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 infiltrate. His ABG demonstrates moderate hypoxemia and his LDH is elevated. What is the most likely diagnosis? A. Streptococcal pneumoniae pneumonia B. Mycoplasma pneumoniae […]
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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? A. repeat the chest x-ray in six […]
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 70
Which of the following is NOT a characteristic feature of multiple myeloma? A. elevated serum calcium B. osteoporosis C. “punched out” osseous lesions D. plasma cell infiltration of bone marrow E. hypogammaglobulinemia Answer: E. hypogammaglobulinemia MM is a HYPERgammaglobulinemia – all of the other findings occur in MM Help Support The Physician Assistant Life for […]
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? A. anterior cerebral B. middle cerebral C. posterior cerebral D. internal carotid E. external carotid […]
The Daily PANCE & PANRE Question 48
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. […]
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 […]
The Daily PANCE & PANRE Question 71
Which of the following is NOT a risk factor for the development of osteoporosis? A. low testosterone levels in men B. low levels of physical activity C. inadequate dietary protein D. cigarette smoking E. chronic corticosteroid use Answer: C, inadequate dietary protein Low dietary Calcium, not protein, is a risk factor for osteoporosis. All of the […]
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? A. Third degree heart block B. Mobitz Type II heart block C. Mobitz Type I heart block D. first degree heart block E. sinus tachycardia Answer: C, Mobitz Type I heart block I […]
The Daily PANCE & PANRE Question 49
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. […]
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 […]
PA Link Love: From PA Study Guides to a Dermatological Instagram
{Every now and then, I publish a series of cool links. Enjoy!} PAs On The Web A PA Tumbler blog with a hidden gem of great study guides (look at the links in the sidebar) I have compiled his study guides into my own dropbox folder to simplify the process. It includes things such as […]
The Daily PANCE & PANRE Question 72
A 12 year-old male presents complaining of no appetite for 24 hours and pain near his navel. During the night, the pain moved to the right lower abdomen. He is now nauseated and vomiting and has a low-grade fever. In the operating room, a normal appendix is discovered. What is the most likely diagnosis? A. […]
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 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 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 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 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 Audio PANCE and PANRE Board Review Podcast Episode 15
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 […]
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 69
A 58 year-old male presents complaining of weakness of his grip. Your examination reveals that the problem is bilateral. During the next few office visits, you note the development of hyperactivity of his DTRs, extensor plantar reflexes and dysarthria. The patient’s sensory system remains normal and he denies any urinary symptomatology. Which of the following […]
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 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 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 71
Which of the following is NOT a risk factor for the development of osteoporosis? A. low testosterone levels in men B. low levels of physical activity C. inadequate dietary protein D. cigarette smoking E. chronic corticosteroid use Answer: C, inadequate dietary protein Low dietary Calcium, not protein, is a risk factor for osteoporosis. All of the […]
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 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 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 72
A 12 year-old male presents complaining of no appetite for 24 hours and pain near his navel. During the night, the pain moved to the right lower abdomen. He is now nauseated and vomiting and has a low-grade fever. In the operating room, a normal appendix is discovered. What is the most likely diagnosis? A. […]
The Daily PANCE and PANRE Question 76
Typically, it produces a local burning, followed in 3 to 4 hours by a white area of vasoconstriction. Subsequently, a bleb forms at the bite site, darkens, and is followed over hours to days by tissue necrosis. Which of the following inflicts this envenomation? A. brown recluse spider B. black widow spider C. scorpion D. […]