A 27-year-old nulliparous female presents because she’s been trying to get pregnant for two years, but has failed. She relates a history of a misdiagnosis of appendicitis that lead to abscess formation when she was 14 years old. Which of the following diagnostic studies would be most helpful at this point in her evaluation? TSH […]
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The Daily PANCE & PANRE Question 52
A 32 year-old male presents after slipping and falling off the roof of his home and striking his head. He suffered a brief loss of consciousness. Since that time, he has noted increasing urination and thirst. His serum chemistries reveal an elevated sodium level. His urine specific gravity is 1.003. Which of the following is […]
The Daily PANCE & PANRE Question 43
A female patient presents for an evaluation for primary amenorrhea. She is noted to be short of stature and has short fourth metacarpals. What diagnosis do you suspect? XO XXY XXX XXXY Trisomy 21 Answer: A XO This is the genotype for Turner’s syndrome. XXY is the genotype for Klinefelter’s (which is a tall, mildly retarded […]
The Daily PANCE & PANRE Question 73
A patient that must be on a beta-blocking agent has reactive airway disease and commonly experiences central nervous system side effects from medications. Which of the following beta-blockers would most likely be tolerated by this patient? A. atenolol B. metoprolol C. nadfilol D. propranolol E. pindolol Answer: B, metoprolol This is a picky Q for the […]
The Daily PANCE & PANRE Question 5
A 34-year-old female presents complaining of symmetrical redness and swelling of the small joints of her hands (PIPs and MCPs). She has noted that the symptoms are worst in the morning. Her erythrocyte sedimentation rate is elevated and her rheumatoid factor is negative. Which of the following diagnosis is most likely? progressive systemic sclerosis CREST […]
The Daily PANCE & PANRE Question 51
Which of the following choices is associated with meconium staining of the amniotic fluid? A. bowel obstruction B. peeling of the infant’s skin C. aspiration pneumonitis and respiratory distress syndrome D. infection with E. coli E. intrauterine cataract formation and sensorineural hearing loss Answer: C, aspiration pneumonitis and respiratory distress syndrome When the infant has meconium […]
Pre-Physician Assistant: The Ultimate Getting Started Guide
Welcome, Future Physician Associates! Hi, and welcome to this special section of the PA Life website designed specifically for future physician assistants/associates. I’m happy to help you as you get started on this journey! Be assured that you are certainly not alone and that I once walked in your shoes. I assume you already know […]
The Daily PANCE & PANRE Question 72
A 12 year-old male presents complaining of no appetite for 24 hours and pain near his navel. During the night, the pain moved to the right lower abdomen. He is now nauseated and vomiting and has a low-grade fever. In the operating room, a normal appendix is discovered. What is the most likely diagnosis? A. […]
The Daily PANCE & PANRE Question 4
A patient describes a history of recurrent bouts of uveitis. Her chemistry panel reveals elevated serum calcium and uric acid levels. Her anergy screen is negative. Her chest x-ray demonstrates bilateral hilar adenopathy. Which diagnosis is most likely? Silicosis Sarcoidosis Alpha-1 antitrypsin deficiency Histoplasmosis Tuberculosis Answer: B Sarcoidosis Sarcoidosis typically presents with hilar lymphadenopathy and noncaseating granulomas […]
The Daily PANCE & PANRE Question 50
This drug causes gingival hyperplasia and hirsutism. At high doses it can cause nystagmus, ataxia and diplopia. Which drug is best described by these statements A. aspirin B. acetaminophen C. acyclovir D. phenytoin E. valproic acid Answer: D, phenytoin Dilantin (phenytoin) causes these typical symptoms Help Support The Physician Assistant Life for FREE! This is […]
The Daily PANCE & PANRE Question 41
A patient at a Christmas party on a cruise ship develops a terrible headache. His blood pressure is 224/158 mm Hg. Which of the following agents is this patient most likely taking regularly? tricyclic antidepressants barbiturates benzodiazepines monoamine oxidase inhibitors phenothiazines Answer: D Monoamine oxidase inhibitors This is a typical scenario for MAOI induced malignant hypertension […]
The Daily PANCE & PANRE Question 71
Which of the following is NOT a risk factor for the development of osteoporosis? A. low testosterone levels in men B. low levels of physical activity C. inadequate dietary protein D. cigarette smoking E. chronic corticosteroid use Answer: C, inadequate dietary protein Low dietary Calcium, not protein, is a risk factor for osteoporosis. All of the […]
The Daily PANCE & PANRE Question 3
Which of the following is NOT a characteristic feature of the nephrotic syndrome? proteinuria hematuria hypoalbuminemia hyperlipidemia generalized edema Answer: B. Hematuria Hematuria is present in NEPHRITIC syndrome. Nephrotic syndrome characteristically includes proteinuria (>3.5 gm/day), with resulting low serum albumin, hyperlipidemia, hypertension, hypercoagulability, and generalized edema (from oncotic third-spacing) Note: * This is part of […]
The Daily PANCE & PANRE Question 49
A 35 year-old male complains of acute left eye pain immediately after he struck a nail with a hammer. On examination, you note that the left pupil is elliptical. What diagnostic test/procedure will most likely confirm your diagnostic suspicion? A. flourescein staining of the ey B. pressing on the globe to assess intraocular pressure C. […]
The Daily PANCE & PANRE Question 40
