C. PCP

PCP can cause extreme agitation as well as fever, muscular rigidity, horizontal nystagmus, and rhabdomyolysis.  The best treatment for these patients is IV fluids and sedation with medications like Geodon, Haldol, Thorazine, and Ativan. You can also add Benadryl to this cocktail.

Review NCCPA Blueprint Topic: Substance-related and addictive disorders

4. A 51-year-old male presents to the ED complaining of substernal burning discomfort. He reports a history of mild hypertension and Raynaud’s phenomenon. On physical exam, you notice he has shortened fingers. When further questioned the patients states that he was once told that he may have a type of autoimmune disease but is unaware of the name. Which of the following medications would be most helpful for the patient’s chronic heartburn??

  1. Omeprazole
  2. Cimetidine
  3. Carafate
  4. Zofran
  5. Amlodipine
Click here to see the answer

Answer: E. Amlodipine

The patient’s symptoms of heartburn, hypertension, Raynaud’s phenomenon, and short fingers are consistent with scleroderma. The best treatment for the reflux esophagitis that can occur with scleroderma is a calcium channel blocker. Calcium channel blockers serve as a smooth muscle relaxant which will relax his tight esophagus resulting in increased mobility and fewer chances for heartburn.

Review NCCPA Blueprint Topic: Systemic sclerosis – Scleroderma

5. You are called to see a patient who is currently on multiple psychiatric medications including Lithium, Lorazepam, Abilify, Trazodone, and Sertraline. He also takes Lasix.  He is in an assisted living facility and is brought to you by his care team for an acute psychotic episode. Which of the following medications is most likely responsible for the patient’s acute psychosis?

  1. Lorazepam
  2. Lasix
  3. Abilify
  4. Trazodone
  5. Sertraline
Click here to see the answer

Answer: B. Lasix

Loop diuretics can be very problematic in patients taking psychiatric medications. Loop diuretic result in a loss of water in the vascular volume, henceforth levels of different psychiatric medications will become higher. For example, if a patient is on lithium and they are currently on Lasix lithium level becomes higher and they can become with lithium toxic.

Review NCCPA Blueprint Topic: Schizophrenia spectrum and other psychotic disorders

6. A young healthy female patient with a recent diagnosis of depression complains of a 4-month history of amenorrhea and decreased sex drive. She has no significant past medical history and usually has normal menstrual cycles. Which of the following medications is most likely the cause of this patient’s symptoms?

  1. Sertraline
  2. Trazodone
  3. Abilify
  4. Venlafaxine
  5. Risperidone
Click here to see the answer

Answer: E. Risperidone

Older (second-generation) atypical antipsychotic agents can cause elevations in plasma prolactin concentrations while the newer atypical antipsychotics have minimal effect. Risperidone (an older second-generation antipsychotic agent) can cause amenorrhea, sexual dysfunction, and infertility.

Review NCCPA Blueprint Topic: Depressive disorders (Pearls)

7. A 64-year-old male presents with a chief complaint of lower extremity pain while walking his dog every afternoon. What is the most important risk factor for developing peripheral vascular disease?

  1. Smoking
  2. Hypertension
  3. Elevated cholesterol
  4. Elevated triglycerides
  5. Diabetes
Click here to see the answer

Answer: A. Smoking

Smoking is the strongest risk factor for PVD. As a class of drugs view nicotine as a very potent vasoconstrictor causing vasoconstriction everywhere. For example vasoconstriction of the vessels in the heart=CAD which can lead to MI. Constricted blood vessels in the brain=CVA and constricted blood vessels in the periphery=PVD.

Review NCCPA Blueprint Topic: Peripheral artery disease (Lesson)

8. A 35-year-old male patient presents concerned about his cardiac risk factors. He has a low HDL level, hypertension, type II DM, and an elevated LDL and triglyceride levels. His brother had CAD at the age of 47. Which of the following risk factor has the highest value when determining this patients risk of developing CAD?

  1. Low HDL levels
  2. Hypertension
  3. Diabetes
  4. High cholesterol
  5. Family history
Click here to see the answer

Answer: C. Diabetes

Diabetes is the strongest risk factor for CAD. All the other choices are risk factors however they do not have the same predictive value as diabetes when it comes to the severity of CAD.

Review NCCPA Blueprint Topic: Coronary Heart Disease (PEARLS)

9. Which of the following is considered to be a 1st line medication used in endocarditis prophylaxis for high-risk patients undergoing invasive procedures such as an esophageal stricture dilation?

  1. Cipro
  2. Clindamycin
  3. Amoxicillin
  4. Clarithromycin
  5. Doxycycline
Click here to see the answer

Answer: C. Amoxicillin

Amoxicillin is the prophylactic agent of choice against endocarditis, as it is able to cover both gram-negative and gram-positive organisms. If the patient is PCN allergic then Clindamycin is the next best choice.

Review NCCPA Blueprint Topic: Acute and subacute bacterial endocarditis

10. In a patient with a VSD murmur which of the following will be seen during the physical exam?

  1. Split S1
  2. Diastolic crescendo murmur
  3. Wide pulse pressures
  4. Holosystolic murmur
  5. Split S2
Click here to see the answer

Answer: D. Holosystolic murmur

In VSD the patient will have a holosystolic murmur moving from left to right during systole causing more blood to move into the right ventricle and pulmonary artery. End game is pulmonary hypertension.

Review NCCPA Blueprint Topic: Ventricular septal defect

[spoiler title=”C

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher
itunes_logo-1

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don't and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

Download for PANCE Download for PANRE

The post Podcast Episode 73: Ten PANCE and PANRE Audio Board Review Questions appeared first on The Audio PANCE and PANRE.

]]>
The Audio PANCE and PANRE Physician Assistant Board Review Podcast Welcome to episode 73 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following t... The Audio PANCE and PANRE Physician Assistant Board Review Podcast







Welcome to episode 73 of the Audio PANCE and PANRE PA Board Review Podcast.



Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).



This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprints. 



Below you will find an interactive exam to complement the podcast.



I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.



* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.* You can listen to the latest episode, take an interactive quiz and download your results below.



Listen Carefully Then Take The Practice Exam





If you can’t see the audio player click here to listen to the full episode.



Podcast Episode 73: Ten Question PANCE and PANRE Podcast Quiz



The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.



1. A 45-year obese female (BMI=36.7 ) presents to your clinic with a random serum glucose level of 242.  You diagnose the patient with type II diabetes and place her on metformin 500 mg twice daily and ask that she check her glucose first thing in the morning and again late at night. The patient states that her glucose first thing in the morning is 424 and by the evening it is 96.  Which of the following tests would you like to order to confirm your diagnosis?



* ACTH level* HgA1C* 24 collection of VMA* Dexamethasone suppression test* Cortisol levels





2. A 49-year-old male is admitted to the hospital with a diagnosis of pneumonia. He has had a cough and fever up to 101.]]>
The Physician Assistant Life | Smarty PANCE clean 15:57 344
Podcast Episode 71: Ten PANCE and PANRE Audio Board Review Questions http://podcast.thepalife.com/podcast-episode-71/ Thu, 09 May 2019 07:01:50 +0000 http://podcast.thepalife.com/?p=339 http://podcast.thepalife.com/podcast-episode-71/#respond http://podcast.thepalife.com/podcast-episode-71/feed/ 0 <p>The Audio PANCE and PANRE Physician Assistant Board Review Podcast Welcome to episode 71 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will be […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/podcast-episode-71/">Podcast Episode 71: Ten PANCE and PANRE Audio Board Review Questions</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> The Audio PANCE and PANRE Physician Assistant Board Review Podcast
Episode 71 The Audio PANCE and PANRE Physician Assistant Board Review Podcast

Welcome to episode 71 of the Audio PANCE and PANRE PA Board Review Podcast.

Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprints. 

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

Listen Carefully Then Take The Practice Exam

If you can’t see the audio player click here to listen to the full episode.

Podcast Episode 71: Ten Question PANCE and PANRE Podcast Quiz

The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.

1. A 52-year-old male presents complaining of urinary frequency, with hesitancy, and nocturia for the past few months. During his physical examination, you note a nontender, non-enlarged prostate with an isolated right posterior lobe nodule. Which of the following options is most appropriate?

  1. order a serum acid phosphatase level
  2. initiate prazosin and schedule a follow-up appointment in 6 weeks
  3. refer the patient for an ultrasound of the prostate and order a PSA level
  4. reassure the patient and schedule a follow-up appointment in six months
  5. initiate norfloxacin therapy for seven days and schedule follow-up in two weeks
Click here to see the answer

Answer: C. refer the patient for an ultrasound of the prostate and order a PSA level

This patient has an isolated nodule of the prostate gland — cancer until proven otherwise. You should order an ultrasound and a PSA. BPH will present as diffuse enlargement and not a discrete nodule.

Review NCCPA Blueprint Topic: Prostate disorders (PEARLS)

2. Which of the following is a major contraindication to curative surgical resection of a lung tumor?

A. Liver metastases
B. Vagus nerve involvement
C. Non-malignant pleural effusion
D. Chest wall invasion of the tumor

Click here to see the answer

Answer: A. Liver metastases

Distant metastases, except for solitary brain and adrenal metastases are an absolute contraindication for pulmonary resection. Other absolute contraindications include MI within the past 3 months, superior vena cava syndrome due to a metastatic tumor, bilateral endobronchial tumor, contralateral lymph node metastases, and malignant pleural effusion.

Review NCCPA Blueprint Topic: Pulmonary Neoplasms (PEARLS)

3. A 23-year-old female complains of fever and genital pain. Examination reveals the presence of lymphadenopathy in the groin and the presence of vulvar vesicles surrounded by erythematous skin. The diagnosis may be confirmed by

A. A culture of a vesicle using blood agar medium
B. The presence of similar lesions on the fingers and hands
C. A Gram stain of a scraping from the base of the lesion
D. The presence of giant multinucleated cells on Tzanck smear

Click here to see the answer

Answer: D. The presence of giant multinucleated cells on Tzanck smear – A Tzanck smear is the standard laboratory test to confirm the herpes virus as an etiologic agent of a vesicular lesion on an erythematous base.

A. Herpes virus will not grow on blood agar medium.
B. Herpes genitalis occurs in skin that comes into contact with the herpes virus. Usually, the infection is localized.
C. A Gram stain will not identify the herpes virus.

Review NCCPA Blueprint Topic: Herpes simplex (ReelDx)

4. A 28-year-old woman is complaining of heavy uterine bleeding and pelvic pressure that has progressively worsened over the past year. Evaluation reveals multiple moderate-sized uterine fibroids. The patient desires to have more children. The most appropriate definitive treatment is

A. Myomectomy
B. Hysterectomy
C. GnRH agonists
D. Oral progesterone

Click here to see the answer

Answer: A. Myomectomy –  Myomectomy is the definitive treatment of choice for moderate-sized uterine fibroids in young women who desire to maintain reproductive capability.

B. Hysterectomy is indicated as definitive treatment in a patient who does not desire to maintain reproductive capability.
C. GnRH agonists are used as an adjunct to surgery for treatment of uterine fibroids. Used alone, they would not be considered a definitive treatment.
D. Oral progesterone may be used to suppress menorrhagia preoperatively. Used alone, it would not be considered a definitive treatment.;

Review NCCPA Blueprint Topic:

5. A 59-year-old otherwise healthy female develops acute dyspnea and chest pain one week post total abdominal hysterectomy. Echocardiogram demonstrates normal heart size with normal right and left ventricular function. Lung scan demonstrates two segmental perfusion defects. Which of the following is the next step in the management of this patient?

A. Anticoagulation
B. Embolectomy
C. Thrombolysis
D. Inferior vena cava filter

Click here to see the answer

Answer: A. Anticoagulation – Anticoagulation is the treatment of choice in patients with pulmonary embolism with normal ventricular function and no absolute contraindications.

B. Embolectomy is not indicated as the initial treatment of a pulmonary embolism in patients with normal ventricular function.
C. Thrombolysis is contraindicated in patients within 10 days of having major surgery.
D. An inferior vena cava filter is considered in patients with contraindications to anticoagulation therapy or failed anticoagulation therapy.

Review NCCPA Blueprint Topic: Pulmonary embolism (ReelDx)

6. Long term use of which of the following drugs may cause a drug-induced lupus-type eruption?

A. prednisone
B. tetracycline
C. procainamide
D. oral contraceptives

Click here to see the answer

Answer: C. Procainamide – Procainamide, and hydralazine are the most common drugs that may cause a lupus-like eruption.

A. Prednisone is not implicated in drug-induced skin reactions.
B. Tetracycline and sulfonamides are known to cause a photosensitive rash on sun-exposed areas of the skin.
D. Oral contraceptives may induce erythema nodosum.

Review NCCPA Blueprint topic: Drug eruptions (ReelDx)

7. Which of the following clinical manifestations is most commonly seen in viral croup?

A. drooling
B. wheezing
C. sputum production
D. inspiratory stridor

Click here to see the answer

Answer: D. inspiratory stridor – Viral croup typically presents with a barking cough and stridor.

A. Drooling is common in epiglottitis, not viral croup.
B. Wheezing is noted in asthma.
C. Sputum production is noted in bacterial infections.

Review NCCPA Blueprint Topic: Croup (ReelDx)

8. Whispered voice test on a patient reveals decreased hearing in the left ear. Which of the following would be most consistent with conductive hearing loss in the left ear?

A. Sounds best heard in the left ear on Weber test.
B. Air conduction longer than bone conduction in the left ear on Rinne test.
C. Sound best heard in the right ear on Weber test.
D. Bone conduction longer than air conduction in the right ear.

Click here to see the answer

Answer: A. Sounds best heard in the left ear on Weber test – Sound best heard in the ear with a decreased hearing on Weber test (in this case, the left ear) is indicative of conductive hearing loss.

B. With conductive hearing loss, bone conduction should be heard as long as or longer than air conduction of sound in the affected ear. Air conduction lasting longer than bone conduction of sound would indicate a sensorineural hearing loss.
C. Sound best heard in the ear with an unaffected hearing on Weber test (in this case, the right ear) is indicative of sensorineural hearing loss.
D. With conductive hearing loss, bone conduction should be heard as long as or longer than air conduction of sound in the affected ear. The right ear showed normal hearing on physical exam.

Review NCCPA Blueprint Topic: Hearing impairment (Lecture)

9. A 65-year-old male presents with multiple lesions on his back. He denies any pruritis. Physical examination reveals the presence of multiple scattered brown plaques with a raised, warty surface that appears to be stuck onto the skin and feel greasy. Which of the following is the most likely diagnosis?

A. lentigines
B. actinic keratosis
C. keratoacanthomas
D. seborrheic keratosis

Click here to see the answer

Answer: D. seborrheic keratosis – Seborrheic keratosis is a common benign plaque in the elderly that characteristically has a velvety or warty surface associated with a stuck on appearance and greasy feel.

A. Lentigines most commonly are seen on the dorsum of the hand and appear as flat brown spots, often with sharp borders.
B. Actinic keratosis usually presents as small patches of flesh-colored, pink or yellow-brown lesions often with an erythematous component. The lesions are better felt than seen, having a rough, sandpaper feel and are often tender to palpation.
C. Keratoacanthomas usually occur as an isolated lesion on the face appearing as an erythematous, dome-shaped nodule with a central keratinaceous plug.

Review NCCPA Blueprint Topic: Keratotic disorders (PEARLS)

10. You are called to the nursery to see a male infant, born by uncomplicated vaginal delivery. He weighs 2,600 grams and has one deep crease on the anterior third of each foot. Respirations are 88 breaths/minute with expiratory grunting and intercostals retractions. He is cyanotic on room air and becomes pink when placed on 60% oxygen. Chest x-ray shows atelectasis with air bronchograms. Which of the following is the most likely diagnosis?

A. neonatal pneumonia
B. congenital heart disease
C. hyaline membrane disease
D. chronic lung disease of prematurity

Click here to see the answer

Answer: C. hyaline membrane disease – Hyaline membrane disease is the most common cause of respiratory distress in the premature infant. The infant typically presents with tachypnea, cyanosis, and expiratory grunting. A chest x-ray reveals hypoexpansion and air bronchograms.

A. While tachypnea, grunting, retractions, and cyanosis may be signs of neonatal pneumonia, they are primarily late findings of progressive respiratory distress and would not be seen immediately at the time of delivery. A chest x-ray in pneumonia would also most commonly reveal an infiltrate or effusion.
B. While congenital heart disease may present with cyanosis, the chest x-ray will reveal a cardiac abnormality, such as cardiomegaly.
D. Chronic lung disease of prematurity is a complication in about 20% of infants with hyaline membrane disease. It is defined as respiratory symptoms, oxygen requirement and chest x-ray abnormalities at 1 month of age so it cannot be diagnosed at this time in this newborn.;

Review NCCPA Blueprint Topic: The PANCE and PANRE Exam Academy + SMARTYPANCE

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher
itunes_logo-1

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

Download for PANCE Download for PANRE

The post Podcast Episode 71: Ten PANCE and PANRE Audio Board Review Questions appeared first on The Audio PANCE and PANRE.

]]> The Audio PANCE and PANRE Physician Assistant Board Review Podcast Welcome to episode 71 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following t... The Audio PANCE and PANRE Physician Assistant Board Review Podcast







Welcome to episode 71 of the Audio PANCE and PANRE PA Board Review Podcast.



Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).



This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprints. 



Below you will find an interactive exam to complement the podcast.



I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.



* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.* You can listen to the latest episode, take an interactive quiz and download your results below.



Listen Carefully Then Take The Practice Exam





If you can’t see the audio player click here to listen to the full episode.



Podcast Episode 71: Ten Question PANCE and PANRE Podcast Quiz



The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.



1. A 52-year-old male presents complaining of urinary frequency, with hesitancy, and nocturia for the past few months. During his physical examination, you note a nontender, non-enlarged prostate with an isolated right posterior lobe nodule. Which of the following options is most appropriate?



* order a serum acid phosphatase level* initiate prazosin and schedule a follow-up appointment in 6 weeks* refer the patient for an ultrasound of the prostate and order a PSA level* reassure the patient and schedule a follow-up appointment in six months* initiate norfloxacin therapy for seven days and schedule follow-up in two weeks





2. Which of the following is a major contraindication to curative surgical resection of a lung tumor?



A. Liver metastasesB. Vagus nerve involvementC. Non-malignant pleural effusionD.]]>
The Physician Assistant Life | Smarty PANCE clean 22:42 339 Podcast Episode 69: Ten PANCE and PANRE Board Review Audio Questions http://podcast.thepalife.com/podcast-episode-69-ten-pance-and-panre-board-review-audio-questions/ Thu, 28 Mar 2019 00:03:06 +0000 http://podcast.thepalife.com/?p=335 http://podcast.thepalife.com/podcast-episode-69-ten-pance-and-panre-board-review-audio-questions/#respond http://podcast.thepalife.com/podcast-episode-69-ten-pance-and-panre-board-review-audio-questions/feed/ 0 <p>The Audio PANCE/PANRE Board Review Exam Questions Welcome to episode 69 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will be covering ten general board […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/podcast-episode-69-ten-pance-and-panre-board-review-audio-questions/">Podcast Episode 69: Ten PANCE and PANRE Board Review Audio Questions</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p>
The Audio PANCE and PANRE Physician Assistant Board Review Podcast - Episode 69

The Audio PANCE/PANRE Board Review Exam Questions

Welcome to episode 69 of the Audio PANCE and PANRE PA Board Review Podcast.

Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprints. 

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

Listen Carefully Then Take The Practice Exam

If you can’t see the audio player click here to listen to the full episode.

Podcast Episode 69: 10 Question PANCE and PANRE Podcast Quiz

The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.

1. Which of the following is the most common cause of acute myocardial infarction?

A. Occlusion caused by coronary microemboli
B. Thrombus development at a site of vascular injury
C. Congenital abnormalities
D. Severe coronary artery spasm

Click here to see the answer

B. Thrombus development at a site of vascular injury – Acute myocardial infarction occurs when a coronary artery thrombus develops rapidly at a site of vascular injury. In most cases, infarction occurs when an atherosclerotic plaque fissures, ruptures, or ulcerates and when conditions favor thrombogenesis so that a mural thrombus forms at the site of rupture and leads to coronary artery occlusion.

A. Coronary microemboli occlusion is a rare cause of acute myocardial infarction.
C. Congenital abnormalities are rare causes of acute MI.
D. Severe coronary artery spasm is more likely to result in Prinzmetal’s angina rather than true infarction.

Review NCCPA Blueprint Topic: Acute myocardial infarction (PEARLS) (Lesson)

2. Endotracheal intubation should be performed with caution in patients with which of the following underlying conditions due to the propensity to cause subluxation of C1 on C2?

A. Rheumatoid arthritis
B. Osteoarthritis
C. Gout
D. Pseudogout

Click here to see the answer

A. Rheumatoid arthritis – Patients with advanced rheumatoid arthritis will have synovitis of the atlantoaxial joint (C1-C2) which may damage the transverse ligament of the atlas, producing a forward displacement of the atlas on the axis (atlantoaxial subluxation).

B. Although patients with osteoarthritis may have neck pain and stiffness, there is no predilection for the atlantoaxial joints.
C. Patients with gout are likely to have involvement of peripheral joints rather than spinal joints.
D. Patients with pseudogout are more likely to have involvement of the knees, wrist, shoulder, ankle, elbow, and hands rather than the cervical spine.

Review NCCPA Blueprint Topic: Rheumatoid arthritis (Lecture) (Lesson)

3. Which of the following interventions is the treatment of choice for an actinic keratosis?

A. Mohs surgery
B. Cryotherapy
C. Acid peels
D. Radiation therapy

Click here to see the answer

B. Cryotherapy – Cryotherapy is the treatment of choice for isolated superficial actinic keratosis.

A. Mohs surgery and radiation therapy are not indicated in the treatment for actinic keratosis.
C. Acid peels can be used to treat actinic keratosis but are not the treatment of choice.

Review NCCPA Blueprint Topic: Actinic keratosis

4. A 55-year-old secretary presents with ongoing pain and numbness in her hand. These symptoms are worse at night and she must shake her hand to regain feeling in it. Which of the following physical examination signs will be
present?

A. Hypothenar atrophy
B. Weakness of finger abduction
C. Inability to maintain wrist extension against resistance
D. Weakness of thumb abduction

Click here to see the answer

D. A weakness of thumb abduction – Median nerve injury causes weakness of thumb abduction (measured by thumb opposition strength) along with thenar atrophy. Tinel’s and Phalen’s signs will also be positive with carpal tunnel syndrome.

A. Hypothenar atrophy may occur with aging and disuse but it is not part of the median nerve involvement that occurs with carpal tunnel syndrome.
B. Finger abduction weakness is associated with ulnar nerve injury, which does not occur with carpal tunnel syndrome.
C. Radial nerve injury causes weakness of wrist extension and this is not part of carpal tunnel syndrome.

Review NCCPA Blueprint Topic: Carpal Tunnel Syndrome (Lesson)

5. A 78-year-old male with history of coronary artery disease status post-CABG and ischemic cardiomyopathy presents with a complaint of progressive dyspnea and orthopnea. He also complains of lower extremity edema. The patient denies fever, chest pain, or cough. On physical examination, vital signs are BP 120/68, HR 75 and regular, RR 22, afebrile. You note the patient to have an S3 heart sound, jugular venous distention, and 2+ lower extremity edema. The patient is admitted and treated. Upon discharge from the hospital, the patient should be educated to monitor which of the following at home?

A. Daily weights
B. Daily spirometry
C. Daily blood glucose
D. Daily fat intake

Click here to see the answer

A. Daily weights – Home monitoring of daily weights can alert the health care provider to the early recognition of worsening heart failure.

B. Spirometry monitoring is important in a patient with asthma, not heart failure.
C. Daily blood glucose monitoring is important in a patient with diabetes, not heart failure.
D. Daily fat intake is important, but will not improve his heart failure management.

Review NCCPA Blueprint Topic: Heart Failure (ReelDx) (Lesson)

6. Which of the following rotator cuff tendons is most likely to sustain injury because of its repeated impingement (carpal tunnel syndrome) between the humeral head and the undersurface of the anterior third of the acromion and coracoacromial ligament?

A. Supraspinatus
B. Infraspinatus
C. Teres minor
D. Subscapularis

Click here to see the answer

A. Supraspinatus – A critical zone exists for the supraspinatus tendon due to its superior insertion site. It is susceptible for injury because it has a reduction in its blood supply that occurs with abduction of the arm. Impingement of the shoulder is most commonly seen with the supraspinatus tendon, the long head of the biceps tendon and/or the subacromial bursa.

Review NCCPA Blueprint topic: Soft tissue injuries of the forearm, wrist, and hand (ReelDx) (Lesson)

7. Which of the following diagnostic findings in the urinary sediment is specific for a diagnosis of chronic renal failure?

A. Hematuria
B. Proteinuria
C. Broad waxy casts
D. Hyaline casts

Click here to see the answer

C. Broad waxy casts – Broad waxy casts in urinary sediment are a specific finding in chronic renal failure.

A. Hematuria and proteinuria are frequent, but nonspecific, findings in chronic renal failure.
D. Hyaline casts may be found in normal urine or in states of dehydration.

Review NCCPA Blueprint Topic: Chronic kidney disease (Lesson)

8. In addition to tobacco products, which of the following is also considered a major risk factor in the development of oral cancer?

A. Sun exposure
B. Alcohol abuse
C. Occupational exposure
D. History of oral candidiasis

Click here to see the answer

B. Alcohol abuse – Major risk factors for the development of oral cancer are the use of tobacco products and alcohol abuse.

A. Sun exposure is a risk factor for cancer of the lip but is not considered a major risk factor for oral cancer.
C. While occupational exposures and the presence of premalignant lesions, such as leukoplakia, are risk factors for the development of oral cancer, they are not considered major risk factors.
D. History of oral candidiasis has no correlation to the development of oral cancer.

Review NCCPA Blueprint Topic: EENT Benign and Malignant Neoplasms (Lesson)

9. A 13-year-old boy with leukemia presents with epistaxis for 2 hours. The bleeding site appears to be from Kiesselbach’s area. The most appropriate intervention is

A. electrocautery of the bleeding site
B. silver nitrate application
C. posterior nasal packing
D. intranasal petrolatum gauze

Click here to see the answer

D. intranasal petrolatum gauze – Petrolatum gauze will provide pressure to the bleeding point while the cause of bleeding is corrected.

A. Cautery is not used because the edges of the cauterized area may begin to bleed.
B. Silver nitrate is not used in children because it increases the risk of nasal septal perforation.
C. Posterior nasal packing is indicated for posterior bleeds in the inferior meatus.

Review NCCPA Blueprint Topic: Epistaxis (ReelDx + Lecture) (Lesson)

10. A 2-year-old female presents with purulent nasal discharge bilaterally with fever and cough for several days. Her mom had taken her out of daycare for a similar occurrence 2 months ago, that was treated with Amoxicillin. Exam further reveals halitosis and periorbital edema. Treatment should be initiated with which of the following?

A. Antihistamines
B. Ribavirin (Rebetol)
C. Intranasal corticosteroids
D. Amoxicillin-clavulanate (Augmentin)

Click here to see the answer

D. Amoxicillin-clavulanate (Augmentin) – High dose amoxicillin-clavulanate is the treatment of choice for resistant bacterial sinusitis, especially in children presenting with risk factors (daycare attendance, previous antibiotic treatment 1-3 months prior, age younger than 2 years).

A. Antihistamines and intranasal corticosteroids have not been adequately studied in children to prove they make a difference in treating recurrent sinusitis.
B. Ribavirin is approved for the treatment of RSV infection.

Review NCCPA Blueprint Topic: Acute and chronic sinusitis (ReelDx + Lecture) (Lesson)

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher
itunes_logo-1

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

Download for PANCE Download for PANRE

The post Podcast Episode 69: Ten PANCE and PANRE Board Review Audio Questions appeared first on The Audio PANCE and PANRE.

]]> The Audio PANCE/PANRE Board Review Exam Questions Welcome to episode 69 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content...



The Audio PANCE/PANRE Board Review Exam Questions



Welcome to episode 69 of the Audio PANCE and PANRE PA Board Review Podcast.



Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).



This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprints. 



Below you will find an interactive exam to complement the podcast.



I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.



* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.* You can listen to the latest episode, take an interactive quiz and download your results below.



Listen Carefully Then Take The Practice Exam





If you can’t see the audio player click here to listen to the full episode.



Podcast Episode 69: 10 Question PANCE and PANRE Podcast Quiz



The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.



1. Which of the following is the most common cause of acute myocardial infarction?



A. Occlusion caused by coronary microemboliB. Thrombus development at a site of vascular injuryC. Congenital abnormalitiesD. Severe coronary artery spasm





2. Endotracheal intubation should be performed with caution in patients with which of the following underlying conditions due to the propensity to cause subluxation of C1 on C2?



A. Rheumatoid arthritisB. OsteoarthritisC. GoutD. Pseudogout





3. Which of the following interventions is the treatment of choice for an actinic keratosis?



A. Mohs surgeryB.]]>
The Physician Assistant Life | Smarty PANCE clean 18:48 335 Podcast Episode 67: Ten PANCE and PANRE Board Review Audio Questions http://podcast.thepalife.com/episode-67/ Fri, 21 Dec 2018 08:01:04 +0000 http://podcast.thepalife.com/?p=326 http://podcast.thepalife.com/episode-67/#respond http://podcast.thepalife.com/episode-67/feed/ 0 <p>The Audio PANCE/PANRE – Ten PA Board Review Exam Questions Welcome to episode 67 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will be covering ten general […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/episode-67/">Podcast Episode 67: Ten PANCE and PANRE Board Review Audio Questions</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> The Audio PANCE and PANRE Physician Assistant Board Review Podcast Episode 67
Ten Mixed PA Board Review Questions

The Audio PANCE/PANRE – Ten PA Board Review Exam Questions

Welcome to episode 67 of the Audio PANCE and PANRE PA Board Review Podcast.

Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SMARTYPANCE which are now bundled together into one very low price.

Listen Carefully Then Take The Practice Exam

If you can’t see the audio player click here to listen to the full episode.

Podcast Episode 67: 10 Question PANCE and PANRE Podcast Quiz

The following questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE & PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.

A 26-year-old female presents with several pruritic lesions on her dorsal forearms. The lesions are erythematous with vesicles, with a few beginning to weep. She works in a photography laboratory but denies any other possible exposures. Which of the following is the most useful diagnostic test?

A. VDRL serology
B. KOH prep
C. Patch testing
D. Gram’s stain

Click here to see the answer

C. Patch testing with a suspected agent is usually positive in cases of allergic contact dermatitis

A. VDRL serology is useful in the diagnosis of syphilis, not contact dermatitis
B. KOH prep is used for diagnosis of fungal infections, not contact dermatitis
D. Gram’s stain is useful in the diagnosis of bacterial infections, not contact dermatitis

2. An elderly female presents for evaluation of exertional syncope, dyspnea, and angina. She admits that previous to these symptoms she had insidious progression of fatigue that caused her to curtail her activities. Which of the following is the most likely diagnosis?

A. Aortic stenosis
B. Aortic regurgitation
C. Mitral stenosis
D. Mitral valve prolapse

Click here to see the answer

A. The major symptoms of aortic stenosis are exertional syncope, dyspnea, and angina. Symptoms do not become apparent for a number of years and usually are not present until the valve is narrowed to less than 0.5 cm to 2 cm of the valve surface area.

B. Patients with aortic regurgitation are likely to complain of an uncomfortable awareness of their heart, especially when lying down. These patients develop sinus tachycardia with exertion and complain of palpitations and head pounding with activity.
C. The symptoms related to mitral stenosis are related to increased pulmonary pressure after the left atrium can no longer overcome the outflow obstruction.
D. Patients with mitral valve prolapse are typically asymptomatic throughout their lives, although a wide range of
symptoms is possible. When symptoms do occur, palpitations from arrhythmias are most common along with lightheadedness. Syncope is not part of this disease process.

3. A 40-year-old female G5P5 complains of small quantities of urine leaking when she coughs, sneezes, or laughs. Her genitourinary examination is unremarkable and her urinalysis is normal. At this time, which of the following is the most appropriate management plan?

A. Refer for a cystoscopy
B. Recommend Kegel exercises
C. Refer for surgical correction
D. Recommend hormone replacement therapy

Click here to see the answer

B. Strengthening the pelvic muscles by Kegel exercises and emptying the bladder frequently may resolve the problem.

A. Conservative therapy for stress incontinence should be attempted prior to any evaluation, such as cystoscopy, that might indicate the need for surgical correction
D. There is no indication in the history for hormone replacement therapy and no vaginal atrophy was noted on pelvic examination

4. A 62-year-old male presents with complaints of vague epigastric abdominal pain associated with jaundice and generalized pruritus. Physical examination reveals jaundice and a palpable non-tender gallbladder but is otherwise unremarkable. Which of the following is the most likely diagnosis?

A. Viral hepatitis
B. Pancreatic cancer
C. Acute cholecystitis
D. Gilbert’s syndrome

Click here to see the answer

B. Pancreatic cancer is suggested by the vague epigastric pain with jaundice resulting from biliary obstruction due to cancer involving the pancreatic head. The presence of a palpable non-tender gallbladder (Courvoisier’s sign) also indicates obstruction due to the cancer

A. While viral hepatitis may cause jaundice, the liver is enlarged and tender
C. While acute cholecystitis may present with jaundice and an enlarged gallbladder, the pain is classically colicky and located in the right upper quadrant. On physical examination with deep inspiration and palpation of the right subcostal area increased pain and respiratory arrest (Murphy’s sign) is usually seen.
D. Gilbert’s syndrome is the most common of the hereditary hyperbilirubinemias. It is most often diagnosed near puberty or adult life based on results of a comprehensive metabolic panel.

