A 51 year-old male with renal artery stenosis and an elevated BUN and creatinine, is newly diagnosed as hypertensive. Which of the following agents should be avoided? A. hydrochlorothiazide-triamterene B. prazosin C. nifedipine D. verapamil E. furosemide Answer: A, hydrochlorothiazide-triamterene This is a potassium sparing diuretic and should be avoided in anyone with renal disease. ACEI […]
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The Daily PANCE & PANRE Question 34
The results of a barium esophagram reveal esophageal webbing in a woman with long-standing iron deficiency anemia. Her diagnosis is: Barrett’s esophagus achalasia Plummer-Vinson syndrome Dressler’s syndrome Ogilvie’s syndrome Answer: C Plummer-Vinson syndrome Plummer-Vinson is something to know for those who want a 100% on the exam. There is no need to memorize this. More […]
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The Daily PANCE & PANRE Question 65
Secondary to a traumatic even, a child complains of pain in the index finger. An x-ray of the digit demonstrates a fracture line through the metaphysic of the proximal aspect of the middle phalanx, ending at the epiphyseal plate. What type of fracture does this child have? A. Salter Harris Type I B. Salter Harris […]
The Daily PANCE & PANRE Question 39
A 6 year-old female presents complaining of right ear pain. The tympanic membrane cannot be well visualized. She complains of pain when the tragus is manipulated. Several periauricular lymph nodes are easily palpable. Which of the following is the most likely diagnosis? A. acute otitis media B. acute otitis externa C. eustachian tube dysfunction D. […]
The Daily PANCE & PANRE Question 33
Laboratory report: elevated serum free t4; low serum TSH level. Which of the following is the MOST likely diagnosis? Primary hypothyroidism Secondary hypothyroidism T3 thyrotoxicosis Graves disease Chronic Hashimoto’s thyroiditis Answer: D Graves disease High T4 (hyperthyroid), with a low TSH, indicates that the pituitary is working normally, and the thyroid is hyperactive i.e. Grave’s […]
The Daily PANCE & PANRE Question 64
A patient is being treated for Tuberculosis. She is experiencing central scotomata, a loss of green-red color perception and decreased visual acuity. Which agent is most likely responsible? A. rifampin B. isoniazid C. streptomycin D. ethambutol E. para-aminosalicylic acid Answer, D Ethambutol is the TB drug that causes “E”ye symptoms. I remember it because it […]
Physician Assistant Salary by State – 2013
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee […]
The Daily PANCE & PANRE Question 38
You note polygonal, purple, popular lesions involving the flexor surfaces of a patient’s wrists. The patient has no other lesions. The lesions appear to follow a linear pattern of distribution. What is this phenomenon? A. Auspitz sign B. Koebner’s phenomenon C. Darier’s sign D. Gorlin’s sign E. Gottron’s papules Answer: B, Koebner’s phenomenon Koebner’s phenomenon is […]
The Daily PANCE & PANRE Question 63
A 38 year-old chronic smoker presents with shortness of breath and wheezing. He has had several similar episodes in the past. He states that each previous episode began after developing a “cold that moved into his chest.” Usually, after treatment with albuterol (VENTOLIN) and several days, the wheezing stops. He adds that he has a […]
The Daily PANCE & PANRE Question 37
A female presents complaining of a grayish, watery vaginal discharge. The KOH prep does not reveal any hyphae. Clue cells are identified on the wet mount. A paucity of WBCs are noted. What diagnosis is most likely? A. Gonorrhea B. Chlamydia C. Candidiasis D. bacterial vaginosis E. Trichomoniasis Answer: D, bacterial vaginosis Clue cells means BV […]
The Daily PANCE & PANRE Question 32
Which of the following agents is effective in the treatment of Parkinson’s? penicillin amantadine erythromycin acyclovir cephalexin Answer: B Amantadine Amantadine (Symmetrel) is effective (somewhat). It is also used in treating Influenza A. Another choice is selegiline, and levodopa/carbidopa. The other antibiotics listed here are not useful in the treatment of Parkinson’s disease. Note: * […]
The Daily PANCE & PANRE Question 36
A 6 year-old male is brought into your office for evaluation of his gait. You note that when ambulatory, the medial aspects of his knees are far apart and his feet are unusually close together. Which of the following best describes this condition? A. cubitus valgus B. cubitus varus C. genu valgus D. genu varum […]
The Daily PANCE & PANRE Question 31
The most common cause of preventable blindness in the United States is: macular degeneration cataracts retinal detachments glaucoma trauma Answer: D Glaucoma The wording is intentionally difficult in this question. Macular degeneration, retinal detachments, and trauma are not preventable. Cataracts are “curable”, but the cataract itself is probably not “preventable.” Chronic glaucoma can be treated to […]
The Daily PANCE & PANRE Question 35
Which of the following agents has a mechanism of action that does not involve beta-receptors? A. epinephrine B. albuterol C. propranolol D. prazosin E. ritodrine Answer: D, prazosin. Of these choices, prazosin is an alpha- blocker. Ritodrine and epinephrine cause beta sympathetic stimulation. Albuterol is a beta agonist. Propranolol is a beta blocker. Help […]
