Podcast Episode 71: Ten PANCE and PANRE Board Review Audio Questions

The Audio PANCE and PANRE Physician Assistant Board Review Podcast

Welcome to episode 71 of the Audio PANCE and PANRE PA Board Review Podcast.

Join me as I cover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will be covering ten general board review questions based on the NCCPA PANCE and PANRE Content Blueprints.

Below you will find an interactive exam to complement the podcast.

I hope you enjoy this free audio component to the examination portion of this site. The full board review includes over 2,000 interactive board review questions and is available to all members of the PANCE and PANRE Academy and Smarty PANCE.

You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.
You can listen to the latest episode, take an interactive quiz and download your results below.

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Podcast Episode 71: 10 Question PANCE and PANRE Podcast Quiz

The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson.

1. A 52-year-old male presents complaining of urinary frequency, with hesitancy, and nocturia for the past few months. During his physical examination, you note a nontender, non-enlarged prostate with an isolated right posterior lobe nodule. Which of the following options is most appropriate?

order a serum acid phosphatase level
initiate prazosin and schedule a follow-up appointment in 6 weeks
refer the patient for an ultrasound of the prostate and order a PSA level
reassure the patient and schedule a follow-up appointment in six months
initiate norfloxacin therapy for seven days and schedule follow-up in two weeks

Click here to see the answer

Answer: C. refer the patient for an ultrasound of the prostate and order a PSA level

This patient has an isolated nodule of the prostate gland — cancer until proven otherwise. You should order an ultrasound and a PSA. BPH will present as diffuse enlargement and not a discrete nodule.

Review NCCPA Blueprint Topic: Prostate disorders (PEARLS)

2. Which of the following is a major contraindication to curative surgical resection of a lung tumor?

A. Liver metastases
B. Vagus nerve involvement
C. Non-malignant pleural effusion
D. Chest wall invasion of the tumor

Click here to see the answer

Answer: A. Liver metastases

Distant metastases, except for solitary brain and adrenal metastases are an absolute contraindication for pulmonary resection. Other absolute contraindications include MI within the past 3 months, superior vena cava syndrome due to a metastatic tumor, bilateral endobronchial tumor, contralateral lymph node metastases, and malignant pleural effusion.

Review NCCPA Blueprint Topic: Pulmonary Neoplasms (PEARLS)

3. A 23-year-old female complains of fever and genital pain. Examination reveals the presence of lymphadenopathy in the groin and the presence of vulvar vesicles surrounded by erythematous skin. The diagnosis may be confirmed by

A. A culture of a vesicle using blood agar medium
B. The presence of similar lesions on the fingers and hands
C. A Gram stain of a scraping from the base of the lesion
D. The presence of giant multinucleated cells on Tzanck smear

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Answer: D. The presence of giant multinucleated cells on Tzanck smear – A Tzanck smear is the standard laboratory test to confirm the herpes virus as an etiologic agent of a vesicular lesion on an erythematous base.

A. Herpes virus will not grow on blood agar medium.
B. Herpes genitalis occurs in skin that comes into contact with the herpes virus. Usually, the infection is localized.
C. A Gram stain will not identify the herpes virus.

Review NCCPA Blueprint Topic: Herpes simplex (ReelDx)

4. A 28-year-old woman is complaining of heavy uterine bleeding and pelvic pressure that has progressively worsened over the past year. Evaluation reveals multiple moderate-sized uterine fibroids. The patient desires to have more children. The most appropriate definitive treatment is

A. Myomectomy
B. Hysterectomy
C. GnRH agonists
D. Oral progesterone

Click here to see the answer

Answer: A. Myomectomy – Myomectomy is the definitive treatment of choice for moderate-sized uterine fibroids in young women who desire to maintain reproductive capability.

B. Hysterectomy is indicated as definitive treatment in a patient who does not desire to maintain reproductive capability.
C. GnRH agonists are used as an adjunct to surgery for treatment of uterine fibroids. Used alone, they would not be considered a definitive treatment.
D. Oral progesterone may be used to suppress menorrhagia preoperatively. Used alone, it would not be considered a definitive treatment.;

Review NCCPA Blueprint Topic: Leiomyoma (Lecture)

5. A 59-year-old otherwise healthy female develops acute dyspnea and chest pain one week post total abdominal hysterectomy. Echocardiogram demonstrates normal heart size with normal right and left ventricular function. Lung scan demonstrates two segmental perfusion defects. Which of the following is the next step in the management of this patient?

A. Anticoagulation
B. Embolectomy
C. Thrombolysis
D. Inferior vena cava filter

Click here to see the answer

Answer: A. Anticoagulation – Anticoagulation is the treatment of choice in patients with pulmonary embolism with normal ventricular function and no absolute contraindications.

B. Embolectomy is not indicated as the initial treatment of a pulmonary embolism in patients with normal ventricular function.
C. Thrombolysis is contraindicated in patients within 10 days of having major surgery.
D. An inferior vena cava filter is considered in patients with contraindications to anticoagulation therapy or failed anticoagulation therapy.

