Welcome to episode 61 of the FREE Audio PANCE and PANRE Physician Assistant 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 Blueprint. 

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 SMARTYPANCE which are now bundled together into one very low price.

If you can’t see the audio player click here to listen to the full episode.

The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content.

1. An 18-year-old male presents with pain in his wrist after he fell off of a moving motorcycle. Physical examination reveals tenderness in the anatomic snuffbox. No fracture is noted on plain radiography of the wrist. Which of the following is the recommended treatment for this patient?

A. An ace wrap of the wrist

Answer: C. Thumb spica cast application

Even with normal initial radiographs, patients with a consistent history and tenderness in the anatomical snuffbox are treated as a stable fracture with immobilization in a thumb spica cast. Casting is recommended for all presumed nondisplaced scaphoid fractures.

Scaphoid fractures covered in fractures and dislocation of the forearm, wrist, and hand and are part of the NCCPA Endocrinology Musculoskeletal Blueprint (10%)

2. A solitary pulmonary nodule is found on a pre-employment screening chest x-ray in a 34-year-old non-smoking male. There are no old chest x-rays to compare. Which of the following is the most appropriate next step in the evaluation?

A. CT scan of the chest

Solitary pulmonary nodules are covered as part of the NCCPA PANCE Blueprint Pulmonary (12%) Content Blueprint (12%)

Answer: A. CT scan of the chest

In the absence of old x-rays in a nonsmoking individual less than 35 years old, CT scan of the chest is the next step in the evaluation of a solitary pulmonary nodule.

B. A needle biopsy would be indicated for a person greater than 35 years old and/or with a history of smoking to evaluate a solitary pulmonary nodule.

3. Early clues to impending delirium tremens include

A. agitation and decreased cognition.

Delirium tremens is covered as part of the NCCPA Psychiatry content blueprint (6%) under the topic of withdrawal

Answer: A. agitation and decreased cognition.

Anxiety, decreased cognition, tremulousness, increasing irritability, and hyperactivity are common early clues to impending delirium tremens.

Mental confusion, tremor, sensory hyperacuity, visual hallucinations, autonomic hyperactivity, diaphoresis, dehydration, electrolyte disturbances, seizures, and cardiovascular abnormalities are common signs and/or symptoms of full-blown delirium tremens.

4. Dental caries are caused by which of the following organisms?

A. Streptococcus mutans

Dental caries are covered as part of the NCCPA EENT Content Blueprint (9%) under diseases of the teeth and gums

Answer: A. Streptococcus mutans

Streptococcus mutans is the principal organism that helps to demineralize the enamel.

5. The most definitive treatment for primary enuresis is

A. oxybutynin chloride (Ditropan).

Primary enuresis is covered under incontinence as part of the NCCPA Genitourinary Content Blueprint (6%)

Answer: D. desmopressin (DDAVP)

Intranasal desmopressin is effective in 50% of patients treated and is the treatment of choice.

A. Oxybutynin chloride is used for bladder spasms. It cannot be used for children under 5 years of age and is not indicated in primary enuresis.

6. A 47-year-old female presents to the clinic with complaints of prolonged, heavy menses that have been getting progressively worse for 3 years. She denies any pain. On physical examination, enlargement of the uterus with multiple smooth, spherical, firm masses is noted. A CBC is consistent with a mild anemia. Which of the following is the most likely diagnosis?

A. Leiomyoma

Leiomyoma is covered as part of the NCCPA Reproductive Content Blueprint (8%)

Answer:  A. Leiomyoma

Abnormal uterine bleeding and irregular enlargement of the uterus are most consistent with leiomyoma. Pain is rarely present unless vascular compromise occurs.

B. While adenomyosis may present with hypermenorrhea, dysmenorrhea is often also present. Physical examination would reveal the presence of diffuse globular uterine enlargement, not the irregular enlargement as noted in the case presented.

7. Which of the following is the laboratory test that marks recovery from Hepatitis B infection and non-infectivity?

A. Hepatitis B surface antibody(anti-HBs)

Hepatitis B serology is covered as part of acute and chronic hepatitis and is part of the NCCPA GI and Nutrition Content Blueprint (10%)

Answer: A. Hepatitis B surface antibody(anti-HBs)

Specific antibody to HBsAg appears in most individuals after clearance of HBsAg which indicates recovery from hepatitis B infection, non-infectivity, and immunity.

B. This test establishes infection with HBV and implies infectivity.

8. A 36-year-old woman admits that her husband has abused her for over ten years. You should inform the woman that she is at most risk for injury or death

A. just before a holiday.

Domestic violence is covered as part of the NCCPA Psychiatry Content Blueprint (6%)

Answer: B. just after leaving an abusive spouse.

Women are more likely to be assaulted or murdered when attempting to report the abuse or leave the abusive relationship; up to 75% of domestic assaults occur after separation.

9. A patient presents with an acutely painful and cold left leg. Distal pulses are absent. Leg is cyanotic. There are no signs of gangrene or other open lesions. Symptoms occurred one hour ago. Which of the following treatments is most appropriate?

A. Vena cava filter

Arterial embolism/thrombosis is covered as part of the NCCPA Cardiology Content Blueprint (16%)

Answer: B. Embolectomy

Embolectomy within 4 to 6 hours is the treatment of choice.

A. Vena cava filters are used in the management of venous thromboembolic disease when anticoagulation cannot be done.

10. A 53-year-old male is seen in the emergency department following a motor vehicle collision in which his knee impacted against the dashboard. The patient has a posterior knee dislocation that is promptly reduced in the emergency department. The patient currently has a palpable pulse in the dorsalis pedis and posterior tibial areas. Which of the following studies is mandatory?

A. Anterior plain film of knee

Fractures and dislocations of the knee are covered as part of the NCCPA Musculoskeletal Content Blueprint (10%)

Answer: D. Angiography

The popliteal artery is at risk for injury whenever a patient sustains a posterior dislocation of the knee and should be evaluated with an arteriogram despite the presence of pedal pulses.

C. Compartment pressures are performed in cases of suspected compartment syndrome, not to determine the patency of the popliteal artery.

This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE

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Follow this link to download your FREE copy of the Content Blueprint Checklist

Print it up and start crossing out the topics you understand, marking the ones you don’t and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on SMARTY PANCE.

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