5. Which of the following would you expect on physical examination in a patient with mitral valve stenosis?

A. Systolic blowing murmur
B. Opening snap
C. Mid-systolic click
D. Paradoxically split S2

Click here to see the answer

B. Mitral stenosis is characterized by a mid-diastolic opening snap

A. Mitral stenosis is a diastolic, not a systolic murmur
C. Mid-systolic clicks are noted in mitral valve prolapse, not mitral stenosis
D. Paradoxical splitting of S2 occurs in aortic stenosis, not mitral stenosis

Review PANCE and PANRE Valvular disorders pearls

6. A positive Wood’s light examination (fluorescence) demonstrates

A. viral infection with herpes zoster
B. bacterial infection with Treponema pallidum
C. parasitic infestation with Pediculus humanus
D. mycotic infection with Microsporum canis

Click here to see the answer

D. Microsporum causes tinea capitis and fluoresces blue-green under Wood’s light

A. Lesions of herpes, Treponema, and Pediculus infections do not fluoresce.

Review topic PANCE Dermatologic system dermatophyte infections

7. In which of the following patients would one most likely find acanthosis nigricans?

A. A 55-year-old obese female with hyperinsulinemia
B. A 55-year-old male with an enlarged spleen and pancytopenia
C. A 24-year-old female with increased Lyme titers
D. A 60-year-old male with increased triglycerides

Click here to see the answer

A. Acanthosis nigricans is associated with patients who have hyperinsulinemia

B. Hairy cell leukemia is associated with an enlarged spleen and pancytopenia. Acanthosis nigricans is not a cutaneous manifestation
C. Erythema chronicum migrans is the characteristic lesion associated with Lyme disease
D. Eruptive xanthelasma is associated with increased triglycerides

8. A 65-year-old male presents with back pain two days after he was shoveling snow. The patient complains of pain in his low back that radiates into his buttocks, posterior thigh and calf, and the bottom of his foot. There is associated numbness of the lateral and plantar surface of his foot. Which of the following disc herniations is most likely to be affected?

A. L3-L4
B. L4-L5
C. L5-S1
D. S1-S2

Click here to see the answer

C. The S1 nerve root impingement is most likely to occur from the herniation of the L5-S1 disc space. The S1 disc affects Achilles’ reflex, the gastrocnemius and soleus muscles, and the abductor hallucis and gluteus maximus muscles.

9. A 22-year-old female presents to the emergency department with a rapid heart rate. She appears quite thin and dehydrated. She denies that she is thin, stating “I am so fat that I can hardly stand myself! That is why I exercise every day.” She runs twelve to fifteen miles a day, and on weekends also bicycles forty to fifty miles. Her LMP was six months ago. On exam, she is 5′ 6″ tall and weighs 98 pounds. Temp 98 degrees F, pulse 100, respirations 18, BP 98/60. EKG shows sinus tachycardia. Laboratory findings include Na 138 mEq/L, K 2.8 mEq/L, Cl 91 mEq/L, BUN 35 mg/dL, Creatinine 1.1 mg/dL. Which of the following is the next most appropriate treatment?

A. Propylthiouracil (PTU) and individual psychotherapy
B. Hormone replacement and cognitive therapy
C. Weight restoration and family therapy
D. IV hydration and antidepressant therapy

Click here to see the answer

C. Anorexia nervosa requires a comprehensive, multidisciplinary approach to treatment that integrates medical management, individual psychotherapy, and family therapy. Currently, the best results have been shown with weight restoration accompanied by family therapy for patients with adolescent-onset anorexia nervosa and individual therapy for patients with onset after 18 years of age. Inpatient treatment is often required.

A. Propylthiouracil is used to treat hyperthyroidism, not anorexia nervosahttps://smartypance.com/lessons/ear-disorders/inner-ear-pearls/acoustic-neuroma/
B. Hormone replacement is not indicated for the amenorrhea of anorexia nervosa, but nutritional support may help.
D. Antidepressant therapy may be useful in bulimia nervosa

10. A 52-year-old female presents with complaints of intermittent episodes of dizziness, tinnitus, and hearing loss in the right ear for 6 months. She describes the dizziness as the “room spinning around her,” with the episodes typically lasting for 2 to 4 hours. Physical examination reveals horizontal nystagmus and right ear hearing loss, but the remainder of the examination is unremarkable. Which of the following is the most likely diagnosis?

A. Acute labyrinthitis
B. Positional vertigo
C. Acoustic neuroma
D. Ménière’s syndrome

Click here to see the answer

D. Ménière’s syndrome uhttps://smartypance.com/lessons/ear-disorders/inner-ear-pearls/vertigo-reeldx294/sually presents with episodes of vertigo that last from 1 to 8 hours, sensorineural hearing loss and tinnitus.

A. Acute labyrinthitis typically presents with an acute onset of continuous vertigo that lasts several days to a week and is associated with nausea and vomiting. It does not have any associated auditory or neurologic symptoms.
B. Positional vertigo occurs following changes in head positioning with very brief, less than 1 minute, episodes. Nystagmus occurs following the position change.
C. Acoustic neuroma typically presents with hearing loss and tinnitus. The neuroma grows slowly and central compensatory mechanisms can prevent or minimize the vertigo. Vertigo, when present, is continuous and not episodic.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher
itunes_logo-1

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

pance-and-panre-nccpa-content-blueprint

Download

The post Podcast Episode 67: Ten PANCE and PANRE Board Review Audio Questions appeared first on The Audio PANCE and PANRE.

]]>
The Audio PANCE/PANRE – Ten PA Board Review Exam Questions Welcome to episode 67 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA... Ten Mixed PA Board Review Questions



The Audio PANCE/PANRE – Ten PA Board Review Exam Questions



Welcome to episode 67 of the Audio PANCE and PANRE PA Board Review Podcast.



Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).



This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 



Below you will find an interactive exam to complement the podcast.



I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SMARTYPANCE which are now bundled together into one very low price.



* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.* You can listen to the latest episode, take an interactive quiz and download your results below.



Listen Carefully Then Take The Practice Exam





If you can’t see the audio player click here to listen to the full episode.



Podcast Episode 67: 10 Question PANCE and PANRE Podcast Quiz



The following questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE & PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.



A 26-year-old female presents with several pruritic lesions on her dorsal forearms. The lesions are erythematous with vesicles, with a few beginning to weep. She works in a photography laboratory but denies any other possible exposures. Which of the following is the most useful diagnostic test?



A. VDRL serologyB. KOH prepC.]]>
The Physician Assistant Life | Smarty PANCE clean 18:58 326
Podcast Episode 65: Hepatitis B Breakdown With Joe Gilboy PA-C http://podcast.thepalife.com/podcast-episode-65-hepatitis-b-breakdown-with-joe-gilboy-pa-c/ Mon, 01 Oct 2018 23:38:14 +0000 http://podcast.thepalife.com/?p=314 http://podcast.thepalife.com/podcast-episode-65-hepatitis-b-breakdown-with-joe-gilboy-pa-c/#respond http://podcast.thepalife.com/podcast-episode-65-hepatitis-b-breakdown-with-joe-gilboy-pa-c/feed/ 0 <p>NCCPA™ PANCE Content Blueprint – The ABC’s of Hepatitis +The Hepatitis B Breakdown Welcome to episode 65 of the Audio PANCE and PANRE PA Board Review Podcast. In today’s episode, I welcome my friend, exclusive smartypance lecturer, and PA board review extraordinaire Joe Gilboy PA-C who will be breaking down Hepatitis B as you’ve never seen […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/podcast-episode-65-hepatitis-b-breakdown-with-joe-gilboy-pa-c/">Podcast Episode 65: Hepatitis B Breakdown With Joe Gilboy PA-C</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> The Audio PANCE and PANRE Episode 65 Hepatitis B Breakdown with Joe Gilboy PA-C

NCCPA™ PANCE Content Blueprint – The ABC’s of Hepatitis +The Hepatitis B Breakdown

Welcome to episode 65 of the Audio PANCE and PANRE PA Board Review Podcast.

In today’s episode, I welcome my friend, exclusive smartypance lecturer, and PA board review extraordinaire Joe Gilboy PA-C who will be breaking down Hepatitis B as you’ve never seen it before.

This is a recorded lecture featured on my smartypance.com board review website covering Hepatitis A, B, and C testing with twelve follow up questions at the end.

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of the site. The full board review covers the entire NCCPA Content Blueprint, all indexed, searchable, and now available with Joe’s Gilboy’s priceless lectures.

To top it off you can sign up today for the free 60-day board review email series which includes Joe’s audio explanations.

If you enjoyed this podcast episode:

Listen Carefully Then Take The Practice Exam

If you can’t see the audio player click here to listen to the full episode.

Podcast Episode 65: Hepatitis PANCE/PANRE Podcast Quiz

Episode 65 The Audio PANCE and PANRE Hepatitis B Breakdown

The following questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE & PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.

1. A patient presents wanting to be tested to see if they presently have Hepatitis A which labs would you order?

a. Anti-HAV (IgG)
b. Anti-HAV (IgA)
c. Anti-HAV (IgM)
d. Anti-HAV (IgE)

Click here to see the answer

c. Anti-HAV (IgM)

2. Which lab result would a PA and an IV drug abuser both have that are positive?

a. Anti-HBs
b. Anti-HBe
c. Anti-HBc
d. HBeAg

Click here to see the answer

a. Anti-HBs

3. Which positive lab tells you a person is currently actively infected with hepatitis B?

a. HBsAg
b. HBsAb
c. HBcAg
d. HBeAg

Click here to see the answer

d. HBeAg

4. Which of the following lab result would a chronic hepatitis B patient have that is positive?

a. HBsAg
b. HBsAb
c. HBcAg
d. HBeAg

Click here to see the answer

a. HBsAg

5. Immunoglobulin is given within two weeks for family members and close contacts when they are exposed to hepatitis A. Which immunoglobulin is given?

a. IgM
b. IgG
c. IgA
d. IgE

Click here to see the answer

b. IgG

6. Hepatitis D needs what part of hepatitis B to exist?

a. HBsAg
b. HBsAb
c. HBcAg
d. HBeAg

Click here to see the answer

a. HBsAg

7. Hepatitis E is transmitted by which vector?

a. IV drug abuse
b. Homosexual sex
c. Fecal-oral
d. Blood transfusion

Click here to see the answer

c. Fecal-oral

8. What is the 1st evidence of infection with hepatitis B?

a. HBcAg
b. HBeAg
c. Anti-HBs
d. HBsAg

Click here to see the answer

c. Anti-HBs

9. What is the lab test to indicate a diagnosis of acute hepatitis B?

a. Anti-HBs
b. Anti-HBe
c. Anti-HBc
d. HBeAg

Click here to see the answer

c. Anti-HBc

10. What is the lab test that indicates viral replication and infectious Hepatitis B?

a. HBcAg
b. HBeAg
c. Anti-HBs
d. HBsAg

Click here to see the answer

b. HBeAg

11. Which of the following is the first sign of a patient with an elevated conjugated bilirubin (direct)?

a. Icteric sclera
b. Jaundice
c. Acholic stool
d. Tea-colored urine

Click here to see the answer

d. Tea-colored urine

12. A 52-yo male with upper abdominal pain and an elevated aminotransferase(AST) >10,000 u/l is consistent with which problem?

a. Gallstones
b. Alcoholic liver disease
c. Bile duct stones
d. Viral Hepatitis

Click here to see the answer

d. Viral Hepatitis

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

pance-and-panre-nccpa-content-blueprint

Download

The post Podcast Episode 65: Hepatitis B Breakdown With Joe Gilboy PA-C appeared first on The Audio PANCE and PANRE.

]]>
NCCPA™ PANCE Content Blueprint – The ABC’s of Hepatitis +The Hepatitis B Breakdown Welcome to episode 65 of the Audio PANCE and PANRE PA Board Review Podcast. In today’s episode, I welcome my friend, exclusive smartypance lecturer,
NCCPA™ PANCE Content Blueprint – The ABC’s of Hepatitis +The Hepatitis B Breakdown
Welcome to episode 65 of the Audio PANCE and PANRE PA Board Review Podcast.
In today’s episode, I welcome my friend, exclusive smartypance lecturer, and PA board review extraordinaire Joe Gilboy PA-C who will be breaking down Hepatitis B as you’ve never seen it before.
This is a recorded lecture featured on my smartypance.com board review website covering Hepatitis A, B, and C testing with twelve follow up questions at the end.
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of the site. The full board review covers the entire NCCPA Content Blueprint, all indexed, searchable, and now available with Joe’s Gilboy’s priceless lectures.
To top it off you can sign up today for the free 60-day board review email series which includes Joe’s audio explanations.
If you enjoyed this podcast episode:

* You can download and listen to past FREE episodes here, on iTunesGoogle Play Music, or Stitcher Radio.

Listen Carefully Then Take The Practice Exam
If you can’t see the audio player click here to listen to the full episode.
Podcast Episode 65: Hepatitis PANCE/PANRE Podcast Quiz

The following questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE & PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.
1. A patient presents wanting to be tested to see if they presently have Hepatitis A which labs would you order?
a. Anti-HAV (IgG)
b. Anti-HAV (IgA)
c. Anti-HAV (IgM)
d. Anti-HAV (IgE)
2. Which lab result would a PA and an IV drug abuser both have that are positive?
a. Anti-HBs
b. Anti-HBe
c. Anti-HBc
d. HBeAg
3. Which positive lab tells you a person is currently actively infected with hepatitis B?
a. HBsAg
b. HBsAb
c. HBcAg
d. HBeAg
4. Which of the following lab result would a chronic hepatitis B patient have that is positive?
a. HBsAg
b. HBsAb
c. HBcAg
d. HBeAg
5. Immunoglobulin is given within two weeks for family members and close contacts when they are exposed to hepatitis A. Which immunoglobulin is given?
a. IgM
b. IgG
c. IgA
d. IgE
6. Hepatitis D needs what part of hepatitis B to exist?
a. HBsAg
b. HBsAb
c.]]>
The Physician Assistant Life | Smarty PANCE clean 22:26 314
Episode 63: The Audio PANCE and PANRE – Ten Mixed NCCPA™ Content Blueprint Multiple Choice Questions http://podcast.thepalife.com/episode-63-the-audio-pance-and-panre-ten-mixed-nccpa-content-blueprint-multiple-choice-questions/ Thu, 09 Aug 2018 16:40:58 +0000 http://podcast.thepalife.com/?p=310 http://podcast.thepalife.com/episode-63-the-audio-pance-and-panre-ten-mixed-nccpa-content-blueprint-multiple-choice-questions/#respond http://podcast.thepalife.com/episode-63-the-audio-pance-and-panre-ten-mixed-nccpa-content-blueprint-multiple-choice-questions/feed/ 0 <p>Ten Mixed NCCPA™ PANCE Content Blueprint Multiple Choice Questions Welcome to episode 63 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will be covering ten […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/episode-63-the-audio-pance-and-panre-ten-mixed-nccpa-content-blueprint-multiple-choice-questions/">Episode 63: The Audio PANCE and PANRE – Ten Mixed NCCPA™ Content Blueprint Multiple Choice Questions</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> The Audio PANCE and PANRE Episode 63 Ten Mixed Multiple Choice Questions

Ten Mixed NCCPA™ PANCE Content Blueprint Multiple Choice Questions

Welcome to episode 63 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SMARTYPANCE which are now bundled together into one very low price.

Listen Carefully Then Take The Practice Exam

If you can’t see the audio player click here to listen to the full episode.

Episode 63 – General PANCE/PANRE Podcast Quiz

The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content.

1. A 24-year-old male presents complaining of a 9-month history of increasing shortness of breath, dyspnea on exertion, and a cough productive of white sputum, mostly in the mornings. He denies orthopnea, PND, peripheral edema, fever, chills, night sweats, recent changes in weight, palpitations, chest pain, food intolerances, or other complaints. Patient has a history of recurrent lung infections. He states that his father had chronic pulmonary problems and died at age 42 from unknown lung disease. The patient denies smoking, alcohol or illicit drug use. On physical examination, the respiratory rate is 22 breaths per minute, a pulse of 98 bpm, a temperature of 98.7 degrees. Pulmonary exam reveals end-expiratory wheezes bilaterally and hyperresonance to percussion. His cardiac exam is normal. Chest X-ray shows decreased lung markings. ECG is normal. Pulmonary function tests show an FEV1 63% of expected and residual capacity is 123% of expected. Which of the following is the most likely diagnosis?

A. Emphysema
B. Pulmonary fibrosis
C. Ventricular septal defect
D. Congestive heart failure

Click here to see the answer

Answer: A. Emphysema

This person has an obstructive lung disease based on PFTs. Emphysema is the most likely diagnosis and may be related to alpha-1 antitrypsin deficiency based on family history and lack of smoking history and young age.

Emphysema is covered as part of the NCCPA Pulmonary Blueprint (12%)

B. The PFTs from a person with pulmonary fibrosis would be consistent with a restrictive pattern. This patient has an obstructive pattern of lung disease.
C. Ventricular septal defect will have a systolic murmur associated with it.
D. Congestive heart failure might explain some of the symptoms of this patient (increasing shortness of breath and DOE), he denies other common symptoms, such as orthopnea and peripheral edema. CHF should not result in changes in the PFTs.

2. A male patient complains of chronic dysuria, frequency, and urgency with associated perineal pain. The most likely diagnosis is

A. cystitis
B. gonococcal urethritis
C. epididymitis
D. prostatitis

Click here to see the answer

Answer: D. prostatitis

Some patients are asymptomatic, but low back or perineal pain, fever, chills, and irritative urinary symptoms are common in prostatitis.

Prostatitis is covered as part of the NCCPA PANCE Genitourinary Blueprint

A. Cystitis is characterized by dysuria without urethral discharge.
B. Initially, there is burning on urination and serous or milky discharge in gonococcal urethritis.
C. Epididymitis is characterized by dysuria, unilateral scrotal pain, and swelling.

3. Which of the following preventive strategies against osteoporosis-associated vertebral fractures has a known side effect of increasing the incidence of hot flashes when used in a perimenopausal female?

A. Calcitonin (Miacalcin) nasal spray
B. Alendronate (Fosamax)
C. Estrogen/progesterone (Prempro)replacement
D. Raloxifene (Evista)

Osteoporosis is covered as part of the PANCE Musculoskeletal Blueprint

Click here to see the answer

Answer: D. Raloxifene (Evista)

Raloxifene has effects on bone turnover and bone mass and has been shown to decrease vertebral fractures. It has anti-estrogen effects on the non-skeletal portions of the body and increases hot flashes in perimenopausal females.

A. Calcitonin does not have any estrogen effects on the body and serves as an analgesic when used in the management of vertebral fractures.
B. Alendronate is a bisphosphonate that does not have any hormonal effects on the body.
C. Estrogen/progesterone replacement has the benefit of maintaining bone and decreasing vertebral fractures but it would improve perimenopausal hot flashes.

4. A 70-year-old presents with a headache and neck stiffness. On physical exam, the patient is febrile, Kernig’s sign is present, and no rash is noted. A spinal tap reveals a white count of 250/cm3 with 100% neutrophils, total protein 250mg/dL, and glucose 35 mg/dL. Which of the following is the most appropriate treatment?

A. Acyclovir (Zovirax)
B. Fluconazole (Diflucan)
C. Ampicillin and ceftriaxone (Rocephin)
D. Penicillin and chloramphenicol (Chloromycetin)

Bacterial meningitis is covered as part of the PANCE Neurology Blueprint

Click here to see the answer

Answer: C. Ampicillin and ceftriaxone (Rocephin)

Ampicillin and ceftriaxone are used to treat bacterial meningitis, secondary to Listeria monocytogenes, which is common in the elderly. Ceftriaxone will cover other common etiologic agents such as Streptococcal pneumonia

A. Acyclovir is used to treat meningitis secondary to herpes. Viral meningitis presents with an increased number of lymphocytes and elevated glucose in the CSF.
B. Fluconazole is used to treat fungal meningitis. Fungal meningitis, typically noted in immunocompromised hosts, presents with an increased number of lymphocytes in the CSF.
D. Penicillin and chloramphenicol is used to treat bacterial meningitis, secondary to Neisseria meningitidis. Bacterial meningitis due to N

5. A 45-year-old patient with type 1 diabetes mellitus is being screened for diabetic nephropathy. Which of the following urinalysis findings is most consistent with early diabetic nephropathy?

A. Microalbuminuria
B. Red cell casts
C. White cell casts
D. Renal epithelial cells

Diabetic neuropathy is covered as part of the PANCE Endocrinology Blueprint

Click here to see the answer

Answer: A. Microalbuminuria

Microalbuminuria is most consistent with early diabetic neuropathy.

B. Red cell casts are more indicative of acute glomerular nephritis.
C. White cell casts are more consistent with acute pyelonephritis.
D. A few renal epithelial cells normally may be found in the urine.

6. A 74-year-old female is being treated for mild hypertension. She is found at home with right hemiparesis and brought to the emergency department. Her daughter states that the patient fell in her kitchen 2 days ago, but had no complaints at that time. She did state that her mother sounded a little confused this morning. The patient’s left pupil is dilated. Which of the following diagnostic studies should be ordered first?

A. MRI of the brain
B. CT scan of the brain
C. Skull x-ray
D. Lumbar puncture

Click here to see the answer

Answer:  B. CT scan of the brain

This patient presents with a history of minor trauma and progressive neurological abnormalities consistent with subdural hematoma. Diagnosis would be confirmed by CT scan, which is less expensive and more sensitive for blood than an MRI.

Intracranial Hemorrhage is covered as part of the PANCE Neurology Blueprint

C. Skull x-rays would not be helpful because they evaluate bony, not soft tissue, injury.
D. A lumbar puncture is contraindicated because of the potential for brain herniation.

7. A post-op patient has signs and symptoms highly suggestive of a pulmonary embolism. The results of the CT scan of the lung is nondiagnostic. What is the most appropriate next step in the evaluation?

A. Ventilation-perfusion (V/Q) scan
B. Ultrasound of the legs
C. Echocardiography
D. D-dimer

Pulmonary embolism and is part of the PANCE Pulmonary Blueprint

Click here to see the answer

Answer: B. Ultrasound of the legs

In a patient with a high likelihood of pulmonary embolism or an inpatient, as in this case, ultrasound of the legs would be the next diagnostic step after a nondiagnostic CT.

A. Ventilation-perfusion scans are performed prior to the CT scan of the chest and would not likely add additional information to this clinical scenario.
C. Although echocardiography may show right ventricular free wall hypokinesis with normal motion of the apex suggestive of pulmonary embolism, more than 50% of patients with a pulmonary embolism will have normal echocardiography. Echocardiography is not used in the diagnosis of inpatients.
D. In a post-op patient, a d-dimer will be positive regardless of the presence or absence of a pulmonary embolism.

8. Seizures that first manifest in early to middle adult life should be considered suspicious of which of the following causes?

A. Cerebrovascular disease
B. Encephalitis
C. Tumor
D. Idiopathic epilepsy

Seizure disorders are covered as part of the PANCE Neurology Blueprint

Click here to see the answer

Answer: C. Tumor

Seizures that develop during adolescence and adult life are predominantly due to tumor, trauma, drug use, or alcohol withdrawal.

9. Which of the following medications used in the treatment of supraventricular tachycardia is able to cause sinus arrest and asystole for a few seconds while it breaks the paroxysmal supraventricular tachycardia?

A. Digoxin (Lanoxin)
B. Adenosine (Adenocard)
C. Verapamil (Calan)
D. Quinidine (Quinaglute)

Paroxysmal supraventricular tachycardia is covered as part of the PANCE Cardiology Blueprint

Click here to see the answer

Answer: B. Adenosine (Adenocard)

Adenosine is an endogenous nucleoside that results in profound (although transient) slowing of the AV conduction and sinus node discharge rate. This agent has a very short half-life of 6 seconds.

A. Digoxin is not used for the acute termination of supraventricular tachycardia.
C. Although verapamil may be used for the termination of acute supraventricular tachycardia, it does not lead to sinus arrest in therapeutic doses.
D. Quinidine is rarely used today and is not indicated for the termination of supraventricular tachycardia.

10. A 32-year-old presents with a 3-day history of diarrhea. The patient denies blood, mucus, or night awakening with diarrhea. He recently returned from a business trip to Canada. On physical examination, the patient is afebrile and vital signs reveal BP 115/80, the pulse is 76, and respirations are 14. The abdominal examination reveals hyperactive bowel sounds but is otherwise unremarkable. Which of the following is the most appropriate initial intervention?

A. Stool for culture, ova, and parasites
B. Proctosigmoidoscopy
C. Metronidazole (Flagyl)
D. Supportive treatment

Infectious and Noninfectious Diarrhea are covered as part of the NCCPA PANCE GI and Nutrition Blueprint

Click here to see the answer

Answer: D. Supportive treatment

Symptomatic treatment, including dietary management and over-the-counter antidiarrheals, is indicated for afebrile patients with watery diarrhea of less than 5 days duration.

A. Stool culture and examination for ova and parasites are indicated when diarrhea has persisted longer than 3 weeks or is associated with abdominal pain, fever, and/or bloody stools.
B. Proctosigmoidoscopy is indicated when inflammatory bowel disease is suspected on the basis of fever, bloody diarrhea, or abdominal pain.
C. Metronidazole is indicated with a confirmed diagnosis of Giardia lamblia or amebic disease.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

pance-and-panre-nccpa-content-blueprint

Download

The post Episode 63: The Audio PANCE and PANRE – Ten Mixed NCCPA™ Content Blueprint Multiple Choice Questions appeared first on The Audio PANCE and PANRE.

]]>
Ten Mixed NCCPA™ PANCE Content Blueprint Multiple Choice Questions Welcome to episode 63 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE cour...
Ten Mixed NCCPA™ PANCE Content Blueprint Multiple Choice Questions
Welcome to episode 63 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).
This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SMARTYPANCE which are now bundled together into one very low price.

* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Practice Exam
If you can’t see the audio player click here to listen to the full episode.
Episode 63 – General PANCE/PANRE Podcast Quiz

The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content.
1. A 24-year-old male presents complaining of a 9-month history of increasing shortness of breath, dyspnea on exertion, and a cough productive of white sputum, mostly in the mornings. He denies orthopnea, PND, peripheral edema, fever, chills, night sweats, recent changes in weight, palpitations, chest pain, food intolerances, or other complaints. Patient has a history of recurrent lung infections. He states that his father had chronic pulmonary problems and died at age 42 from unknown lung disease. The patient denies smoking, alcohol or illicit drug use. On physical examination, the respiratory rate is 22 breaths per minute, a pulse of 98 bpm, a temperature of 98.7 degrees. Pulmonary exam reveals end-expiratory wheezes bilaterally and hyperresonance to percussion.]]>
The Physician Assistant Life | Smarty PANCE clean 17:38 310
Episode 61: The Audio PANCE and PANRE – Ten Mixed NCCPA™ Content Blueprint Multiple Choice Questions http://podcast.thepalife.com/episode-61-the-audio-pance-and-panre-ten-mixed-nccpa-content-blueprint-multiple-choice-questions/ Mon, 14 May 2018 07:53:07 +0000 http://podcast.thepalife.com/?p=303 http://podcast.thepalife.com/episode-61-the-audio-pance-and-panre-ten-mixed-nccpa-content-blueprint-multiple-choice-questions/#respond http://podcast.thepalife.com/episode-61-the-audio-pance-and-panre-ten-mixed-nccpa-content-blueprint-multiple-choice-questions/feed/ 0 <p>Ten Mixed NCCPA™ Content Blueprint Multiple Choice Questions Welcome to episode 61 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will be covering ten general […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/episode-61-the-audio-pance-and-panre-ten-mixed-nccpa-content-blueprint-multiple-choice-questions/">Episode 61: The Audio PANCE and PANRE – Ten Mixed NCCPA™ Content Blueprint Multiple Choice Questions</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Ten Mixed NCCPA™ Content Blueprint Multiple Choice Questions

Welcome to episode 61 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Episode 61 The Audio PANCE and PANRE Board Review PodcastJoin me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SMARTYPANCE which are now bundled together into one very low price.

Listen Carefully Then Take The Practice Exam

If you can’t see the audio player click here to listen to the full episode.

Episode 5 – General PANCE/PANRE Podcast Quiz

The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content.

1. An 18-year-old male presents with pain in his wrist after he fell off of a moving motorcycle. Physical examination reveals tenderness in the anatomic snuffbox. No fracture is noted on plain radiography of the wrist. Which of the following is the recommended treatment for this patient?

A. An ace wrap of the wrist
B. Closed reduction of the fracture site
C. Thumb spica cast application
D. Open reduction of the fracture site

Click here to see the answer

Answer: C. Thumb spica cast application

Even with normal initial radiographs, patients with a consistent history and tenderness in the anatomical snuffbox are treated as a stable fracture with immobilization in a thumb spica cast. Casting is recommended for all presumed nondisplaced scaphoid fractures.

Scaphoid fractures covered in fractures and dislocation of the forearm, wrist, and hand and are part of the NCCPA Endocrinology Musculoskeletal Blueprint (10%)

2. A solitary pulmonary nodule is found on a pre-employment screening chest x-ray in a 34-year-old non-smoking male. There are no old chest x-rays to compare. Which of the following is the most appropriate next step in the evaluation?

A. CT scan of the chest
B. Needle biopsy of the lesion
C. Positron emission tomography of the chest
D. Fiberoptic bronchoscopy

Solitary pulmonary nodules are covered as part of the NCCPA PANCE Blueprint Pulmonary (12%) Content Blueprint (12%)

Click here to see the answer

Answer: A. CT scan of the chest

In the absence of old x-rays in a nonsmoking individual less than 35 years old, CT scan of the chest is the next step in the evaluation of a solitary pulmonary nodule.

B. A needle biopsy would be indicated for a person greater than 35 years old and/or with a history of smoking to evaluate a solitary pulmonary nodule.
C. Positron emission tomography (PET scan) would be indicated if the CT scan was nonconclusive.
D. Fiberoptic bronchoscopy would be indicated only in the presence of a history of tobacco use or if the lesion was suggestive of malignancy.

3. Early clues to impending delirium tremens include

A. agitation and decreased cognition.
B. visual hallucinations and diaphoresis.
C. autonomic hyperactivity and dehydration.
D. mental confusion and sensory hyperacuity.

Delirium tremens is covered as part of the NCCPA Psychiatry content blueprint (6%) under the topic of withdrawal

Click here to see the answer

Answer: A. agitation and decreased cognition.

Anxiety, decreased cognition, tremulousness, increasing irritability, and hyperactivity are common early clues to impending delirium tremens.

Mental confusion, tremor, sensory hyperacuity, visual hallucinations, autonomic hyperactivity, diaphoresis, dehydration, electrolyte disturbances, seizures, and cardiovascular abnormalities are common signs and/or symptoms of full-blown delirium tremens.

4. Dental caries are caused by which of the following organisms?

A. Streptococcus mutans
B. Streptococcus pyogenes
C. Staphylococcus epidermidis
D. Staphylococcus aureus

Dental caries are covered as part of the NCCPA EENT Content Blueprint (9%) under diseases of the teeth and gums

Click here to see the answer

Answer: A. Streptococcus mutans

Streptococcus mutans is the principal organism that helps to demineralize the enamel.

5. The most definitive treatment for primary enuresis is

A. oxybutynin chloride (Ditropan).
B. imipramine (Tofranil).
C. trimethoprim-sulfamethoxazole (Bactrim).
D. desmopressin (DDAVP)

Primary enuresis is covered under incontinence as part of the NCCPA Genitourinary Content Blueprint (6%)

Click here to see the answer

Answer: D. desmopressin (DDAVP)

Intranasal desmopressin is effective in 50% of patients treated and is the treatment of choice.

A. Oxybutynin chloride is used for bladder spasms. It cannot be used for children under 5 years of age and is not indicated in primary enuresis.
B. Imipramine is an older form of treatment that is moderately effective, but many patients relapse when therapy is stopped. This is no longer considered the treatment of choice.
C. TMP-SMX is indicated for urinary tract infections that may cause secondary enuresis, but it is not used in primary enuresis.

6. A 47-year-old female presents to the clinic with complaints of prolonged, heavy menses that have been getting progressively worse for 3 years. She denies any pain. On physical examination, enlargement of the uterus with multiple smooth, spherical, firm masses is noted. A CBC is consistent with a mild anemia. Which of the following is the most likely diagnosis?

A. Leiomyoma
B. Adenomyosis
C. Endometriosis
D. Endometrial polyps

Click here to see the answer

Leiomyoma is covered as part of the NCCPA Reproductive Content Blueprint (8%)

Answer:  A. Leiomyoma

Abnormal uterine bleeding and irregular enlargement of the uterus are most consistent with leiomyoma. Pain is rarely present unless vascular compromise occurs.

B. While adenomyosis may present with hypermenorrhea, dysmenorrhea is often also present. Physical examination would reveal the presence of diffuse globular uterine enlargement, not the irregular enlargement as noted in the case presented.
C. Endometriosis presents with dyspareunia, dysmenorrhea, and infertility. If the pelvic exam were abnormal, uterine findings would include tender nodules in the cul de sac, not the uterus.
D. While endometrial polyps are compatible with the history of abnormal uterine bleeding, the uterus would be normal size without the irregular enlargement noted in the case presented.

7. Which of the following is the laboratory test that marks recovery from Hepatitis B infection and non-infectivity?

A. Hepatitis B surface antibody(anti-HBs)
B. Hepatitis B surface antigen (HBsAg)
C. Hepatitis B core antigen (HBcAg)
D. Hepatitis A antibody (anti-HAV)

Hepatitis B serology is covered as part of acute and chronic hepatitis and is part of the NCCPA GI and Nutrition Content Blueprint (10%)

Click here to see the answer

Answer: A. Hepatitis B surface antibody(anti-HBs)

Specific antibody to HBsAg appears in most individuals after clearance of HBsAg which indicates recovery from hepatitis B infection, non-infectivity, and immunity.

B. This test establishes infection with HBV and implies infectivity.
C. Presence of the hepatitis B core antigen reflects active infection.
D. Patients who have immunity to hepatitis A do not have immunity to hepatitis B.

