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 […]
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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 40
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? hydrochlorothiazide-triamterene prazosin nifedipine verapamil furosemide Answer: A Hydrochlorothiazide-triamterene This is a potassium-sparing diuretic and should be avoided in anyone with renal disease. ACEI should be avoided as well (but none […]
Use VisualCV to Create a Stunning Physician Assistant Resume
I have a confession to make. For many years I have had a copy of my physician assistant resume posted here on the website, available for download as a guide to help you structure and organize your own physician assistant CV. It has helped 100’s (if not 1000’s) of practicing and new graduate PAs like […]
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 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? acute otitis media acute otitis externa eustachian tube dysfunction Ramsay-Hunt syndrome perforated tympanic membrane […]
The Daily PANCE & PANRE Question 5
A 34-year-old female presents complaining of symmetrical redness and swelling of the small joints of her hands (PIPs and MCPs). She has noted that the symptoms are worst in the morning. Her erythrocyte sedimentation rate is elevated and her rheumatoid factor is negative. Which of the following diagnosis is most likely? progressive systemic sclerosis CREST […]
The Daily PANCE & PANRE Question 38
You note polygonal, purple, papular 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? Auspitz sign Koebner’s phenomenon Darier’s sign Gorlin’s sign Gottron’s papules Answer: B Koebner’s phenomenon Koebner’s phenomenon is described – it suggests […]
The Daily PANCE & PANRE Question 4
A patient describes a history of recurrent bouts of uveitis. Her chemistry panel reveals elevated serum calcium and uric acid levels. Her anergy screen is negative. Her chest x-ray demonstrates bilateral hilar adenopathy. Which diagnosis is most likely? Silicosis Sarcoidosis Alpha-1 antitrypsin deficiency Histoplasmosis Tuberculosis Answer: B Sarcoidosis Sarcoidosis typically presents with hilar lymphadenopathy and noncaseating granulomas […]
The Daily PANCE & PANRE Question 3
Which of the following is NOT a characteristic feature of the nephrotic syndrome? proteinuria hematuria hypoalbuminemia hyperlipidemia generalized edema Answer: B. Hematuria Hematuria is present in NEPHRITIC syndrome. Nephrotic syndrome characteristically includes proteinuria (>3.5 gm/day), with resulting low serum albumin, hyperlipidemia, hypertension, hypercoagulability, and generalized edema (from oncotic third-spacing) Note: * This is part of […]
The Daily PANCE and PANRE Question Two
Which term is used to describe the characteristic concave or “spoon-shaped” nails of iron deficiency anemia? leukonychia koilonychia clubbing onycholysis paronychia Answer: B Koilonychia Koilonychia is a spoon-shaping of the nail itself. It is usually a result of iron deficiency anemia. Leukonychia is often associated with hypoalbuminemia that causes partial or complete white discoloration of the nails. […]
The Daily PANCE & PANRE Question 35
Which of the following agents has a mechanism of action that does not involve beta-receptors? epinephrine albuterol propranolol prazosin 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. Note: * This is part of the Daily […]
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 […]
The Daily PANCE and PANRE Fast Track – Question 39
Which of the following increases the likelihood that a patient will precipitate calcium-containing kidney stones? A an increase in daily water intake B an increase in daily sodium chloride intake C a reduction in daily sugar consumption D a reduction in daily protein consumption E “normal” daily dairy product consumption Answer: B The combination of […]
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 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 […]
Secrets of Successful PA School Letters of Recommendation
Your essay is your voice about yourself. A recommendation letter is someone else’s voice about you. Whether we like it or not, other people’s opinions matter. A good letter of recommendation can make your day; a great letter of recommendation can change your life. Whether it is a dating review on Tinder, a restaurant recommendation […]
The Physician Assistant Life Book Club
ISSUE 44 | NOVEMBER 2017 The Mask of Masculinity HOW MEN CAN EMBRACE VULNERABILITY, CREATE STRONG RELATIONSHIPS, AND LIVE THEIR FULLEST LIVES By Lewis Howes BUY THE BOOK The Mask of Masculinity isn’t a book I necessarily planned on reading, but I was compelled to read it for two reasons: One, Lewis Howes is a […]
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 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 […]
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 26
A Caucasian male has a history of a meconium ileus as a newborn, steatorrhea and a positive sweat test. What is the most likely diagnosis? Von Gierke’s disease Hurler’s syndrome Cystic fibrosis Hunter’s syndrome Cri du chat syndrome Answer: C Cystic fibrosis This is the classic presentation of Cystic fibrosis Note: * This is part […]
The Daily PANCE & PANRE Question 54
Wolff-Parkinson-White (WPW) and Lown-Ganong-Levine (LGL) syndrome are both characterized by: left ventricular dysfunction a shortened PR interval the presence of delta waves large pericardial effusions marked left ventricular hypertrophy Answer: B Shortened PR interval WPW & LGL both have short PR intervals. WPW also has a “delta wave” and predisposes the patient to supraventricular tachyarrhythmias. Note: […]
The Daily PANCE & PANRE Question 25
A patient with AIDS develops severe headaches. A CT scan demonstrates multiple ring-enhancing lesions of the brain. What diagnosis is most likely? Toxoplasmosis Histoplasmosis Lymphoma Cytomegalovirus Herpes encephalitis Answer: A Toxoplasmosis Toxoplasmosis occurs commonly in HIV and is a parasitic infection causing ring-enhancing lesions (but lots of things can cause ring-enhancing lesions). CMV is common […]
The Daily PANCE & PANRE Question 51
Which of the following choices is associated with meconium staining of the amniotic fluid? bowel obstruction peeling of the infant’s skin aspiration pneumonitis and respiratory distress syndrome infection with E. coli intrauterine cataract formation and sensorineural hearing loss Answer: C Aspiration pneumonitis and respiratory distress syndrome When the infant has meconium in the amniotic fluid, he […]
31 Online Medical Calculators for Physician Assistants
A comprehensive list of medical calculators for the busy Physician Assistant (Just in case you forgot your iPhone) Absolute Neutrophil Count Calculator: A calculator for determining absolute neutrophil count (ANC). Absolute Reticulocyte Count Calculator:A calculator for determining absolute reticulocyte count (ARC). Anion Gap Calculator: A calculator for determining anion gap. Asthma Management Calculator: 12 Years of […]
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9 Simple Steps to Avoid Silly Spelling and Grammar Goofs in Your PA School Personel Statement
Did you spot my grammar goof? If not take a second look at the title. You have spent days, weeks, and months writing and perfecting your personal (not personel) statement. You have slaved countless hours in front of the computer screen trying to shed a creative light on your background and highlight your experiences. Don’t […]
How to Study for (and Pass) The Physician Assistant Recertification Exam (PANRE)
Looking for the essential three steps? click here First of all, let me give you a few truisms: You can choose one of two recertification options: You have three options for PANRE preparation: The PANRE Preparation Process Whether you like it or not, the time will come when you have to recertify. And, of course, it’s […]