A 48-year-old male presents with crushing chest pain for 45 minutes. He is diaphoretic, nauseous and short of breath. His EKG demonstrates 4 mm of ST segment depression in leads I, aVL, V5, and V6. What is the most likely diagnosis? esophageal spasm hiatal hernia acute lateral wall subendocardial myocardial ischemia acute inferior wall myocardial […]
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The Daily PANCE and PANRE Question 79
During a sports ‘screening physical’ examination, a 15 year-old male is noted to have a murmur. You perform bedside maneuvers in an attempt to delineate which type of murmur you are auscultating. Which of the following would be the finding associated with the highest risk of sudden death for this patient? A. the intensity of […]
Scholarships, Grants and Loan Repayment Programs for Physician Assistants
PA School is Expensive It goes without saying PA school is expensive. PA school is also demanding, which means you will have limited time (if any) to work while attending school. With the average undergraduate education debt prior to PA school at $36,300 and the average anticipated debt load from PA school at $75,000-$124,000, it […]
The Daily PANCE & PANRE Question 56
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 […]
The Daily PANCE and PANRE Question 46
A 17-year-old male is stabbed in the anterior chest with an ice pick. He quickly becomes hypotensive, tachycardic and obtunded. His breath sounds are equal, his neck veins are distended, and his chest x-ray is normal. What condition is most likely? Simple pneumothorax Tension pneumothorax Pericardial Tamponade aortic laceration distal to the origin of the […]
Fix Your 401K
Address Your Debt The 401K Fix Does Your Employer offer a 401K with a Match? Yes 401K with a Match Look at your fees. The median annual fees for all plans is 0.72% of assets. My wifes hospital charges 0.13% and my work charges 1.5% This is important as we will see below Meet your company […]
The Daily PANCE and PANRE Question 78
All of the following, when administered to the physically dependent opiate abuser, can precipitate withdrawal symptoms EXCEPT: A. naloxone. B. pentazocine. C. nalbuphine. D. methadone. E. buprenorphine. Answer: D, methadone. That is why we use methadone when weaning folks from opiates (like heroin) Help Support The Physician Assistant Life for FREE! This is provided as […]
The Daily PANCE & PANRE Question 11
Combinations of antimicrobial agents are commonly employed in the treatment of meningitis in infants less than three months old. Ampicillin is commonly an agent included in this regimen. Ampicillin is used empirically for the possible presence of: Escherichia coli Listeria monocytogenes Cytomegalovirus Herpesvirus Haemophilus influenzae Answer: B Listeria monocytogenes While E. Coli can infect an […]
The Daily PANCE & PANRE Question 55
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 […]
Personal Statement Panel Review (Replay)
We successfully launched our first large group live event on April 28, 2022, to celebrate the opening of CASPA! Just as AdComs are not uniform in how they react to personal statements, neither is our team! In this personal statement panel review, we analyze essays from clients who have been accepted into PA school to illustrate […]
A Conversation Every Physician Assistant Has Had
If you are a practicing Physician Assistant this will surely make you laugh! How many times have you had this conversation? The Conversation Highlights: What are you doing these days? I have a great girlfriend, Kim and she’s a nurse I met her here at the hospital where I sometimes work as a physician assistant […]
The Daily PANCE and PANRE Question 77
A patient with acute renal failure proves a urine specimen that demonstrates normal osmolality and sodium content. The urine contains no casts, but RBCs are present. Which of the following is the most likely etiology of this patient’s acute renal failure? A. prerenal cause B. intrarenal — glomerulonephritis C. intrarenal — acute tubular necrosis D. […]
The Daily PANCE & PANRE Question 10
An EKG demonstrates a PR interval of 0.16 seconds, a P to QRS relationship of 1:1, a variable heart rate and an R to R interval that is noted to accelerate and decelerate during the respiratory cycle. What is the diagnosis? Wenckebach third-degree heart block atrial fibrillation sinus arrhythmia atrial flutter Answer: D sinus arrhythmia […]
