Podcast Episode 75: Ten FREE PANCE and PANRE Audio Board Review Questions

Welcome to episode 75 of the Audio PANCE and PANRE PA 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 Blueprints.  Below you will find an interactive exam to complement the podcast. The Audio PANCE and PANRE Physician Assistant Board Review 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 Smarty PANCE. You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio.You can listen to the latest episode, take an interactive quiz and download your results below. Listen Carefully Then Take The Practice Exam If you can't see the audio player click here to listen to the full episode. Podcast Episode 75: Ten Question PANCE and PANRE Podcast Quiz The following questions are linked to NCCPA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson. 1. A 5-year-old girl is brought to the emergency department after drinking a bottle of drain cleaner. It is unknown how much the child drank. She has a past medical history of Down syndrome and obesity. The patient's vitals are unremarkable. Physical exam is notable for a child in no acute distress. She is tolerating her oral secretions and is interactive. Inspection of the oropharynx is unremarkable. Which of the following is the appropriate management of this patient? Dilute hydrochloric acidEndoscopyIntubationObservationPolyethylene glycol Click here to see the answer Answer: B. Endoscopy  Ingestion of caustic fluids (acid or alkali) such as drain cleaner may lead to esophageal damage and stricture. Any patient presenting after caustic ingestion should have an endoscopy performed between 12 and 24 hours of presentation. Injury due to ingestion of alkaline fluids such as drain/oven cleaner occurs rapidly in the first minutes to hours and is characterized by liquefactive necrosis of the esophageal tissue. Subsequently, esophageal strictures form due to scarring of the affected tissue. Patients should immediately be resuscitated following the ABC’s (airway, breathing, and circulation). Subsequent management involves endoscopy (typically within 12 to 24 hours of ingestion) to assess the extent of the damage and plan any further treatment that may be needed. Incorrect Answers: Answer 1: Dilute hydrochloric acid or administration of any agent to titrate the ingestion is always contraindicated as this will lead to more tissue damage. Answer 3: Intubation would be indicated if the patient was failing to protect their airway or if they had impending airway loss. This well-appearing patient has no airway concerns. Answer 4: Observation is certainly a part of this patient’s care; however, she must also receive endoscopy to assess for any esophageal/GI tract injury. Answer 5: Polyethylene glycol or whole bowel irrigation has limited indications. It may be used to pass bags of drugs if ingested by a packer/stuffer but would not aid in the management of caustic ingestion. Review NCCPA Blueprint Topic: Ingestion of toxic substances or foreign bodies 2. A 27-year-old man presents to the emergency department after a motor vehicle collision. The patient was a front seat unrestrained driver in a head-on collision. The patient’s echocardiogram (ECG) is notable only for sinus tachycardia. His temperature is 99.5°F (37.5°C), blood pressure is 107/58 mmHg, pulse is 120/min, respirations are 17/min, and oxygen saturation is 98% on room air.