8. A 36-year-old woman admits that her husband has abused her for over ten years. You should inform the woman that she is at most risk for injury or death

A. just before a holiday.
B. just after leaving an abusive spouse.
C. when an abusive spouse arrives home after work.
D. when an abusive spouse has been drinking heavily.

Domestic violence is covered as part of the NCCPA Psychiatry Content Blueprint (6%)

Click here to see the answer

Answer: B. just after leaving an abusive spouse.

Women are more likely to be assaulted or murdered when attempting to report the abuse or leave the abusive relationship; up to 75% of domestic assaults occur after separation.

9. A patient presents with an acutely painful and cold left leg. Distal pulses are absent. Leg is cyanotic. There are no signs of gangrene or other open lesions. Symptoms occurred one hour ago. Which of the following treatments is most appropriate?

A. Vena cava filter
B. Embolectomy
C. Amputation
D. Aspirin

Arterial embolism/thrombosis is covered as part of the NCCPA Cardiology Content Blueprint (16%)

Click here to see the answer

Answer: B. Embolectomy

Embolectomy within 4 to 6 hours is the treatment of choice.

A. Vena cava filters are used in the management of venous thromboembolic disease when anticoagulation cannot be done.
C. Amputation is done only when no viable tissue is present. Cutting off a viable limb is never a good idea.
D. Aspirin is used in the prevention and treatment of coronary disease and has no role in the treatment of peripheral arterial embolism.

10. A 53-year-old male is seen in the emergency department following a motor vehicle collision in which his knee impacted against the dashboard. The patient has a posterior knee dislocation that is promptly reduced in the emergency department. The patient currently has a palpable pulse in the dorsalis pedis and posterior tibial areas. Which of the following studies is mandatory?

A. Anterior plain film of knee
B. Sunrise view of the knee
C. Measurement of compartment pressures
D. Angiography

Fractures and dislocations of the knee are covered as part of the NCCPA Musculoskeletal Content Blueprint (10%)

Click here to see the answer

Answer: D. Angiography

The popliteal artery is at risk for injury whenever a patient sustains a posterior dislocation of the knee and should be evaluated with an arteriogram despite the presence of pedal pulses.

C. Compartment pressures are performed in cases of suspected compartment syndrome, not to determine the patency of the popliteal artery.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

pance-and-panre-nccpa-content-blueprint

Download

The post Episode 61: The Audio PANCE and PANRE – Ten Mixed NCCPA™ Content Blueprint Multiple Choice Questions appeared first on The Audio PANCE and PANRE.

]]>
Ten Mixed NCCPA™ Content Blueprint Multiple Choice Questions Welcome to episode 61 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course con... Welcome to episode 61 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).
This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SMARTYPANCE which are now bundled together into one very low price.

* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Practice Exam
If you can’t see the audio player click here to listen to the full episode.
Episode 5 – General PANCE/PANRE Podcast Quiz
The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content.
1. An 18-year-old male presents with pain in his wrist after he fell off of a moving motorcycle. Physical examination reveals tenderness in the anatomic snuffbox. No fracture is noted on plain radiography of the wrist. Which of the following is the recommended treatment for this patient?

A. An ace wrap of the wrist
B. Closed reduction of the fracture site
C. Thumb spica cast application
D. Open reduction of the fracture site
2. A solitary pulmonary nodule is found on a pre-employment screening chest x-ray in a 34-year-old non-smoking male. There are no old chest x-rays to compare. Which of the following is the most appropriate next step in the evaluation?
A. CT scan of the chest
B. Needle biopsy of the lesion
C. Positron emission tomography of the chest
D. Fiberoptic bronchoscopy
Solita...]]>
The Physician Assistant Life | Smarty PANCE clean 14:01 303
Episode 59: Emergency Medicine EOR – The Audio PANCE and PANRE Board Review Podcast http://podcast.thepalife.com/episode-59-emergency-medicine-eor-the-audio-pance-and-panre-board-review-podcast/ Mon, 09 Apr 2018 07:01:43 +0000 http://podcast.thepalife.com/?p=298 http://podcast.thepalife.com/episode-59-emergency-medicine-eor-the-audio-pance-and-panre-board-review-podcast/#respond http://podcast.thepalife.com/episode-59-emergency-medicine-eor-the-audio-pance-and-panre-board-review-podcast/feed/ 0 <p>The Audio PANCE/PANRE PA Board Review Podcast Welcome to episode 59 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten Emergency Medicine End of Rotation Exam (EOR) review questions from the SMARTYPANCE course content following the NCCPA™ and PAEA content blueprint (download the FREE cheat sheet). This week […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/episode-59-emergency-medicine-eor-the-audio-pance-and-panre-board-review-podcast/">Episode 59: Emergency Medicine EOR – The Audio PANCE and PANRE Board Review Podcast</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> The Audio PANCE and PANRE Emergency Medicine End of Rotation Exam

The Audio PANCE/PANRE PA Board Review Podcast

Welcome to episode 59 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I cover ten Emergency Medicine End of Rotation Exam (EOR) review questions from the SMARTYPANCE course content following the NCCPA™ and PAEA content blueprint (download the FREE cheat sheet).

This week we will be covering ten emergency medicine end of rotation exam questions based on the NCCPA PANCE and PANRE Content Blueprint. 

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SMARTYPANCE which are now bundled together into one very low price.

Listen Carefully Then Take The Practice Exam

If you can’t see the audio player click here to listen to the full episode.

Episode 59 – Emergency Medicine EOR Podcast Quiz

The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content.

1. During a baseball game, a 22-year-old college student is hit in the right eye by a baseball. He complains of blurry vision in that eye. On physical exam, the physician assistant notes proptosis of the right eye and limitation of movement in all directions. On CT scan, which of the following is most likely to be seen?

A. Fracture of the medial orbital wall
B. Prolapse of orbital soft tissue
C. Hematoma of the orbit
D. Orbital emphysema

Click here to see the answer

Answer: C. Hematoma of the orbit

Orbital hemorrhage into the space surrounding the globe following blunt trauma and rupture of the orbital vessels results in increased ocular pressure, proptosis, visual loss, and limitation of movement in all directions. CT reveals a hematoma.

A. Fracture of the medial orbital wall is associated with diplopia from medial rectus impingement, orbital emphysema, and epistaxis.
B. Prolapse of orbital soft tissue, including inferior rectus muscle, inferior oblique muscle, orbital fat, and connective tissue results in enophthalmos, ptosis, diplopia, anesthesia of the ipsilateral cheek and upper lip, and limitation of upward gaze and is seen with fractures of the orbital floor.
D. Orbital emphysema is seen with fractures of the medial orbital wall or floor of the orbit into the maxillary and ethmoid sinuses respectively. It will not lead to proptosis.

Blowout fractures are covered as part of the NCCPA EENT Content Blueprint which accounts for 9% of your exam.

2. A 29-year-old male presents with a complaint of substernal chest pain for 12 hours. The patient states that the pain radiates to his shoulders and is relieved with sitting forward. The patient admits to recent upper respiratory symptoms. On examination vital signs are BP 126/68, HR 86, RR 20, temp 100.3 degrees F. There is no JVD noted. Heart exam reveals regular rate and rhythm with no S3 or S4. There is a friction rub noted. Lungs are clear to auscultation. EKG shows diffuse ST-segment elevation. What is the treatment of choice for this patient?

A. Pericardiocentesis
B. Nitroglycerin
C. Percutaneous coronary intervention
D. Indomethacin (Indocin)

Click here to see the answer

Answer: D. Indomethacin

Indomethacin, a nonsteroidal anti-inflammatory medication, is the treatment of choice in a patient with acute pericarditis.

A. Pericardiocentesis is the treatment of choice in a patient with a pericardial effusion and cardiac tamponade, there is no evidence of either of these in this patient.
B. Nitroglycerin is indicated in the treatment of chest pain related to angina.
C. Percutaneous coronary intervention is the treatment of choice in a patient with an acute myocardial infarction.

Acute pericarditis is covered the NCCPA Cardiology Content Blueprint which accounts for 16% of your exam.

3. A 19-year-old female presents with a sore throat for nearly two weeks. She complains of fatigue and a low-grade fever. On physical examination, there is cervical, axillary, and inguinal lymphadenopathy, and mild splenomegaly. On review of the blood smear, which of the following would be expected?

A. Atypical lymphocytes
B. Hypersegmented neutrophils
C. Hypochromic red blood cells
D. Schistocytes

Click here to see the answer

Answer: A. Atypical lymphocytes

The hallmark of infectious mononucleosis is the presence of lymphocytosis with atypical large lymphocytes seen in the blood smear. These are larger than normal mature lymphocytes, stain more darkly, and frequently show vacuolated, foamy cytoplasm, and dark chromatin in the nucleus.

B. Hypersegmented neutrophils are seen in vitamin B12 deficiency.
C. Anemia, if seen in mononucleosis, is normocytic and normochromic.
D. Schistocytes are noted in hemolytic anemias.

Mononucleosis as part of the NCCPA Infectious Disease Content Blueprint which accounts for 3% of your exam.

4. A 30-year-old female complains of fatigue, weakness, diminished appetite, weight loss, and syncope. She denies fever, chest or abdominal pain, palpitations, changes in bowel patterns or sleep patterns. Physical examination reveals a thin female, BP 90/65 mmHg, and pulse 80 beats per minute. Pulmonary, cardiovascular, abdominal, and neurologic exam are without abnormalities. Areas of brown and bronze hyperpigmentation are noted on her elbows and the creases of her hands. Which of the following tests will be the most useful in making the diagnosis?

A. Drug screen
B. Urine dipstick
C. Complete blood count
D. Serum creatinine kinase

Click here to see the answer

Answer: D. Serum creatinine kinase

Serum creatinine kinase is the most sensitive test to detect rhabdomyolysis, a serious complication of seizures and hyperthermia related to drug abuse.

A. Although a drug screen may identify specific drugs, the results will not alter the care of this patient.
B. Urine dipstick is not sensitive for myoglobinuria.
C. This patient is at risk for myoglobinuria, and a complete blood count will not alter the treatment.

5. A 15-year-old male was seen last week with complaints of a sore throat, headache, and mild cough. A diagnosis of URI was made and supportive treatment was initiated. He returns today with complaints of worsening cough and increasing fatigue. At this time, chest x-ray reveals bilateral hilar infiltrates. A WBC count is normal and a cold hemagglutinin titer is elevated. The most likely diagnosis is

A. tuberculosis.
B. mycoplasma pneumonia.
C. pneumococcal pneumonia.
D. staphylococcal pneumonia.

Click here to see the answer

Answer: B. mycoplasma pneumonia.

The insidious onset of symptoms, the interstitial infiltrates on chest x-ray, and elevated cold hemagglutinin titer makes this diagnosis the most likely.

A. Most children with pulmonary tuberculosis are asymptomatic with few physical examination findings. The results of the diagnostic studies do not support tuberculosis as the most likely diagnosis.
C. The clinical presentation of bacterial pneumonia in children is variable, but usually involves fever of acute onset. The WBC count is also usually elevated, making this a less likely diagnosis.

Mycoplasma pneumonia is covered as part of the NCCPA Pulmonary Content Blueprint and accounts for 12% of the exam

6. Which of the following clinical manifestations is common in candidal vulvovaginitis?

A. Extreme vulvar irritation
B. Firm, painless ulcer
C. Tender lymphadenopathy
D. Purulent discharge

Click here to see the answer

Answer:  A. Extreme vulvar irritation 

Candida infection presents with pruritus, vulvovaginal erythema, and white, cheese-like (curd) discharge that may be malodorous.

B. A firm painless ulcer is seen in syphilis.
C. Tender lymphadenopathy is associated with bacterial infections and is not a feature of candidal vulvovaginitis.
D. Purulent discharge is noted in gonorrhea.

Vaginitis is covered as part of the NCCPA Reproductive System Content Blueprint and accounts for 8% of the exam

7. A 63-year-old female presents with a complaint of chest pressure for one hour noticed upon awakening. She admits to associated nausea, vomiting, and shortness of breath. 12 lead EKG reveals ST-segment elevation in leads II, III, and AVF. Which of the following is the most likely diagnosis?

A. Aortic dissection
B. Inferior wall myocardial infarction
C. Acute pericarditis
D. Pulmonary embolus

Click here to see the answer

Answer: B. Inferior wall myocardial infarction 

Myocardial infarction often presents with chest pressure and associated nausea and vomiting. ST-segment elevation in leads II, III, and AVF are classic findings seen in acute inferior wall myocardial infarction.

A. A patient with aortic dissection will complain of tearing, ripping pain. EKG is often normal but may reveal left ventricular strain pattern.
C. Acute pericarditis presents with atypical chest pain and diffuse ST-segment elevation.
D. Pulmonary embolism often presents with either no EKG changes or sinus tachycardia. Classically described, rarely seen findings include a large S wave in lead I, a Q wave with T wave inversion in lead III, ST-segment depression in lead II, T wave inversion in leads V1-V4 and a transient right bundle branch block.

Acute myocardial infarction is covered as part of the NCCPA Cardiology Content Blueprint and accounts for 16% of the exam

8. Small grayish vesicles and punched-out ulcers in the posterior pharynx in a child with pharyngitis is representative of which organism?

A. Epstein-Barr virus
B. Group C Streptococcus
C. Coxsackievirus
D. Gonorrhea

Click here to see the answer

Answer: C. Coxsackievirus

Coxsackievirus presents with small grayish vesicles and punched-out ulcers in the posterior pharynx.

A. Epstein-Barr virus presents with enlarged tonsils with exudates and petechiae of the palate.
B. Group C Streptococcus presents with a red pharynx and enlarged tonsils with a yellow, blood tinged exudates
D. Neisseria gonorrhea of the pharynx may be asymptomatic

Coxsackievirus is covered as part of the NCCPA Dermatology Content Blueprint which accounts for 5% of your exam.

9. Which of the following is the most appropriate management of acute psychosis in a patient with schizophrenia?

A. Amitriptyline (Elavil)
B. Risperidone (Risperdal)
C. Lithium (Eskalith)
D. Sertraline (Zoloft)

Click here to see the answer

Answer: B. Risperidone (Risperdal)

There are numerous options used in the management of acute psychosis including benzodiazepines and antipsychotics such as haloperidol (first generation – typical -antipsychotic), risperidone or aripiprazole (second Generation – atypical – antipsychotics). Antidepressants and lithium have no benefit in the treatment of acute psychosis.

Schizophrenia is covered as part of the NCCPA psychiatry Content Blueprint which accounts for 6% of your exam.

10. A 25-year-old presents with pain in the proximal ulna after falling directly on the forearm. X-ray shows a fracture of the proximal 1/3rd of the ulna. There is an associated anterior radial head dislocation. What is the proper name for this condition?

A. Galeazzi fracture
B. Monteggia fracture
C. Colles’ fracture
D. Smith fracture

Click here to see the answer

Answer: B. Monteggia fracture

A Monteggia fracture is a fracture of the proximal ulna with anterior dislocation of the radial head.

A. A Galeazzi fracture is a fracture along the length of the radius with an injury to the distal radioulnar joint.
C. A Colles’ fracture is a fracture of the distal radius with dorsal displacement of the radial head.
D. A Smith fracture is a fracture of the distal radius with a ventral displacement of the radial head.

Monteggia fracture is covered as part of the NCCPA Musculoskeletal Content Blueprint which accounts for 10% of your exam.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

pance-and-panre-nccpa-content-blueprint

Download

The post Episode 59: Emergency Medicine EOR – The Audio PANCE and PANRE Board Review Podcast appeared first on The Audio PANCE and PANRE.

]]> The Audio PANCE/PANRE PA Board Review Podcast Welcome to episode 59 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten Emergency Medicine End of Rotation Exam (EOR) review questions from the SMARTYPANCE c...
The Audio PANCE/PANRE PA Board Review Podcast
Welcome to episode 59 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Join me as I cover ten Emergency Medicine End of Rotation Exam (EOR) review questions from the SMARTYPANCE course content following the NCCPA™ and PAEA content blueprint (download the FREE cheat sheet).
This week we will be covering ten emergency medicine end of rotation exam questions based on the NCCPA PANCE and PANRE Content Blueprint. 
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SMARTYPANCE which are now bundled together into one very low price.

* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.
* Members can take Emergency medicine EOR 1 (200 questions) and Emergency Medicine EOR 2 (184 questions)

Listen Carefully Then Take The Practice Exam
If you can’t see the audio player click here to listen to the full episode.
Episode 59 – Emergency Medicine EOR Podcast Quiz
The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content.
1. During a baseball game, a 22-year-old college student is hit in the right eye by a baseball. He complains of blurry vision in that eye. On physical exam, the physician assistant notes proptosis of the right eye and limitation of movement in all directions. On CT scan, which of the following is most likely to be seen?
A. Fracture of the medial orbital wall
B. Prolapse of orbital soft tissue
C. Hematoma of the orbit
D. Orbital emphysema
2. A 29-year-old male presents with a complaint of substernal chest pain for 12 hours. The patient states that the pain radiates to his shoulders and is relieved with sitting forward.]]>
The Physician Assistant Life | Smarty PANCE clean 18:14 298 Episode 57: Endocrinology – The Audio PANCE/PANRE Board Review Podcast – Content Blueprint Review Endocrinology http://podcast.thepalife.com/episode-57-endocrinology/ Tue, 20 Feb 2018 05:55:20 +0000 http://podcast.thepalife.com/?p=290 http://podcast.thepalife.com/episode-57-endocrinology/#respond http://podcast.thepalife.com/episode-57-endocrinology/feed/ 0 <p>The Audio PANCE/PANRE PA Board Review Podcast Welcome to episode 57 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will be covering ten endocrinology […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/episode-57-endocrinology/">Episode 57: Endocrinology – The Audio PANCE/PANRE Board Review Podcast – Content Blueprint Review Endocrinology</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Episode 57 - Endocrinology NCCPA Content Blueprint Board Review

The Audio PANCE/PANRE PA Board Review Podcast

Welcome to episode 57 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will be covering ten endocrinology board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SMARTYPANCE which are now bundled together into one very low price.

Listen Carefully Then Take The Practice Exam

If you can’t see the audio player click here to listen to the full episode.

Episode 57 – Endocrinology PANCE/PANRE Podcast Quiz

The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content.

1. A 53-year-old Hispanic woman comes to your clinic for her annual physical exam. She is obese, does not exercise, and regularly eats fried foods. A random blood glucose is 249 mg/dL. Her hemoglobin A1C is 9.5. Which of the following treatments would be weight neutral or cause weight loss in this patient?

A. Glargine
B. Glyburide
C. Actos
D. Metformin
E. Glipizide

Diabetes Mellitus Type 2 is covered as part of the NCCPA Endocrinology Content Blueprint which accounts for 6% of your exam.

Click here to see the answer

Answer: D. Metformin

The patient in this vignette most likely has type II diabetes. Of the given treatments, only metformin is weight neutral in the majority of cases (i.e. it does not cause significant weight gain/loss). Metformin is a first-line treatment for type II DM in most patients. Although the exact mechanism is unknown, it appears to decrease gluconeogenesis and increase insulin sensitivity. There is no risk of hypoglycemia or weight gain (though some patients even lose weight). The most high yield side effect involves lactic acidosis, particularly in patients with renal insufficiency. 

A. Glargine, a long-acting insulin, can cause weight gain.
B. Glyburide, a second-generation sulfonylurea, can cause weight gain.
C. Actos, a thiazolidinedione, can cause weight gain.
E. Glipizide, a second-generation sulfonylurea, can cause weight gain.

2. A solitary thyroid nodule is noted on physical examination. The TSH level is normal. The next step in the evaluation is:

A. measurement of T4 and free T3 levels.
B. a radionuclide thyroid scan.
C. a fine needle biopsy.
D. a surgical excision.

Solitary thyroid nodule is covered as part of thyroid neoplastic disease in the NCCPA Endocrinology Content Blueprint which accounts for 6% of your exam.

Click here to see the answer

Answer: C. a fine needle biopsy

Fine needle aspiration (FNA) is the first step in the evaluation of a solitary nodule with a normal TSH level. FNA has a high level of accuracy in diagnosing benign versus malignant nodules in this setting.

A. Measurement of T4 and T3 levels would not be of benefit in the evaluation of a solitary thyroid nodule with a normal TSH level.
B. A thyroid scan would be the next step if there were a low TSH level.
D. Surgical excision would be the final step after determination of malignancy or suspicion of malignancy by FNA.

3. An 18-year-old male with a past medical history of type I diabetes presents to the emergency room with polyuria, polydipsia, and dehydration. Vital signs reveal tachycardia and hypotension. The physical exam is significant for dry mucous membranes and decreased skin turgor. In the waiting room, he begins vomiting and complains of intense abdominal pain. You observe him taking rapid, deep breaths, and over the course of his brief stay, getting more somnolent. Which of the following abnormalities would be expected in this patient?

A. Hypernatremia
B. Decreased total body potassium
C. Hypoglycemia
D. Absence of urinary beta-OH-butyrate
E. Non-anion-gap metabolic acidosis

Diabetic ketoacidosis is covered under Diabetes Mellitus Type 1 as part of the NCCPA Endocrinology Content Blueprint which accounts for 6% of your exam.

Click here to see the answer

Answer: B. Decreased total body potassium

This type I diabetic is presenting with signs and symptoms of diabetic ketoacidosis (DKA). In DKA, total body potassium stores are generally decreased due to osmotic diuresis. DKA is a life-threatening emergency that may occur in either type I or type II diabetics but is significantly more common in patients with type I. The pathogenesis is related to insulin deficiency resulting in hyperglycemia that leads to osmotic diuresis and hypovolemia. The inability of the body to use the available glucose for ATP production results in ketone formation and eventually an anion gap metabolic acidosis. Serum potassium levels may be low, normal, or elevated, but total body stores are generally low and require repletion. Common precipitating factors include infection, trauma, myocardial infarction, sepsis and, of course, inadequate insulin administration. Patients may present with nausea, vomiting, abdominal pain, Kussmaul respirations (rapid, deep breaths), dehydration, polydipsia, polyuria and may eventually progress to altered mental status.

A. Patients with DKA more often present with hyponatremia. Remember that serum sodium decreases 1.6 mEq/L for every 100 mg/dL increase in glucose.
C. DKA requires hyperglycemia by definition. Hypoglycemia can be a complication of treatment if glucose is not monitored closely.
D. Ketones, such as Beta-OH-Butyrate, are commonly found in patients with DKA since ketogenesis is a normal response to starvation caused by the inadequate transit of serum glucose into cells.
E. Patients with DKA present with an anion-gap metabolic acidosis secondary to ketoacids.

4. A 30-year-old female complains of fatigue, weakness, diminished appetite, weight loss, and syncope. She denies fever, chest or abdominal pain, palpitations, changes in bowel patterns or sleep patterns. Physical examination reveals a thin female, BP 90/65 mmHg, and pulse 80 beats per minute. Pulmonary, cardiovascular, abdominal, and neurologic exam are without abnormalities. Areas of brown and bronze hyperpigmentation are noted on her elbows and the creases of her hands. Which of the following is the most likely diagnosis?

A. Addison’s disease
B. Cushing’s disease
C. Anorexia nervosa
D. Porphyria

This condition is covered as part of the NCCPA Endocrinology Content Blueprint and accounts for 6% of the exam

Click here to see the answer

Answer: A. Addison’s disease

Addison’s disease (adrenal insufficiency) would account for all her symptoms, the hypotension, and the hyperpigmentation of the skin.

B. Cushing’s disease, the presence of an ACTH-producing adenoma, is characterized by central obesity, hypertension, moon facies, purple striae, and glucose intolerance.
C. Anorexia nervosa may explain the weakness, weight loss, hypotension, and syncope, however, a normal pulse rate would be an unexpected finding along with the hyperpigmentation.
D. Porphyria presents acutely with anxiety, depression, disorientation, and insomnia.

5. A 39-year-old male presents to your clinic complaining of increasing constant headaches and progressive loss of peripheral vision. His medical and family history is unremarkable. Physical examination reveals bitemporal hemianopsia but is otherwise without any abnormalities. Which of the following is the most likely diagnosis?
Answers

A. An aneurysm involving the circle of Willis
B. A migraine headache
C. Multiple sclerosis
D. Pituitary tumor

This condition is covered as part of the NCCPA Endocrinology Content Blueprint and accounts for 6% of the exam

Click here to see the answer

Answer: D. A pituitary tumor 

A pituitary tumor would account for the headaches and the loss of the peripheral vision in both visual fields. As the tumor grows, the optic chiasm will be compressed by the tumor.

A. An aneurysm involving the circle of Willis would result in CN III palsy. This would be a rare finding.
B. Although a migraine headache may produce visual field defects, these defects would remit upon resolution of the migraine. It would also be unusual to have the scotomas occur bilaterally.
C. Optic neuritis associated with multiple sclerosis presents with decreased visual acuity, dimness, or color desaturation in the central visual field. It would not affect the periphery.

6. Radioactive iodine is most successful in treating hyperthyroidism that results from

A. Grave’s disease.
B. subacute thyroiditis.
C. Hashimoto’s thyroiditis.
D. papillary thyroid carcinoma.

Watch this ReelDx Video of a 16-year-old with ADHD presents with chest pain and exophthalmos

Diseases of the thyroid gland are covered as part of the NCCPA Endocrinology Content Blueprint and accounts for 6% of the exam

Click here to see the answer

Answer:  A. Grave’s disease.

Radioactive iodine is an excellent method to destroy overactive thyroid tissue of Grave’s disease.

B. Radioactive iodine is ineffective in subacute thyroiditis due to the thyroid’s low uptake of iodine.
C. Radioiodine uptake is low in Hashimoto’s thyroiditis and is often transient.
D. Papillary thyroid carcinoma is a common thyroid malignancy and must be treated by a thyroidectomy.

7. A newborn infant exhibits prolonged jaundice, feeding problems, hypotonia, and an enlarged tongue. Proper treatment in this infant would consist of which of the following?

A. IV antibiotics
B. Thyroid hormone replacement
C. Hepatitis B immunoglobulin
D. Vitamin B6 supplement

This condition is covered as part of the NCCPA Endocrinology Content Blueprint and accounts for 6% of the exam

Click here to see the answer

Answer: B. Thyroid hormone replacement 

This scenario is consistent with congenital hypothyroidism. Measurement of TSH or T4 would confirm this and T4 should be given.

C. Hepatitis and sepsis may account for the presence of jaundice, feeding problems, and hypotonia, but would not result in an enlarged tongue.
D. A deficiency in vitamin B6 may lead to glossitis but would not account for or any of the other signs.

8. Which of the following glucose-lowering agents act by delaying glucose absorption?

A. Metformin (Glucophage)
B. Acarbose (Precose)
C. Glipizide (Glucotrol)
D. Pioglitazone (Actos)

Diabetes Mellitus Type 2 and associated medications are covered as part of the NCCPA Endocrinology Content Blueprint which accounts for 6% of your exam.

Click here to see the answer

Answer: B. Acarbose (Precose)

Alpha-glucosidase inhibitors, such as acarbose, reduce glucose by delaying glucose absorption.

A. Metformin, a biguanide, lowers glucose by decreasing hepatic glucose production and increased glucose utilization.
C. Glipizide and other sulfonylureas work by increasing insulin secretion.
D. Pioglitazone is a thiazolidinedione and decreases insulin resistance and increases glucose utilization.c

9. Which of the following conditions may result in hypokalemia?

A. Adrenal adenoma
B. Hypoparathyroidism
C. Hyperthyroidism
D. Adrenal insufficiency

Diseases of the Adrenal Glands are covered as part of the NCCPA Endocrinology Content Blueprint which accounts for 6% of your exam.

Click here to see the answer

Answer: A. Adrenal adenoma

Excessive secretion of aldosterone from an adrenal adenoma will lead to sodium retention and the secretion of potassium in the distal tubule of the kidney, eventually leading to hypokalemia.

B. Hypoparathyroidism and hyperthyroidism should not have any effect on potassium levels.
D. Adrenal insufficiency would lead to hyperkalemia.

10. A 7-year-old child with a history of type 1 diabetes mellitus for 3 years presents for routine follow-up. The mother states that the child has been having nightmares and night sweats. Additionally, his average morning glucose readings have risen from an average of 100 mg/dL to 145 mg/dL over the past week. This child is most likely experiencing

A. a growth spurt.
B. emotional problems.
C. the Somogyi effect.
D. the dawn phenomenon.

The Somogyi effect and the dawn phenomenon are covered under Diabetes Mellitus Type 1 as part of the NCCPA Endocrinology Content Blueprint which accounts for 6% of your exam.

Click here to see the answer

Answer: C. the Somogyi effect.

This refers to nocturnal hypoglycemia, which stimulates counter-regulatory hormone release resulting in rebound hyperglycemia.

A. Nightmares and night sweats are not associated with growth spurts.
B. With this limited history, it is impossible to label the child as emotionally unstable.
D. This refers to an early morning rise in plasma glucose due to reduced tissue sensitivity to insulin between 5 AM and 8 AM. It is not associated with nightmares and night sweats.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

pance-and-panre-nccpa-content-blueprint

Download

The post Episode 57: Endocrinology – The Audio PANCE/PANRE Board Review Podcast – Content Blueprint Review Endocrinology appeared first on The Audio PANCE and PANRE.

]]>
The Audio PANCE/PANRE PA Board Review Podcast Welcome to episode 57 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following ...
The Audio PANCE/PANRE PA Board Review Podcast
Welcome to episode 57 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).
This week we will be covering ten endocrinology board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SMARTYPANCE which are now bundled together into one very low price.

* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Practice Exam
If you can’t see the audio player click here to listen to the full episode.
Episode 57 – Endocrinology PANCE/PANRE Podcast Quiz
The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content.
1. A 53-year-old Hispanic woman comes to your clinic for her annual physical exam. She is obese, does not exercise, and regularly eats fried foods. A random blood glucose is 249 mg/dL. Her hemoglobin A1C is 9.5. Which of the following treatments would be weight neutral or cause weight loss in this patient?
A. Glargine
B. Glyburide
C. Actos
D. Metformin
E. Glipizide
Diabetes Mellitus Type 2 is covered as part of the NCCPA Endocrinology Content Blueprint which accounts for 6% of your exam.
2. A solitary thyroid nodule is noted on physical examination. The TSH level is normal. The next step in the evaluation is:
A. measurement of T4 and free T3 levels.
B. a radionuclide thyroid scan.
C.]]>
The Physician Assistant Life | Smarty PANCE clean 17:07 290
Episode 55: The Audio PANCE and PANRE Board Review Podcast – Mixed Content Blueprint Review http://podcast.thepalife.com/episode-55-audio-pance-panre-board-review-podcast-mixed-content-blueprint-review/ Thu, 30 Nov 2017 05:41:24 +0000 http://podcast.thepalife.com/?p=285 http://podcast.thepalife.com/episode-55-audio-pance-panre-board-review-podcast-mixed-content-blueprint-review/#respond http://podcast.thepalife.com/episode-55-audio-pance-panre-board-review-podcast-mixed-content-blueprint-review/feed/ 0 <p>Welcome to episode 55 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will be covering ten general board review questions based on the NCCPA PANCE […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/episode-55-audio-pance-panre-board-review-podcast-mixed-content-blueprint-review/">Episode 55: The Audio PANCE and PANRE Board Review Podcast – Mixed Content Blueprint Review</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Episode 55 The Audio PANCE and PANRE Physician Assistant Board ReviewWelcome to episode 55 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SMARTYPANCE which are now bundled together into one very low price.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Episode 55 PANCE and PANRE Podcast Quiz

The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content.

1. Which of the following physical examination findings would be consistent with a pleural effusion?

A. Hyperresonance to percussion
B. Increased tactile fremitus
C. Unilateral lag on chest expansion
D. Egophony

Pleural effusions are covered as part of the NCCPA Content Blueprint Pulmonology section which accounts for 10% of the exam

View this ReelDx patient video case of a 68-year-old female complaining of bilateral chest pain and difficulty breathing. Included in this lesson is the Picmonic explaning Light’s Criteria.

Click here to see the answer

Answer: C. Unilateral lag on chest expansion

A lag on chest expansion may be seen in the presence of a pleural effusion.

A. Hyperresonance to percussion would be suggestive of emphysema or pneumothorax.
B. Increased tactile fremitus would be consistent with a consolidation.
D. The presence of egophony would be consistent with a consolidation.

2. A 55 year-old female presents with complaints of stiffness, aching, and pain in the muscles of her neck, shoulders, lower back, hips, and thighs. There is no associated weakness associated with the stiffness and achiness. Laboratory evaluation shows an elevated C reactive protein and erythrocyte sedimentation rate. Which of the following medications is used to treat this condition immediately and will also serve to prevent a known complication from this disorder?

A. Glucocorticoids
B. Cyclophosphamide (Cytoxan)
C. Methotrexate (Rheumatrex)
D. Azathioprine (Imuran)

This condition is covered as part of the NCCPA Musculoskeletal Content Blueprint and accounts for 10% of the exam

Click here to see the answer

Answer: A. Glucocorticoids

This patient has polymyalgia rheumatica and treatment with glucocorticoids can relieve discomfort and prevent the associated ischemic temporal arteritis, which threatens vision.

B. Cyclophosphamide is an immunosuppressant used in the treatment of acute leukemia.
C. Methotrexate is a folate inhibitor used to treat rheumatoid arthritis, not polymyalgia rheumatica.
D. Azathioprine is an immunosuppressant that is used to treat rheumatic disease and inflammatory bowel disease, not polymyalgia rheumatica.

3. A 35 year-old pregnant patient presents with fever, chills, and left-sided flank pain. On physical examination left-sided CVA tenderness is noted. Urinalysis reveals numerous white blood cells and white blood cell casts. Which of the following is the most appropriate treatment?

A. Oral ciprofloxacin (Cipro)
B. Oral trimethoprim-sulfamethoxazole (Bactrim)
C. IV gentamicin (Garamycin)
D. IV ceftriaxone (Rocephin)

This condition is covered as part of the NCCPA Genitourinary Content Blueprint and accounts for 6% of the exam

Click here to see the answer

Answer: D. IV ceftriaxone (Rocephin)

IV cephalosporins are first line treatment of pyelonephritis in a pregnant patient, followed by oral step-down therapy.

