Podcast Episode 104: Ten PANCE, PANRE, and Rotation Review Questions

Listen to Podcast Episode 104: Ten PANCE, PANRE, and Rotation Review Questions If you can't see the audio player, click here to listen to the full episode. Welcome to episode 104 of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast. Join me today as we cover ten board review questions for your PANCE, PANRE, EOR, and EOC exams. Links from today's episode: Sign up for the Entire Blueprint Email Series Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram Follow Smarty PANCE and The Daily PANCE Blueprint on Facebook Join the Smarty PANCE Member's Community, then sign up for a study group to get updates about upcoming webinars. I hope you enjoy this free audio component of the examination portion of this site. Smarty PANCE includes over 2,000 interactive board review questions, along with flashcards, ReelDx cases, integrated Picmonics, and lessons covering every blueprint topic available to all Smarty PANCE members. You can download and listen to past FREE episodes here, on iTunes, Spotify, Google Podcasts, Stitcher, Amazon Music, and all podcasting apps You can listen to all the latest episodes, take interactive quizzes, and download more resources on each episode page. Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants. Interactive exam to complement today's podcast When is screening for gestational diabetes done? A. 16 weeks B. 22 weeks C. 24 weeks D. 32 weeks E. 34 weeks Answer and topic summary The answer is C. 24 weeks Prenatal care is extremely important. Screening for gestational diabetes is routinely done in pregnant patients at 24 weeks of gestation (typically until 28 weeks). Pregnancy is associated with insulin resistance, mostly because of the placenta’s secretion of human placental lactogen. There are bad consequences of gestational diabetes, so it is critical it is diagnosed and treated adequately. The initial test is a one-hour 50-gram oral glucose tolerance test (GTT). A positive test >135 mg/dL. If a patient tests positive, they need to undergo the second test, which is a three-hour 100 mg oral GTT. The cut-offs are debated, but generally, the following are positive results: fasting > 95 mg/dL, 1 hour>180 mg/dL, 2 hours>155 mg/dL, 3 hours>140 mg/dL. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Reproductive System ⇒ Complicated Pregnancy ⇒ Gestational diabetes Also covered as part of the Women’s Health EOR topic list 2. A 60-year-old male with a history of alcohol abuse and esophageal varices is brought to the ER with lethargy, delirium, weakness, and nausea. He is normotensive and afebrile. On physical exam, he is ill-appearing with jaundice, spider angiomas, a distended abdomen, and 3+ pretibial pitting edema. Based on his history and clinical presentation, which of the following electrolyte abnormalities would you expect to see in this patient? A. Hyponatremia B. Hypocalcemia C. Hypercalcemia D. Hyperphosphatemia E. Hypermagnesemia Answer and topic summary The answer is A. Hyponatremia The patient has hypervolemic hyponatremia secondary to cirrhosis. The causes of hypervolemic hyponatremia are cirrhosis, nephrotic syndrome, and CHF. Symptoms include nausea, headache, lethargy, and seizures. It’s important to have an approach to hyponatremia since it is the most common electrolyte abnormality in the hospital. First, it’s important to rule out pseudohyponatremia due to proteins, glucose, or mannitol. Also, make sure it’s not a diuretic causing hyponatremia. Next, consider the volume status – are they hypervolemic, hypovolemic, or euvolemic? Hypovolemic causes are more obvious (emesis, hemorrhage, etc.); however, urinary sodium can help differentiate between hypovolemia and euvolemia. If uNA < 20, then this means the renin-angiotensin-aldosterone system is on and trying...