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 […]
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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 & 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 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 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 & 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 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 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 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 […]
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 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. […]
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 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 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 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 57
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 […]
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 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 58
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 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 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 […]
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. […]
Pulmonary System: PANCE and PANRE Examination Content Blueprint
The PANCE and PANRE: Examination Content Blueprint checklist 2017 The PANCE and PANRE Pulmonology Content Blueprint represents 12% of your exam and includes 32 diseases/disorders [genesis_column size=”one-half” position=”first”] Infectious Disorders Acute bronchitis Acute bronchiolitis Acute epiglottitis Croup Influenza Pertussis Pneumonias Bacterial Viral Fungal HIV-related Respiratory syncytial virus infection Tuberculosis Neoplastic Disease Carcinoid tumors Lung cancer Pulmonary nodules […]
The Daily PANCE & PANRE Question 59
Which of the following is the earliest manifestation of diabetic nephropathy? A. proteinuria B. a progressive decline in the creatinine clearance C. an elevated serum haptoglobin D. renal insufficiency E. 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 […]
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 […]
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? A. Silicosis B. Sarcoidosis C. Alpha-1 antitrypsin deficiency D. Histoplasmosis E. Tuberculosis Answer: B Sarcoid typically presents […]
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? 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 […]
The Daily PANCE & PANRE Question 60
Fluid from a thoracentesis is grossly purulent. The effusion from which this fluid was aspirated is best described as a(n): A. loculated effusion B. chylothorax. C. empyema. D. hydrothorax. E. hemothorax. Answer: C, empyema. A grossly purulent tap would suggest staph (empyema). Loculated effusion does not describe either a trans or exudative effusion. Chylo and hydro […]