A. See B for explanation.
B. The fluoroquinolones and trimethoprim-sulfamethoxazole are contraindicated in pregnancy.
C. Gentamicin is not indicated as first line therapy in the treatment of pyelonephritis in a pregnant patient.

4. A 26 year-old female arrives in the emergency department with friends who say she was standing in front of her church, dressed in a white bathrobe, claiming to be the Virgin Mary and handing out $100 bills to all passers-by. Her friends noted that she had been depressed lately, but now seems completely euphoric. She had a similar episode two years ago. Which of the following is the most appropriate treatment?

A. Inpatient olanzapine (Zyprexa) therapy
B. Inpatient electroconvulsive therapy
C. Outpatient paroxetine (Paxil) therapy
D. Outpatient psychotherapy

This condition is covered as part of the NCCPA Psychiatry Content Blueprint and accounts for 6% of the exam

Click here to see the answer

Answer: A. Inpatient olanzapine (Zyprexa) therapy

Treatment of the manic phase is usually done in the hospital to protect patients from behaviors associated with grandiosity (spending inordinate amounts of money, making embarrassing speeches, etc.). Lithium, valproate, and olanzapine are considered effective in the manic stage; the depressive stage is treated with
antidepressants.

5. A 19 year-old patient was involved in a motor vehicle crash and brought to the emergency department fully immobilized. The patient sustained multiple blunt injuries to the chest and abdomen. During the trauma assessment, there was no blood at the urethral meatus and a Foley catheter was placed. The urine was positive for blood on the dipstick. Which of the following is the most appropriate diagnostic test

A. Retrograde urethrography
B. CT scan of abdomen and pelvis
C. Serum haptoglobin
D. Urine myoglobin

Click here to see the answer

Answer: B. CT scan of abdomen and pelvis

CT scan of the abdomen and pelvis is indicated in blunt trauma including those resulting in hematuria or when renal injury is suspected.

A. A retrograde urethrogram should be performed when blood is found at the external urinary meatus prior to insertion of a catheter.
C. A decreased serum haptoglobin is seen in hemolysis and does not provide information on renal status.
D. A positive test for blood in the absence of red blood cells on urine examination suggests myoglobinuria, and should be confirmed by electrophoresis.

6. A 48 year-old male presents with complaints of heartburn that occurs approximately 45 minutes after eating about three times a week that is relieved by antacids. He claims to have followed advice about elevating the head of the bed, avoiding spicy foods, and losing weight, but continues to have heartburn. Which of the following is the most appropriate next step?

A. Ranitidine (Zantac)
B. Sucralfate (Carafate)
C. Metoclopramide (Reglan)
D. Misoprostol (Cytotec)

GERD (Gastroesophageal reflux disease) is covered as part of the NCCPA GI and Nutrition Content Blueprint and accounts for 10% of the exam

Click here to see the answer

Answer: A. Ranitidine (Zantac)

Ranitidine, an H2 receptor blocker, is indicated for the treatment of mild, intermittent symptoms of gastroesophageal reflux disease.

B. Sucralfate is used in the treatment of duodenal ulcers.
C. Metoclopramide is indicated for the treatment of gastroparesis as a first-line agent and as a second-line agent in the treatment of refractory gastroesophageal reflux.
D. Misoprostol is indicated for the prevention of NSAID-induced gastritis.

7. Radioactive iodine (I131) is most successful in treating hyperthyroidism that results from

A. Grave’s disease.
B. subacute thyroiditis.
C. Hashimoto’s thyroiditis.
D. papillary thyroid carcinoma.

Watch this ReelDx Video of a 16-year-old with ADHD presents with chest pain and exophthalmos

Diseases of the thyroid gland are covered as part of the NCCPA Endocrinology Content Blueprint and accounts for 6% of the exam

Click here to see the answer

Answer: A. Grave’s disease.

Radioactive iodine (I131) is an excellent method to destroy overactive thyroid tissue of Grave’s disease.

B. Radioactive iodine is ineffective in subacute thyroiditis due to the thyroid’s low uptake of iodine.
C. Radioiodine uptake is low in Hashimoto’s thyroiditis making radioactive therapy ineffective.
D. Papillary thyroid carcinoma is a common thyroid malignancy and should be treated by a thyroidectomy.

8. An 8 year-old boy is brought to a health care provider complaining of dyspnea and fatigue. On physical examination, a continuous machinery murmur is heard best in the second left intercostal space and is widely transmitted over the precordium. The most likely diagnosis is

A. ventricular septal defect
B. atrial septal defect
C. congenital aortic stenosis
D. patent ductus arteriosus

This disorder is covered as part of the NCCPA Cardiology Content Blueprint and accounts for 9% of the exam

Click here to see the answer

Answer: D. patent ductus arteriosus.

Patent ductus arteriosus is classically described in children as a continuous machinery-type murmur that is widely transmitted across the precordium.

A. Ventricular septal defect causes a holosystolic murmur rather than a continuous machinery-like murmur.
B. Atrial septal defect causes a fixed split S2 rather than a continuous systolic heart murmur.
C. Congenital aortic stenosis causes a crescendo-decrescendo systolic murmur heard best in the second intercostal space.

9. A 63 year-old male with history of hypertension and tobacco abuse presents complaining of dyspnea on exertion for two weeks. The patient admits to one episode of chest discomfort while shoveling snow which was relieved after five minutes of rest. Vital signs are BP 130/70, HR 68, RR 14. Heart exam reveals regular rate and rhythm, normal S1 and S2, no murmur, gallop, or rub. Lungs are clear to auscultation bilaterally. There is no edema noted. Which of the following is the most appropriate initial diagnostic study for this patient?

A. Helical CT scan
B. Chest x-ray
C. Nuclear stress test
D. Cardiac catheterization

Angina is covered as part of the NCCPA Cardiology Content Blueprint which accounts for 10% of the exam

Click here to see the answer

Answer: C. Nuclear stress test

In patients with classic symptoms of angina, nuclear stress testing is the most widely used test for diagnosis of ischemic heart disease.

A. Helical CT scan aids in the diagnosis of pulmonary embolism, not in the evaluation of angina.
B. Chest x-ray is not used as a diagnostic study to evaluate symptoms of angina or coronary heart disease.
D. Coronary angiography is indicated in patients with classic stable angina who are severely symptomatic despite medical therapy and are being considered for percutaneous intervention (PCI), patients with troublesome symptoms that are difficult to diagnose, angina symptoms in a patient who has survived sudden cardiac death event, patients with ischemia on noninvasive testings.

10. A 52 year-old male with history of hypertension and hyperlipidemia presents with an acute myocardial infarction. Urgent cardiac catheterization is performed and shows a 90% occlusion of the left anterior descending artery. The other arteries have minimal disease. Ejection fraction is 45%. Which of the following is the treatment of choice in this patient?

A. Coronary artery bypass grafting (CABG)
B. Streptokinase
C. Percutaneous coronary intervention (PCI)
D. Warfarin (Coumadin)

Acute myocardial infarction [Non-ST-segment elevation (NSTEMI)] and [ST-segment elevation myocardial infarction (STEMI)] are covered as part of the NCCPA Cardiology Content Blueprint which represents 16% of your exam

Click here to see the answer

Answer: C. Percutaneous coronary intervention (PCI)

Immediate coronary angiography and primary percutaneous coronary intervention have been shown to be superior to thrombolysis.

A. Percutaneous coronary intervention is a better, less invasive alternative to CABG for single vessel coronary artery disease.
B. Streptokinase is not commonly used for the treatment of acute myocardial infarction because it is ineffective at opening the occluded artery and reducing mortality. Streptokinase would be harmful because it would increase the risk of bleeding.
D. Warfarin is used to prevent thrombosis and not for acute treatment.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

pance-and-panre-nccpa-content-blueprint

Download

The post Episode 55: The Audio PANCE and PANRE Board Review Podcast – Mixed Content Blueprint Review appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 55 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FRE... Welcome to episode 55 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).
This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SMARTYPANCE which are now bundled together into one very low price.

* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Episode 55 PANCE and PANRE Podcast Quiz
The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content.
1. Which of the following physical examination findings would be consistent with a pleural effusion?
A. Hyperresonance to percussion
B. Increased tactile fremitus
C. Unilateral lag on chest expansion
D. Egophony
Pleural effusions are covered as part of the NCCPA Content Blueprint Pulmonology section which accounts for 10% of the exam

View this ReelDx patient video case of a 68-year-old female complaining of bilateral chest pain and difficulty breathing. Included in this lesson is the Picmonic explaning Light’s Criteria.
2.]]>
The Physician Assistant Life | Smarty PANCE clean 19:30 285
Episode 53: General Surgery End of Rotation Exam – The Audio PANCE and PANRE Podcast http://podcast.thepalife.com/episode-53-general-surgery-end-rotation-exam-audio-pance-panre-podcast/ Thu, 05 Oct 2017 06:03:07 +0000 http://podcast.thepalife.com/?p=280 http://podcast.thepalife.com/episode-53-general-surgery-end-rotation-exam-audio-pance-panre-podcast/#respond http://podcast.thepalife.com/episode-53-general-surgery-end-rotation-exam-audio-pance-panre-podcast/feed/ 0 <p>Welcome to episode 53 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet) and the PAEA End of Rotation™ Exams Blueprints & Topic Lists. This week we will be […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/episode-53-general-surgery-end-rotation-exam-audio-pance-panre-podcast/">Episode 53: General Surgery End of Rotation Exam – The Audio PANCE and PANRE Podcast</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> General Surgery End of Rotation Exam - The Audio PANCE and PANRE Board Review Podacst - The PA Life and SMARTY PANCEWelcome to episode 53 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I cover ten PANCE and PANRE Board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet) and the PAEA End of Rotation™ Exams Blueprints & Topic Lists.

This week we will be covering ten General Surgery End of Rotation Exam Questions that are now part of the SMARTYPANCE website. 

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SMARTYPANCE which are now bundled together into one very low price.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Episode 51: General Surgery Endo of Rotation Exam Podcast Quiz

The following 10 questions are linked to NCCPA™ Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content.

1. An 18-year-old patient has a tibia/fibula fracture following a motorcycle crash. Twelve hours later the patient presents with increased pain despite adequate doses of analgesics and immobilization. Which of the following is the most likely diagnosis?

A. avascular necrosis
B. myositis ossificans
C. compartment syndrome
D. reflex sympathetic dystrophy

Click here to see the answer

Answer: C. Compartment syndrome

Compartment syndrome is characterized by a pathological increase of pressure within a closed space and results from edema or bleeding within the compartment. It may occur as an early local complication of fracture.

A. Avascular necrosis occurs primarily in muscles post-traumatically and may not arise for several months after an injury.

B. Myositis ossificans is a late complication of fracture resulting from disruption of the blood supply to the bone.

D. Reflex sympathetic dystrophy is characterized by painful wasting of the hand muscles that may be secondary to injury and could occur as a late complication.

2. A 25-year-old male presents to the ED with left calf pain and cramping, as well as nausea and vomiting. He admits to “partying with cocaine all night”. He describes his urine as a dark brown color. Serum creatinine kinase (CK) is 1325 IU/L (Normal Range 32-267 IU/L). Which of the following is the initial mainstay of therapy for this condition?

A. IV rehydration
B. Fasciotomy
C. Toradol (Ketorolac)
D. Hydrotherapy

Click here to see the answer

Answer: A. IV rehydration

IV rehydration with crystalloids for 24 to 72 hours is the mainstay of therapy for rhabdomyolysis.

B. Fasciotomy is indicated for compartment syndrome.

C. NSAIDs, such as Toradol (Ketorolac), should not be used due to the vasoconstrictive effects on the kidneys.

D. Hydrotherapy is not useful or indicated for Rhabdomyolysis

3. A 42-year-old male presents complaining of a sudden onset of a severe intermittent pain originating in the flank and radiating into the right testicle. He also complains of nausea and vomiting. On examination, the patient is afebrile but restless. Examination of the abdomen reveals tenderness to palpation along the right flank with no rebound or direct testicular tenderness. Urinalysis reveals a pH of 5.4 and microscopic hematuria but is otherwise unremarkable. Which of the following is the most likely diagnosis?

A. Bladder cancer
B. Nephrolithiasis
C. Acute appendicitis
D. Acute epididymitis

Click here to see the answer

Answer: B. Nephrolithiasis

A sudden onset of severe colicky flank pain associated with nausea and vomiting as well as the absence of rebound or direct testicular tenderness makes nephrolithiasis the most likely diagnosis. This is further supported by the presence of hematuria on the urinalysis.

A. While bladder cancer may have associated microscopic hematuria, it presents with painless hematuria or irritative voiding symptoms.

C. While an acute abdomen, such as acute appendicitis, is in the differential diagnosis, the absence of fever and peritoneal signs makes this diagnosis less likely

D. The absence of fever, as well as non-tenderness to palpation of the testes, suggests a renal rather than gonadal cause of the patient’s symptoms

4. What is the term for blue discoloration about the umbilicus?

A. Cullen’s sign
B. Murphy’s sign
C. Rovsing’s sign
D. Turner sign

Click here to see the answer

Answer: A. Cullen’s sign

Cullen’s sign is a blue discoloration about the umbilicus and can occur in hemorrhagic pancreatitis and results from hemoperitoneum.

B. Murphy’s sign is seen in liver and gallbladder disease by which the patient abruptly halts deep inspiration due to pain in the right upper quadrant while the examiner’s hand is keeping stable pressure to the area.

C. Rovsing’s sign is positive when the patient experiences right-sided abdominal pain with palpation to the left side. This is generally seen in those with appendicitis.

D. Turner sign is also seen in severe, acute pancreatitis but is represented by a green-brown discoloration of bilateral flanks

5. A 25-year-old female presents with right lower quadrant pain, right flank pain, nausea, and vomiting. Her temperature is 39.6 degrees C. There is right CVA tenderness and RLQ tenderness. The pelvic exam is unremarkable. Urinalysis reveals pH 7.0, trace protein, negative glucose, negative ketones, positive blood, and positive nitrates. Specific gravity is 1.022. Microscopy shows 102 RBCs/HPF, 50-75 WBCs/HPF, rare epithelial cells, and WBC casts. The most likely diagnosis is

A. acute salpingitis
B. nephrolithiasis
C. acute pyelonephritis
D. appendicitis

Click here to see the answer

Answer: C. acute pyelonephritis

Acute pyelonephritis presents with flank pain, fever, and generalized muscle tenderness. Urinalysis shows pyuria with leukocyte casts.

A. Acute salpingitis would be suggested if pelvic exam abnormalities were present.

B. Nephrolithiasis does not usually present with fever or casts. Urinalysis will have RBCs present.

D. This scenario is consistent with acute pyelonephritis, not acute appendicitis.

6. A 26-year-old gravida 0 sexually active female presents to the emergency room complaining of colicky pain in her lower abdomen for the past 12 hours. She passed out earlier in the day while trying to have a bowel movement. Her last menstrual period was 6 weeks ago. She has noted vaginal spotting over the last 24 hours. Vital signs show Temp 37 degrees C, BP 96/60mmHg, P 110, R 16, Oxygen Sat. 98%. Abdominal exam is positive for distension and tenderness. Bowel sounds are decreased. Pelvic exam shows cervical motion and adnexal tenderness. Which of the following is the most likely diagnosis?

A. Ectopic pregnancy 
B. Appendicitis 
C. Crohn’s disease 
D. Pelvic inflammatory disease

Click here to see the answer

Answer: A. Ectopic pregnancy 

High suspicion for ectopic pregnancy should be maintained when any possible pregnant woman presents with vaginal bleeding or abdominal pain.

B. Appendicitis presents with nausea, vomiting and periumbilical pain that moves to the right lower quadrant of the abdomen.

C. Crohn’s disease is more common in women and may present with an acute abdomen. However, the pelvic examination would be normal.

D. In pelvic inflammatory disease, the temperature is usually above 38 degrees C and pelvic pain usually follows onset of cessation of menses

7. A 12-year-old boy presents to the office with pain in his legs with activity gradually becoming worse over the past month. He is unable to ride a bicycle with his friends due to the pain in his legs. Examination of the heart reveals an ejection click and accentuation of the second heart sound. Femoral pulses are weak and delayed compared to the brachial pulses. Blood pressure obtained in both arms is elevated. Chest x-ray reveals rib notching. Which of the following is the most likely diagnosis?

A. abdominal aortic aneurysm
B. pheochromocytoma
C. coarctation of the aorta
D. thoracic outlet syndrome

Click here to see the answer

Answer: C. coarctation of the aorta

Coarctation is a discrete or long segment of narrowing adjacent to the left subclavian artery. As a result of the coarctation, systemic collaterals develop. X-ray findings occur from the dilated and pulsatile intercostal arteries and the “3” is due to the coarctation site with proximal and distal dilations.

A. Abdominal aortic aneurysm is usually asymptomatic until the patient has dissection or rupture. It is uncommon in a child.

B. Pheochromocytoma classically causes paroxysms of hypertension due to catecholamine release from the adrenal medulla but does not cause variations in blood pressure in the upper and lower extremities.

D. Thoracic outlet syndrome occurs when the brachial plexus, subclavian artery, or subclavian vein becomes compressed in the region of the thoracic outlet. It is the most common cause of acute arterial occlusion in the upper extremity of adults under 40 years old

8. A 28-year-old male presents with burns sustained from hot grease splashed on his left hand earlier this afternoon. The burn extends from his palm to the volar aspect of his wrist and has an erythematous base, covered by an intact blister. There are a few small scattered blisters over the dorsum of the left hand. Which of the following is the initial intervention of choice?

A. Tetanus prophylaxis 
B. Admission to a burn unit 
C. Intravenous fluid administration 
D. Debridement of blisters

Click here to see the answer

Answer: A. Tetanus prophylaxis

Tetanus prophylaxis should be initially considered in all burn patients

B. Admission to a burn unit is not indicated for adult patients with uncomplicated partial thickness burns covering less than 15 to 20% of total body surface area (TBSA).

C. IV fluids are indicated for severe partial thickness burns covering more than 10% TBSA or in burns with complications.

D. Debridement of blisters is controversial, however blisters on the palms and soles should remain intact.

9. Which of the following is the selected method for the prevention of venous thromboembolism in a 38-year-old male undergoing an inguinal hernia repair?

A. early ambulation
B. elastic stockings
C. intermittent pneumatic compression
D. low-molecular weight heparin

Click here to see the answer

Answer: A. early ambulation 

Early ambulation is recommended for prophylaxis of venous thromboembolism in low-risk, minor procedures when the patient is under 40 years of age and there are no clinical risk factors.

B. Elastic stockings are indicated for patients at moderate risk of venous thromboembolism in ages 40-60 with minor procedures with additional thrombosis risk factor, or major operations for patients under age 40 without additional clinical risk factors.

C. Intermittent pneumatic compression is indicated in patients undergoing a major operation plus an increased risk of bleeding.

D. Low molecular weight heparin is indicated in patients undergoing orthopedic surgery, neurosurgery, or trauma with an identifiable risk factor for thromboembolism.

10. A patient presents with abdominal pain in the right lower quadrant, examination reveals increased pain in the right lower quadrant on deep palpation of the left lower quadrant. This is commonly known as which of the following?

A. Psoas sign
B. Murphy’s sign
C. Rovsing’s sign
D. Obturator sign

Click here to see the answer

Answer: C. Rovsing’s sign 

A positive Rovsing’s sign can be elicited in a patient with appendicitis when increased pain occurs in the right lower quadrant upon palpation of the left lower quadrant. 

A. Psoas sign is right lower quadrant pain with right leg extension seen in acute appendicitis

B. Murphy’s sign is seen in liver and gallbladder disease in which the patient abruptly halts deep inspiration due to discomfort as the examiner’s hand applies pressure to the right upper quadrant.

D. Obturator sign is right lower quadrant pain with internal rotation of the hip seen in acute appendicitis

Appendicitis: RLQ pain, + Obturator and Psoas sign

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

pance-and-panre-nccpa-content-blueprint

FREE Download

The post Episode 53: General Surgery End of Rotation Exam – The Audio PANCE and PANRE Podcast appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 53 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE ch... Welcome to episode 53 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Join me as I cover ten PANCE and PANRE Board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet) and the PAEA End of Rotation™ Exams Blueprints & Topic Lists.
This week we will be covering ten General Surgery End of Rotation Exam Questions that are now part of the SMARTYPANCE website. 
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SMARTYPANCE which are now bundled together into one very low price.

* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Episode 51: General Surgery Endo of Rotation Exam Podcast Quiz
The following 10 questions are linked to NCCPA™ Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content.
1. An 18-year-old patient has a tibia/fibula fracture following a motorcycle crash. Twelve hours later the patient presents with increased pain despite adequate doses of analgesics and immobilization. Which of the following is the most likely diagnosis?
A. avascular necrosis
B. myositis ossificans
C. compartment syndrome
D. reflex sympathetic dystrophy
2. A 25-year-old male presents to the ED with left calf pain and cramping, as well as nausea and vomiting.]]>
The Physician Assistant Life | Smarty PANCE clean 19:22 280
Episode 51: The Audio PANCE and PANRE Board Review Podcast – Comprehensive Audio Quiz http://podcast.thepalife.com/episode-51-audio-pance-panre-board-review-podcast-comprehensive-audio-quiz/ Tue, 11 Jul 2017 16:40:07 +0000 http://podcast.thepalife.com/?p=271 http://podcast.thepalife.com/episode-51-audio-pance-panre-board-review-podcast-comprehensive-audio-quiz/#respond http://podcast.thepalife.com/episode-51-audio-pance-panre-board-review-podcast-comprehensive-audio-quiz/feed/ 0 <p>Welcome to episode 51 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will be covering ten general board review questions based on the NCCPA PANCE […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/episode-51-audio-pance-panre-board-review-podcast-comprehensive-audio-quiz/">Episode 51: The Audio PANCE and PANRE Board Review Podcast – Comprehensive Audio Quiz</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> The Audio PANCE and PANRE Physician Assistant Board Review Episode 51Welcome to episode 51 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I cover ten PANCE and PANRE Board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SmartyPANCE which are now bundled together into one very low price.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Episode 51 PANCE and PANRE Podcast Quiz

The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content.

1. A 42-year-old male with a history of constipation presents with complaints of severe pain with defecation described as feeling like he is “tearing apart.” He has also noted occasional small amounts of blood on toilet paper. External examination of the rectum is unremarkable and an internal rectal exam cannot be performed due to severe pain when attempted. Which of the following is the most likely diagnosis?

A. Proctitis
B. Anal fissure
C. Rectal prolapse
D. Internal hemorrhoids

Anal fissures are covered as part of the NCCPA Content Blueprint GI and Nutrition which accounts for 10% of the exam

View this ReelDx patient video case of a 51-year-old with rectal bleeding and abdominal pain (proctitis)

Click here to see the answer

Answer: B. Anal fissures

Anal fissures are easily diagnosed from history alone with the classic finding of severe pain upon defecation. Constipation is also a common cause of the trauma that leads to the development of a fissure.

A. Proctitis is usually caused by anorectal infections that produce symptoms of anorectal discomfort, tenesmus, constipation, and discharge from the rectum.
C. Rectal prolapse is commonly seen in elderly females with complaints that include an anal mass, rectal bleeding and a change in bowel habits.
D. While internal hemorrhoids may cause rectal bleeding, tearing pain is an uncommon complaint unless there is evidence of thrombosis of irreducible tissue.

2. What type of chest pain is most commonly associated with a dissecting aortic aneurysm?

A. Squeezing
B. Dull, aching
C. Ripping, tearing
D. Burning

Dissecting aortic aneurysm is covered as part of the NCCPA Cardiology Content Blueprint and accounts for 16% of the exam

Click here to see the answer

Answer: C. A dissecting aortic aneurysm often presents with a very severe ripping, tearing like pain.

A dissecting aortic aneurysm often presents with a very severe ripping, tearing like pain.

A. Squeezing pain is more characteristic of angina or esophageal pain.
B. Dull, aching pain is more characteristic of chest wall pain, possibly angina, or anxiety.
D. Burning pain is more characteristic of esophageal reflux, esophagitis, or tracheobronchitis.

3. A 15-year-old softball player presents after jamming the distal tip of her finger into severe flexion. She is unable to extend the distal phalanx and she has pain on palpation of the distal interphalangeal joint. X-ray of the hand fails to reveal any associated avulsion fracture. Which of the following is the treatment of choice?

A. Open reduction and internal fixation
B. Continuous extension of the DIP with splinting
C. Continuous flexion of the PIP with splinting
D. Application of short arm cast

Soft tissue injuries of the forearm, wrist, and hand are covered as part of the NCCPA Musculoskeletal Content Blueprint and accounts for 10% of the exam

Click here to see the answer

Answer: B. Continuous extension of the DIP with splinting

The treatment of choice for a tear in the extensor tendon of the finger is continuous extension of the DIP via splinting for 6 to 8 weeks.

D. Short arm casting is indicated in wrist and metacarpal injuries but not in DIP extensor injuries.

4. A patient presents with loss of pigmentation on the back of hands, face, and body folds due to the absence of epidermal melanocytes. There has been improvement with PUVA treatment. Which of the following is the most likely diagnosis?

A. Pityriasis alba
B. Tinea versicolor
C. Vitiligo
D. Melasma

View this ReelDx patient video case of a 7-year-old female with localized, depigmented skin patches; rash

Click here to see the answer

Answer: C. Vitiligo

 Vitiligo is the acquired loss of pigmentation due to the absence of epidermal melanocytes presenting on the back of hands, face, or body folds.

A. Pityriasis alba is caused by dermal inflammation that becomes scaly and hypopigmented.
B. Tinea versicolor is a fungal infection of the skin presenting as oval or circular lesions
D. Melasma is an acquired brown hyperpigmentation involving the face and neck in women during their second or third trimester of pregnancy.

5. Which of the following medications used in the management of anxiety has a delayed onset of action?

A. Buspirone (BuSpar)
B. Diphenhydramine (Benadryl)
C. Lorazepam (Ativan)
D. Butalbital (Fiorinal)

Anxiety disorders are covered as part of the NCCPA Content Psychiatry Blueprint which accounts for 6% of your exam

Click here to see the answer

Answer: A. buspirone (BuSpar)

Buspirone takes several days to weeks for it to have clinical activity.

B. Diphenhydramine works as a histamine blocker and will cause sedation immediately because of its anticholinergic effects.
C. Lorazepam is an anxiolytic medication that has an immediate onset of activity.
D. Butalbital is a short to intermediate-acting barbiturate that has immediate activity.

6. A 57-year-old male was working on his farm when some manure was slung hitting his left eye. He presents several days after with a red, tearing, painful eye. Fluorescein stain reveals uptake over the cornea looking like a shallow crater. Which of the following interventions would be harmful?

A. Ophthalmic antibiotics
B. Pressure patch
C. Examination for visual acuity
D. Copious irrigation

Corneal abrasion is covered as part of the NCCPA EENT Content Blueprint and accounts for 9% of the exam

Click here to see the answer

Answer: B. Pressure patch

Patching of the eye after a corneal abrasion associated with organic material contamination is contraindicated due to increased risk of fungal infection.

A. Ophthalmic antibiotics and copious irrigation are indicated when treating a patient with a suspected corneal ulcer due to an infectious cause.
C. Examination for assessment of visual acuity should be performed.

7. A 75-year-old female falls on her outstretched arm. She sustains a humeral mid-shaft fracture. Nerve impingement occurs due to the fracture. What is the most likely physical examination abnormality that will be encountered?

A. Inability to extend the wrist against resistance
B. Numbness over the deltoid muscle in the shoulder
C. Winging of the scapula
D. Weakness of the rotator cuff

Fractures and dislocations of the forearm, wrist, and hand are covered as part of the NCCPA Musculoskeletal Content Blueprint and accounts for 10% of the exam

Click here to see the answer

Answer: D. Inability to extend the wrist against resistance

The radial nerve is most likely entrapped by this fracture. Radial nerve damage will cause an inability to extend the wrist against resistance.

B. Axillary nerve injury results in numbness over the deltoid muscle; this nerve is more commonly injured in proximal humeral fractures and anterior shoulder dislocations.
C. Injury to the long thoracic nerve causes winging of the scapula due to its innervation of the serratus anterior muscle.
D. Injury to the subscapular nerve results in weakness and pain of the infraspinatus muscle; this injury is commonly seen in volleyball players from repetitive stress.

8. A 16-year-old male involved in a fight sustained a laceration to his right upper eyelid. He is unable to open his eye, and a possible laceration of the globe is suspected. Which of the following is the next step?

A. Use a slit lamp to determine the extent of the injury.
B. Use fluorescein strips to determine the extent of the injury.
C. Apply a metal eye shield and refer to an ophthalmologist.
D. Apply antibiotic ointment to the lid and recheck in 24 hours.

Disorders of they eye are covered as part of the NCCPA EENT Content Blueprint and accounts for 9% of the exam

Blowout Fracture

66-year-old female with acute onset of periorbital deformitySmartyPANCE ReelDx + members can view this real-world case!

Click here to see the answer

Answer: C. Apply a metal eye shield and refer to an ophthalmologist.

Protect the eye from any pressure with a rigid metal eye shield and refer for immediate ophthalmologic consultation. Avoid unnecessary actions that would delay treatment or cause further injury.

9. Which of the following typical findings would be revealed during a sigmoidoscopy on a patient with Crohn’s disease of the intestine?

A. Rectal pseudopolyps
B. Diffuse ulceration and bleeding
C. Sheets of WBCs with inflamed mucosa
D. Intermittent longitudinal mucosal ulcers and fissures

Inflammatory bowel disease is covered as part of the NCCPA Content Blueprint GI and Nutrition which accounts for 10% of the exam

Click here to see the answer

Answer: D. Intermittent longitudinal mucosal ulcers and fissures

Ulcerations tend to be linear with transverse fissures in Crohn’s disease. These skip lesions are common with Crohn’s disease.

A. Rectal pseudopolyps are associated with ulcerative colitis rather than Crohn’s.
B. Diffuse ulcerations and bleeding are more characteristic of ulcerative colitis than Crohn’s disease.
C. Sheets of WBCs or “pseudomembranes” can be detected in patients with pseudomembranous colitis.

10. A 72-year-old patient with a history of hypertension and atrial fibrillation presents with episodes of weakness, numbness, and paresthesia’s in the right arm. At the same time, she notes speech difficulty and loss of vision in her left eye. These symptoms come on abruptly and clear within minutes. Physical examination is normal except for the previously known arrhythmia. Which of the following is the most likely diagnosis?

A. Focal seizure
B. Migraine headache
C. Hypoglycemic episodes
D. Transient ischemic attack

Atrial fibrillation is covered as part of the NCCPA Cardiology Content Blueprint which is 16% of your exam

SmartyPANCE + ReelDx members can view this ReelDx patient case video of an 83-year-old with fast heart rate, palpitations

Click here to see the answer

Answer: D. Transient ischemic attack

This patient’s symptoms are consistent with transient ischemia in the carotid territory. Atrial fibrillation is a risk factor for cerebral emboli.

A. Focal seizures usually cause abnormal motor movement rather than weakness or loss of feeling.
B. Patients with migraines commonly have a history of episodes since adolescence.
C. Hypoglycemic episodes do not present with focal neurological findings.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

pance-and-panre-nccpa-content-blueprint

FREE Download

The post Episode 51: The Audio PANCE and PANRE Board Review Podcast – Comprehensive Audio Quiz appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 51 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE ch... Welcome to episode 51 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Join me as I cover ten PANCE and PANRE Board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet).
This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SmartyPANCE which are now bundled together into one very low price.

* You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Episode 51 PANCE and PANRE Podcast Quiz
The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content.
1. A 42-year-old male with a history of constipation presents with complaints of severe pain with defecation described as feeling like he is “tearing apart.” He has also noted occasional small amounts of blood on toilet paper. External examination of the rectum is unremarkable and an internal rectal exam cannot be performed due to severe pain when attempted. Which of the following is the most likely diagnosis?
A. Proctitis
B. Anal fissure
C. Rectal prolapse
D. Internal hemorrhoids
Anal fissures are covered as part of the NCCPA Content Blueprint GI and Nutrition which accounts for 10% of the exam
]]>
The Physician Assistant Life | Smarty PANCE clean 17:39 271
Episode 49: The Audio PANCE and PANRE Board Review Podcast – Comprehensive Audio Quiz http://podcast.thepalife.com/episode-49/ Tue, 16 May 2017 18:40:58 +0000 http://podcast.thepalife.com/?p=262 http://podcast.thepalife.com/episode-49/#respond http://podcast.thepalife.com/episode-49/feed/ 0 <p>Welcome to episode 49 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will be covering 10 general board review questions based on the NCCPA PANCE […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/episode-49/">Episode 49: The Audio PANCE and PANRE Board Review Podcast – Comprehensive Audio Quiz</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> The Audio PANCE and PANRE Episode 49Welcome to episode 49 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I cover ten PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will be covering 10 general board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SmartyPANCE.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Episode 49 PANCE and PANRE Podcast Quiz

The following 10 questions are linked to NCCPA Content Blueprint lessons from the SmartyPANCE PANCE and PANRE board review website. If you are a member and login you will be able to view this content.

1. Which of the following clinical findings would be seen in a patient with food poisoning caused by Staphylococcus aureus?

A. Ingestion of mayonnaise-based salads 48 hours earlier
B. Bloody diarrhea with mucus for one week
C. Abdominal cramps and vomiting for 48 hours
D. High fever for 1 week

Staphylococcus aureus food poisoning is part of the NCCPA Content Blueprint GI and Nutrition which accounts for 10% of the exam

Click here to see the answer

Answer: C. Abdominal cramps and vomiting for 48 hours

Abdominal cramps, nausea, vomiting, and watery diarrhea typically last 1-2 days with staphylococcal food poisoning.

