The 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 full series is available to all members of the PANCE and PANRE Academy. * You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio. * You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below. Listen Carefully Then Take The Quiz Questions 1-10 The Audio PANCE and PANRE Episode 13 1. During a baseball game, a 22 year-old college student is hit in the right eye by a baseball. He complains of blurry vision in that eye. On physical exam, the physician assistant notes proptosis of the right eye, and limitation of movement in all directions. On CT scan, which of the following is most likely to be seen? A. Fracture of the medial orbital wall B. Prolapse of orbital soft tissue C. Hematoma of the orbit D. Orbital emphysema 2. Which of the following physical findings is suggestive of atrial septal defect? A. Fixed split S2 B. Increased pulse pressure C. Continuous mechanical murmur D. Difference in blood pressure between the left and right arm 3. Which of the following is essential to make a diagnosis of cystic fibrosis? A. Positive family history B. Elevated sweat chloride C. Recurrent respiratory infections D. Elevated trypsinogen levels 4. In infants, the eyes should move in parallel without deviation by the age of A. 2 weeks. B. 3 months. C. 6 months. D. 1 year. 5. Which of the following physical exam findings is consistent with moderate emphysema? A. Increased tactile fremitus B. Dullness to percussion C. Distant heart sounds D. Deviated trachea 6. Which of the following is the most common indication for operative intervention in patients with chronic pancreatitis? A. Weight loss B. Intractable pain C. Exocrine deficiency D. To decrease risk of cancer 7. A 22 year old male presents to the ED with pain that radiates to his shoulders and is relieved with sitting forward. The patient admits to recent upper respiratory symptoms. On examination vital signs are BP 126/68, HR 86, RR 20, temp 100.3 degrees F. There is no JVD noted. Heart exam reveals regular rate and rhythm with no S3 or S4. There is a friction rub noted. Lungs are clear to auscultation. EKG shows diffuse ST segment elevation. What is the treatment of choice in this patient? A. Pericardiocentesis B. Nitroglycerin C. Percutaneous coronary intervention D. Indomethacin (Indocin) 8. As a general rule, sutures in the face should be removed in A. 3 days. B. 5 days. C. 7 days. D. 10 days. 9. Patient education for a 23 year-old using oral contraceptives should include which of the following? A. Rifampin may decrease the effectiveness of the oral contraceptives. B. Acetaminophen may decrease the effectiveness of the oral contraceptives. C. Oral contraceptives may provide some protection from coronary artery disease. D. Changing to the “minipill” (progestin only) will inhibit ovulation more consistently than combination oral co...

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 full series is available to all members of the PANCE and PANRE Academy. * You can download and listen to past FREE episodes here, on iTunes or Stitcher. (sometimes it takes a few hours to show up on iTunes after publication) * You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below. Listen Carefully Then Take The Quiz Questions 1-10 The Audio PANCE and PANRE Episode 11 1. What is the initial treatment of choice for hyperthyroidism in a 10-week pregnant patient? A. No treatment is necessary. B. Propylthiouracil (PTU) C. Radioiodine treatment D. Subtotal thyroidectomy 2. A patient presents with eye pain and blurred vision. Snellen testing reveals vision of 20/200 in the affected eye and 20/20 in the unaffected eye. Fluorescein staining reveals the presence of a dendritic ulcer. Which of the following is the most likely diagnosis? A. Viral keratitis B. Fungal corneal ulcer C. Acanthamoeba keratitis D. Bacterial corneal ulcer And in case you were wondering: B. Fungal corneal ulcers have an indolent course with intraocular infection being common but fluorescein staining is negative for a dendritic pattern. C. Acanthamoeba keratitis has a waxing and waning course over several months and has no fluorescein staining in a dendritic pattern. D. Bacterial corneal ulcers can progress aggressively resulting in corneal perforation. Fluorescein staining does not occur in a dendritic pattern. 