Daily PANCE and PANRE

A patient presents with a recurrent history of swelling on the right side of the jaw that begins while eating and subsides within two hours postprandially. You suspect: A. hypochondriasis B. sialolithiasis C. parotitis. D. an abscessed tooth. E. conjunctivitis manibularis.  Answer: B, sialolithiasis Sialo(salivary gland) lithiasis (stone) is described in this question. Parotitis would be […]

The examination of a 26 year-old male demonstrates a “bag of worms” consistency within the left hemiscrotum. This finding is suggestive of a(n): A. acute case of balanitis B. varicocele. C. hydrocele. D. spermatocele. E. paraphimosis.  Answer: B, varicocele. This is a description of varicocele (varicose veins of the scrotum). Hydrocele is just a water collection […]

A 22 year-old female complains of vaginal bleeding for 24 hours. Her last menstrual cycle was seven weeks ago She has had an IUD, but currently uses no form of contraception. Her HCG is positive. She denies fever, chills and vaginal discharge, prior to the onset of the vaginal bleeding. You order a pelvic ultrasound […]

A patient that you are examining for carpal tunnel syndrome reveals that her paresthesias occur in all five digits. Which digit does NOT experience paresthesias with median nerve neuropathy? A. first (thumb) B. second (index) C. third (long) D. fourth (ring) E. fifth (pinky)  Answer: E, fifth (pinky) The fifth finger is ALWAYS innervated by the […]

Wolf-Parkinson-White (WPW) and Lown-Ganong-Levine (LGL) syndrome are both characterized by: A. left ventricular dysfunction. B. a shortened PR interval. C. the presence of delta waves. D. large pericardial effusions. E. marked left ventricular hypertrophy.  Answer: B, a shortened PR interval. WPW & LGL both have short PR intervals. WPW also has a “delta wave” and predisposes […]

You are educating a patient that has just been advised that he has “polyps” in his colon. Which of the following statements is FALSE? A. The larger the colonic polyp, the greater the risk of malignant transformation B. Villous adenomas have a 30-70% risk of malignant transformation. C. The greater the number of concomitant colonic […]

A 32 year-old male presents after slipping and falling off the roof of his home and striking his head. He suffered a brief loss of consciousness. Since that time, he has noted increasing urination and thirst. His serum chemistries reveal an elevated sodium level. His urine specific gravity is 1.003. Which of the following is […]

Which of the following choices is associated with meconium staining of the amniotic fluid? A. bowel obstruction B. peeling of the infant’s skin C. aspiration pneumonitis and respiratory distress syndrome D. infection with E. coli E. intrauterine cataract formation and sensorineural hearing loss  Answer: C, aspiration pneumonitis and respiratory distress syndrome When the infant has meconium […]

This drug causes gingival hyperplasia and hirsutism. At high doses it can cause nystagmus, ataxia and diplopia. Which drug is best described by these statements A. aspirin B. acetaminophen C. acyclovir D. phenytoin E. valproic acid Answer: D, phenytoin Dilantin (phenytoin) causes these typical symptoms   Help Support The Physician Assistant Life for FREE! This is […]

A 35 year-old male complains of acute left eye pain immediately after he struck a nail with a hammer. On examination, you note that the left pupil is elliptical. What diagnostic test/procedure will most likely confirm your diagnostic suspicion? A. flourescein staining of the ey B. pressing on the globe to assess intraocular pressure C. […]

A 14 month-old female is brought to your office with a 1 day history of a fever of 101 degrees rectally. Suddenly, today, the parent noted small red spots that became bumps and are now blisters. The majority of the lesions are on the thorax. Each vesicle resides on its own erythematous base. A. shingles. […]

An 18 year-old female presents after completing her freshman year at college. Two months ago, she developed “bronchitis” which has persisted. She has become increasingly tired and has frequent night sweats. A chest x-ray today reveals a left mediastinal mass. What is the next step in her evaluation? A. repeat the chest x-ray in six […]

A female patient presents for an evaluation for primary amenorrhea. She is noted to be short of stature and have short fourth metacarpals. What diagnosis do you suspect? A. XO B. XXY C. XXX D. XXXY E. Trisomy 21 Answer: A, XO This is the genotype for Turner’s syndrome. XXY is the genotype for Klinefelter’s (which […]

A patient with known hyperlipidemia, taking clofibrate, presents to your office complaining of severe myalgias and weakness. He has noted a dark color to his urine. The laboratory calls with a panic value CPK of 8500. He was recently started on a new medication, four days earlier. Which of the following is most likely the […]

A patient at a Christmas party on a cruise ship develops a terrible headache. His blood pressure is 224/158 mm Hg. Which of the following agents is this patient most likely taking regularly? A. tricyclic antidepressants B. barbiturates C. benzodiazepines D. monoamine oxidase inhibitors E. phenothiazines Answer: D, monoamine oxidase inhibitors This is a typical scenario […]