A. A preformed toxin causes staphylococcal food poisoning; it has a short incubation period of 1-8 hours.
B. Because Staphylococcus aureus does not invade the mucus, blood and mucus are not seen with this noninflammatory cause of food poisoning.
D. Staphylococcal food poisoning may be associated with low-grade fever or subnormal temperature.

2. Which of the following diagnostic tests should be ordered initially to evaluate for suspected deep venous thrombosis

A. Venogram
B. Arteriogram
C. Duplex ultrasound
D. Impedance plethysmography

Venous thrombosis is part of the NCCPA Cardiology Content Blueprint and represents 16% of the exam

Click here to see the answer

Answer: C. Duplex ultrasound

Ultrasound is the technique of choice to detect deep venous thrombosis in the leg.

A. Venogram has been replaced by noninvasive tests due to discomfort, cost, technical difficulties, and complications, such as phlebitis.
B. Thrombophlebitis is a venous problem, not an arterial one. Any unnecessary invasive procedure is potentially harmful.
D. Impedance plethysmography is equivalent to ultrasound in detecting thrombi of the femoral and popliteal veins, but it may miss early, nonocclusive thrombi.

3. A patient presents with signs and symptoms of Cushing’s syndrome. Extensive diagnostic evaluation reveals an ACTH-secreting pituitary adenoma. First-line therapy should consist of

A. pituitary radiation
B. medical adrenalectomy
C. transsphenoidal resection of the tumor
D. amiloride (Midamor)

Cushings disease is part of the NCCPA Content Blueprint Endocrinology which represents 6% of your exam

Click here to see the answer

Answer: C. transsphenoidal resection of the tumor

Transsphenoidal resection of the tumor cures about 80% of patients. The remainder can be given a combination of pituitary radiation and medical adrenalectomy with one or more drugs. If these procedures fail, the last option is bilateral adrenalectomy.

4. A 26-year-old man is stung by a bee, and shortly thereafter, a wheal develops at the site of the sting. He soon feels flushed and develops hives, rhinorrhea, and tightness in the chest. He is seen in the urgent care center. Immediate therapy should be to

A. transfer him to a local hospital emergency department
B. apply a cold compress to site of the sting
C. administer subcutaneous epinephrine
D. administer oral albuterol

Click here to see the answer

Answer: C. administer subcutaneous epinephrine

Epinephrine hydrochloride 1:1000, 0.2 to 0.5 mL subcutaneously is indicated for the initial treatment of this systemic reaction. Additional injections may be given every 20 to 30 minutes if needed.

A. Systemic (anaphylactic) reactions can rapidly become life-threatening. Delay in treatment may cause death.
B. This is only supportive local therapy and does not address the need to treat the systemic reaction present.
D. Albuterol is indicated in the presence of bronchospasm (suggested by the presence of chest tightness) but would be delivered by an aerosol, not an oral, route.

5. An 18-year-old sexually active female was seen in the student health clinic 1 week ago for a sore throat. A streptococcal antigen test was positive, and she was given a prescription for oral penicillin. After 3 days, she stopped her medication because she felt better. She now presents with a severe sore throat. On physical examination, she has a temperature of 102.6° F (39.2° C), marked pharyngeal erythema, medial deviation of the soft palate on the left, tender left anterior cervical adenopathy, and a “hot potato” voice. The rest of her history and physical examination are unremarkable. Which of the following is the most likely diagnosis?

A. Recurrent streptococcal pharyngitis
B. Infectious mononucleosis
C. Gonococcal pharyngitis
D. Peritonsillar abscess

Peritonsillar abscess is covered as part of the NCCPA Content Blueprint EENT which accounts for 6% of your exam

Peritonsillar abcess

View this ReelDx patient video case ~4d pain back of throat; swelling; difficulty swallowing

SmartyPANCE ReelDx + members can view this real-world case!

Click here to see the answer

Answer: D. Peritonsillar abscess

The soft palate deviation and a muffled voice are classic signs of peritonsillar abscess.

A. This presentation suggests a complication of an incompletely treated streptococcal pharyngitis rather than recurrent disease
B. Infectious mononucleosis may present with a severe sore throat and cervical adenopathy in this age group, but would not cause deviation of the soft palate or the muffled voice
C. Gonococcal pharyngitis usually follows a more indolent course than this patient’s presentation

6. Which of the following would provide the most specific information regarding the functional cardiac status in a patient with chronic heart failure?

A. Electrocardiogram
B. Chest x-ray
C. Serum electrolytes
D. Echocardiogram

Heart Failure is covered as part of the NCCPA Content Blueprint Cardiology and accounts for 16% of the exam

Heart Failure 2

View this SMARTYPANCE ReelDx patient video case: 45-year-old female with difficulty breathing; edema; 8/10 chest pain and whole-body pain

SmartyPANCE ReelDx + members can view this real-world case!

Click here to see the answer

Answer: D. Echocardiogram

An echocardiogram will estimate ejection fraction, which is an indicator of left ventricular function.

A. Electrocardiogram offers no specific information of functional status but may provide clues about the cause.
B. A chest x-ray may show findings of chronic heart failure, such as cardiomegaly or pulmonary congestion, but does not reflect cardiac functional status.
C. Serum electrolytes may be abnormal, either as a result of heart failure, or as a contributing factor, but they do not indicate functional status.

7.  A 33-year-old female presents for follow-up of her Pap smear that showed a low-grade squamous intraepithelial lesion. Reflex HPV testing is positive. Which of the following is the most appropriate diagnostic procedure?

A. Cone biopsy
B. Aspiration needle biopsy
C. Dilation and curettage
D. Colposcopy-directed biopsy

Cervical dysplasia and cervical cancer are covered as part of the NCCPA Content Blueprint Reproductive system and accounts for 8% of your exam

Click here to see the answer

Answer: D. Colposcopy-directed biopsy

A colposcopy-directed biopsy is the first diagnostic evaluation indicated for cervical dysplasia.

A. A cervical cone biopsy may be indicated in further evaluation of this patient, but it is dependent on the results of the colposcopy.
B. An aspiration needle biopsy has no role in the evaluation of cervical dysplasia.
C. Dilatation and curettage has no role in either the diagnosis or treatment of isolated cervical dysplasia.

8. A decrease in the fetal heart rate (FHR) occurring late during contractions is noted. The FHR returns to the baseline slowly after the uterine contraction. The physician assistant should be alerted to the possibility of

A. pelvic dystocia
B. precipitous labor
C. fetal head compression
D. placental insufficiency

Fetal distress is covered as part of the NCCPA Content Blueprint Reproductive system and accounts for 8% of your exam

SmartyPANCE ReelDx + members can view this real-world case!

Click here to see the answer

Answer: D. placental insufficiency

Placental insufficiency is the probable cause of fetal distress resulting in late decelerations.

A. Pelvic dystocia, particularly that due to small bony architecture, is the most common cause of passage abnormalities and is not directly associated with FHR decelerations.
B. This refers to the length of labor, not decelerations in FHR.
C. The drop in FHR is caused by an interference with uterine blood flow to the intervillous space causing an early, not late, deceleration.

9. A 36-year-old patient with cardiomyopathy secondary to viral myocarditis develops fatigue, increasing dyspnea, and lower extremity edema over the past 3 days. He denies fever. A chest x-ray shows no significant increase in heart size but reveals prominence of the superior pulmonary vessels. Based on these clinical findings, which of the following is the most likely diagnosis?

A. Heart failure
B. Subacute bacterial endocarditis
C. Pulmonary embolus
D. Pneumonia

Heart Failure is covered as part of the NCCPA Content Blueprint Cardiology and accounts for 16% of the exam

Click here to see the answer

Answer: A. Heart failure

Given the presence of cardiomyopathy, the patient’s heart has decreased functional reserve. The symptoms and chest x-ray findings are typical of congestive heart failure.

B. Endocarditis occurs as a result of an infection that primarily occurs in the blood stream. Endocarditis would present with signs of infection or seeding rather than signs of heart failure.
C. Pulmonary embolus usually presents with an acute onset of chest pain, severe dyspnea, and anxiety.
D. Pneumonia is less likely since there is no fever and edema is not usually associated with pneumonia.

10. Which of the following is the first-line treatment for symptomatic bradyarrhythmias due to sick sinus syndrome (SSS)?

A. Permanent pacemaker
B. Radiofrequency ablation
C. Antiarrhythmics
D. Anticoagulation therapy

Sick sinus syndrome is covered as part of the NCCPA Cardiology Content Blueprint which is 16% of your exam

Click here to see the answer

Answer: A. Permanent pacemaker

Permanent pacemakers are the therapy of choice in patients with symptomatic bradyarrhythmias in sick sinus syndrome.

B. Radiofrequency ablation is used for the treatment of accessory pathways in the heart.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

pance-and-panre-nccpa-content-blueprint

FREE Download

The post Episode 49: The Audio PANCE and PANRE Board Review Podcast – Comprehensive Audio Quiz appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 49 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE ch... Welcome to episode 49 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Join me as I cover ten PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet).
This week we will be covering 10 general board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and SmartyPANCE.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Episode 49 PANCE and PANRE Podcast Quiz
The following 10 questions are linked to NCCPA Content Blueprint lessons from the SmartyPANCE PANCE and PANRE board review website. If you are a member and login you will be able to view this content.
1. Which of the following clinical findings would be seen in a patient with food poisoning caused by Staphylococcus aureus?
A. Ingestion of mayonnaise-based salads 48 hours earlier
B. Bloody diarrhea with mucus for one week
C. Abdominal cramps and vomiting for 48 hours
D. High fever for 1 week
Staphylococcus aureus food poisoning is part of the NCCPA Content Blueprint GI and Nutrition which accounts for 10% of the exam
2. Which of the following diagnostic tests should be ordered initially to evaluate for suspected deep venous thrombosis
A. Venogram
B. Arteriogram
C. Duplex ultrasound
D. Impedance plethysmography
Venous thrombosis is part of the NCCPA Cardiology Content Blueprint and represents 16% of the exam
3. A patient presents with signs and symptoms of Cushing’s syndrome. Extensive diagnostic evaluation reveals an ACTH-secreting pituitary adenoma. First-line therapy should consist of
A. pituitary radiation
B. medical adrenalectomy
C. transsphenoidal resection of the tumor
D. amiloride (Midamor)
clean 18:13 262
Episode 47: The Audio PANCE and PANRE Podcast – Mixed Content Blueprint Board Review http://podcast.thepalife.com/episode-47-audio-pance-panre-podcast-mixed-content-blueprint-board-review/ Wed, 01 Mar 2017 06:23:50 +0000 http://podcast.thepalife.com/?p=253 http://podcast.thepalife.com/episode-47-audio-pance-panre-podcast-mixed-content-blueprint-board-review/#respond http://podcast.thepalife.com/episode-47-audio-pance-panre-podcast-mixed-content-blueprint-board-review/feed/ 0 <p>Welcome to episode 47 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will be covering 10 general board review questions based on the NCCPA PANCE […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/episode-47-audio-pance-panre-podcast-mixed-content-blueprint-board-review/">Episode 47: The Audio PANCE and PANRE Podcast – Mixed Content Blueprint Board Review</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Episode 47 Welcome to episode 47 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will be covering 10 general board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full genitourinary board review includes over 72 GU specific questions and is available to all members of the PANCE and PANRE Academy and SmartyPANCE

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Episode 47 PANCE and PANRE Podcast Quiz

The following 10 questions are linked to NCCPA Content Blueprint lessons from the SmartyPANCE PANCE and PANRE board review website. If you are a member and login you will be able to view this content.

1. To relieve dependent edema in a pregnant patient, which of the following should be instituted as treatment?

  1. Limit fluid intake
  2. Elevate the legs
  3. Prescribe thiazide diuretics
  4. Strict avoidance of sodium

Uncomplicated pregnancy is part of the NCCPA Content Blueprint Reproductive System which is 8% of the exam

Click here to see the answer

Answer: B. Elevate the legs.

Dependent edema is a common and rarely serious complication of pregnancy due to impedance of venous return. Leg elevation improves circulation

A. Limitation of fluid is not indicated and may be harmful.
C. Thiazide diuretics are contraindicated and could be harmful.
D. Edema due to impedance of venous return will not respond to sodium restriction.

2. To further assess ascites in a patient, the physician assistant instructs the patient to turn onto one side while performing percussion. Which of the following is the reason for this maneuver?

  1. Testing for shifting of dullness on percussion
  2. Shifting of internal organs making percussion easier
  3. Trying to elicit any pain while moving
  4. Trying to produce a caput medusae

Ascites is a common complication of liver disease. Disorders of the liver is part of the NCCPA GI and Nutrition Content Blueprint and represents 10% of the exam

Click here to see the answer

Answer:  A. Testing for shifting of dullness on percussion.

In ascites, dullness shifts to the more dependent side as the fluid relocates into dependent space, while tympany shifts to the top as the gas-filled organs float to the top of the ascitic fluid

C. Pain with movement is associated with peritonitis and not ascites.
D. Caput medusae is the dilation of the superficial abdominal veins due to increased intra abdominal fluid accumulation. It is visible with the patient standing and does not need a special maneuver for identification.

3.  A 7-year-old child with a history of type 1 diabetes mellitus for 3 years presents for routine follow-up. The mother states that the child has been having nightmares and night sweats. Additionally, his average morning glucose readings have risen from an average of 100 mg/dL to 145 mg/dL over the past week. This child is most likely experiencing

  1. a growth spurt
  2. emotional problems
  3. the Somogyi effect
  4. the dawn phenomenon

Diabetes mellitus type 1 is part of the NCCPA Content Blueprint Endocrinology which represents 6% of your exam

Click here to see the answer

Answer: C. the Somogyi effect.

This refers to nocturnal hypoglycemia, which stimulates counterregulatory hormone release resulting in rebound hyperglycemia

A. Nightmares and night sweats are not associated with growth spurts.
B. With this limited history, it is impossible to label the child as emotionally unstable.
D. This refers to an early morning rise in plasma glucose due to reduced tissue sensitivity to insulin between 5AM and 8AM. It is not associated with nightmares and night sweats.

4. A patient complains of loss of sensation at the level of the umbilicus. Which of the following dermatomes is affected?

  1. T6
  2. T8
  3. T10
  4. T12

Radicular pain is a common symptom of a herniated nucleus pulposus covered as part of the NCCPA Content Blueprint Musculoskeletal System which is 10% of your exam

Click here to see the answer

Answer: C. T10.

The dermatome T10 is at the level of the umbilicus.

5. A 25-year-old female graduate student presents to the student health center for the eighth time in three weeks to be sure she does not have meningitis. She read that there was a student on campus who had meningitis last month, and now she has headaches and is requesting to be tested to make sure she does not have meningitis. She has been evaluated at each visit, and physical examination has been completely normal each time. Which of the following is the most likely diagnosis?

  1. Conversion disorder
  2. Hypochondriasis
  3. Malingering
  4. Somatization disorder

Somatoform disorders are covered as part of the NCCPA Content Blueprint Psychiatry which is 6% of your exam

Click here to see the answer

Answer: B. Hypochondriasis.

Hypochondriasis is the chronic preoccupation with the idea of having a serious disease, which is usually not amenable to reassurance

A. Conversion disorder is characterized by onset of symptoms or deficits mimicking neurologic or medical illness, but the etiology is psychological.
C. Malingering is the intentional production or feigning of physical or psychological signs and symptoms for some gain.
D. Somatization disorder is characterized by complaints of pain, often related to gastrointestinal and sexual dysfunction, and pseudoneurological symptoms

6. What is the mechanism for the relapsing fevers associated with malaria?

  1. Release of malarial merozoites into the bloodstream
  2. Release of toxins from Plasmodium species
  3. Attachment of Plasmodium species to receptor sites on the red blood cells
  4. Invasion of hepatocytes by Plasmodium species

Malaria is covered as part of the NCCPA Content Blueprint Infectious Disease and is 3% of the exam

Click here to see the answer

Answer: A. Release of malarial merozoites into the bloodstream.

Fever, chills, and sweats coincide with the release of merozoites from red blood cells that have been infected with Plasmodium species. Each merozoite may infect a new red blood cell, leading to a cycle of invasion growth, and release.

7. A 29-year-old patient with idiopathic thrombocytopenia purpura (ITP) is treated with prednisone therapy. Despite therapy, platelet counts remain consistently below 20,000/microliter over the course of 6 weeks. Which of the following is the most appropriate intervention for this patient?

  1. Aspirin
  2. Intravenous immunoglobulin
  3. Danazol (Danocrine)
  4. Splenectomy

Idiopathic thrombocytopenic purpura is covered as part of the NCCPA Content Blueprint Hematology and is 3% of your exam

Click here to see the answer

Answer: D. Splenectomy

Persistently low platelet counts (< 20,000) require effective long-term treatment, and splenectomy is the treatment of choice.

A. Aspirin inhibits platelet function and could lead to significant bleeding and death of this patient.
B. Intravenous immunoglobulin can be utilized for short-term treatment, but the platelet count is likely to return to baseline within a month.
C. Danazol is typically reserved for ITP that fails to respond to splenectomy.

8. A 27 year-old female presents to your office for evaluation of weakness, visual loss, and sensory loss over the right great toe. These symptoms have occurred during three episodes approximately three months apart with each episode lasting about three days. Which of the following tests would be most useful in further evaluating this patient?

  1. MRI of the brain
  2. Electromyography
  3. Glucose tolerance test
  4. Electroencephalograph

This condition is covered as part of the NCCPA Content Blueprint Neurology which is 6% of your exam

SmartyPANCE ReelDx + members can view this real-world case!

MS

Click here to see the answer

Answer: A. MRI of the brain.

Multiple sclerosis typically presents with relapsing weakness of the limbs, sensory loss, paresthesias, and visual changes. Diagnosis is based on history and either abnormal brain or spinal cord MRI, or visual, auditory, or somatosensory evoked electrical response.

C. Glucose tolerance test is used in the evaluation of diabetes mellitus.
D. Electroencephalograph is used to evaluate patients for possible seizure disorder.

9. A patient taking bleomycin (Blenoxane) should be monitored for which of the following side effects?

  1. Optic neuritis
  2. Hyperuricemia
  3. Encephalopathy
  4. Pulmonary fibrosis

This condition is is covered as part of the NCCPA Pulmonary Content Blueprint which represents 12% of your exam

Click here to see the answer

Answer: D. Pulmonary fibrosis.

Pulmonary fibrosis and pulmonary infiltrates are known side effects of bleomycin

A. Optic neuritis is a potential side effect of ethambutol, used in the treatment of tuberculosis.
B. Hyperuricemia or encephalopathy are not known side effects of bleomycin.

10. A patient presents for a follow-up visit for chronic hypertension. Which of the following findings may be noted on the fundoscopic examination of this patient?

  1. cherry-red fovea
  2. boxcar segmentation of retinal veins
  3. papilledema
  4. arteriovenous nicking

This condition is a common complications of chronic hypertension covered as part of the NCCPA Cardiology Content Blueprint which is 16% of your exam

Click here to see the answer

Answer: D. arteriovenous nicking

Arteriovenous nicking is common in chronic hypertension

A. Cherry-red fovea and boxcar segmentation of the retinal veins are findings seen in central retinal artery occlusion.
C. Papilledema is noted in conditions causing increased intracranial pressure.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SmaryPANCE

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Links From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

Download The Content Blueprint Checklist

Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

pance-and-panre-nccpa-content-blueprint

FREE Download

The post Episode 47: The Audio PANCE and PANRE Podcast – Mixed Content Blueprint Board Review appeared first on The Audio PANCE and PANRE.

]]> Welcome to episode 47 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE che... Welcome to episode 47 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet).
This week we will be covering 10 general board review questions based on the NCCPA PANCE and PANRE Content Blueprint. 
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full genitourinary board review includes over 72 GU specific questions and is available to all members of the PANCE and PANRE Academy and SmartyPANCE

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Episode 47 PANCE and PANRE Podcast Quiz
The following 10 questions are linked to NCCPA Content Blueprint lessons from the SmartyPANCE PANCE and PANRE board review website. If you are a member and login you will be able to view this content.
1. To relieve dependent edema in a pregnant patient, which of the following should be instituted as treatment?

* Limit fluid intake
* Elevate the legs
* Prescribe thiazide diuretics
* Strict avoidance of sodium

Uncomplicated pregnancy is part of the NCCPA Content Blueprint Reproductive System which is 8% of the exam
2. To further assess ascites in a patient, the physician assistant instructs the patient to turn onto one side while performing percussion. Which of the following is the reason for this maneuver?

* Testing for shifting of dullness on percussion
* Shifting of internal organs making percussion easier
* Trying to elicit any pain while moving
* Trying to produce a caput medusae

Ascites is a common complication of liver disease. Disorders of the liver is part of the NCCPA GI and Nutrition Content Blueprint and represents 10% of the exam
3.  A 7-year-old child with a history of type 1 diabetes mellitus for 3 years presents for routine follow-up. The mother states that the child has been having nightmares and night sweats. Additionally, his average morning glucose readings have risen from an average of 100 mg/dL to 145 mg/dL over the past week. This child is most likely experiencing

]]>
The Physician Assistant Life | Smarty PANCE clean 17:34 253 Murmur Madness: The Audio PANCE and PANRE Episode 45 http://podcast.thepalife.com/murmur-madness-the-audio-pance-and-panre-episode-45/ Thu, 05 Jan 2017 00:56:12 +0000 http://podcast.thepalife.com/?p=248 http://podcast.thepalife.com/murmur-madness-the-audio-pance-and-panre-episode-45/#respond http://podcast.thepalife.com/murmur-madness-the-audio-pance-and-panre-episode-45/feed/ 0 <p>Welcome to episode 45 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Today we are going to take a brief detour away from 10 daily questions and instead cover the murmurs you need to know for your PANCE and PANRE exam. I have still included an 11 question exam at the end […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/murmur-madness-the-audio-pance-and-panre-episode-45/">Murmur Madness: The Audio PANCE and PANRE Episode 45</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Murmur Madness The Audio PANCE and PANRE Board Review PodcastWelcome to episode 45 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Today we are going to take a brief detour away from 10 daily questions and instead cover the murmurs you need to know for your PANCE and PANRE exam.

I have still included an 11 question exam at the end of this post so make sure you scroll down after you listen to the podcast.

There are a total of 17 cardiac conditions that may present on exam day in the form of a descriptive sound/murmur.

You will often be given supporting evidence such as the location of auscultation or radiation which you can use to narrow down your options.

There are total of 51 cardiac topics in the  NCCPA™ Cardiology PANCE and PANRE Content Blueprint which represents 16% of the PANCE and PANRE exam.

(click here to download the FREE NCCPA Content Blueprint cheat sheet)

These cardiac conditions and their associated murmurs cover a whopping 33% of the cardiology section of the PANCE and PANRE exam!

Take a listen to this week’s podcast episode

If you can’t see the audio player click here to listen to the full episode.

Let’s break this all down:

Each of the links below opens the corresponding lesson on SmartyPANCE and is available to members (you must be logged in or join now)

There are 9 valvular disorders associated with murmurs:

Valvular Disorders (PEARLS and Flashcards)

  1. Aortic stenosis (ReelDx)
  2. Aortic regurgitation (Diastolic Murmur)
  3. Mitral stenosis (Diastolic)
  4. Mitral regurgitation
  5. Mitral valve prolapse
  6. Tricuspid stenosis
  7. Tricuspid regurgitation
  8. Pulmonary stenosis
  9. Pulmonary regurgitation

Five congenital heart diseases that have corresponding murmurs

Congenital Heart Diseases (PEARLS)

  1. Atrial septal defect
  2. Coarctation of the aorta
  3. Patent ductus arteriosus
  4. Tetralogy of Fallot
  5. Ventricular septal defect

One murmur associated with cardiomyopathy

  1. Hypertrophic cardiomyopathy

And a pair of conditions nested under the label of “other forms of heart disease” that have associated murmurs/heart sounds worth mentioning

Other Forms of Heart Disease (PEARLS)

  1. Acute and subacute bacterial endocarditis
  2. Acute pericarditis

Making Sense of Murmurs

Let’s start with the valvular disorders:

You have 4 heart valves with two main conditions – half are diastolic murmurs and half are systolic murmurs. Here is a helpful mnemonic:

Recalling Common Systolic Heart Murmurs: MR PASS

  • itral
  • egurgitation
  • hysiologic (also known as functional, systolic flow murmur, a heart murmur heard in the absence of cardiac abnormality)
  • ortic
  • tenosis
  • ystolic – All the above murmurs are heard during systole.

MR PASS wins the Most Valuable Player award.

  • itral
  • alve
  • rolapse – Add MVP as another systolic murmur.

MR PASS often hangs around with MS ARD.

  • itral
  • tenosis
  • ortic
  • egurgitation
  • iastolic – All the above murmurs are heard during diastole.

Here are the nine valvular murmurs and their associated descriptions

Remember which are systolic and diastolic this can be very helpful at ruling out or ruling in a condition come exam day.

  1. Aortic Stenosis – Systolic harsh ejection crescendo decrescendo murmur at RUSB (aortic area) with radiation to the neck and apex
  2. Aortic Regurgitation – diastolic – soft high pitched blowing at LSB with patient sitting leaning forward and exhaling
  3. Mitral stenosis – diastolic – low pitched decrescendo rumbling with opening snap at the APEX (the mitral area) enhanced by expiration
  4. Mitral regurgitation – blowing holosystolic murmur loudest at the APEX (the mitral area) with a split S2 that radiates to the axilla and is increased by squatting, handgrip and expiration
  5. Tricuspid Stenosis – diastolic – mid diastolic rumbling at LLSB (tricuspid area) with opening snap
  6. Tricuspid regurgitation – High pitched holosystolic blowing murmur that radiates to the LSB (tricuspid area)
  7. Pulmonic stenosis – harsh midsystolic ejection crescendo-decrescendo murmur with widely split s2 at LSB that radiates to the left shoulder and neck
  8. Pulmonic regurgitation – diastolic –  high pitched, decrescendo murmur at LUSB increase with inspiration
  9. Mitral valve prolapse – Midsystolic ejection click head best at the APEX (the mitral area)

With these valvular murmurs you have 4 auscultation points which can be easily remembered using the mnemonic APT Ment watch this amazing video so you never forget!

Another helpful mnemonic: Aortic Pulmonic Tricuspid Mitral – ll P hysicians T ake M oney!

cardiac-auscultation-locations

  1. Aortic area: right 2nd interspace (Right upper sternal border RUSB)
  2. Pulmonic area: 2nd left interspace (Left upper sternal border LUSB)
  3. Tricuspid area: Left lower sternal border LLSB
  4. Mitral area: APEX

You can use the auscultation point to successfully narrow down your murmur and use the designation of systolic or diastolic to narrow down even further.

Five congenital heart diseases that have corresponding murmurs

Congenital Heart Diseases (PEARLS)

  1. Atrial septal defect – Systolic ejection murmur at 2nd left intercostal space with an early to mid-systolic rumble and fixed splitting of the 2nd heart sound (s2) and CXR will show pulmonary vascular markings.
  2. Coarctation of the aorta – Late systolic ejection murmur-posterior or continuous murmur if collateral flow. Will have absent or weak femoral pulses with a delay of palpable femoral pulse and HTN in arms but low or normal blood pressure in the legs
  3. Patent ductus arteriosus – Continuous, rough, machinery-like murmur, heard best in the first interspaces of the LSB
  4. Tetralogy of Fallot – Harsh systolic ejection murmur heard best at the left sternal border. Associated with bluish skin, trouble gaining weight, and sudden loss of consciousness during crying or feeding
  5. Ventricular septal defect – Harsh high pitched holosystolic murmur heard best at the LSB with ride radiation and a fixed split S2

Several of these conditions have a “tell” that make it easy to identify the condition and they are usually always part of the root of the question.

  • PDA = machinery like murmur (remember that the physician assistant got a patent on his machine).
  • Tetralogy of Fallot usually presents with a young child having TET spells which are described as bluish skin, trouble gaining weight, and sudden loss of consciousness during crying or feeding. 
  • Coarctation will almost always present with absent or weak femoral pulses with a delay of palpable femoral pulse and HTN in arms but low or normal blood pressure in the legs. 
  • ASD is a bit tougher but they will usually give you a wide and fixed splitting of the S2 and patients will be easily fatigued. CXR will show pulmonary vascular markings.
  • VSD will have a high pitched holosystolic murmur and newborns may show dyspnea.

One murmur associated with cardiomyopathy

  1. Hypertrophic cardiomyopathy – Medium-pitched, mid-systolic murmur that decreases with squatting and increases with straining. S4 gallop and apical lift with thick, stiff left ventricle. HCM is the leading cause of sudden death in athletes and may cause angina.

And a pair of conditions nested under the label of “other forms of heart disease” that have associated murmurs/heart sounds worth mentioning

Other Forms of Heart Disease (PEARLS)

  1. Acute and subacute bacterial endocarditis  – A new mitral regurgitant murmur in a patient with a history of IVDA, fever (39.0º C),* and a blood culture that reveals 2 out of 2 positive growth
  2. Acute pericarditis – Although this is not a murmur, it is important to identify a pericardial friction rub heard best with patient upright and leaning forward. Chest pain is also relieved by sitting and/or leaning forward

You can listen to all these murmurs and see their associated waveforms at www.smartypance.com/courses/cardiology

Here is a wonderful video from the Khan Academy of how to approach murmurs video of murmurs

Murmur Flash Cards

Episode 45 PANCE and PANRE Murmur Quiz

You will see from these questions on the PANCE and PANRE things aren’t always so straightforward.

You can take the exam here: thepalife.com/murmur-madness

Looking for all the podcast episodes?

This FREE podcast series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SmartyPANCE

I will be releasing new episodes every few weeks. The Academy is discounted and now includes complimentary access to SmartyPANCE so sign up now.

Included is a full cardiology content blueprint board review exam with over 147 cardiology specific questions and 51 cardiology blueprint topics covered in detail. This is in addition to 1,000’s of additional board review questions and NCCPA content blueprint courses covering all 13 organ areas.

I am also happy to introduce ReelDX™ patient case based integration into many of the SmartyPANCE blueprint lessons. It’s like a virtual rotation from the comfort of your couch!

This podcast is available on iTunes and Stitcher Radio (among others)

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

The post Murmur Madness: The Audio PANCE and PANRE Episode 45 appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 45 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Today we are going to take a brief detour away from 10 daily questions and instead cover the murmurs you need to know for your PANCE and PANRE exam. Welcome to episode 45 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Today we are going to take a brief detour away from 10 daily questions and instead cover the murmurs you need to know for your PANCE and PANRE exam.
I have still included an 11 question exam at the end of this post so make sure you scroll down after you listen to the podcast.
There are a total of 17 cardiac conditions that may present on exam day in the form of a descriptive sound/murmur.
You will often be given supporting evidence such as the location of auscultation or radiation which you can use to narrow down your options.
There are total of 51 cardiac topics in the  NCCPA™ Cardiology PANCE and PANRE Content Blueprint which represents 16% of the PANCE and PANRE exam.
(click here to download the FREE NCCPA Content Blueprint cheat sheet)
These cardiac conditions and their associated murmurs cover a whopping 33% of the cardiology section of the PANCE and PANRE exam!
Take a listen to this week’s podcast episode
If you can’t see the audio player click here to listen to the full episode.
Let’s break this all down:
Each of the links below opens the corresponding lesson on SmartyPANCE and is available to members (you must be logged in or join now)
There are 9 valvular disorders associated with murmurs:
Valvular Disorders (PEARLS and Flashcards)

Aortic stenosis (ReelDx)
Aortic regurgitation (Diastolic Murmur)
Mitral stenosis (Diastolic)
Mitral regurgitation
Mitral valve prolapse
Tricuspid stenosis
Tricuspid regurgitation
Pulmonary stenosis
Pulmonary regurgitation

Five congenital heart diseases that have corresponding murmurs
Congenital Heart Diseases (PEARLS)

]]>
The Physician Assistant Life | Smarty PANCE clean 14:41 248
Episode 43: The Audio PANCE and PANRE Board Review Podcast http://podcast.thepalife.com/episode-43-the-audio-pance-and-panre-board-review-podcast/ Thu, 27 Oct 2016 05:43:30 +0000 http://podcast.thepalife.com/?p=240 http://podcast.thepalife.com/episode-43-the-audio-pance-and-panre-board-review-podcast/#respond http://podcast.thepalife.com/episode-43-the-audio-pance-and-panre-board-review-podcast/feed/ 0 <p>Welcome to episode 43 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will continue to take a break from topic specific board review and […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/episode-43-the-audio-pance-and-panre-board-review-podcast/">Episode 43: The Audio PANCE and PANRE Board Review Podcast</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> episode-43-the-audio-pance-and-panre-board-review-podcastWelcome to episode 43 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will continue to take a break from topic specific board review and covering 10 general board review questions.

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full genitourinary board review includes over 72 GU specific questions and is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Episode 43 PANCE and PANRE Podcast Quiz

1. A mother brings in her five-year-old boy for his school physical. She voices some concerns about his readiness for school, saying he seems to be socially immature. She has noticed he does not interact with other children well, and that when he plays with them, he has a tendency to “place them” and then run around them as if they were statues. He rarely cries when he is hurt, and he shrugs off any attempt to hug him. He has good attention to details, and will sit and draw the same geometric shapes over and over again, but does not seem interested in learning the alphabet. He avoids eye contact with anyone. Which of the following is the most likely diagnosis?

  1. Normal 5 year-old
  2. Social phobia
  3. Autism
  4. Avoidant personality

Click here to see the answer

Answer: C. Autism

Children with autism do not tend to make eye contact, and even avoid it. They do not accept comfort when hurt and stiffen up when hugged. They do not tend to play with others, and do not tend to imitate grown-ups in play.
They approach play in a more mechanical way, using others as props rather than interacting with them.

Explanations

  • A. This behavior is not normal for a child this age.
  • B. Social phobia is an excessive and persistent fear of social situations in which the person may be scrutinized by others.
  • D. Avoidant personality disorder is characterized by timidity, social awkwardness, and a pervasive sense of inadequacy and fear of criticism.