3. A 63 year-old female with history of diabetes mellitus presents for blood pressure follow-up. At her last two visits her blood pressure was 150/92 and 152/96. Today in the office her blood pressure is 146/92. Recent blood work shows a Sodium 140 mEq/L, Potassium 4.2 mEq/L, BUN of 23 mg/dL, and Creatinine of 1.1 mg/dL. Which of the following is the most appropriate initial medication in this patient? A. Terazosin (Hytrin) B. Atenolol (Tenormin) C. Lisinopril (Zestril) D. Hydrochlorothiazide (HCTZ) 4. What is the EKG manifestation of cardiac end-organ damage due to hypertension? A. Right bundle branch block B. Left ventricular hypertrophy C. Right ventricular hypertrophy D. ST segment elevation in lateral precordial leads 5. Annual blood pressure determinations should be obtained beginning at the age of A. 3 years. B. 5 years. C. 12 years. D. 18 years. 6. In adults and intravenous drug abusers, which of the following bones is most commonly affected with acute osteomyelitis? A. Femur B. Humerus C. Vertebral spine D. Tibia 7. Treatment of the patient with Pediculosis pubis consists of which of the following? A. Permethrin (Nix) cream B. Clotrimazole (Gyne-Lotrimin) C. Podofilox (Condylox) solution D. Selenium sulfide (Selsun) suspension 8. A 43 year-old asymptomatic diabetic female is found to have an elevated total calcium level of 12.4 mg/dL. Which of the following tests must be assessed in order to evaluate this laboratory abnormality? A. Intact parathyroid hormone B.

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 created this audio series to help you fill some downtime when you are unable to read (like in the car) with some useful board review. I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy. * You can download and listen to past FREE episodes here or on iTunes. * You can listen to the latest episode and take an interactive quiz of the questions below. Listen Carefully Then Take The Quiz Questions 1-10 The Audio PANCE and PANRE Episode 9 1. A 3 year-old girl is diagnosed with atopic dermatitis. Which of the following disorders is this child at risk for in the future? A. Asthma B. Tinea pedis C. Squamous carcinoma D. Systemic lupus erythematosus (SLE) 2. A 3 year-old boy is seen in the office with a 5-day history of fever, erythema, edema of the hands and feet, a generalized rash over the body, bilateral conjunctival injections, fissuring and erythema of the lips, and cervical adenopathy. Antistreptolysin A (ASO) titer and throat culture are negative. The most serious systemic complication associated with this disorder is A. renal. B. cardiac. C. pulmonary. D. hepatic. 3. Which of the following medication classes is the treatment of choice in a patient with variant or Prinzmetal’s angina? A. Calcium channel blockers B. ACE inhibitors C. Beta blockers D. Angiotensin II receptor blockers 4. Pharmacologic treatment of a patient with gestational diabetes should consist of which of the following? A. Oral hypoglycemic agents B. Regular insulin C. Oral corticosteroids D. Glucagon 5. Which of the following is an indication for vaccination against hepatitis A? A. Illicit drug users B. Health care workers C. Renal dialysis patients D. Routine vaccination starting at birth 6. A 2 month-old infant presents for a routine health maintenance visit. The mother has been concerned about the infant’s hearing since birth. Physical examination reveals no apparent response to a sudden loud sound. Which of the following is the most appropriate diagnostic evaluation? A. audiometry B. tympanometry C. acoustic reflectometry D. auditory-evoked potentials 7. A 53 year-old female status post abdominal hysterectomy 3 days ago suddenly develops pleuritic chest pain and dyspnea. On exam, she is tachycardic and tachypneic with rales in the left lower lobe. A chest x-ray is unremarkable and an EKG reveals sinus tachycardia. Which of the following is the most likely diagnosis? A. Atelectasis B. Pneumothorax C. Pulmonary embolism D. Myocardial infarction 8. Which of the following is an independent risk factor for development of a mesothelioma? A. Cigarette smoking B. Asbestos exposure C. Radon gas exposure D. Chronic obstructive lung disease 9. A 34 year-old female with a history of asthma presents with complaints of increasing asthma attacks. The patient states she has been well-controlled on albuterol inhaler until one month ago. Since that time she notices that she has had to use her inhaler 3-4 times a week and also has had increasing nighttime use averaging about three episodes in the past month.