Review NCCPA Blueprint Topic: Pulmonary embolism (ReelDx)

6. Long term use of which of the following drugs may cause a drug-induced lupus-type eruption?

A. prednisone
B. tetracycline
C. procainamide
D. oral contraceptives

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Answer: C. Procainamide – Procainamide, and hydralazine are the most common drugs that may cause a lupus-like eruption.

A. Prednisone is not implicated in drug-induced skin reactions.
B. Tetracycline and sulfonamides are known to cause a photosensitive rash on sun-exposed areas of the skin.
D. Oral contraceptives may induce erythema nodosum.

Review NCCPA Blueprint topic: Drug eruptions (ReelDx)

7. Which of the following clinical manifestations is most commonly seen in viral croup?

A. drooling
B. wheezing
C. sputum production
D. inspiratory stridor

Click here to see the answer

Answer: D. inspiratory stridor – Viral croup typically presents with a barking cough and stridor.

A. Drooling is common in epiglottitis, not viral croup.
B. Wheezing is noted in asthma.
C. Sputum production is noted in bacterial infections.

Review NCCPA Blueprint Topic: Croup (ReelDx)

8. Whispered voice test on a patient reveals decreased hearing in the left ear. Which of the following would be most consistent with conductive hearing loss in the left ear?

A. Sounds best heard in the left ear on Weber test.
B. Air conduction longer than bone conduction in the left ear on Rinne test.
C. Sound best heard in the right ear on Weber test.
D. Bone conduction longer than air conduction in the right ear.

Click here to see the answer

Answer: A. Sounds best heard in the left ear on Weber test – Sound best heard in the ear with a decreased hearing on Weber test (in this case, the left ear) is indicative of conductive hearing loss.

B. With conductive hearing loss, bone conduction should be heard as long as or longer than air conduction of sound in the affected ear. Air conduction lasting longer than bone conduction of sound would indicate a sensorineural hearing loss.
C. Sound best heard in the ear with an unaffected hearing on Weber test (in this case, the right ear) is indicative of sensorineural hearing loss.
D. With conductive hearing loss, bone conduction should be heard as long as or longer than air conduction of sound in the affected ear. The right ear showed normal hearing on physical exam.

Review NCCPA Blueprint Topic: Hearing impairment (Lecture)

9. A 65-year-old male presents with multiple lesions on his back. He denies any pruritis. Physical examination reveals the presence of multiple scattered brown plaques with a raised, warty surface that appears to be stuck onto the skin and feel greasy. Which of the following is the most likely diagnosis?

A. lentigines
B. actinic keratosis
C. keratoacanthomas
D. seborrheic keratosis

Click here to see the answer

Answer: D. seborrheic keratosis – Seborrheic keratosis is a common benign plaque in the elderly that characteristically has a velvety or warty surface associated with a stuck on appearance and greasy feel.

A. Lentigines most commonly are seen on the dorsum of the hand and appear as flat brown spots, often with sharp borders.
B. Actinic keratosis usually presents as small patches of flesh-colored, pink or yellow-brown lesions often with an erythematous component. The lesions are better felt than seen, having a rough, sandpaper feel and are often tender to palpation.
C. Keratoacanthomas usually occur as an isolated lesion on the face appearing as an erythematous, dome-shaped nodule with a central keratinaceous plug.

Review NCCPA Blueprint Topic: Keratotic disorders (PEARLS)

10. You are called to the nursery to see a male infant, born by uncomplicated vaginal delivery. He weighs 2,600 grams and has one deep crease on the anterior third of each foot. Respirations are 88 breaths/minute with expiratory grunting and intercostals retractions. He is cyanotic on room air and becomes pink when placed on 60% oxygen. Chest x-ray shows atelectasis with air bronchograms. Which of the following is the most likely diagnosis?

A. neonatal pneumonia
B. congenital heart disease
C. hyaline membrane disease
D. chronic lung disease of prematurity

Click here to see the answer

Answer: C. hyaline membrane disease – Hyaline membrane disease is the most common cause of respiratory distress in the premature infant. The infant typically presents with tachypnea, cyanosis, and expiratory grunting. A chest x-ray reveals hypoexpansion and air bronchograms.

A. While tachypnea, grunting, retractions, and cyanosis may be signs of neonatal pneumonia, they are primarily late findings of progressive respiratory distress and would not be seen immediately at the time of delivery. A chest x-ray in pneumonia would also most commonly reveal an infiltrate or effusion.
B. While congenital heart disease may present with cyanosis, the chest x-ray will reveal a cardiac abnormality, such as cardiomegaly.
D. Chronic lung disease of prematurity is a complication in about 20% of infants with hyaline membrane disease. It is defined as respiratory symptoms, oxygen requirement and chest x-ray abnormalities at 1 month of age so it cannot be diagnosed at this time in this newborn.;

Review NCCPA Blueprint Topic: Hyaline membrane disease

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