2. A 3-week-old male infant presents with recurrent regurgitation after feeding that has progressed to projectile vomiting in the last few days. The mother states that the child appears hungry all of the time. She denies any diarrhea in the child. Which of the following clinical findings is most likely?

  1. Bile-stained vomitus
  2. Hemoccult positive stools
  3. Olive-sized mass in the right upper abdomen
  4. Sausage-shaped mass in the upper-mid abdomen

Click here to see the answer

Answer: C. Olive-sized mass in the right upper abdomen

An olive-sized mass may be palpated in the right upper abdomen in pyloric stenosis and if found, is pathognomonic for pyloric stenosis.

Explanations

  • D. A sausage-shaped mass may be noted in intussusception, not pyloric stenosis.
  • A. Gastric obstruction, such as that seen with pyloric stenosis, causes vomiting that is not bilious.
  • B. Blood-streaked vomitus, but not hemoccult positive stools, may be seen in pyloric stenosis.

3. A 65 year-old with COPD receiving their first pneumococcal polysaccharide PPSV23 vaccination should be revaccinated in

  1. 1 year
  2. 3 years
  3. 5 years
  4. Never

Click here to see the answer

Answer: D. Never

People who are first vaccinated with PPSV23 at age 65 years or older should receive only 1 dose, regardless of their underlying medical condition.

ACIP recommendations for revaccination remain unchanged from the 1997 recommendations. For most persons for whom PPSV23 is indicated, ACIP does not recommend routine revaccination. A second dose of PPSV23 is recommended 5 years after the first dose for persons aged 19–64 years with functional or anatomic asplenia and for persons with immunocompromising conditions . ACIP does not recommend multiple revaccinations because of insufficient data regarding clinical benefit, particularly the degree and duration of protection, and safety.

All adults age 65 years and older should also receive one dose of PCV13.

Click here to review the CDC guidelines

4. Which of the following therapies is recommended for a 13 month-old child with sickle cell disease?

  1. Folic acid and penicillin V
  2. Ferrous sulfate and penicillin V
  3. Folic acid and ferrous sulfate
  4. Folic acid, ferrous sulfate and penicillin V

Click here to see the answer

Answer: A. Folic acid and penicillin V

Patients with sickle cell disease should receive prophylactic penicillin V starting at 2 months of age and folic acid starting at 1 year of age. Ferrous sulfate is not globally recommended for patients with sickle cell disease.

5. A patient with severe COPD presents to the Emergency Department with a 3 day history of increasing shortness of breath with exertion and cough productive of purulent sputum. An arterial blood gas reveals a pH of 7.25, PaCO2 of 70 mmHg and PaO2 of 50 mmHg. He is started on albuterol nebulizer, nasal oxygen at 2 liters per minute, and an IV is started. After one hour of treatment, his arterial blood gas now reveals a pH of 7.15, PaCO2 100 mmHg and PaO2 of 70 mmHg. Which of the following is the most appropriate next step in his treatment?

A. Decrease the oxygen flow rate.
B. Administer oral corticosteroids.
C. Intubate the patient.
D. Administer salmeterol (Serevent)

Click here to see the answer

Answer: C. Intubate the patient.

This person has increasing respiratory failure as indicated by the raising PaCO2 levels. Intubation is required at this time.

Explanations

  • A. Decreasing the oxygen flow rate would be harmful as it would decrease the amount of oxygen delivered to the patient.
  • B. Administration of steroids is an important treatment modality but this patient is in respiratory failure and needs more immediate therapy.
  • D. Long-acting beta agonist therapy such as salmeterol is not utilized for rescue therapy.

6. A patient should be tested for tuberculosis prior to being treated with

A. etanercept (Enbrel).
B. cyclosporine (Neoral).
C. methotrexate (Rheumatrex).
D. prednisone (Deltasone).

Click here to see the answer

Answer: A. etanercept (Enbrel)

Etanercept is an anti-cytokine agent used in the treatment of rheumatoid arthritis and has as a side effect the potential for serious infections. One of these side effects includes reactivation of dormant tuberculosis.

Explanations

B. Cyclosporine, methotrexate, and prednisone do not have the requirement to check for tuberculosis prior to initiating treatment.

7. Which of the following side effects is associated with long-term administration of phenytoin (Dilantin)?

A. Ataxia
B. Hypotension
C. Osteomalacia
D. Cardiac dysrhythmia

Click here to see the answer

Answer: C. Osteomalacia

Osteomalacia, or demineralization of bone, is a side effect of phenytoin that may occur after chronic administration.

Explanations

  • A. Ataxia is associated most often with acute oral overdosage of phenytoin.
  •  B. Cardiac dysrhythmia, with or without hypotension, is an expected side effect of rapid IV phenytoin administration.

8. Hairy leukoplakia has the greatest prevalence of distribution on the

A. palate.
B. floor of the mouth.
C. lateral tongue.
D. gingiva.

Click here to see the answer

Answer: C. lateral tongue.

The lateral border of the tongue is where hairy leukoplakia is commonly seen.

9. 75 year-old male presents for a routine physical. Vitals are normal with no orthostatic changes. On physical examination, a fine cortical movement with repetitive rubbing of the tip of the thumb along the tips of the fingers is noted at rest. Which of the following is the most likely diagnosis?

A. Seizure disorder
B. Peripheral neuropathy
C. Shy-Drager syndrome
D. Parkinson's disease

Click here to see the answer

Answer: D. Parkinson’s disease

Parkinson’s disease presents with tremor at rest (pill-rolling), bradykinesia, rigidity, and postural instability.

Explanations

  • A. While a seizure may present with fine or gross uncontrolled motor movements, the tremor described is classic pill-rolling tremor noted in Parkinson’s disease.
  • B. Peripheral neuropathy presents with loss of sensation not tremor.
  • C. Shy-Drager syndrome is due to autonomic degeneration and typically presents with orthostatic hypotension.

10. A 45 year-old female presents to the emergency department with generalized, hot, erythema of the skin. Physical exam reveals an oral temperature of 102 degrees Fahrenheit, purulent conjunctivitis, and mucosal erosions. Her skin is painful and separates from the dermis with touch. Which of the following is the most likely cause for this condition?

A. Penicillin
B. Prednisolone
C. Aspirin
D. Hydrochlorothiazide (HCTZ)

Click here to see the answer

Answer: A. Penicillin

Medications are most frequently implicated in toxic epidermal necrolysis. These usually include, analgesics (NSAIDs), antibiotics – sulfonamides (sulfamethoxazole, sulfadiazine, sulfapyridine,
beta-lactams (cephalosporins, penicillins, carbapenems) and anticonvulsants (Carbamazepine).

Explanations

  • B. Systemic glucocorticoids may be used early in the treatment of this condition and are not a cause.
  • C. Aspirin is not linked to toxic epidermal necrolysis.
  • D. Hydrochlorothiazide diuretics are not associated with the production of toxic epidermal necrolysis.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

The post Episode 43: The Audio PANCE and PANRE Board Review Podcast appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 43 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE che... Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet).
This week we will continue to take a break from topic specific board review and covering 10 general board review questions.
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full genitourinary board review includes over 72 GU specific questions and is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Episode 43 PANCE and PANRE Podcast Quiz
1. A mother brings in her five-year-old boy for his school physical. She voices some concerns about his readiness for school, saying he seems to be socially immature. She has noticed he does not interact with other children well, and that when he plays with them, he has a tendency to “place them” and then run around them as if they were statues. He rarely cries when he is hurt, and he shrugs off any attempt to hug him. He has good attention to details, and will sit and draw the same geometric shapes over and over again, but does not seem interested in learning the alphabet. He avoids eye contact with anyone. Which of the following is the most likely diagnosis?

* Normal 5 year-old
* Social phobia
* Autism
* Avoidant personality

2. A 3-week-old male infant presents with recurrent regurgitation after feeding that has progressed to projectile vomiting in the last few days. The mother states that the child appears hungry all of the time. She denies any diarrhea in the child. Which of the following clinical findings is most likely?

* Bile-stained vomitus
* Hemoccult positive stools
* Olive-sized mass in the right upper abdomen
* Sausage-shaped mass in the upper-mid abdomen


3. A 65 year-old with COPD receiving their first pneumococcal polysaccharide PPSV23 vaccination should be revaccinated in

* 1 year
* 3 years
* 5 years
* Never

4. Which of the following therapies is recommended for a 13 month-old child with sickle cell disease?


* Folic acid and penicillin V
* Ferrous sulfate and penicillin V
* Folic acid and ferrous sulfate
* Folic acid, ferrous sulfate and penicillin V

5. A patient with severe COPD presents to the Emergency Department with a 3 day history of increasing shortness of breath with exertion and cough productive of purulent sputum. An arterial blood gas reveals a pH of 7.25, PaCO2 of 70 mmHg and PaO2 of 50 mmHg. He is started on albuterol nebulizer, nasal oxygen at 2 liters per minute,]]>
The Physician Assistant Life | Smarty PANCE clean 16:12 240
Episode 41: The Audio PANCE and PANRE Board Review Podcast http://podcast.thepalife.com/episode-41-the-audio-pance-and-panre-board-review-podcast/ Mon, 29 Aug 2016 21:02:32 +0000 http://podcast.thepalife.com/?p=227 http://podcast.thepalife.com/episode-41-the-audio-pance-and-panre-board-review-podcast/#respond http://podcast.thepalife.com/episode-41-the-audio-pance-and-panre-board-review-podcast/feed/ 0 <p>Welcome to episode 41 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint. This week we will be taking a break from topic specific board review and covering 10 general board review questions. […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/episode-41-the-audio-pance-and-panre-board-review-podcast/">Episode 41: The Audio PANCE and PANRE Board Review Podcast</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> The Audio PANCE and PANRE Episode 41Welcome to episode 41 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint.

This week we will be taking a break from topic specific board review and covering 10 general board review questions.

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full genitourinary board review includes over 72 GU specific questions and is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Episode 41 PANCE and PANRE Podcast Quiz

1. A mother brings her 6-year-old boy for evaluation of school behavior problems. She says the teacher told her that the boy does not pay attention in class, that he gets up and runs around the room when the rest of the children are listening to a story, and that he seems to be easily distracted by events outside or in the hall. He refuses to remain in his seat during class, and occasionally sits under his desk or crawls around under a table. The teacher told the mother this behavior is interfering with the child’s ability to function in the classroom and to learn. The mother states that she has noticed some of these behaviors at home, including his inability to watch his favorite cartoon program all the way through. Which of the following is the most likely diagnosis?

  1. Antisocial disorder
  2. Dysthymic mood disorder
  3. Obsessive-compulsive disorder
  4. Attention deficit hyperactivity disorder

Click here to see the answer

Answer: D. Attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder is characterized by inattention, including increased distractibility and difficulty sustaining attention; poor impulse control and decreased self-inhibitory capacity; and motor over activity and motor restlessness, which are pervasive and interfere with the individual’s ability to function under normal circumstances.

Explanations

  • Antisocial behavior disorder is characterized by disregard for rights of others; a defect in the experience of compunction or remorse for harming others.
  • Dysthymic mood disorder is characterized by chronic, sad mood occurring for at least 2 years in an adult (one year in a child). Behavioral problems are not part of this disorder.
  • Obsessive-compulsive disorder is characterized by recurrent obsessions and compulsions that result in anxiety and disruptive behaviors related to those compulsions.

2. Which of the following is the treatment of choice for a torus (buckle) fracture involving the distal radius?

A. Open reduction and internal fixation
B. Ace wrap or anterior splinting
C. Closed reduction and casting
D. Corticosteroid injection followed by splinting

Click here to see the answer

Answer: B. Ace wrap or anterior splinting

A torus or buckle fracture occurs after a minor fall on the hand. These fractures are very stable and are not as painful as unstable fractures. They heal uneventfully in 3-4 weeks.

3. Which of the following can be used to treat chronic bacterial prostatitis?

A. Penicillin
B. Cephalexin (Keflex)
C. Nitrofurantoin (Macrobid)
D. Levofloxacin (Levaquin)

Click here to see the answer

Answer: D. Levofloxacin (Levaquin)

Chronic bacterial prostatitis (Type II prostatitis) can be difficult to treat and requires the use of fluoroquinolones or trimethoprim-sulfamethoxazole, both of which penetrate the prostate.

4. A 25 year-old male with history of syncope presents for evaluation. The patient admits to intermittent episodes of rapid heart beating that resolve spontaneously. 12 Lead EKG shows delta waves and a short PR interval. Which of the following is the treatment of choice in this patient?

A. Radiofrequency catheter ablation
B. Verapamil (Calan)
C. Percutaneous coronary intervention
D. Digoxin (Lanoxin)

Click here to see the answer

Answer: A. Radiofrequency catheter ablation

Radiofrequency catheter ablation is the treatment of choice on patients with accessory pathways, such as Wolff-Parkinson-White Syndrome.

Explanations

  • Calcium channel blockers such as verapamil decrease refractoriness of the accessory pathway or increase that of the AV node leading to faster ventricular rates, therefore calcium channel blockers should be avoided in patients with WPW.
  • Percutaneous coronary intervention is indicated in the treatment of coronary artery disease, not preexcitation syndromes.
  • (Digoxin decreases refractoriness of the accessory pathway and increases that of the AV node leading to faster ventricular rates. It should therefore be avoided in patients with WPW.

5. Which of the following pathophysiological processes is associated with chronic bronchitis?

A. Destruction of the lung parenchyma
B. Mucous gland enlargement and goblet cell hyperplasia
C. Smooth muscle hypertrophy in the large airways
D. Increased mucus adhesion secondary to reduction in the salt and water content of the mucus

Click here to see the answer

Answer: B. Mucous gland enlargement and goblet cell hyperplasia

Chronic bronchitis results from the enlargement of mucous glands and goblet cell hypertrophy in the large airways.

Explanations

  • Destruction of the gas-exchanging structures in the lung is characteristic of emphysema.
  • There may be smooth muscle hypertrophy in chronic bronchitis but it is not to the extent as found in asthma and is not an underlying factor in the pathology of chronic bronchitis.
  • Abnormal absorption of sodium and a reduced rate of chloride secretion in cystic fibrosis leads to thickening of the mucus and increase in adhesion of the mucus.

6. Which of the following dietary substances interact with monoamine oxidase-inhibitor antidepressant drugs?

A. Lysine
B. Glycine
C. Tyramine
D. Phenylalanine

Click here to see the answer

Answer: C. Tyramine

Monoamine oxidase inhibitors are associated with serious food/drug and drug/drug interactions. Patient must restrict intake of foods having a high tyramine content to avoid serious reactions. Tyramine is a precursor to norepinephrine.

Explanations

Lysine, glycine, and phenylalanine are not known to interact with MAO inhibitors.

7. Gallstones usually result in biliary symptoms by causing inflammation or obstruction following migration into the common bile duct or

A. cystic duct
B. pancreatic duct
C. duodenal ampulla
D. common hepatic duct

Click here to see the answer

Answer: A. cystic duct

Obstruction of the cystic duct by gallstones causes the typical symptom of biliary colic. Once obstructed the gallbladder distends and becomes edematous and inflamed. Gallstones can also migrate into the common bile duct through the cystic duct leading to a condition known as choledocholithiasis.

Explanations

  • Obstruction of the pancreatic duct leads to development of acute pancreatitis.
  • The duodenal ampulla is the area where the pancreatic duct and the common bile duct empty into the duodenum. Gallstones do not cause obstruction at this distal site.
  • The common hepatic duct from the liver joins the cystic duct from the gallbladder to form the common bile duct. Stone migration occurs along the pathway of the cystic duct to the common bile duct, not along the common hepatic duct.

8. An elderly patient with poorly-controlled Type 2 diabetes and renal disease develops a fever of 102°F orally, productive cough, and dyspnea. Physical examination demonstrates a respiratory rate of 32/min, labored breathing, and rales at the left base. Pulse oximetry is 90%. Which of the following is the next appropriate step in the management of this patient?

A. Administer nebulized corticosteroids
B. Admit to the hospital
C. Oral antimicrobial therapy
D. Endotracheal intubation

Click here to see the answer

Answer: B. Admit to the hospital

Community acquired pneumonia is the most deadly infectious disease in the U.S. Important risk factors for increased morbidity and mortality include advanced age, alcoholism, comorbid medical conditions, altered mental status, respiratory rate greater than 30 breaths/min, hypotension, and a BUN greater than 30.

Explanations

  • Inhaled corticosteroids are not utilized in the management of community-acquired pneumonia.
  • Due to the age of the patient, comorbid diseases, and current signs of respiratory distress, intravenous not oral antimicrobial therapy is indicated.
  • Endotracheal intubation is indicated for respiratory failure unresponsive to conservative management.

9. A 53 year-old female who is well known to the practice presents to the office complaining of increasing fatigue, constipation, and a weight gain of 10 lb (4.5 kg) over the past year. She also states others have noticed a recent hoarseness to her voice, and she is bothered by “charley horses” in her legs that wake her up at night. Her past medical history is unremarkable except for a history of hyperthyroidism treated by radioactive iodine 5 years ago. She is currently taking no medications and has no known drug allergies. Which of the following is the most likely cause of the patient’s symptoms?

A. Hypothyroidism
B. Hypoparathyroidism
C. Vocal cord paralysis
D. Radiation thyroiditis

Click here to see the answer

Answer: A. Hypothyroidism

The current symptoms, along with the past treatment of hyperthyroidism with radioactive iodine, would indicate hypothyroidism.

Explanations

  • This is a possible later complication of subtotal thyroidectomy, not radioactive iodine therapy.
  • This is an immediate complication of subtotal thyroidectomy or injury and does not occur with radioactive iodine therapy.
  • Radiation thyroiditis may occur following radiation therapy but there is no history of the patient having previous external beam radiation therapy.

10. Which of the following is most frequently associated with bladder cancer?

A. Hematuria
B. Dysuria
C. Urgency
D. Frequency

Click here to see the answer

Answer: A. Hematuria

Significant persistent hematuria >3 RBC/HPF on three urinalyses, a single urinalysis with >100 RBC, or gross hematuria, identifies significant renal or urologic lesions. Bladder cancer usually presents with painless hematuria.

Explanations

Dysuria, urgency, and frequency are associated with irritative voiding symptoms associated with cystitis.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

reeldx_signup1-ssmallGet ReelDx at 40% off!

I am so excited to be introducing ReelDx cases into my new SmartyPANCE board review website. This is a $99 value now included to all registered SmartyPANCE users. If you are just interested in access to the ReelDx cases through their website as a listener of this podcast you can get 40% off a one year subscription by entering the code “ThePALife” at checkout:

Resources From The Show

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

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]]>
Welcome to episode 41 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint. Welcome to episode 41 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint.
This week we will be taking a break from topic specific board review and covering 10 general board review questions.
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full genitourinary board review includes over 72 GU specific questions and is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Episode 41 PANCE and PANRE Podcast Quiz
1. A mother brings her 6-year-old boy for evaluation of school behavior problems. She says the teacher told her that the boy does not pay attention in class, that he gets up and runs around the room when the rest of the children are listening to a story, and that he seems to be easily distracted by events outside or in the hall. He refuses to remain in his seat during class, and occasionally sits under his desk or crawls around under a table. The teacher told the mother this behavior is interfering with the child’s ability to function in the classroom and to learn. The mother states that she has noticed some of these behaviors at home, including his inability to watch his favorite cartoon program all the way through. Which of the following is the most likely diagnosis?

* Antisocial disorder
* Dysthymic mood disorder
* Obsessive-compulsive disorder
* Attention deficit hyperactivity disorder

2. Which of the following is the treatment of choice for a torus (buckle) fracture involving the distal radius?
A. Open reduction and internal fixation
B. Ace wrap or anterior splinting
C. Closed reduction and casting
D. Corticosteroid injection followed by splinting
3. Which of the following can be used to treat chronic bacterial prostatitis?
A. Penicillin
B. Cephalexin (Keflex)
C. Nitrofurantoin (Macrobid)
D. Levofloxacin (Levaquin)
4. A 25 year-old male with history of syncope presents for evaluation. The patient admits to intermittent episodes of rapid heart beating that resolve spontaneously. 12 Lead EKG shows delta waves and a short PR interval. Which of the following is the treatment of choice in this patient?
A. Radiofrequency catheter ablation
B. Verapamil (Calan)
C. Percutaneous coronary intervention
D. Digoxin (Lanoxin)
5. Which of the following pathophysiological processes is associated with chronic bronchitis?
A. Destruction of the lung parenchyma
B. Mucous gland enlargement and goblet cell hyperplasia
C. Smooth muscle hypertrophy in the large airways
D. Increased mucus adhesion secondary to reduction in the salt and water content of the mucus
The Physician Assistant Life | Smarty PANCE clean 15:52 227
REPRODUCTIVE SYSTEM : THE AUDIO PANCE AND PANRE PODCAST TOPIC SPECIFIC REVIEW EPISODE 39 http://podcast.thepalife.com/reproductive-system-the-audio-pance-and-panre-podcast-topic-specific-review-episode-39/ Mon, 20 Jun 2016 20:52:43 +0000 http://podcast.thepalife.com/?p=220 http://podcast.thepalife.com/reproductive-system-the-audio-pance-and-panre-podcast-topic-specific-review-episode-39/#respond http://podcast.thepalife.com/reproductive-system-the-audio-pance-and-panre-podcast-topic-specific-review-episode-39/feed/ 0 <p>Welcome to episode 39 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint. Click here to download my interactive content blueprint checklist This week we will be covering 10 topic specific OBGYN/reproductive board […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/reproductive-system-the-audio-pance-and-panre-podcast-topic-specific-review-episode-39/">REPRODUCTIVE SYSTEM : THE AUDIO PANCE AND PANRE PODCAST TOPIC SPECIFIC REVIEW EPISODE 39</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Reproductive System Board Review PodcastWelcome to episode 39 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint.

Click here to download my interactive content blueprint checklist

This week we will be covering 10 topic specific OBGYN/reproductive board review questions.

The reproductive system accounts for 8% of your PANCE/PANRE board exam.  

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full reproductive review includes over 107 reproductive system content blueprint specific questions and is available to all members of the PANCE and PANRE Academy or my new site SMARTY PANCE!!

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Reproductive System PANCE and PANRE Podcast Quiz

You can take the interactive quiz by clicking here

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Show Notes:

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Google Play: The Audio PANCE and PANRE Podcast Google Play
  3. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

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The post REPRODUCTIVE SYSTEM : THE AUDIO PANCE AND PANRE PODCAST TOPIC SPECIFIC REVIEW EPISODE 39 appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 39 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint. Welcome to episode 39 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint.
Click here to download my interactive content blueprint checklist
This week we will be covering 10 topic specific OBGYN/reproductive board review questions.
The reproductive system accounts for 8% of your PANCE/PANRE board exam.  
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full reproductive review includes over 107 reproductive system content blueprint specific questions and is available to all members of the PANCE and PANRE Academy or my new site SMARTY PANCE!!

* You can download and listen to past FREE episodes here, on iTunes, Google Play and Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Reproductive System PANCE and PANRE Podcast Quiz
You can take the interactive quiz by clicking here
Looking for all the podcast episodes?
This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.
I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.
Resources and Show Notes:

* Reproductive system PANCE and PANRE content blueprint course on Smarty PANCE
* Reproductive System Contentent Blueprint 107 question exam on Smarty PANCE (members only)
* Download my free interactive content blueprint checklist
* My list of recommended PANCE and PANRE review books
* USE CODE “PALIFE” TO GET 10% OFF THE RUTGERS PANCE AND PANRE REVIEW COURSE

This Podcast is also available on iTunes and Stitcher Radio for Android

* iTunes: The Audio PANCE A...]]>
The Physician Assistant Life | Smarty PANCE clean 13:46 220
Musculoskeletal 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 37 http://podcast.thepalife.com/musculoskeletal-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-37/ Mon, 25 Apr 2016 04:06:08 +0000 http://podcast.thepalife.com/?p=214 http://podcast.thepalife.com/musculoskeletal-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-37/#respond http://podcast.thepalife.com/musculoskeletal-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-37/feed/ 0 <p>Welcome to episode 37 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint. Click here to download my interactive content blueprint checklist This week we will be covering 10 topic specific […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/musculoskeletal-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-37/">Musculoskeletal 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 37</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Musculoskeletal PART 1 - The Audio PANCE and PANRE Board Review PodcastWelcome to episode 37 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint.

Click here to download my interactive content blueprint checklist

This week we will be covering 10 topic specific Musculoskeletal board review questions.

The Musculoskeletal System accounts for 10% of your PANCE/PANRE board exam.  

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full genitourinary board review includes over 72 GU specific questions and is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Musculoskeletal PANCE and PANRE Podcast Quiz

You can take the interactive exam by clicking here.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Show Notes:

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

The post Musculoskeletal 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 37 appeared first on The Audio PANCE and PANRE.

]]> Welcome to episode 37 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint. Welcome to episode 37 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint.
Click here to download my interactive content blueprint checklist
This week we will be covering 10 topic specific Musculoskeletal board review questions.
The Musculoskeletal System accounts for 10% of your PANCE/PANRE board exam.  
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full genitourinary board review includes over 72 GU specific questions and is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Musculoskeletal PANCE and PANRE Podcast Quiz
You can take the interactive exam by clicking here.
Looking for all the podcast episodes?
This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.
I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.
Resources and Show Notes:

* My list of recommended PANCE and PANRE review books
* My secret upcoming website which will cover the entire NCCPA Content Blueprint (coming soon)
* USE CODE “PALIFE” TO GET 10% OFF THE RUTGERS PANCE AND PANRE REVIEW COURSE

This Podcast is also available on iTunes and Stitcher Radio for Android

* iTunes: The Audio PANCE AND PANRE Podcast iTunes
* Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher


]]>
The Physician Assistant Life | Smarty PANCE clean 13:50 214 Genitourinary 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 35 http://podcast.thepalife.com/genitourinary-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-35/ Mon, 14 Mar 2016 03:41:59 +0000 http://podcast.thepalife.com/?p=203 http://podcast.thepalife.com/genitourinary-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-35/#respond http://podcast.thepalife.com/genitourinary-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-35/feed/ 0 <p>Welcome to episode 35 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint. This week we will be covering 10 topic specific Genitourinary board review questions. GU accounts for 6% of […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/genitourinary-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-35/">Genitourinary 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 35</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> The Audio PANCE and PANRE Genitourinary Review 1Welcome to episode 35 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint.

This week we will be covering 10 topic specific Genitourinary board review questions.

GU accounts for 6% of your PANCE/PANRE board exam.  

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full genitourniary board review includes over 72 GU specific questions and is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Genitourinary PANCE and PANRE Podcast Quiz

You can take the interactive exam by clicking here.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Show Notes:

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

The post Genitourinary 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 35 appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 35 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint. Welcome to episode 35 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint.
This week we will be covering 10 topic specific Genitourinary board review questions.
GU accounts for 6% of your PANCE/PANRE board exam.  
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full genitourniary board review includes over 72 GU specific questions and is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Genitourinary PANCE and PANRE Podcast Quiz
You can take the interactive exam by clicking here.
Looking for all the podcast episodes?
This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.
I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.
Resources and Show Notes:

* My list of recommended PANCE and PANRE review books
* My secret upcoming website which will cover the entire NCCPA Content Blueprint (coming soon)
* USE CODE “PALIFE” TO GET 10% OFF THE RUTGERS PANCE AND PANRE REVIEW COURSE

This Podcast is also available on iTunes and Stitcher Radio for Android

* iTunes: The Audio PANCE AND PANRE Podcast iTunes
* Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher


]]>
The Physician Assistant Life | Smarty PANCE clean 17:54 203
EENT 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 33 http://podcast.thepalife.com/eent-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-33/ Fri, 05 Feb 2016 06:23:01 +0000 http://podcast.thepalife.com/?p=197 http://podcast.thepalife.com/eent-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-33/#respond http://podcast.thepalife.com/eent-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-33/feed/ 0 <p>Welcome to episode 33 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint. This week we will be covering 10 topic specific HEENT board review questions. Eyes, Ears Nose and Throat accounts […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/eent-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-33/">EENT 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 33</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> PANCE and PANRE HEENT Audio Review Part OneWelcome to episode 33 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint.

This week we will be covering 10 topic specific HEENT board review questions.

Eyes, Ears Nose and Throat accounts for 9% of your PANCE/PANRE board exam.  

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full Gastroenterology/Nutrition review includes over 111 EENT specific questions and is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

EENT PANCE and PANRE Podcast Quiz

You can take the interactive exam by clicking here.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.

Resources and Show Notes:

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

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The post EENT 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 33 appeared first on The Audio PANCE and PANRE.

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Welcome to episode 33 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint. Welcome to episode 33 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint.
This week we will be covering 10 topic specific HEENT board review questions.
Eyes, Ears Nose and Throat accounts for 9% of your PANCE/PANRE board exam.  
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full Gastroenterology/Nutrition review includes over 111 EENT specific questions and is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
EENT PANCE and PANRE Podcast Quiz
You can take the interactive exam by clicking here.
Looking for all the podcast episodes?
This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.
I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now.
Resources and Show Notes:

* My list of recommended PANCE and PANRE review books
* Physician Assistant Exam Review Podcast covering Diseases of the Gallbladder and Liver

This Podcast is also available on iTunes and Stitcher Radio for Android

* iTunes: The Audio PANCE AND PANRE Podcast iTunes
* Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher


]]>
The Physician Assistant Life | Smarty PANCE clean 18:12 197
Gastroenterology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 31 http://podcast.thepalife.com/gastroenterology-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-31/ Mon, 21 Dec 2015 17:50:45 +0000 http://podcast.thepalife.com/?p=191 http://podcast.thepalife.com/gastroenterology-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-31/#respond http://podcast.thepalife.com/gastroenterology-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-31/feed/ 0 <p>Welcome to episode 31 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint. This week we will be covering 10 topic specific Gastroenterology board review questions. Gastroenterology and Nutrition accounts for 10% […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/gastroenterology-1-the-audio-pance-and-panre-podcast-topic-specific-review-episode-31/">Gastroenterology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 31</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Gastroenterology 1 The Audio PANCE and PANRE Podcast Topic Specific Review Episode 31Welcome to episode 31 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint.

This week we will be covering 10 topic specific Gastroenterology board review questions.

Gastroenterology and Nutrition accounts for 10% of your PANCE/PANRE board exam.  

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full Gastroenterology/Nutrition review includes over 149 GI/Nutrition specific questions and is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Pulmonology PANCE and PANRE Podcast Quiz

You can take the interactive exam by clicking here.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be releasing new episodes every few weeks. The Academy is currently discounted, so sign up now.

Resources and Show Notes:

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

 

The post Gastroenterology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 31 appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 31 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint. Welcome to episode 31 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint.
This week we will be covering 10 topic specific Gastroenterology board review questions.
Gastroenterology and Nutrition accounts for 10% of your PANCE/PANRE board exam.  
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full Gastroenterology/Nutrition review includes over 149 GI/Nutrition specific questions and is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Pulmonology PANCE and PANRE Podcast Quiz
You can take the interactive exam by clicking here.
Looking for all the podcast episodes?
This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.
I will be releasing new episodes every few weeks. The Academy is currently discounted, so sign up now.
Resources and Show Notes:

* My list of recommended PANCE and PANRE review books
* Physician Assistant Exam Review Podcast covering Diseases of the Gallbladder and Liver

This Podcast is also available on iTunes and Stitcher Radio for Android

* iTunes: The Audio PANCE AND PANRE Podcast iTunes
* Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher


 
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The Physician Assistant Life | Smarty PANCE clean 13:53 191
Pulmonology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 29 http://podcast.thepalife.com/episode-29/ Mon, 09 Nov 2015 19:40:36 +0000 http://podcast.thepalife.com/?p=183 http://podcast.thepalife.com/episode-29/#respond http://podcast.thepalife.com/episode-29/feed/ 0 <p>Welcome to episode 29 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Over the next few episodes I will be covering topic specific PANCE and PANRE review from the Academy course content following the NCCPA content blueprint. This week we will be covering 10 topic specific Pulmonology board review questions. Below you […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/episode-29/">Pulmonology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 29</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Pulmonology 1 The Audio PANCE and PANRE Episode 29Welcome to episode 29 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Over the next few episodes I will be covering topic specific PANCE and PANRE review from the Academy course content following the NCCPA content blueprint.

This week we will be covering 10 topic specific Pulmonology board review questions.

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full pulmonology review includes over 142 pulmonology specific questions and is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Pulmonology PANCE and PANRE Podcast Quiz

You can take the interactive exam by clicking here.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be releasing new episodes every few weeks. The Academy is currently discounted, so sign up now.

Resources and Show Notes:

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

The post Pulmonology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 29 appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 29 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Over the next few episodes I will be covering topic specific PANCE and PANRE review from the Academy course content following the NCCPA content blueprint.... Welcome to episode 29 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
Over the next few episodes I will be covering topic specific PANCE and PANRE review from the Academy course content following the NCCPA content blueprint.
This week we will be covering 10 topic specific Pulmonology board review questions.
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full pulmonology review includes over 142 pulmonology specific questions and is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Pulmonology PANCE and PANRE Podcast Quiz
You can take the interactive exam by clicking here.
Looking for all the podcast episodes?
This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.
I will be releasing new episodes every few weeks. The Academy is currently discounted, so sign up now.
Resources and Show Notes:

* My list of recommended PANCE and PANRE review books

This Podcast is also available on iTunes and Stitcher Radio for Android

* iTunes: The Audio PANCE AND PANRE Podcast iTunes
* Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher


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The Physician Assistant Life | Smarty PANCE clean 15:43 183
Cardiology 1: The Audio PANCE and PANRE Board Review Podcast Episode 27 http://podcast.thepalife.com/cardiology-1-the-audio-pance-and-panre-board-review-podcast-episode-27/ Wed, 30 Sep 2015 21:14:41 +0000 http://podcast.thepalife.com/?p=176 http://podcast.thepalife.com/cardiology-1-the-audio-pance-and-panre-board-review-podcast-episode-27/#respond http://podcast.thepalife.com/cardiology-1-the-audio-pance-and-panre-board-review-podcast-episode-27/feed/ 0 <p>Welcome to episode 27 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Over the next few episodes I will be covering topic specific PANCE and PANRE review from the Academy course content following the NCCPA content blueprint. This week we will be covering 10 topic specific Cardiology board review questions. Below you […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/cardiology-1-the-audio-pance-and-panre-board-review-podcast-episode-27/">Cardiology 1: The Audio PANCE and PANRE Board Review Podcast Episode 27</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> The Audio PANCE and PANRE Board Review Podcast Episode 27Welcome to episode 27 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Over the next few episodes I will be covering topic specific PANCE and PANRE review from the Academy course content following the NCCPA content blueprint.