The Daily PANCE & PANRE Question 54
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 […]
The Daily PANCE and PANRE Question 45
An elderly patient is recovering from pneumonia caused by Influenza. Suddenly, the patient’s condition deteriorates. You order a chest x-ray that demonstrates an air-fluid level, suggestive of an abscess. You empirically begin treatment for: Streptococcal pneumoniae Chlamydia Haemophilus influenzae Staphylococcus aureus Legionella pneumophila Answer: D Staphylococcus aureus Empyema (lung abscess) is almost always staph aureus. While […]
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The Daily PANCE & PANRE Question 53
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 […]
The Daily PANCE & PANRE Question 44
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? repeat the chest x-ray in six months ultrasound […]
Protected: 1- Year PA Life Academy Membership
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The Daily PANCE and PANRE Question 75
Which of the following agents is most appropriate in the treatment of a pregnant patient infected with Chlamydia? A. tetracycline B. penicillin C. norfloxacin D. erythromycin E. doxycycline Answer: D, erythromycin Of these choices, erythromycin is best in a pg lady. PCN does not work for Chlamydia. Tetracyclines (A & E) should be avoided. Quinolones (norfloxacin) […]
The Daily PANCE & PANRE Question 8
A 48-year-old nurse, with a body mass index of 31, presents for an evaluation of back pain. She relates that historically, she had a positive PPD test a year ago and did not follow-up as directed. She has recently been experiencing night sweats and coughing. An x-ray of her lumbar spine reveals osteopenia and cortical […]
The Daily PANCE & PANRE Question 52
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 […]
The Daily PANCE & PANRE Question 43
A female patient presents for an evaluation for primary amenorrhea. She is noted to be short of stature and has short fourth metacarpals. What diagnosis do you suspect? XO XXY XXX XXXY Trisomy 21 Answer: A XO This is the genotype for Turner’s syndrome. XXY is the genotype for Klinefelter’s (which is a tall, mildly retarded […]
The Daily PANCE & PANRE Question 74
A polarized light microscopic study of joint fluid demonstrates negative birefringent crystals. What is the diagnosis? A. rheumatoid arthritis B. septic arthritis C. pseudogout gout D. aseptic arthritis E. gout Answer: E, gout Uric acid (gout) is “Needle-shaped crystals with Negative birefringence) Calcium Pyrophosphate (pseudogout) is Prism-shaped crystals with Positive birefringence) Help Support The Physician […]
The Daily PANCE & PANRE Question 7
A 14-year-old is experiencing a severe asthma attack. Although he is using accessory muscles to breath, auscultation of his chest reveals no audible wheezing. His heart rate is 160 and his respiratory rate is 52. Which of the following arterial blood gases represents the worst prognosis? pH = 7.52; pC02 = 28; p02 = 80 […]
The Daily PANCE & PANRE Question 51
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 […]
The Daily PANCE & PANRE Question 73
A patient that must be on a beta-blocking agent has reactive airway disease and commonly experiences central nervous system side effects from medications. Which of the following beta-blockers would most likely be tolerated by this patient? A. atenolol B. metoprolol C. nadfilol D. propranolol E. pindolol Answer: B, metoprolol This is a picky Q for the […]
The Daily PANCE & PANRE Question 6
A 27-year-old nulliparous female presents because she’s been trying to get pregnant for two years, but has failed. She relates a history of a misdiagnosis of appendicitis that lead to abscess formation when she was 14 years old. Which of the following diagnostic studies would be most helpful at this point in her evaluation? TSH […]
The Daily PANCE & PANRE Question 50
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 […]
The Daily PANCE & PANRE Question 41
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? tricyclic antidepressants barbiturates benzodiazepines monoamine oxidase inhibitors phenothiazines Answer: D Monoamine oxidase inhibitors This is a typical scenario for MAOI induced malignant hypertension […]