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 created this audio series to help you fill some downtime when you are unable to read (like in the car) with some useful board review. I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy. Questions 1-10 1. Which of the following is a staphylococcal infection characterized by a localized red swollen and acutely tender abscess of the upper or lower eyelid? A. Hordeolum B. Uveitis C. Chalazion D. Dacryocystitis 2. Progesterone influence on the breast tissue prior to menstruation causes A. proliferation of the mammary ducts. B. growth of the lobules and alveoli. C. proliferation of Cooper’s ligaments. D. increase in the number of glands of Montgomery. 3. A 3 year-old girl is diagnosed with atopic dermatitis. Which of the following disorders is this child at risk for in the future? A. Asthma B. Tinea pedis C. Squamous carcinoma D. Systemic lupus erythematosus (SLE) 4. A patient presents with chronic back pain. On physical examination testing, the patient is found to have abnormalities of proprioception and vibration discrimination. Which of the following portions of the spinal column are most likely affected? A. Lateral spinothalamic tract B. Ventral spinothalamic tract C. Posterior column D. Transection of the cord 5. A 44 year-old female presents for follow-up results of her lipid profile. She is asymptomatic and has a past medicalhistory of hypothyroidism treated with levothyroxine and hypertension controlled with atenolol (Tenormin). She drinks an average of 6 alcoholic beverages a day and smokes 1 pack per day for the last 32 years. Her family history is unremarkable for premature coronary artery disease. Her fasting blood glucose is 98 mg/dL, total cholesterol is 198 mg/dL, LDL cholesterol is 132 mg/dL, HDL cholesterol is 56 mg/dL and triglycerides of 90 mg/dL. Excluding LDL cholesterol levels, how many major risk factors for coronary artery disease does this female possess? A. 2 B. 3 C. 4 D. 5 6. A 65 year-old patient with steroid-dependent chronic obstructive lung disease presents with a headache that has been increasing in severity over the past week, accompanied by nausea and vomiting. He denies fever, but has had photophobia and a stiff neck. Which of the following is the most likely diagnosis? A. Transient ischemic attack B. Bacterial meningitis C. Migraine headache D. Cryptococcosis 7. A 40 year-old female presents with a 1.5 cm well-circumscribed mass noted on mammography in the right upper, outer quadrant. Which of the following procedures is most appropriate and should be done next? A. Fine needle aspiration B. BRCA 1 and BRCA 2 genetic testing C. Serum CA-125 D. Radiation therapy 8. On examination of a pregnant patient the physician assistant notes the fundal height is at the level of the umbilicus. This corresponds to what gestational age? A. 16 weeks B. 20 weeks C. 24 weeks D. 28 weeks 9. Which of the following is a common symptom associated with laryngotracheobronchitis (viral croup)? A. Drooling B. High fever C. “Hot potato” voice D. Barking cough 10. A 23 year-old female with history of asthma for the past 5 years presents with complaints of increasing shortness ofbreath for 2 days. Her asthma has been well-controlled until 2 days ago. Since yesterday, she has been using heralbuterol inhaler every 4 to 6 hours. She is normally very active, however yesterday she did not complete her 30minu...

