Welcome to episode 47 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet).

This week we will be covering 10 general board review questions based on the NCCPA PANCE and PANRE Content Blueprint.

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

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Episode 47 PANCE and PANRE Podcast Quiz

The following 10 questions are linked to NCCPA Content Blueprint lessons from the SmartyPANCE PANCE and PANRE board review website. If you are a member and login you will be able to view this content.

1. To relieve dependent edema in a pregnant patient, which of the following should be instituted as treatment?

Limit fluid intake Elevate the legs Prescribe thiazide diuretics Strict avoidance of sodium

Uncomplicated pregnancy is part of the NCCPA Content Blueprint Reproductive System which is 8% of the exam

Click here to see the answer Answer: B. Elevate the legs. Dependent edema is a common and rarely serious complication of pregnancy due to impedance of venous return. Leg elevation improves circulation A. Limitation of fluid is not indicated and may be harmful.

C. Thiazide diuretics are contraindicated and could be harmful.

D. Edema due to impedance of venous return will not respond to sodium restriction.

2. To further assess ascites in a patient, the physician assistant instructs the patient to turn onto one side while performing percussion. Which of the following is the reason for this maneuver?

Testing for shifting of dullness on percussion Shifting of internal organs making percussion easier Trying to elicit any pain while moving Trying to produce a caput medusae

Ascites is a common complication of liver disease. Disorders of the liver is part of the NCCPA GI and Nutrition Content Blueprint and represents 10% of the exam

Click here to see the answer Answer: A. Testing for shifting of dullness on percussion. In ascites, dullness shifts to the more dependent side as the fluid relocates into dependent space, while tympany shifts to the top as the gas-filled organs float to the top of the ascitic fluid C. Pain with movement is associated with peritonitis and not ascites.

D. Caput medusae is the dilation of the superficial abdominal veins due to increased intra abdominal fluid accumulation. It is visible with the patient standing and does not need a special maneuver for identification.

3. A 7-year-old child with a history of type 1 diabetes mellitus for 3 years presents for routine follow-up. The mother states that the child has been having nightmares and night sweats. Additionally, his average morning glucose readings have risen from an average of 100 mg/dL to 145 mg/dL over the past week. This child is most likely experiencing

a growth spurt emotional problems the Somogyi effect the dawn phenomenon

Diabetes mellitus type 1 is part of the NCCPA Content Blueprint Endocrinology which represents 6% of your exam

Click here to see the answer Answer: C. the Somogyi effect. This refers to nocturnal hypoglycemia, which stimulates counterregulatory hormone release resulting in rebound hyperglycemia A. Nightmares and night sweats are not associated with growth spurts.

B. With this limited history, it is impossible to label the child as emotionally unstable.

D. This refers to an early morning rise in plasma glucose due to reduced tissue sensitivity to insulin between 5AM and 8AM. It is not associated with nightmares and night sweats.

4. A patient complains of loss of sensation at the level of the umbilicus. Which of the following dermatomes is affected?

T6 T8 T10 T12

Radicular pain is a common symptom of a herniated nucleus pulposus covered as part of the NCCPA Content Blueprint Musculoskeletal System which is 10% of your exam

Click here to see the answer Answer: C. T10. The dermatome T10 is at the level of the umbilicus.

5. A 25-year-old female graduate student presents to the student health center for the eighth time in three weeks to be sure she does not have meningitis. She read that there was a student on campus who had meningitis last month, and now she has headaches and is requesting to be tested to make sure she does not have meningitis. She has been evaluated at each visit, and physical examination has been completely normal each time. Which of the following is the most likely diagnosis?

Somatoform disorders are covered as part of the NCCPA Content Blueprint Psychiatry which is 6% of your exam

Click here to see the answer Answer: B. Hypochondriasis. Hypochondriasis is the chronic preoccupation with the idea of having a serious disease, which is usually not amenable to reassurance A. Conversion disorder is characterized by onset of symptoms or deficits mimicking neurologic or medical illness, but the etiology is psychological.

