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.

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.

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

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)

4. What is the EKG manifestation of cardiac end-organ damage due to hypertension?

A. Right bundle branch block

5. Annual blood pressure determinations should be obtained beginning at the age of

A. 3 years.

6. In adults and intravenous drug abusers, which of the following bones is most commonly affected with acute osteomyelitis?

A. Femur

7. Treatment of the patient with Pediculosis pubis consists of which of the following?

A. Permethrin (Nix) cream

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

9. Which of the following conditions would cause a positive Kussmaul’s sign on physical examination?

A. Left ventricular failure

10. Treatment of Bell’s palsy includes which of the following?

A. Acyclovir

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, so sign up now.

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.

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

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.

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

4. Pharmacologic treatment of a patient with gestational diabetes should consist of which of the following?

A. Oral hypoglycemic agents

5. Which of the following is an indication for vaccination against hepatitis A?

A. Illicit drug users

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

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

8. Which of the following is an independent risk factor for development of a mesothelioma?

A. Cigarette smoking

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. Spirometry reveals greater than 85% predicted value. Which of the following is the most appropriate intervention at this time?

A. Oral prednisone

10. Which of the following mechanisms leads to a primary pneumothorax?

A. Penetrating or blunt trauma forces

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, so sign up now.

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.

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

2. Progesterone influence on the breast tissue prior to menstruation causes

A. proliferation of the mammary ducts.

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

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

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

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

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

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

9. Which of the following is a common symptom associated with laryngotracheobronchitis (viral croup)?

A. Drooling

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 30minute exercise routine due to increasing dyspnea. She denies any cough, fever, recent surgeries, or use of oralcontraceptives. On examination, you note the presence of prolonged expiration and diffuse wheezing. The remainder of the exam is unremarkable. Which of the following is the most appropriate initial diagnostic evaluation prior to initiation of treatment?

A. Chest x-ray

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.

And, as always, if you haven’t already, make sure to download Brian Wallaces’ excellent Physician Assistant Exam Review Podcast. Follow along with Brian who covers new topics twice monthly and really does an amazing job! He is running a contest on his site to win some free goodies! You can sign up to win free stuff here!

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.

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

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

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.

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

Which of the following is considered a risk factor for the development of malignant melanoma?

A. male gender

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.

Which of the following is a cause of prerenal azotemia?

A. Infection

Which of the following is the most common cause of secondary hypertension?

A. Renal parenchymal disease

A newborn weighs 8 pounds at birth. On average, what should the infant weigh at 1 year of age?

A. 16 pounds

The most reliable sign of acute otitis media (AOM) is

A. bulging of the tympanic membrane.

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.

And, if you haven’t already, make sure to download Brian Wallaces’ excellent Physician Assistant Exam Review Podcast. Follow along with Brian who covers new topics twice monthly and really does an amazing job!

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.

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

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

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. 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

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)

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

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

A. Common manifestations of obsessive compulsive disorder include phobias of germ and contaminants which results in frequent handwashing leading to chafed and reddened hands. The other answers are inconsistent with obsessive compulsive disorder.

As a rule, solid foods such as cereal and fruits are best introduced into an infant’s diet at approximately

A. 1 to 3 weeks.

C. The inclusion of solid foods in the diet is best done at approximately 4-6 months. Before 4 to 6 months of age does not contribute significantly to the infant’s health and it increases their risk of allergies and atopy.

A 56 year-old female four days post myocardial infarction presents with a new murmur. On examination the murmur is a grade 3/6 pansystolic murmur radiating to the axilla. She is dyspenic at rest and has rales throughout all her lung fields. Blood pressure is 108/68 mmHg, pulse 70 bpm. Which of the following would be the definitive clinical intervention?

A. Intra-aortic balloon counterpulsation

B. MVR is the definitive intervention to correct MR caused by papillary muscle rupture.

During an influenza epidemic, a 6 year-old male is seen with fever and a severe sore throat. The parents report that his symptoms have not improved despite administration of aspirin. The next day, the parent calls to report that the child has persistent vomiting and increased lethargy. On examination, he is found to be delirious and disoriented with hyperactive reflexes. The liver edge is 3 cm below the right costal margin in the midclavicular line. Which of the following is the most likely diagnosis?

A. Reye’s syndrome

A. The suspected influenza associated with development of vomiting, progressive mental status changes, hyperreflexia, and hepatomegaly are consistent with a diagnosis of Reye’s syndrome.

What is the treatment of magnesium sulfate toxicity?

A. Nifedipine

D. 10% calcium gluconate is used to treat magnesium sulfate toxicity.