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 created this audio series to help you fill some downtime when you are unable to read (like in the car) with some useful board review. I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy. Questions 6 y/o male presents w/ hemarthrosis of the L knee. Coag studies: PT 12.5s (normal12-14 sec), INR 1.0, aPTT 58s (normal 18-28 sec), platelet 430,000/microliter (normal 150,000-450,000/microliter), & bleeding time 4m (normal 2-12m). Which is the best tx option for this pt? A. Desmopressin acetate B. Corticosteroids C. Vitamin K D. Cryoprecipitate HIV+ pt presents w/ worsening dementia, fever, HA, & R hemiparesis. Brain MRI reveals 6 lesions throughout the brain that show ring enhancement & surrounding edema. Which is the tx of choice? A. Sulfadiazine and pyrimethamine B. Trimethoprim-sulfamethoxazole C. Radiation therapy D. Ventricular shunt placement On examination of a pregnant patient the physician assistant notes a bluish or purplish discoloration of the vagina and cervix. This is called A. Hegar’s sign. B. McDonald’s sign. C. Cullen’s sign D. Chadwick’s sign A 52 year-old female comes to the office because of black stools for the past 3 days. She is afebrile and she has no pertinent physical examination abnormalities. Which of the following is the most appropriate initial diagnostic study? A. Stool for occult blood B. Stool cultures C. Sigmoidoscopy D. Abdominal CT scan Which of the following is considered a risk factor for the development of malignant melanoma? A. male gender B. inability to tan C. Japanese ethnicity D. brown-haired individuals A 43 year-old data entry clerk presents with a one-month history of pain and tingling in the right thumb, index finger, and middle finger. Tinel’s sign and Phalen’s maneuver are positive. The most appropriate intervention at this time is A. methylprednisolone (Medrol) dose pack. B. splint in neutral position. C. observation. D. surgery. Which of the following is a cause of prerenal azotemia? A. Infection B. Renal toxins C. Poor renal perfusion D. Urinary tract obstruction Which of the following is the most common cause of secondary hypertension? A. Renal parenchymal disease B. Primary aldosteronism C. Oral contraceptive use D. Cushing’s syndrome A newborn weighs 8 pounds at birth. On average, what should the infant weigh at 1 year of age? A. 16 pounds B. 20 pounds C. 24 pounds D. 28 pounds The most reliable sign of acute otitis media (AOM) is A. bulging of the tympanic membrane. B. loss of tympanic membrane mobility. C. reddening of the tympanic membrane. D. air bubbles behind the tympanic membrane. Looking for all the episodes? This FREE series is limited to every 3rd episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy. I will be be releasing new episodes every two weeks. The Academy is currently discounted at $35 for the entire year, so sign up now. This Podcast is also available on iTunes and Stitcher Radio for Android * iTunes: The Audio PANCE AND PANRE Podcast iTunes * Stitcher Radio: 

This FREE series is limited to every 3rd episode,  you can download and enjoy the complete audio series by joining the PANCE and PANRE Exam Academy. Questions and Answers A 62 year-old homeless patient presents complaining of fever, weight loss, anorexia, night sweats and a chronic cough that recently became productive of purulent sputum that is blood streaked. On physical examination, the patient appears chronically ill and malnourished. Which of the following chest x-ray findings supports your suspected diagnosis? A. Hyperinflation and flat diaphragms B. Interstitial fibrosis and pleural thickening C. Cavitary lesions involving the upper lobes D. “Eggshell” calcification of hilar lymph nodes C. This patient most likely has tuberculosis. A chest x-ray finding of cavitary lesions involving the upper lobes would support this suspected diagnosis. Abduction of the shoulder against resistance helps localize pain in which of the following muscles of the shoulder girdle? A. Supraspinatus B. Infraspinatus C. Teres minor D. Subscapularis A. Abduction against resistance tests the supraspinatus. What is the recommended method for screening pregnant women for gestational diabetes? A. Fasting blood sugar and 2 hour post prandial B. 50 gram glucose load followed by a blood sugar in 1 hour C. 75 gram glucose load followed by a blood sugar in 2 hours D. 100 gram glucose load followed by a blood sugar at 1 hour, 2 hours, and 3 hours B. One hour Glucola is the screening test for gestational diabetes. It is a 50 gram glucose load, with a serum glucose obtained 1 hour after the dose. Normal value is less than 140 mg/dL. A 45 year-old smoker presents with a sore mouth and increasing difficulty eating for two weeks. Physical examination reveals a 1 cm white lesion on the buccal mucosa that cannot be rubbed off. Which of the following is the most likely diagnosis? A. Oral cancer B. Oral candidiasis C. Aphthous ulcer D. Necrotizing ulcerative gingivitis A. The presence of leukoplakia in a smoker over the age of 40 should be biopsied to rule out the presence of oral cancer. A 25 year-old female presents to the emergency department after an episode of substernal chest pain with radiation to the middle of her back that came on suddenly and lasted for about four minutes this morning while in bed. She denies previous episodes. Examination is unremarkable, but she appears jittery. Toxicology screen is positive for cocaine. Which of the following medications is contraindicated in this patient? A. Lorazepam (Ativan) B. Diltiazem (Cardizem) C. Nitroglycerin (Nitrostat) D. Propanolol (Inderal) D. Pure Beta blockers, such as propranol, can cause a paradoxical hypertension because of unopposed alpha-adrenergic effects. Which immunoglobulin is the first to respond during the primary immune response for a gram positive bacterial infection? A. IgM B. IgG C. IgA D. IgE A. IgM is the first immunoglobin to respond during the acute exposure. This immunoglobulin promotes opsonization and phagocytosis. IgG is the immunoglobulin that responds during the secondary exposure. IgE is the immunoglobulin that responds during an allergic response as well as during a parasitic infection. IgA is an antibody found in colostrums and GI secretions. A patient with obsessive compulsive disorder would most likely have which of the following findings? A. Raw, red hands B. Priapism C. Memory impairment D. Abdominal pain A. Common manifestations of obsessive compulsive disorder include phobias of germ and contaminan...