A 51-year-old male with renal artery stenosis and an elevated BUN and creatinine is newly diagnosed as hypertensive. Which of the following agents should be avoided? hydrochlorothiazide-triamterene prazosin nifedipine verapamil furosemide Answer: A Hydrochlorothiazide-triamterene This is a potassium-sparing diuretic and should be avoided in anyone with renal disease. ACEI should be avoided as well (but none […]
The Daily PANCE & PANRE Question 70
Which of the following is NOT a characteristic feature of multiple myeloma? A. elevated serum calcium B. osteoporosis C. “punched out” osseous lesions D. plasma cell infiltration of bone marrow E. hypogammaglobulinemia Answer: E. hypogammaglobulinemia MM is a HYPERgammaglobulinemia – all of the other findings occur in MM Help Support The Physician Assistant Life for […]
The Daily PANCE and PANRE Question Two
Which term is used to describe the characteristic concave or “spoon-shaped” nails of iron deficiency anemia? leukonychia koilonychia clubbing onycholysis paronychia Answer: B Koilonychia Koilonychia is a spoon-shaping of the nail itself. It is usually a result of iron deficiency anemia. Leukonychia is often associated with hypoalbuminemia that causes partial or complete white discoloration of the nails. […]
The Daily PANCE & PANRE Question 48
A 14 month-old female is brought to your office with a 1 day history of a fever of 101 degrees rectally. Suddenly, today, the parent noted small red spots that became bumps and are now blisters. The majority of the lesions are on the thorax. Each vesicle resides on its own erythematous base. A. shingles. […]
The Daily PANCE & PANRE Question 39
A 6-year-old female presents complaining of right ear pain. The tympanic membrane cannot be well visualized. She complains of pain when the tragus is manipulated. Several periauricular lymph nodes are easily palpable. Which of the following is the most likely diagnosis? acute otitis media acute otitis externa eustachian tube dysfunction Ramsay-Hunt syndrome perforated tympanic membrane […]
The Daily PANCE & PANRE Question 69
A 58 year-old male presents complaining of weakness of his grip. Your examination reveals that the problem is bilateral. During the next few office visits, you note the development of hyperactivity of his DTRs, extensor plantar reflexes and dysarthria. The patient’s sensory system remains normal and he denies any urinary symptomatology. Which of the following […]
Personal Statement Panel Review (Replay)
We successfully launched our first large group live event on April 28, 2022, to celebrate the opening of CASPA! Just as AdComs are not uniform in how they react to personal statements, neither is our team! In this personal statement panel review, we analyze essays from clients who have been accepted into PA school to illustrate […]
The Daily PANCE and PANRE Question One
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 […]
The Daily PANCE & PANRE Question 44
An 18 year-old female presents after completing her freshman year at college. Two months ago, she developed “bronchitis” which has persisted. She has become increasingly tired and has frequent night sweats. A chest x-ray today reveals a left mediastinal mass. What is the next step in her evaluation? A. repeat the chest x-ray in six […]
The Daily PANCE & PANRE Question 38
You note polygonal, purple, papular lesions involving the flexor surfaces of a patient’s wrists. The patient has no other lesions. The lesions appear to follow a linear pattern of distribution. What is this phenomenon? Auspitz sign Koebner’s phenomenon Darier’s sign Gorlin’s sign Gottron’s papules Answer: B Koebner’s phenomenon Koebner’s phenomenon is described – it suggests […]
The Daily PANCE & PANRE Question 68
Your 27 year-old sister is visiting and requests you to provide refills of dexamethasone and homotropine ophthalmic drops for her. What condition is most likely being treated? A. conjunctivitis B. glaucoma C. iritis D. Herpes keratitis E. blepharitis Answer: C, iritis Iritis is treated with steroid drops (dexamethasone) and miotic drops *homotropine, like atropine (to constrict […]
The Daily PANCE & PANRE Question 43
A female patient presents for an evaluation for primary amenorrhea. She is noted to be short of stature and have short fourth metacarpals. What diagnosis do you suspect? A. XO B. XXY C. XXX D. XXXY E. Trisomy 21 Answer: A, XO This is the genotype for Turner’s syndrome. XXY is the genotype for Klinefelter’s (which […]
The Daily PANCE & PANRE Question 37
A female presents complaining of a grayish, watery vaginal discharge. The KOH prep does not reveal any hyphae. Clue cells are identified on the wet mount. A paucity of WBCs is noted. What diagnosis is most likely? Gonorrhea Chlamydia Candidiasis Bacterial Vaginosis Trichomoniasis Answer: D Bacterial Vaginosis Clue cells mean BV Note: * This is part […]
The Daily PANCE & PANRE Question 67
A 2 month-old febrile male is brought to your facility to be evaluated for loss of appetite, irritability, and an acute petechial rash. Rectal temperature is 102.8F. Which of the following diagnostic studies is the most important in this child’s evaluation? A. white blood count and differentia B. urinalysis C. CSF analysis D. serum glucose […]
The Daily PANCE & PANRE Question 42
A patient with known hyperlipidemia, taking clofibrate, presents to your office complaining of severe myalgias and weakness. He has noted a dark color to his urine. The laboratory calls with a panic value CPK of 8500. He was recently started on a new medication, four days earlier. Which of the following is most likely the […]
The Daily PANCE & PANRE Question 66
A 24 year-old male presents complaining of chest pain. He states that it is worse with swallowing and taking a deep breath. It is improved sitting up and leaning forward. He denies trauma, a cough and shortness of breath. Which of the following test would be most compatible with your suspected diagnosis? A. a hiatal […]