C. Malingering is the intentional production or feigning of physical or psychological signs and symptoms for some gain.

D. Somatization disorder is characterized by complaints of pain, often related to gastrointestinal and sexual dysfunction, and pseudoneurological symptoms

6. What is the mechanism for the relapsing fevers associated with malaria?

Release of malarial merozoites into the bloodstream Release of toxins from Plasmodium species Attachment of Plasmodium species to receptor sites on the red blood cells Invasion of hepatocytes by Plasmodium species

Malaria is covered as part of the NCCPA Content Blueprint Infectious Disease and is 3% of the exam

Click here to see the answer Answer: A. Release of malarial merozoites into the bloodstream. Fever, chills, and sweats coincide with the release of merozoites from red blood cells that have been infected with Plasmodium species. Each merozoite may infect a new red blood cell, leading to a cycle of invasion growth, and release.

7. A 29-year-old patient with idiopathic thrombocytopenia purpura (ITP) is treated with prednisone therapy. Despite therapy, platelet counts remain consistently below 20,000/microliter over the course of 6 weeks. Which of the following is the most appropriate intervention for this patient?

Aspirin Intravenous immunoglobulin Danazol (Danocrine) Splenectomy

Idiopathic thrombocytopenic purpura is covered as part of the NCCPA Content Blueprint Hematology and is 3% of your exam

Click here to see the answer Answer: D. Splenectomy Persistently low platelet counts (< 20,000) require effective long-term treatment, and splenectomy is the treatment of choice. A. Aspirin inhibits platelet function and could lead to significant bleeding and death of this patient.

B. Intravenous immunoglobulin can be utilized for short-term treatment, but the platelet count is likely to return to baseline within a month.

C. Danazol is typically reserved for ITP that fails to respond to splenectomy.

8. A 27 year-old female presents to your office for evaluation of weakness, visual loss, and sensory loss over the right great toe. These symptoms have occurred during three episodes approximately three months apart with each episode lasting about three days. Which of the following tests would be most useful in further evaluating this patient?

MRI of the brain Electromyography Glucose tolerance test Electroencephalograph

This condition is covered as part of the NCCPA Content Blueprint Neurology which is 6% of your exam

SmartyPANCE ReelDx + members can view this real-world case!

Click here to see the answer Answer: A. MRI of the brain. Multiple sclerosis typically presents with relapsing weakness of the limbs, sensory loss, paresthesias, and visual changes. Diagnosis is based on history and either abnormal brain or spinal cord MRI, or visual, auditory, or somatosensory evoked electrical response. C. Glucose tolerance test is used in the evaluation of diabetes mellitus.

D. Electroencephalograph is used to evaluate patients for possible seizure disorder.

9. A patient taking bleomycin (Blenoxane) should be monitored for which of the following side effects?



Optic neuritis Hyperuricemia Encephalopathy Pulmonary fibrosis

This condition is is covered as part of the NCCPA Pulmonary Content Blueprint which represents 12% of your exam

Click here to see the answer Answer: D. Pulmonary fibrosis. Pulmonary fibrosis and pulmonary infiltrates are known side effects of bleomycin A. Optic neuritis is a potential side effect of ethambutol, used in the treatment of tuberculosis.

B. Hyperuricemia or encephalopathy are not known side effects of bleomycin.

10. A patient presents for a follow-up visit for chronic hypertension. Which of the following findings may be noted on the fundoscopic examination of this patient?

cherry-red fovea boxcar segmentation of retinal veins papilledema arteriovenous nicking

This condition is a common complications of chronic hypertension covered as part of the NCCPA Cardiology Content Blueprint which is 16% of your exam

Click here to see the answer Answer: D. arteriovenous nicking Arteriovenous nicking is common in chronic hypertension A. Cherry-red fovea and boxcar segmentation of the retinal veins are findings seen in central retinal artery occlusion.

C. Papilledema is noted in conditions causing increased intracranial pressure.

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