This week we will be covering 10 topic specific Cardiology board review questions.

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full cardiology review includes over 147 cardiology specific questions and is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Cardiology Questions 1-10

You can take the interactive exam by clicking here.

Looking for all the podcast episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be be releasing new episodes every two weeks. The Academy is currently discounted, so sign up now.

Resources and Show Notes:

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

The post Cardiology 1: The Audio PANCE and PANRE Board Review Podcast Episode 27 appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 27 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Over the next few episodes I will be covering topic specific PANCE and PANRE review from the Academy course content following the NCCPA content blueprint.... Over the next few episodes I will be covering topic specific PANCE and PANRE review from the Academy course content following the NCCPA content blueprint.
This week we will be covering 10 topic specific Cardiology board review questions.
Below you will find an interactive exam to complement the podcast.
I hope you enjoy this free audio component to the examination portion of this site. The full cardiology review includes over 147 cardiology specific questions and is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, take an interactive quiz and download your results below.

Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Cardiology Questions 1-10
You can take the interactive exam by clicking here.
Looking for all the podcast episodes?
This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.
I will be be releasing new episodes every two weeks. The Academy is currently discounted, so sign up now.
Resources and Show Notes:

* My list of recommended PANCE and PANRE review books

This Podcast is also available on iTunes and Stitcher Radio for Android

* iTunes: The Audio PANCE AND PANRE Podcast iTunes
* Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher


]]>
The Physician Assistant Life | Smarty PANCE clean 13:31 176
The Audio PANCE and PANRE Board Review Podcast Episode 25 http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-25/ Mon, 31 Aug 2015 19:44:06 +0000 http://podcast.thepalife.com/?p=165 http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-25/#respond http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-25/feed/ 0 <p>Welcome to episode 25 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. I hope you enjoy this free audio component to the examination portion of this site. The […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-25/">The Audio PANCE and PANRE Board Review Podcast Episode 25</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Episode 25 The Audio PANCE and PANRE Board Review Podcast They Physician Assistant LifeWelcome to episode 25 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.

I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

adobe pdfDownload the FREE PDF transcript for FREE here or on Scribd.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Questions 1-10

The Audio PANCE and PANRE Episode 25

1. Which of the following conditions will produce a transudative pleural effusion?

A. Kaposi’s sarcoma
B. Pneumonia
C. Cirrhosis
D. Mesothelioma

Click here to see the answer

Answer: C. Cirrhosis

Transudative pleural effusions result from alteration in the formation of pleural fluid, the absorption of pleural fluid, or both, by systemic factors. Local factors affecting pleural fluid absorption and/or formation produce exudative pleural effusions.

2. Which of the following pathophysiological processes is believed to initiate acute appendicitis?

A. Obstruction
B. Perforation
C. Hemorrhage
D. Vascular compromise

Click here to see the answer

Answer: A. Obstruction

Obstruction of the appendiceal lumen by lymphoid hyperplasia, a fecalith or foreign body initiates most cases of appendicitis.

3. A 23 year-old female with a history of palpitations presents for evaluation. She admits to acute onset of rapid heart beating lasting seconds to minutes with associated shortness of breath and chest pain. The patient states she can relieve her symptoms with Valsalva. Which of the following is the most appropriate diagnostic study to establish a definitive diagnosis in this patient?

A. Cardiac catheterization
B. Cardiac MRI
C. Chest CT scan
D. Electrophysiology study

Click here to see the answer

Answer: D. Electrophysiology study

Electrophysiology study is useful in establishing the diagnosis and pathway of complex arrhythmias such as supraventricular tachycardia.

4. A known alcoholic presents to the emergency department with altered level of consciousness and a blood glucose level of 35 mg/dL. Which of the following best explains this glucose result?

A. Excess pancreatic insulin release
B. Rapid carbohydrate discharge into the small bowel
C. Agonist insulin receptor antibody formation
D. Hepatic glycogen depletion and impaired gluconeogenesis

Click here to see the answer

Answer: D. Hepatic glycogen depletion and impaired gluconeogenesis

Alcohol-related hypoglycemia results from hepatic glycogen depletion and impaired gluconeogenesis and not due to antibody formation, excessive insulin release from the pancreas, or rapid release of carbohydrate into the small bowel.

5. Which of the following is the chief adverse effect of thiazide diuretics?

A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
D. Hypermagnesemia

Click here to see the answer

Answer: A. Hypokalemia

Thiazide diuretics can induce electrolyte changes. Principle among those is hypokalemia.

6. The most distinctive sign of pertussis is

A. stridor without cough.
B. productive cough with basilar rales.
C. loose cough with coarse rhonchi.
D. paroxysmal cough with crowing inspiration.

Click here to see the answer

Answer: D. paroxysmal cough with crowing inspiration.

A paroxysmal cough with a loud inspiration (the whoop) is noted in pertussis.

7. The finding of egophony is most consistent with

A. emphysema.
B. atelectasis.
C. pneumothorax.
D. lobar pneumonia

Click here to see the answer

Answer D. Lobar pneumonia

Egophony occurs with consolidation caused by lobar pneumonia.

8. A patient presents with edema, which is most noticeable in the hands and face. Laboratory findings include proteinuria, hypoalbuminemia, and hyperlipidemia. The most likely diagnosis is

A. congestive heart failure.
B. end-stage liver disease.
C. nephrotic syndrome.
D. malnutrition.

Click here to see the answer

Answer: C. nephrotic syndrome.

Proteinuria, hyperlipidemia, and hypoalbuminemia are consistent with nephrotic syndrome.

9. The best course of action for a patient with a bothersome inflamed pinguecula (pingueculitis) is

A. antibiotic drops.
B. excision.
C. Visine drops.
D. no treatment.

Click here to see the answer

Answer: D. no treatment.

With pingueculitis, no treatment is necessary; a short course of NSAID drops or steroids may help.

pinguekula

10. An immunocompromised patient presents with signs and symptoms consistent with Legionella pneumophila who has not responded to initial antibiotic therapy with a macrolide. Which of the following should be added?

A. Clarithromycin (Biaxin)
B. Rifampin (Rifadin)
C. Levofloxacin (Levaquin)
D. Amoxicillin-clavulanate (Augmentin)

Click here to see the answer

Answer B. Rifampin

Rifampin should be used as an adjunct in patients with either a macrolide or quinolone antibiotic, who have failed therapy, are immunocompromised or have severe illness.

Looking for all the episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be be releasing new episodes every two weeks. The Academy is currently discounted, so sign up now.

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1


While you are over there, download and subscribe to Brian Wallaces’ excellent Physician Assistant Exam Review Podcast. Follow along with Brian who covers new topics twice monthly and really does an amazing job!

Cheers,

Stephen Pasquini PA-C

The post The Audio PANCE and PANRE Board Review Podcast Episode 25 appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 25 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. Welcome to episode 25 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.
I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

Download the FREE PDF transcript for FREE here or on Scribd.
Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Questions 1-10
The Audio PANCE and PANRE Episode 25
1. Which of the following conditions will produce a transudative pleural effusion?
A. Kaposi’s sarcoma
B. Pneumonia
C. Cirrhosis
D. Mesothelioma
2. Which of the following pathophysiological processes is believed to initiate acute appendicitis?
A. Obstruction
B. Perforation
C. Hemorrhage
D. Vascular compromise
3. A 23 year-old female with a history of palpitations presents for evaluation. She admits to acute onset of rapid heart beating lasting seconds to minutes with associated shortness of breath and chest pain. The patient states she can relieve her symptoms with Valsalva. Which of the following is the most appropriate diagnostic study to establish a definitive diagnosis in this patient?
A. Cardiac catheterization
B. Cardiac MRI
C. Chest CT scan
D. Electrophysiology study
4. A known alcoholic presents to the emergency department with altered level of consciousness and a blood glucose level of 35 mg/dL. Which of the following best explains this glucose result?
A. Excess pancreatic insulin release
B. Rapid carbohydrate discharge into the small bowel
C. Agonist insulin receptor antibody formation
D. Hepatic glycogen depletion and impaired gluconeogenesis
5. Which of the following is the chief adverse effect of thiazide diuretics?
A. Hypokalemia
B. Hypernatremia
C. Hypocalcemia
D. Hypermagnesemia
6. The most distinctive sign of pertussis is
A. stridor without cough.
B. productive cough with basilar rales.
C. loose cough with coarse rhonchi.
D. paroxysmal cough with crowing inspiration.
7. The finding of egophony is most consistent with
A. emphysema.
B. atelectasis.
C. pneumothorax.
D.]]>
The Physician Assistant Life | Smarty PANCE clean 8:29 165
The Audio PANCE and PANRE Board Review Podcast Episode 23 http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-23/ Tue, 04 Aug 2015 08:25:31 +0000 http://podcast.thepalife.com/?p=110 http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-23/#respond http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-23/feed/ 0 <p>Welcome to episode 23 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. I hope you enjoy this free audio component to the examination portion of this site. The […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-23/">The Audio PANCE and PANRE Board Review Podcast Episode 23</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Welcome to episode 23 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.

I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

adobe pdfDownload the FREE PDF transcript for FREE here or on  Scribd.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Questions 1-10

The Audio PANCE and PANRE Episode 23

1. A 72 year-old female presents with vulvular pruritus for the last nine months, which has progressively worsened over the last two months. She states that she went through menopause at age 54 and has been on estrogen and progesterone therapy since that time. Physical examination reveals red lesions with white plaques on the vulva. What should the next course of management include?

A. Refer to a gynecologist for biopsy.

B. Refer to a dermatologist for antifungal therapy.

C. Treat with a topical steroid.

D. Treat with estrogen cream.

Click here to see the answer

Answer: A. Refer to a gynecologist for biopsy.

Vulvular squamous cell hyperplasia causes thickening and hyperkeratosis of the vulva. The lesions are red and moist and cause intense pruritus over time the area becomes thickened and a white plaque may develop. Biopsy must be done to evaluate for intraepithelial neoplasm or invasive tumor.

2. A 30 year-old female presents to the emergency department with a syncopal episode. She has a history of irregular menstrual cycles and infertility. She has scanty, persistent vaginal bleeding and sharp pelvic pain. A left adnexal mass is palpated. The most likely diagnosis is

A. placenta abruptio.

B. ectopic pregnancy.

C. pelvic inflammatory disease.

D. ruptured ovarian cyst.

Click here to see the answer

Answer B. ectopic pregnancy.

Infertility increases the risk of developing ectopic pregnancy. The onset of vaginal bleeding, pelvic pain, and formation of an adnexal mass makes this the most likely diagnosis.

3. A patient presents complaining of periumbilical pain. Which of the following anatomical sites is this finding associated with?

A. Bladder

B. Stomach

C. Pancreas

D. Small bowel

Click here to see the answer

Answer: D. Small bowel

Pain from the small intestine, appendix, or proximal colon causes periumbilical pain.

4. A 53 year-old patient presents with severe pain at the base of the thumb and no other finger involvement. The pain is worse with activity and lasts a short period of time following rest. There is no specific history of trauma to the thumb but the patient admits working with her hands as a typist. Which of the following is the most likely diagnosis?

A. Rheumatoid arthritis

B. Osteoarthritis

C. Hemochromatosis

D. Pseudogout

Click here to see the answer

Answer: B. Osteoarthritis

The base of the thumb is typically involved with osteoarthritis as are the DIP joints of the other fingers.

5. A 38 year-old female with history of coarctation of the aorta repair at the age of two presents with fevers for four weeks. The patient states that she has felt fatigued and achy during this time. Maximum temperature has been 102.1 degrees F. She denies cough, congestion, or other associated symptoms. Physical examination reveals a pale tired appearing female in no acute distress. Heart reveals a new grade III-IV/VI systolic ejection border at the apex, and a II/VI diastolic murmur at the right sternal border. What is the most likely diagnosis?

A. Acute myocardial infarction

B. Bacterial endocarditis

C. Acute pericarditis

D. Restrictive cardiomyopathy

Click here to see the answer

Answer B: Bacterial endocarditis

Bacterial endocarditis presents as febrile illness lasting several days to weeks, commonly with nonspecific symptoms, echocardiogram often reveals vegetations on affected valves.

6. A 45 year-old male presents with abdominal pain and one episode of mild hematemesis, which happened days ago. On physical examination, vital signs are stable and he is in no acute distress. Hemoglobin and hematocrit are unremarkable; endoscopy reveals non-bleeding small superficial ulceration of the duodenal bulb. Rapid urease test is positive. Which of the following is the most appropriate treatment at this time?

A. Schedule for a selective vagotomy and antrectomy

B. Start an antacid along with omeprazole (Prilosec)

C. Schedule elective ulcer excision and start sucralfate (Carafate)

D. Start omeprazole (Prilosec) and antibiotic therapy against H. pylori

Click here to see the answer

Answer: D. Start omeprazole (Prilosec) and antibiotic therapy against H. pylori

Treatment goals of H. pylori associated ulcers include eradicating the infection with appropriate antibiotics as well as use of a proton pump inhibitor, such as omeprazole,

7. Which of the following findings is usually associated with Addison’s disease?

A. Weight gain

B. Hypertension

C. Increased pigmentation

D. High plasma cortisol levels

Click here to see the answer

Answer: C. Increased pigmentation

Patients with Addison’s disease have diffuse tanning over nonexposed and exposed skin due to increased melanocytic factor that is released with adrenocorticotropic hormone.

8. A 60 year-old patient with COPD characteristic of emphysema presents with a cough and increased sputum production. The following information is noted: Temperature 100°F (37.8°C); Respiratory rate 20/min; Heart rate 88 beats/min; pH 7.44; PaO2 75 mmHg; PaCO2 40 mmHg; O2 saturation 92%. Physical examination is remarkable for increased AP diameter, diminished breath sounds without wheezes, rhonchi, or other signs of respiratory distress. Which of the following would be an appropriate treatment for this patient?

A. Broad-spectrum antibiotic

B. Admission to the hospital

C. Oxygen at 6 L/min by nasal cannula

D. Brief course of oral theophylline

Click here to see the answer

Answer: A. Broad-spectrum antibiotic

A. Sputum production is extremely variable from patient to patient, but any increase in sputum with a history of COPD reported by a patient must be regarded as potentially infectious and treated promptly.

9. Which of the following physical findings suggest pernicious anemia?

A. Splenomegaly and hepatomegaly

B. Petechiae and ecchymosis

C. Loss of position and vibratory sensation

D. Cheilosis and koilonychia

Click here to see the answer

Answer: C. Loss of position and vibratory sensation

Loss of position and vibratory sensation are common neurologic findings in pernicious anemia.

10. A 60 year-old male presents with a normochromic, normocytic anemia and splenomegaly. His past history reveals several episodes of bacterial pneumonia in the past year. The WBC count is 43,000 mm3 with 25% segmented neutrophils, 3% blasts, 70% mature lymphocytes, 1% basophils, and 1% eosinophils. This most likely represents

A. myelodysplastic syndrome.

B. acute lymphocytic leukemia.

C. chronic lymphocytic leukemia.

D. chronic myelogenous leukemia.

Click here to see the answer

Answer: C. chronic lymphocytic leukemia.

Chronic lymphocytic leukemia usually occurs after the age of 50 presenting with lymphocytosis > 20,000 mm3 and lymphocytes that appear mature.

Watch the video

Looking for all the episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be be releasing new episodes every two weeks. The Academy is currently discounted, so sign up now.

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

Cheers,

Stephen Pasquini PA-C

The post The Audio PANCE and PANRE Board Review Podcast Episode 23 appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 23 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. Welcome to episode 23 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.
I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

Download the FREE PDF transcript for FREE here or on  Scribd.
Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Questions 1-10
The Audio PANCE and PANRE Episode 23
1. A 72 year-old female presents with vulvular pruritus for the last nine months, which has progressively worsened over the last two months. She states that she went through menopause at age 54 and has been on estrogen and progesterone therapy since that time. Physical examination reveals red lesions with white plaques on the vulva. What should the next course of management include?
A. Refer to a gynecologist for biopsy.
B. Refer to a dermatologist for antifungal therapy.
C. Treat with a topical steroid.
D. Treat with estrogen cream.
2. A 30 year-old female presents to the emergency department with a syncopal episode. She has a history of irregular menstrual cycles and infertility. She has scanty, persistent vaginal bleeding and sharp pelvic pain. A left adnexal mass is palpated. The most likely diagnosis is
A. placenta abruptio.
B. ectopic pregnancy.
C. pelvic inflammatory disease.
D. ruptured ovarian cyst.
3. A patient presents complaining of periumbilical pain. Which of the following anatomical sites is this finding associated with?
A. Bladder
B. Stomach
C. Pancreas
D. Small bowel
4. A 53 year-old patient presents with severe pain at the base of the thumb and no other finger involvement. The pain is worse with activity and lasts a short period of time following rest. There is no specific history of trauma to the thumb but the patient admits working with her hands as a typist. Which of the following is the most likely diagnosis?
A. Rheumatoid arthritis
B. Osteoarthritis
C. Hemochromatosis
D. Pseudogout
5. A 38 year-old female with history of coarctation of the aorta repair at the age of two presents with fevers for four weeks. The patient states that she has felt fatigued and achy during this time. Maximum temperature has been 102.]]>
The Physician Assistant Life | Smarty PANCE clean 11:25 110
The Audio PANCE and PANRE Board Review Podcast Episode 21 http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-21/ Sun, 07 Jun 2015 09:04:27 +0000 http://podcast.thepalife.com/?p=106 http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-21/#respond http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-21/feed/ 0 <p>Welcome to episode 21 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. I hope you enjoy this free audio component to the examination portion of this site. The […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-21/">The Audio PANCE and PANRE Board Review Podcast Episode 21</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Welcome to episode 21 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.

I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

adobe pdfDownload the FREE PDF transcript for FREE here or on  Scribd.

Listen Carefully Then Take The Quiz

If you can’t see the audio player click here to listen to the full episode.

Questions 1-10

The Audio PANCE and PANRE Episode 21

1. A 28-year-old female, who has experienced occasional painful migratory arthralgias, complains now of a tender, swollen, and hot left ankle. The joint was aspirated and the synovial fluid showed 55,000 WBCs, 75% polymorphonuclear lymphocytes, low glucose level, and no crystals. Which of the following would be the most likely diagnosis?

A. Rheumatoid arthritis
B. Septic arthritis
C. Gouty arthritis
D. Osteoarthritis

Click here to see the answer

Answer: B. Cyanosis

Cyanosis is very common in tetralogy of Fallot.

2. When the diagnosis of gonococcal urethritis is confirmed, which of the following is the treatment of choice?

A. Ceftriaxone (Rocephin)
B. Azithromycin 1g orally in a single dose
C. Ceftriaxone 250 mg IM in a single dose PLUS Azithromycin 1g orally in a single dose
D. Doxycycline (Vibramycin)

Click here to see the answer

Answer: C. Ceftriaxone 250 mg IM in a single dose PLUS Azithromycin 1g orally in a single dose.

Because of resistance, the CDC now recommends dual therapy with Ceftriaxone 250 mg IM in a single dose PLUS Azithromycin 1g orally in a single dose Alertnative regimens if ceftriaxone is not available include Cefixime 400 mg orally in a single dose PLUS Azithromycin 1 g orally in a single dose

3. Erythema nodosum is characterized by

A. subcutaneous red tender nodules.
B. brown pigmentation on the lower extremities.
C. tender lymph nodes in the groin.
D. scaling red macules.

Click here to see the answer

Answer: A, subcutaneous red tender nodules.

Erythema nodosum produces erythematous red tender nodules, especially on the shins.

4. Use of systemic corticosteroids can cause which of the following adverse effects in the eye?

A. Cortical blindness
B. Optic atrophy
C. Glaucoma
D. Papilledema

Click here to see the answer

Answer: C. Glaucoma

Glaucoma can be caused by the long-term use of steroids.

5. It is determined that a woman has a nonexistent rubella titer level during her first trimester of pregnancy. When should she receive the rubella vaccine?

A. During the first trimester of pregnancy
B. During the second trimester of pregnancy
C. During the third trimester of pregnancy
D. After delivery of the infant

Click here to see the answer

Answer: D. After delivery of the infant

The patient should not receive the rubella vaccine during the course of her pregnancy as the possibility of transmission of the rubella virus does exist. During the time that the patient is without protective titer she should avoid anyone with active rubella infection. The proper time to receive the vaccine is after delivery of the infant.

6. A patient with which of the following is at highest risk for coronary artery disease?

A. Congenital heart disease
B. Polycystic ovary syndrome
C. Acute renal failure
D. Diabetes mellitus

Click here to see the answer

Answer: D. Diabetes mellitus

Patients with diabetes mellitus are in the same risk category for coronary artery disease as those patients with established atherosclerotic disease.

7. A 44-year-old female presents with ongoing arthralgias and myalgias with intermittent flares of arthritis. She is found to have a malar rash that worsens with sun exposure. She is known to have progressive renal damage and has recurrent infections that are slow to respond to therapy. She takes ibuprofen (Motrin) as needed for her joint pain and takes no other medication. Which of the following tests would be the initial test recommended to screen for this diagnosis?

A. Rheumatoid factor
B. Antihistone antibodies
C. Anti-Smith (Anti-Sm) antibodies
D. Anti-nuclear antibodies (ANA)

Click here to see the answer

Answer: A. Glipizide

Sulfonylureas increase insulin levels and predispose patients to hypoglycemia.

8. Upon stroking of the lateral aspect of the sole from the heel to the ball of the foot, the great toe dorsiflexes and the other toes fan. This is a positive

A. Kernig’s sign.
B. Brudzinski’s sign.
C. Babinski’s sign.
D. Gower’s sign.

Click here to see the answer

Answer: C. A Babinski test is performed by stroking the lateral aspect of the sole from the heel to the ball of the foot, the great toe dorsiflexes and the other toes fan in a positive test.

For your knowledge:

Kernig’s sign is positive when pain is noted on straightening the knee after flexing both the hip and knee.

Brudzinski’s sign occurs with neck flexion resulting in resultant flexion of the hips. It is a sign of meningeal irritation.

A positive Gower’s sign is noted in certain types of muscular dystrophy and is described as children rising to stand by rolling over prone and pushing off the floor with arms while the legs remain extended.

9. Which of the following strategies promotes improved carbohydrate metabolism and is recommended for all Type 2 diabetic patients?

A. Low-carbohydrate, high-protein diet
B. Routine aerobic exercise
C. Metformin (Glucophage)
D. Acupuncture

Click here to see the answer

Answer: B. Routine aerobic exercise

Routine exercise improves carbohydrate metabolism and insulin sensitivity.

10. Acute rebound hypertensive episodes have been reported to occur with the sudden withdrawal of

A. verapamil (Calan).
B. lisinopril (Prinivil).
C. clonidine (Catapres).
D. hydrochlorothiazide (HCTZ)

Click here to see the answer

Answer: C, Clonodine

Clonidine (Catapres) is a central alpha agonist and abrupt withdrawal may produce a rebound hypertensive crisis.

Looking for all the episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be be releasing new episodes every two weeks. The Academy is currently discounted, so sign up now.

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

 

Cheers,

Stephen Pasquini PA-C

The post The Audio PANCE and PANRE Board Review Podcast Episode 21 appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 21 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. Welcome to episode 21 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.
I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

Download the FREE PDF transcript for FREE here or on  Scribd.

Listen Carefully Then Take The Quiz
If you can’t see the audio player click here to listen to the full episode.
Questions 1-10
The Audio PANCE and PANRE Episode 21
1. A 28-year-old female, who has experienced occasional painful migratory arthralgias, complains now of a tender, swollen, and hot left ankle. The joint was aspirated and the synovial fluid showed 55,000 WBCs, 75% polymorphonuclear lymphocytes, low glucose level, and no crystals. Which of the following would be the most likely diagnosis?
A. Rheumatoid arthritis
B. Septic arthritis
C. Gouty arthritis
D. Osteoarthritis
2. When the diagnosis of gonococcal urethritis is confirmed, which of the following is the treatment of choice?
A. Ceftriaxone (Rocephin)
B. Azithromycin 1g orally in a single dose
C. Ceftriaxone 250 mg IM in a single dose PLUS Azithromycin 1g orally in a single dose
D. Doxycycline (Vibramycin)
3. Erythema nodosum is characterized by
A. subcutaneous red tender nodules.
B. brown pigmentation on the lower extremities.
C. tender lymph nodes in the groin.
D. scaling red macules.
4. Use of systemic corticosteroids can cause which of the following adverse effects in the eye?
A. Cortical blindness
B. Optic atrophy
C. Glaucoma
D. Papilledema
5. It is determined that a woman has a nonexistent rubella titer level during her first trimester of pregnancy. When should she receive the rubella vaccine?
A. During the first trimester of pregnancy
B. During the second trimester of pregnancy
C. During the third trimester of pregnancy
D. After delivery of the infant
6. A patient with which of the following is at highest risk for coronary artery disease?
A. Congenital heart disease
B. Polycystic ovary syndrome
C. Acute renal failure
D. Diabetes mellitus
7. A 44-year-old female presents with ongoing arthralgias and myalgias with intermittent flares of arthritis. She is found to have a malar rash that worsens with sun exposure. She is known to have progressive renal damage and has recurrent infections that are slow to respond to therapy.]]>
The Physician Assistant Life | Smarty PANCE clean 9:43 106
The Audio PANCE and PANRE Board Review Podcast Episode 19 http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-19/ Sat, 02 May 2015 14:34:53 +0000 http://podcast.thepalife.com/?p=99 http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-19/#respond http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-19/feed/ 0 <p>Welcome to episode 19 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. I hope you enjoy this free audio component to the examination portion of this site. The […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-19/">The Audio PANCE and PANRE Board Review Podcast Episode 19</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Welcome to episode 19 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.

I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

adobe pdfUse one of the social links below to unlock and download the FREE PDF Transcript of this podcast:

[sociallocker id=”10126″]Download the PDF for FREE here or on  Scribd [/sociallocker]

Listen Carefully Then Take The Quiz

Questions 1-10

The Audio PANCE and PANRE Episode 17

1. A 12 month-old child with tetralogy of Fallot is most likely to have which of the following clinical features?

A. Chest pain
B. Cyanosis
C. Convulsions
D. Palpitations

Click here to see the answer

Answer: B. Cyanosis

Cyanosis is very common in tetralogy of Fallot.

2. Intraarticular injection of hyaluronic acid has been approved for treatment of patients with which of the following conditions?

A. Rheumatoid arthritis of the knee
B. Osteoarthritis of the knee
C. Olecranon bursitis
D. Gouty arthritis

Click here to see the answer

Answer: B. Osteoarthritis of the knee

Intraarticular injection of hyaluronic acid has been approved recently for treatment of patients with osteoarthritis of the knee that have failed other therapies. Although the onset of action of this medication is slower than injected glucocorticoids, it has a sustained length of activity outlasting the injected glucocorticoids.

3. A 28 year-old female, who has experienced occasional painful migratory arthralgias, complains now of a tender, swollen, and hot left ankle. The joint was aspirated and the synovial fluid showed 55,000 WBCs, 75% polymorphonuclear lymphocytes, low glucose level, and no crystals. Which of the following would be the most likely diagnosis?

A. Rheumatoid arthritis
B. Septic arthritis
C. Gouty arthritis
D. Osteoarthritis

Click here to see the answer

Answer:  B. Septic arthritis

Septic arthritis presents with a large number of WBCs, predominantly polymorphonuclear, and with glucose levels much lower than serum levels.

4. A 25 year-old presents with pain in the proximal ulna after falling directly on the forearm. X-ray shows fracture of the proximal 1/3rd of the ulna. There is an associated anterior radial head dislocation. What is the proper name for this condition?

A. Galeazzi fracture
B. Monteggia fracture
C. Colles’ fracture
D. Smith fracture

Click here to see the answer

Answer: B. Monteggia fracture

A Monteggia fracture is a fracture of the proximal ulna with anterior dislocation of the radial head.

5. A 20 year-old male presents with a mass in the groin. On examination with the patient standing, a mass is noted that extends into the scrotum. The patient denies any trauma. The most likely diagnosis is

A. an indirect inguinal hernia.
B. a direct inguinal hernia.
C. an obturator hernia.
D. a femoral hernia.

Click here to see the answer

Answer: A. an indirect inguinal hernia.

An indirect inguinal hernia is caused by a patent processus vaginalis and the hernial contents may be felt in the ipsilateral scrotum.

6. A patient with type 2 diabetes mellitus presents for a yearly eye exam. Ophthalmoscopic exam reveals neovascularization. Which of the following is the most likely complication related to this finding?

A. Glaucoma
B. Cataracts
C. Vitreous hemorrhage
D. Optic neuritis

Click here to see the answer

Answer: C. Vitreous hemorrhage

Proliferative retinopathy, as evidenced by neovascularization, is associated with an increased risk of vitreous hemorrhage.

7. Which of the following oral hypoglycemic agents when used as monotherapy is most likely to cause hypoglycemia?

A. Glipizide (Glucotrol)
B. Metformin (Glucophage)
C. Pioglitazone (Actos)
D. Acarbose (Precose)

Click here to see the answer

Answer: A. Glipizide

Sulfonylureas increase insulin levels and predispose patients to hypoglycemia.

8. A 75 year-old female presents with medial knee pain that worsens with stair climbing. Physical examination reveals swelling and point tenderness inferior and medial to the patella and tenderness overlying the medial tibial plateau. Which of the following is the most likely diagnosis?

A. Pes anserine bursitis
B. Prepatellar bursitis
C. Infrapatellar bursitis
D. Trochanteric bursitis

Click here to see the answer

Answer: A. Pes anserine bursitis

The pes anserine bursa underlies the semimembranosus tendon and may become inflamed or painful owing to trauma, overuse, or inflammation. It is a common cause of knee pain and it is often misdiagnosed in adults.

9. A 23 year-old male presents with syncope. On physical examination you note a medium-pitched, mid-systolic murmur that decreases with squatting and increases with straining. Which of the following is the most likely diagnosis?

A. Hypertrophic cardiomyopathy
B. Aortic stenosis
C. Mitral regurgitation
D. Pulmonic stenosis

Click here to see the answer

Answer: A. Hypertrophic cardiomyopathy

Hypertrophic cardiomyopathy is characterized by a medium- pitched, mid-systolic murmur that decreases with squatting and increases with straining.

10. Which of the following can be a very serious consequence of using antidiarrheals in a patient with inflammatory bowel disease?

A. Lymphoma
B. Toxic megacolon
C. Bone marrow suppression
D. Delayed serum sickness-like reaction

Click here to see the answer

Answer: B. Toxic megagolon.

Antidiarrheals may cause the development of toxic megacolon when used by patients with active severe inflammatory bowel disease.

Looking for all the episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be be releasing new episodes every two weeks. The Academy is currently discounted, so sign up now.

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

The post The Audio PANCE and PANRE Board Review Podcast Episode 19 appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 19 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. Welcome to episode 19 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.
I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

Use one of the social links below to unlock and download the FREE PDF Transcript of this podcast:
[sociallocker id=”10126″]Download the PDF for FREE here or on  Scribd [/sociallocker]
Listen Carefully Then Take The Quiz
Questions 1-10
The Audio PANCE and PANRE Episode 17
1. A 12 month-old child with tetralogy of Fallot is most likely to have which of the following clinical features?
A. Chest pain
B. Cyanosis
C. Convulsions
D. Palpitations
2. Intraarticular injection of hyaluronic acid has been approved for treatment of patients with which of the following conditions?
A. Rheumatoid arthritis of the knee
B. Osteoarthritis of the knee
C. Olecranon bursitis
D. Gouty arthritis
3. A 28 year-old female, who has experienced occasional painful migratory arthralgias, complains now of a tender, swollen, and hot left ankle. The joint was aspirated and the synovial fluid showed 55,000 WBCs, 75% polymorphonuclear lymphocytes, low glucose level, and no crystals. Which of the following would be the most likely diagnosis?
A. Rheumatoid arthritis
B. Septic arthritis
C. Gouty arthritis
D. Osteoarthritis
4. A 25 year-old presents with pain in the proximal ulna after falling directly on the forearm. X-ray shows fracture of the proximal 1/3rd of the ulna. There is an associated anterior radial head dislocation. What is the proper name for this condition?
A. Galeazzi fracture
B. Monteggia fracture
C. Colles’ fracture
D. Smith fracture
5. A 20 year-old male presents with a mass in the groin. On examination with the patient standing, a mass is noted that extends into the scrotum. The patient denies any trauma. The most likely diagnosis is
A. an indirect inguinal hernia.
B. a direct inguinal hernia.
C. an obturator hernia.
D. a femoral hernia.
6. A patient with type 2 diabetes mellitus presents for a yearly eye exam. Ophthalmoscopic exam reveals neovascularization. Which of the following is the most likely complication related to this finding?
A. Glaucoma
B. Cataracts
C. Vitreous hemorrhage
D. Optic neuritis
7. Which of the following oral hypoglycemic agents when used as monotherapy is most likely to cause hypoglycemia?
A. Glipizide (Glucotrol)
B. Metformin (Glucophage)
C. Pioglitazone (Actos)
D. Acarbose (Precose)
8.]]>
The Physician Assistant Life | Smarty PANCE clean 8:09 99
The Audio PANCE and PANRE Board Review Podcast Episode 17 http://podcast.thepalife.com/episode-17/ Wed, 25 Mar 2015 12:00:38 +0000 http://podcast.thepalife.com/?p=93 http://podcast.thepalife.com/episode-17/#respond http://podcast.thepalife.com/episode-17/feed/ 0 <p>Welcome to episode 17 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. I hope you enjoy this free audio component to the examination portion of this site. The […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/episode-17/">The Audio PANCE and PANRE Board Review Podcast Episode 17</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> Welcome to episode 17 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.