The Daily PANCE & PANRE Question 30
A 14-month-old female is brought to your office with a 3-day history of a fever of 104 degrees rectally. Suddenly, today, the fever stopped and a rash developed. Examination reveals a diffuse, fine, maculopapular rash. Presently, the child does not appear ill. The most likely diagnosis is: Rubella Rubeola (measles) erythema infectiosum (Fifth disease) Roseola […]
The Daily PANCE & PANRE Question 34
The results of a barium esophagram reveal esophageal webbing in a woman with long-standing iron deficiency anemia. Her diagnosis is: A. Barretts esophagus. B. achalasia. C. Plummer-Vinson syndrome. D. Dresslers syndrome. E. Ogilvies syndrome. Answer: C, Plummer-Vinson syndrome. Plummer-Vinson is something to know for those who want a 100% on the exam. There is no need […]
The Daily PANCE & PANRE Question 29
Upon review of an EKG, you notice periodic, repetitively absent QRS complexes and “grouped beating.” Which of the following is the explanation? Third-degree heart block Mobitz Type II heart block Mobitz Type I heart block First-degree heart block Sinus tachycardia Answer: C Mobitz Type I heart block I don’t like the wording of this question, […]
The Daily PANCE & PANRE Question 59
Which of the following is the earliest manifestation of diabetic nephropathy? proteinuria a progressive decline in the creatinine clearance an elevated serum haptoglobin renal insufficiency microalbuminuria Answer: E Microalbuminuria Tiny amounts of albumin (microalbumin) show up first – but need a special test ordered to detect it. Intervention at this point with an ACEI prolongs the […]
The Daily PANCE & PANRE Question 33
Laboratory report: elevated serum free t4; low serum TSH level. Which of the following is the MOST likely diagnosis? A. Primary hypothyroidism B. Secondary hypothyroidism C. T3 thyrotoxicosis D. Graves disease E. Chronic Hashimoto’s thyroiditis Answer: D, Graves disease High T4 (hyperthyroid), with a low TSH indicates that the pituitary is working normally, and the […]
The Daily PANCE & PANRE Question 28
A patient describes a history of a “curtain being brought down over my right eye it stayed there for a few minutes then was lifted back up.” In which of the following arteries is the etiology of this complaint located? anterior cerebral middle cerebral posterior cerebral internal carotid external carotid Answer: D Internal Carotid This […]
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The Daily PANCE & PANRE Question 32
Which of the following agents is effective in the treatment of Parkinson’s? A. penicillin B. amantadine C. erythromycin D. acyclovir E. cephalexin Answer: B, amantadine Amantadine (Symmetrel) is effective (somewhat). It is used in treating Influenza A. Another choice is selegiline, and levodopa/carbidopa. The other antibiotics listed here are not useful in Parkinson’s. Help Support […]
The Daily PANCE & PANRE Question 68
Your 27 year-old sister is visiting and requests you to provide refills of dexamethasone and homotropine ophthalmic drops for her. What condition is most likely being treated? A. conjunctivitis B. glaucoma C. iritis D. Herpes keratitis E. blepharitis Answer: C, iritis Iritis is treated with steroid drops (dexamethasone) and miotic drops *homotropine, like atropine (to constrict […]
The Daily PANCE & PANRE Question 31
The most common cause of curable blindness in the United States is: A. macular degeneration. B. cataracts. C. retinal detachments. D. glaucoma. E. trauma. Answer: D, glaucoma Again, the wording is difficult in this question. Macular degeneration, retinal detachments and trauma are not preventable. Cataracts are “curable”, but the cataract itself is probably not […]
The Daily PANCE & PANRE Question 67
A 2 month-old febrile male is brought to your facility to be evaluated for loss of appetite, irritability, and an acute petechial rash. Rectal temperature is 102.8F. Which of the following diagnostic studies is the most important in this child’s evaluation? A. white blood count and differentia B. urinalysis C. CSF analysis D. serum glucose […]
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 to […]
The Daily PANCE & PANRE Question 30
A 14 month-old female is brought to your office with a 3-day history of a fever of 104 degrees rectally. Suddenly, today, the fever stopped and a rash developed. Examination reveals a diffuse, fine, maculopapular rash. Presently, the child does not appear ill. The most likely diagnosis is: A. Rubella B. Rubeola C. erythema infectiosum […]
The Daily PANCE & PANRE Question 27
A 32-year-old male presents with dyspnea and a nonproductive cough. His is tachycardic, tachypneic and febrile. Auscultation of his chest reveals scattered rhonchi. His chest x-ray demonstrates a diffuse interstitial infiltrates. His ABG demonstrates moderate hypoxemia and his LDH is elevated. What is the most likely diagnosis? Streptococcal pneumoniae pneumonia Mycoplasma pneumoniae pneumonia Pneumocystis carinii […]
The Daily PANCE & PANRE Question 66
A 24 year-old male presents complaining of chest pain. He states that it is worse with swallowing and taking a deep breath. It is improved sitting up and leaning forward. He denies trauma, a cough and shortness of breath. Which of the following test would be most compatible with your suspected diagnosis? A. a hiatal […]