This FREE series is limited to every 3rd episode,  you can download and enjoy the complete audio series by joining the PANCE and PANRE Exam Academy. Which of the following factors in patients with chronic venous insufficiency predisposes them to development of skin ulcers? A. Increased intravascular oncotic pressure B. Leakage of fibrinogen and growth factors into the interstitial space C. Decreased capillary leakage D. Inherited deficiency of protein C B. Leakage of fibrinogen and growth factors into the interstitial space, leukocyte aggregation and activation, and obliteration of the cutaneous lymphatic network can predispose a patient to skin ulcers A 26 year-old monogamous female presents with cyclic pelvic pain that has been increasing over the last 6 months. She complains of significant dysmenorrhea and dyspareunia. She uses condoms for birth control. On physical examination her uterus is retroverted and non-mobile, and she has a palpable adnexal mass on the left side. Her serum pregnancy test is negative. Which of the following is the most likely diagnosis? A. Ovarian cancer B. Endometriosis C. Functional ovarian cyst D. Pelvic inflammatory disease B. With endometriosis, the uterus is often fixed and retroflexed in the pelvis. The palpable mass is an endometrioma or “chocolate cyst”. The patient with endometriosis also often has dysmenorrhea, dyspareunia, and dyschezia. At what age does the first tooth usually erupt in an infant? A. 2-4 months B. 6-8 months C. 10-12 months D. 14-16 months B. The first tooth in an infant to erupt is the central incisor at the average age of 6-8 months. A 7 year-old boy wets the bed on most nights. Which of the following is the preferred pharmacological agent to decrease the incidence of bed wetting episodes? A. Imipramine (Tofranil) B. Phenytoin (Dilantin) C. Pramipexole (Mirapex) D. Hyoscyamine (Urised) A. Imipramine is an anti-cholinergic and when given before bedtime has been shown to decrease the incidence of bed wetting. A newborn is being evaluated for perioral cyanosis while feeding associated with sweating. Vital signs are rectal temperature, 37.8 degrees C (100 degrees F), blood pressure 80/45 mmHg, pulse 180/min, and respirations 40/min. A grade 3/6 harsh systolic ejection murmur with a single loud S2 is heard at the left upper sternal border. Electrocardiogram (ECG) shows right ventricular hypertrophy with right axis deviation. Chest x-ray shows a boot-shaped heart and decreased pulmonary vascular markings. Which of the following is the most likely diagnosis? A. Atrial septal defect B. Total anomalous pulmonary venous return C. Coarctation of the aorta D. Tetralogy of Fallot D. This is a common presentation for tetralogy of fallot. Which of the following is considered to be the modality of choice for the identification of a pituitary macroadenoma that is suspected on the basis of a visual field deficit? A. Skull x-ray B. PET scan C. CT of the brain D. MRI of the brain D. MRI of the brain provides the best visualization of pituitary tumors. A 2 year-old male presents with a four day history of fever and general malaise. On examination the vitals reveal an oral temperature of 102 degrees F. The child appears to have rubor on the trunk which started one day prior to this visit. Physical examination reveals a maculopapular rash with defervescence. Which of the following is the most appropriate management at this time? A. Ibuprofen (Motrin) B. Aspirin C. Amoxicillin D. Valacyclovir (Valtrex) A. Motrin is indicated for management of the fever in Roseola inf...