I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

You can download a Free PDF Transcript of the Questions and Answers

Listen Carefully Then Take The Quiz

Questions 1-10

The Audio PANCE and PANRE Episode 17

1. A 64 year-old male presents complaining of new onset of fatigue, weight gain, constipation, erectile dysfunction, and loss of body hair. Laboratory investigation demonstrates: TSH less than 0.5 microunits/mL (normal range 0.5-5.0 microU/mL); Thyroxine (T4) 2 mcg/dL (normal range 5-12 mcg/dL); Prolactin 10 nanograms/ml (normal 2 – 18 ng/mL.) What is the most likely diagnosis?

A. Primary hypothyroidism
B. Excessive dosing of levothyroxine (Synthroid)
C. Hypopituitarism
D. Subacute thyroiditis

Click here to see the answer
C. The low trophic and target hormone levels combined with symptoms of hypogonadism indicate this patient has hypopituitarism.

2. A 15 year-old male was seen last week with complaints of sore throat, headache, and mild cough. A diagnosis of URI was made and supportive treatment was initiated. He returns today with complaints of worsening cough and increasing fatigue. At this time, chest x-ray reveals bilateral hilar infiltrates. A WBC count is normal and a cold hemagglutinin titer is elevated. The most likely diagnosis is

A. tuberculosis.
B. mycoplasma pneumonia.
C. pneumococcal pneumonia.
D. staphylococcal pneumonia.

Click here to see the answer
B. The insidious onset of symptoms, the interstitial infiltrate on chest x-ray, and elevated cold hemagglutinin titer make this diagnosis the most likely.

3. Which of the following clinical manifestations is common in candidal vulvovaginitis?

A. Extreme vulvar irritation
B. Firm, painless ulcer
C. Tender lymphadenopathy
D. Purulent discharge

Click here to see the answer
A. Candida infection presents with pruritus, vulvovaginal erythema, and white, cheese-like (curd) discharge that may be malodorous.

4. A 63 year-old female presents with a complaint of chest pressure for one hour, noticed upon awakening. She admits to associated nausea, vomiting, and shortness of breath. 12 lead EKG reveals ST segment elevation in leads II, III, and AVF. Which of the following is the most likely diagnosis?

A. Aortic dissection
B. Inferior wall myocardial infarction
C. Acute pericarditis
D. Pulmonary embolus

Click here to see the answer
B. Myocardial infarction often presents with chest pressure and associated nausea and vomiting. ST segment elevation in leads II, III, and AVF are classic findings seen in acute inferior wall myocardial infarction.

5. An 18 year-old woman presents to the clinic complaining of fatigue. She reports a past history of lifelong frequent nosebleeds and bleeding gums. She also has menorrhagia. Her mother and maternal grandfather have a similar bleeding history. Initial lab results are as follows: WBC 9,500/mm3, Hgb 10.9 g/dL, HCT 33%, MCV 69 fL, MCHC 26 pg and platelets 284,000/mm3. Which of the following tests should be ordered to evaluate this patient’s diagnosis?

A. Hemoglobin electrophoresis
B. Bleeding time and platelet aggregometry
C. Bone marrow aspiration
D. PT and aPTT

Click here to see the answer
B. The patient’s presentation is consistent with a congenital qualitative platelet disorder, most likely von Willebrand’s Disease, necessitating a bleeding time and evaluation of platelet function.

6. A 35 year-old patient has recurrent seasonal rhinitis and a history of mild asthma. Which of the following should be included for first-line management?

A. Immunotherapy
B. Decongestants
C. Corticosteroid inhalers
D. Cromolyn sodium (Intal)

Click here to see the answer
C. Regular use of corticosteroid nasal spray and oral inhalers prior to the allergy season is among the best means of preventing allergies.

7. A 35-year-old female presents with multiple ulcerative lesions on her labia and perineum. A Tzanck preparation of one of the lesions reveals multinucleated giant cells. Which of the following is the most likely diagnosis?

A. Herpes Simplex Virus (HSV)
B. Molluscum Contagiosum Virus (MCV)
C. Human Papilloma Virus (HPV)
D. Syphilis

Click here to see the answer
A. The presentation seen on the Tzanck preparation is characteristic of HSV.

8. Small grayish vesicles and punched-out ulcers in the posterior pharynx in a child with pharyngitis is representative of which organism?

A. Epstein-Barr virus
B. Group C Streptococcus
C. Coxsackievirus
D. Gonorrhea

Click here to see the answer
C. Coxsackievirus presents with small grayish vesicles and punched-out ulcers in the posterior pharynx.

9. A 53 year-old female has a diagnosis of migraine headaches. She had been using sumatriptan (Imitrex) to abort her headaches, but she is now having one or two headaches per week. The most appropriate preventive therapy is

A. zolmitriptan (Zomig).
B. promethazine (Phenergan).
C. propranolol (Inderal).
D. fluoxetine (Prozac).

Click here to see the answer
C. Propanolol is useful in preventing migraine headaches and may be maintained indefinitely.

10. Which of the following primitive reflexes should begin to disappear at about 2 months of age in a normal infant?

A. Moro
B. Grasp
C. Tonic neck
D. Parachute

Click here to see the answer
B. The grasp reflex starts to disappear at about 2-3 months of age.

Looking for all the episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be be releasing new episodes every two weeks. The Academy is currently discounted, so sign up now.

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

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The post The Audio PANCE and PANRE Board Review Podcast Episode 17 appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 17 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. Welcome to episode 17 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.
I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

Listen Carefully Then Take The Quiz
Questions 1-10
The Audio PANCE and PANRE Episode 17
1. A 64 year-old male presents complaining of new onset of fatigue, weight gain, constipation, erectile dysfunction, and loss of body hair. Laboratory investigation demonstrates: TSH less than 0.5 microunits/mL (normal range 0.5-5.0 microU/mL); Thyroxine (T4) 2 mcg/dL (normal range 5-12 mcg/dL); Prolactin 10 nanograms/ml (normal 2 – 18 ng/mL.) What is the most likely diagnosis?
A. Primary hypothyroidism
B. Excessive dosing of levothyroxine (Synthroid)
C. Hypopituitarism
D. Subacute thyroiditis
2. A 15 year-old male was seen last week with complaints of sore throat, headache, and mild cough. A diagnosis of URI was made and supportive treatment was initiated. He returns today with complaints of worsening cough and increasing fatigue. At this time, chest x-ray reveals bilateral hilar infiltrates. A WBC count is normal and a cold hemagglutinin titer is elevated. The most likely diagnosis is
A. tuberculosis.
B. mycoplasma pneumonia.
C. pneumococcal pneumonia.
D. staphylococcal pneumonia.
3. Which of the following clinical manifestations is common in candidal vulvovaginitis?
A. Extreme vulvar irritation
B. Firm, painless ulcer
C. Tender lymphadenopathy
D. Purulent discharge
4. A 63 year-old female presents with a complaint of chest pressure for one hour, noticed upon awakening. She admits to associated nausea, vomiting, and shortness of breath. 12 lead EKG reveals ST segment elevation in leads II, III, and AVF. Which of the following is the most likely diagnosis?
A. Aortic dissection
B. Inferior wall myocardial infarction
C. Acute pericarditis
D. Pulmonary embolus
5. An 18 year-old woman presents to the clinic complaining of fatigue. She reports a past history of lifelong frequent nosebleeds and bleeding gums. She also has menorrhagia. Her mother and maternal grandfather have a similar bleeding history. Initial lab results are as follows: WBC 9,500/mm3, Hgb 10.9 g/dL, HCT 33%, MCV 69 fL, MCHC 26 pg and platelets 284,000/mm3. Which of the following tests should be ordered to evaluate this patient’s diagnosis?
A. Hemoglobin electrophoresis
B. Bleeding time and platelet aggregometry
C. Bone marrow aspiration
D. PT and aPTT
6. A 35 year-old patient has recurrent seasonal rhinitis and a history of mild asthma. Which of the following should be included for first-line management?
A. Immunotherapy
B. Decongestants
C. Corticosteroid inhalers
D. Cromolyn sodium (Intal)
7. A 35-year-old female presents with multiple ulcerative lesions on her labia and perineum. A Tzanck preparation of one of the lesions reveal...]]>
The Physician Assistant Life | Smarty PANCE clean 8:05 93
The Audio PANCE and PANRE Board Review Podcast Episode 15 http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-15/ Sat, 14 Feb 2015 03:26:01 +0000 http://podcast.thepalife.com/?p=83 http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-15/#respond http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-15/feed/ 0 <p>Welcome to episode 15 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. I hope you enjoy this free audio component to the examination portion of this site. The […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/the-audio-pance-and-panre-board-review-podcast-episode-15/">The Audio PANCE and PANRE Board Review Podcast Episode 15</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> The Audio PANCE and PANRE Episode 15 - The Physician Assistant Life Board Review PodcastWelcome to episode 15 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.

I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

Download a Free PDF Transcript of the Questions and Answers

Listen Carefully Then Take The Quiz

Questions 1-10

The Audio PANCE and PANRE Episode 15

1. A patient with prostate cancer has a nonpalpable, focal lesion, and the patient is reluctant to have surgery at this time. Which of the following would best monitor disease progression?

A. Periodic rectal exams
B. Transrectal ultrasonography
C. Measurements of serum acid phosphatase
D. Measurements of prostate-specific antigen

Click here to see the answer
D. Measurements of prostate-specific antigen – PSA measurement correlates well with volume and stage of disease and is the recommended examination for monitoring disease progression

2. If a woman has a normal 28-day menstrual cycle what tissue and hormonal phase occurs during the last 14 days

A. Proliferative follicular phase under the influence of estrogen.
B. Secretory luteal phase under the influence of estrogen and progesterone.
C. Proliferative follicular phase under the influence of estrogen and progesterone.
D. Secretory luteal phase under the influence of estrogen

Click here to see the answer
B. Secretory luteal phase under the influence of estrogen and progesterone. – The endometrial changes seen in the latter half of the cycle are under the influence of both estrogen and progesterone from the corpus luteum. During this phase, the endometrium becomes more vascularized and slightly edematous.

3. A 24 year-old male presents for routine physical examination. On physical examination, you find that the patient’s upper extremity blood pressure is higher than the blood pressure in the lower extremity. Heart exam reveals a late systolic murmur heard best posteriorly. What is the most likely diagnosis in this patient?

A. Hypertrophic obstructive cardiomyopathy
B. Patent foramen ovale
C. Coarctation of the aorta
D. Patent ductus arteriosus

Click here to see the answer
C. Coarctation of the aorta -Coarctation of the aorta commonly presents with higher systolic pressures in the upper extremities than the lower extremities and absent or weak femoral pulses

4. A mother brings a 3 month-old infant to the office because she is concerned about a red, vascular, nodular growth on the child’s back. It appears to be enlarging slightly and the vessels are slightly dilated. It seems to cause the child no discomfort. The most likely diagnosis is

A. a hemangioma.
B. a pigmented nevus.
C. a salmon patch (stork bite).
D. a malignant melanoma.

Click here to see the answer
A. A hemangioma – A hemangioma is a bright red to deep purple vascular nodule or plaque that often develops at birth, may enlarge, and may regress and disappear with aging.

5. A 45 year-old male with Type 1 diabetes presents with the following lipid panel: Total cholesterol 321 mg/dL; Triglycerides 225 mg/dL; HDL 30 mg/dL; LDL 155 mg/dL. The treatment of choice for this patient is

A. Nicotinic acid (Niacin).
B. Cholestyramine (Questran).
C. Gemfibrozil (Lopid).
D. Simvastatin (Zocor).

Click here to see the answer
D. Simvastatin – As of now, Simvastatin is still considered the drug of choice – as it will decreases triglyceride level, decrease LDL, and increase HDL. (I do foresee changes to this recommendation in the future)

6. A 45 year-old male presents with abdominal pain and one episode of mild hematemesis, which happened days ago. On physical examination, vital signs are stable and he is in no acute distress. Hemoglobin and hematocrit are unremarkable; endoscopy reveals non-bleeding small superficial ulceration of the duodenal bulb. Rapid urease test is positive. Which of the following is the most appropriate treatment at this time?

A. Schedule for a selective vagotomy and antrectomy
B. Start an antacid along with omeprazole (Prilosec)
C. Schedule elective ulcer excision and start sucralfate (Carafate)
D. Start omeprazole (Prilosec) and antibiotic therapy against H. pylori

Click here to see the answer
D. Start omeprazole (Prilosec) and antibiotic therapy against H. pylori – Treatment goals of H. pylori associated ulcers include eradicating the infection with appropriate antibiotics as well as use of a proton pump inhibitor, such as omeprazole, to promote ulcer healing.

7. A 19 year-old female presents with a sore throat for nearly two weeks. She complains of fatigue and a low-grade fever. On physical examination, there is cervical, axillary, and inguinal lymphadenopathy, and mild splenomegaly. On review of the blood smear, which of the following would be expected?

A. Atypical lymphocytes
B. Hypersegmented neutrophils
C. Hypochromic red blood cells
D. Schistocytes

Click here to see the answer
A. Atypical lymphocytes – The hallmark of infectious mononucleosis is the presence of lymphocytosis with atypical large lymphocytes seen in the blood smear. These are larger than normal mature lymphocytes, stain more darkly, and frequently show vacuolated, foamy cytoplasm, and dark chromatin in the nucleus.

8. Which of the following increases the risk of developing testicular cancer?

A. Low socioeconomic status
B. History of cryptorchidism
C. Multiple episodes of epididymitis
D. Being of African-American ethnicity

Click here to see the answer
History of cryptorchidism – The major predisposing risk factor is cryptorchidism unrepaired until after age two.

9. A 17 year-old patient presents to the emergency department with agitation and hallucinations, and has one seizure. He admits to using “some drugs” but does not know what they were. On physical examination, temperature is 103 degrees F, BP 140/90, pulse 120, respirations 20. Remainder of the examination is unremarkable. Which of the following diagnostic studies will be of most help in managing this patient?

A. Drug screen
B. Urine dipstick
C. Complete blood count
D. Serum creatinine kinase

Click here to see the answer
D. Serum creatinine kinase – Serum creatinine kinase is the most sensitive test to detect rhabdomyolysis, a serious complication of seizures and hyperthermia related to drug abuse.
(note) * A. Although a drug screen may identify specific drugs, the results will not alter the care of this patient.
.

10. Which of the following medications is the treatment of choice for patients with chronic gout to prevent recurrence of symptoms during its quiescent phase?

A. Probenecid (Benemid)
B. Allopurinol (Zyloprim)
C. Colchicine
D. Indomethacin (Indocin)

Click here to see the answer
B. Allopurinol – Allopurinol is the best drug to lower serum urate in overproducers, stone formers, and patients with advanced renal failure. It is a xanthine oxidase inhibitor that is used to prevent the formation of uric acid.

Looking for all the episodes?

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be be releasing new episodes every two weeks. The Academy is currently discounted, so sign up now.

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

The post The Audio PANCE and PANRE Board Review Podcast Episode 15 appeared first on The Audio PANCE and PANRE.

]]>
Welcome to episode 15 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. Welcome to episode 15 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.
The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.
I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

Listen Carefully Then Take The Quiz
Questions 1-10
The Audio PANCE and PANRE Episode 15
1. A patient with prostate cancer has a nonpalpable, focal lesion, and the patient is reluctant to have surgery at this time. Which of the following would best monitor disease progression?
A. Periodic rectal exams
B. Transrectal ultrasonography
C. Measurements of serum acid phosphatase
D. Measurements of prostate-specific antigen
2. If a woman has a normal 28-day menstrual cycle what tissue and hormonal phase occurs during the last 14 days
A. Proliferative follicular phase under the influence of estrogen.
B. Secretory luteal phase under the influence of estrogen and progesterone.
C. Proliferative follicular phase under the influence of estrogen and progesterone.
D. Secretory luteal phase under the influence of estrogen
3. A 24 year-old male presents for routine physical examination. On physical examination, you find that the patient’s upper extremity blood pressure is higher than the blood pressure in the lower extremity. Heart exam reveals a late systolic murmur heard best posteriorly. What is the most likely diagnosis in this patient?
A. Hypertrophic obstructive cardiomyopathy
B. Patent foramen ovale
C. Coarctation of the aorta
D. Patent ductus arteriosus
4. A mother brings a 3 month-old infant to the office because she is concerned about a red, vascular, nodular growth on the child’s back. It appears to be enlarging slightly and the vessels are slightly dilated. It seems to cause the child no discomfort. The most likely diagnosis is
A. a hemangioma.
B. a pigmented nevus.
C. a salmon patch (stork bite).
D. a malignant melanoma.
5. A 45 year-old male with Type 1 diabetes presents with the following lipid panel: Total cholesterol 321 mg/dL; Triglycerides 225 mg/dL; HDL 30 mg/dL; LDL 155 mg/dL. The treatment of choice for this patient is
A. Nicotinic acid (Niacin).
B. Cholestyramine (Questran).
C. Gemfibrozil (Lopid).
D. Simvastatin (Zocor).
6. A 45 year-old male presents with abdominal pain and one episode of mild hematemesis, which happened days ago. On physical examination, vital signs are stable and he is in no acute distress. Hemoglobin and hematocrit are unremarkable; endoscopy reveals non-bleeding small superficial ulceration of the duodenal bulb. Rapid urease test is positive. Which of the following is the most appropriate treatment at this time?
A. Schedule for a selective vagotomy and antrectomy
B. Start an antacid along with omeprazole (Prilosec)
C. Schedule elective ulcer excision and start sucralfate (Carafate)
D.]]>
The Physician Assistant Life | Smarty PANCE clean 9:27 83
The Audio PANCE and PANRE Board Review Podcast Episode 13 http://podcast.thepalife.com/the-audio-pance-and-panre-episode-13/ Fri, 16 Jan 2015 01:37:30 +0000 http://podcast.thepalife.com/?p=67 http://podcast.thepalife.com/the-audio-pance-and-panre-episode-13/#respond http://podcast.thepalife.com/the-audio-pance-and-panre-episode-13/feed/ 0 <p>The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy. You can […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/the-audio-pance-and-panre-episode-13/">The Audio PANCE and PANRE Board Review Podcast Episode 13</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> The Audio PANCE and PANRE Episode 13 - The Physician Assistant LifeThe Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.

I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
  • You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

Download a Free PDF Transcript of the Questions and Answers

Listen Carefully Then Take The Quiz

Questions 1-10

The Audio PANCE and PANRE Episode 13

1. During a baseball game, a 22 year-old college student is hit in the right eye by a baseball. He complains of blurry vision in that eye. On physical exam, the physician assistant notes proptosis of the right eye, and limitation of movement in all directions. On CT scan, which of the following is most likely to be seen?

A. Fracture of the medial orbital wall
B. Prolapse of orbital soft tissue
C. Hematoma of the orbit
D. Orbital emphysema

Click here to see the answer
C. Hematoma of the orbit – Orbital hemorrhage into the space surrounding the globe following blunt trauma and rupture of the orbital vessels results in increased ocular pressure, proptosis, visual loss, and limitation of movement in all directions. CT reveals a hematoma.

2. Which of the following physical findings is suggestive of atrial septal defect?

A. Fixed split S2
B. Increased pulse pressure
C. Continuous mechanical murmur
D. Difference in blood pressure between the left and right arm

Click here to see the answer
A. Fixed split S2 – An atrial septal defect will cause a shunt of blood from the left to the right atrium. This will result in an equalization in the amount of blood entering both the left and right ventricles which effectively eliminates the normally wide splitting that inspiration typically causes in hearts without an atrial septal defect.

3. Which of the following is essential to make a diagnosis of cystic fibrosis?

A. Positive family history
B. Elevated sweat chloride
C. Recurrent respiratory infections
D. Elevated trypsinogen levels

Click here to see the answer
B. Elevated sweat chloride – The diagnosis of cystic fibrosis is made only after an elevated sweat chloride test or demonstration of a genotype consistent with cystic fibrosis.

4. In infants, the eyes should move in parallel without deviation by the age of

A. 2 weeks.
B. 3 months.
C. 6 months.
D. 1 year.

Click here to see the answer
C. 6 months – Intermittent alternating convergent strabismus is frequently noted for the first 6 months of life, but referral is indicated if it persists beyond 6 months.

5. Which of the following physical exam findings is consistent with moderate emphysema?

A. Increased tactile fremitus
B. Dullness to percussion
C. Distant heart sounds
D. Deviated trachea

Click here to see the answer
C. Distant heart sounds – Distant heart sounds are common in emphysema patients due to hyperinflation of the lungs.

6. Which of the following is the most common indication for operative intervention in patients with chronic pancreatitis?

A. Weight loss
B. Intractable pain
C. Exocrine deficiency
D. To decrease risk of cancer

Click here to see the answer
B. Intractable pain – Indications for surgical treatment of chronic pancreatitis include severe pain that limits the patient’s functioning or intractable pain despite the use of non-narcotic analgesics and absence of alcohol intake.

7. A 22 year old male presents to the ED with pain that radiates to his shoulders and is relieved with sitting forward. The patient admits to recent upper respiratory symptoms. On examination vital signs are BP 126/68, HR 86, RR 20, temp 100.3 degrees F. There is no JVD noted. Heart exam reveals regular rate and rhythm with no S3 or S4. There is a friction rub noted. Lungs are clear to auscultation. EKG shows diffuse ST segment elevation. What is the treatment of choice in this patient?

A. Pericardiocentesis
B. Nitroglycerin
C. Percutaneous coronary intervention
D. Indomethacin (Indocin)

Click here to see the answer
D. Indomethacin (Indocin) – Indomethacin, a nonsteroidal anti-inflammatory medication, is the treatment of choice in a patient with acute pericarditis.

8. As a general rule, sutures in the face should be removed in

A. 3 days.
B. 5 days.
C. 7 days.
D. 10 days.

Click here to see the answer
B. 5 days – Sutures of the face should be removed in 5 days in order to allow for adequate healing and to limit the amount of scarring.

9. Patient education for a 23 year-old using oral contraceptives should include which of the following?

A. Rifampin may decrease the effectiveness of the oral contraceptives.
B. Acetaminophen may decrease the effectiveness of the oral contraceptives.
C. Oral contraceptives may provide some protection from coronary artery disease.
D. Changing to the “minipill” (progestin only) will inhibit ovulation more consistently than combination oral contraceptives.

Click here to see the answer
A. Rifampin may interfere with the efficacy of the oral contraceptives.

10. When performing a rectal examination, prostatic massage is contraindicated in

A. acute bacterial prostatitis.
B. chronic bacterial prostatitis.
C. nonbacterial prostatitis.
D. prostatodynia.

Click here to see the answer
A. Acute bacterial prostatitis – Vigorous manipulation of the prostate during rectal examination may result in septicemia. This is contraindicated in the presence of fever, irritative voiding symptoms, and perineal/sacral pain.

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

itunes_logo-1

The post The Audio PANCE and PANRE Board Review Podcast Episode 13 appeared first on The Audio PANCE and PANRE.

]]>
The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. I hope you enjoy this free audio component to the examination portion of this site. The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.
I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio.
* You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

Listen Carefully Then Take The Quiz
Questions 1-10
The Audio PANCE and PANRE Episode 13
1. During a baseball game, a 22 year-old college student is hit in the right eye by a baseball. He complains of blurry vision in that eye. On physical exam, the physician assistant notes proptosis of the right eye, and limitation of movement in all directions. On CT scan, which of the following is most likely to be seen?
A. Fracture of the medial orbital wall
B. Prolapse of orbital soft tissue
C. Hematoma of the orbit
D. Orbital emphysema
2. Which of the following physical findings is suggestive of atrial septal defect?
A. Fixed split S2
B. Increased pulse pressure
C. Continuous mechanical murmur
D. Difference in blood pressure between the left and right arm
3. Which of the following is essential to make a diagnosis of cystic fibrosis?
A. Positive family history
B. Elevated sweat chloride
C. Recurrent respiratory infections
D. Elevated trypsinogen levels
4. In infants, the eyes should move in parallel without deviation by the age of
A. 2 weeks.
B. 3 months.
C. 6 months.
D. 1 year.
5. Which of the following physical exam findings is consistent with moderate emphysema?
A. Increased tactile fremitus
B. Dullness to percussion
C. Distant heart sounds
D. Deviated trachea
6. Which of the following is the most common indication for operative intervention in patients with chronic pancreatitis?
A. Weight loss
B. Intractable pain
C. Exocrine deficiency
D. To decrease risk of cancer
7. A 22 year old male presents to the ED with pain that radiates to his shoulders and is relieved with sitting forward. The patient admits to recent upper respiratory symptoms. On examination vital signs are BP 126/68, HR 86, RR 20, temp 100.3 degrees F. There is no JVD noted. Heart exam reveals regular rate and rhythm with no S3 or S4. There is a friction rub noted. Lungs are clear to auscultation. EKG shows diffuse ST segment elevation. What is the treatment of choice in this patient?
A. Pericardiocentesis
B. Nitroglycerin
C. Percutaneous coronary intervention
D. Indomethacin (Indocin)
8. As a general rule, sutures in the face should be removed in
A. 3 days.
B. 5 days.
C. 7 days.
D. 10 days.
9. Patient education for a 23 year-old using oral contraceptives should include which of the following?
A. Rifampin may decrease the effectiveness of the oral contraceptives.
B. Acetaminophen may decrease the effectiveness of the oral contraceptives.
C. Oral contraceptives may provide some protection from coronary artery disease.
D. Changing to the “minipill” (progestin only) will inhibit ovulation more consistently than combination oral co...]]>
The Physician Assistant Life | Smarty PANCE clean 7:42 67
The Audio PANCE and PANRE Board Review Podcast Episode 11 http://podcast.thepalife.com/the-audio-pance-and-panre-episode-11/ Thu, 01 Jan 2015 01:24:08 +0000 http://podcast.thepalife.com/?p=64 http://podcast.thepalife.com/the-audio-pance-and-panre-episode-11/#respond http://podcast.thepalife.com/the-audio-pance-and-panre-episode-11/feed/ 0 <p>The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy. You can […]</p> <p>The post <a rel="nofollow" href="http://podcast.thepalife.com/the-audio-pance-and-panre-episode-11/">The Audio PANCE and PANRE Board Review Podcast Episode 11</a> appeared first on <a rel="nofollow" href="http://podcast.thepalife.com">The Audio PANCE and PANRE</a>.</p> The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.

I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

  • You can download and listen to past FREE episodes here, on iTunes or Stitcher. (sometimes it takes a few hours to show up on iTunes after publication)
  • You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

Download a Free PDF Transcript of the Questions and Answers

Listen Carefully Then Take The Quiz

Questions 1-10

The Audio PANCE and PANRE Episode 11

1. What is the initial treatment of choice for hyperthyroidism in a 10-week pregnant patient?

A. No treatment is necessary.
B. Propylthiouracil (PTU)
C. Radioiodine treatment
D. Subtotal thyroidectomy

Click here to see the answer
B. Propylthiouracil (PTU) – This is the initial treatment of choice.

2. A patient presents with eye pain and blurred vision. Snellen testing reveals vision of 20/200 in the affected eye and 20/20 in the unaffected eye. Fluorescein staining reveals the presence of a dendritic ulcer. Which of the following is the most likely diagnosis?

A. Viral keratitis
B. Fungal corneal ulcer
C. Acanthamoeba keratitis
D. Bacterial corneal ulcer

Click here to see the answer
A. Viral keratitis – Herpes Simplex virus is a common cause of dendritic ulceration noted on fluorescein staining.

And in case you were wondering:

B. Fungal corneal ulcers have an indolent course with intraocular infection being common but fluorescein staining is negative for a dendritic pattern.

C. Acanthamoeba keratitis has a waxing and waning course over several months and has no fluorescein staining in a dendritic pattern.

D. Bacterial corneal ulcers can progress aggressively resulting in corneal perforation. Fluorescein staining does not occur in a dendritic pattern.

3. A 63 year-old female with history of diabetes mellitus presents for blood pressure follow-up. At her last two visits her blood pressure was 150/92 and 152/96. Today in the office her blood pressure is 146/92. Recent blood work shows a Sodium 140 mEq/L, Potassium 4.2 mEq/L, BUN of 23 mg/dL, and Creatinine of 1.1 mg/dL. Which of the following is the most appropriate initial medication in this patient?

A. Terazosin (Hytrin)
B. Atenolol (Tenormin)
C. Lisinopril (Zestril)
D. Hydrochlorothiazide (HCTZ)

Click here to see the answer
C. Lisinopril (Zestril) – For the boards ACE inhibitors should be part of the initial treatment of hypertension in diabetics because of beneficial effects in diabetic nephropathy and is the most appropriate initial medication. In real practice, despite what we have been led to believe, it actually makes little difference which antihypertensive is used in diabetic patients just as long as we reach our blood pressure goals.

4. What is the EKG manifestation of cardiac end-organ damage due to hypertension?

A. Right bundle branch block
B. Left ventricular hypertrophy
C. Right ventricular hypertrophy
D. ST segment elevation in lateral precordial leads

Click here to see the answer
B. Left ventricular hypertrophy – Long-standing hypertension can lead to left ventricular hypertrophy with characteristic changes noted on EKG.

5. Annual blood pressure determinations should be obtained beginning at the age of

A. 3 years.
B. 5 years.
C. 12 years.
D. 18 years.

Click here to see the answer
A. 3 years – Periodic measurements of blood pressure should be part of routine preventive health assessments beginning at the age of 3 years.

6. In adults and intravenous drug abusers, which of the following bones is most commonly affected with acute osteomyelitis?

A. Femur
B. Humerus
C. Vertebral spine
D. Tibia

Click here to see the answer
C. Vertebral spine – The bones of the vertebral spine are most commonly affected in a patient with osteomyelitis. Organisms reach the well-perfused vertebral body of adults via spinal arteries and quickly spread from the end plate into the disk space and then to the adjacent vertebral body. The infection may originate in the urinary tract and intravenous drug use carries an increased risk of spinal infection.

7. Treatment of the patient with Pediculosis pubis consists of which of the following?

A. Permethrin (Nix) cream
B. Clotrimazole (Gyne-Lotrimin)
C. Podofilox (Condylox) solution
D. Selenium sulfide (Selsun) suspension

Click here to see the answer
A. Permethrin 1% cream/shampoo is used to kill the louse and remove the eggs from the hair shafts.

8. A 43 year-old asymptomatic diabetic female is found to have an elevated total calcium level of 12.4 mg/dL. Which of the following tests must be assessed in order to evaluate this laboratory abnormality?

A. Intact parathyroid hormone
B. Serum albumin
C. 24 hour urine calcium level
D. Complete blood count

Click here to see the answer
B. Serum albumin – Since approximately 50% of calcium is protein bound, total calcium levels should be interpreted relative to albumin levels.

9. Which of the following conditions would cause a positive Kussmaul’s sign on physical examination?

A. Left ventricular failure
B. Pulmonary edema
C. Coarctation of the aorta
D. Constrictive pericarditis

Click here to see the answer
D. Constrictive pericarditis – Kussmaul’s sign is an increase rather than the normal decrease in the CVP during inspiration. It is most often caused by severe right-sided heart failure; it is a frequent finding in patients with constrictive pericarditis or right ventricular infarction.

10. Treatment of Bell’s palsy includes which of the following?

A. Acyclovir
B. Reassurance of the patient’s recovery
C. Referral to a neurosurgeon
D. Electromyography

Click here to see the answer
B. Reassurance of the patient’s recovery – Although I usually always treat with Acyclovir, Bell’s palsy is a peripheral neuropathy of cranial nerve VII. Although it has been suggested it may be related to an activation of herpes simplex virus, there is little empiric evidence for this. Approximately 60% of cases of Bell’s palsy recover without treatment and patient reassurance of this is advised. Electromyography may provide aid in the prognosis, but not as a treatment option. A neurosurgeon has no role in the management of Bell’s palsy.

Looking for all the episodes?

This FREE series is limited to every 3rd episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy.

I will be be releasing new episodes every two weeks. The Academy is currently discounted, so sign up now.

This Podcast is also available on iTunes and Stitcher Radio for Android

  1. iTunes: The Audio PANCE AND PANRE Podcast iTunes
  2. Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher

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The post The Audio PANCE and PANRE Board Review Podcast Episode 11 appeared first on The Audio PANCE and PANRE.

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The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. I hope you enjoy this free audio component to the examination portion of this site. The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.
I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

* You can download and listen to past FREE episodes here, on iTunes or Stitcher. (sometimes it takes a few hours to show up on iTunes after publication)
* You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

Listen Carefully Then Take The Quiz
Questions 1-10
The Audio PANCE and PANRE Episode 11
1. What is the initial treatment of choice for hyperthyroidism in a 10-week pregnant patient?
A. No treatment is necessary.
B. Propylthiouracil (PTU)
C. Radioiodine treatment
D. Subtotal thyroidectomy
2. A patient presents with eye pain and blurred vision. Snellen testing reveals vision of 20/200 in the affected eye and 20/20 in the unaffected eye. Fluorescein staining reveals the presence of a dendritic ulcer. Which of the following is the most likely diagnosis?
A. Viral keratitis
B. Fungal corneal ulcer
C. Acanthamoeba keratitis
D. Bacterial corneal ulcer
And in case you were wondering:
B. Fungal corneal ulcers have an indolent course with intraocular infection being common but fluorescein staining is negative for a dendritic pattern.
C. Acanthamoeba keratitis has a waxing and waning course over several months and has no fluorescein staining in a dendritic pattern.
D. Bacterial corneal ulcers can progress aggressively resulting in corneal perforation. Fluorescein staining does not occur in a dendritic pattern.
3. A 63 year-old female with history of diabetes mellitus presents for blood pressure follow-up. At her last two visits her blo