The Audio PANCE and PANRE Board Review Podcast Episode 13

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. You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio. You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below. Download a Free PDF Transcript of the Questions and AnswersFREE  PDF Transcript or view on Scribd Listen Carefully Then Take The Quiz Questions 1-10 The Audio PANCE and PANRE Episode 13 1. During a baseball game, a 22 year-old college student is hit in the right eye by a baseball. He complains of blurry vision in that eye. On physical exam, the physician assistant notes proptosis of the right eye, and limitation of movement in all directions. On CT scan, which of the following is most likely to be seen? A. Fracture of the medial orbital wall B. Prolapse of orbital soft tissue C. Hematoma of the orbit D. Orbital emphysema Click here to see the answerC. Hematoma of the orbit – Orbital hemorrhage into the space surrounding the globe following blunt trauma and rupture of the orbital vessels results in increased ocular pressure, proptosis, visual loss, and limitation of movement in all directions. CT reveals a hematoma. 2. Which of the following physical findings is suggestive of atrial septal defect? A. Fixed split S2 B. Increased pulse pressure C. Continuous mechanical murmur D. Difference in blood pressure between the left and right arm Click here to see the answerA. Fixed split S2 – An atrial septal defect will cause a shunt of blood from the left to the right atrium. This will result in an equalization in the amount of blood entering both the left and right ventricles which effectively eliminates the normally wide splitting that inspiration typically causes in hearts without an atrial septal defect. 3. Which of the following is essential to make a diagnosis of cystic fibrosis? A. Positive family history B. Elevated sweat chloride C. Recurrent respiratory infections D. Elevated trypsinogen levels Click here to see the answerB. Elevated sweat chloride – The diagnosis of cystic fibrosis is made only after an elevated sweat chloride test or demonstration of a genotype consistent with cystic fibrosis. 4. In infants, the eyes should move in parallel without deviation by the age of A. 2 weeks. B. 3 months. C. 6 months. D. 1 year. Click here to see the answerC. 6 months – Intermittent alternating convergent strabismus is frequently noted for the first 6 months of life, but referral is indicated if it persists beyond 6 months. 5. Which of the following physical exam findings is consistent with moderate emphysema? A. Increased tactile fremitus B. Dullness to percussion C. Distant heart sounds D. Deviated trachea Click here to see the answerC. Distant heart sounds – Distant heart sounds are common in emphysema patients due to hyperinflation of the lungs. 6. Which of the following is the most common indication for operative intervention in patients with chronic pancreatitis? A. Weight loss B. Intractable pain C. Exocrine deficiency D. To decrease risk of cancer Click here to see the answerB. Intractable pain – Indications for surgical treatment of chronic pancreatitis include severe pain that limits the patient’s functioning or intractable pain despite the use of non-narcotic analgesics and absence of alcohol intake. 7. A 22 year old male presents to the ED with pain that radiates to his shoulders and is relieved with sitting forward. The patient admits to recent upper respiratory symptoms. On examination vital signs are BP 126/68, HR 86, RR 20, temp 100.3 degrees F. There is no JVD noted. Heart exam reveals regular rate and rhythm with no S3 or S...