The Audio PANCE and PANRE Board Review Podcast Episode 23

Welcome to episode 23 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. 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 the FREE PDF transcript for FREE here or on  Scribd. Listen Carefully Then Take The Quiz If you can't see the audio player click here to listen to the full episode. Questions 1-10 The Audio PANCE and PANRE Episode 23 1. A 72 year-old female presents with vulvular pruritus for the last nine months, which has progressively worsened over the last two months. She states that she went through menopause at age 54 and has been on estrogen and progesterone therapy since that time. Physical examination reveals red lesions with white plaques on the vulva. What should the next course of management include? A. Refer to a gynecologist for biopsy. B. Refer to a dermatologist for antifungal therapy. C. Treat with a topical steroid. D. Treat with estrogen cream. Click here to see the answer Answer: A. Refer to a gynecologist for biopsy. Vulvular squamous cell hyperplasia causes thickening and hyperkeratosis of the vulva. The lesions are red and moist and cause intense pruritus over time the area becomes thickened and a white plaque may develop. Biopsy must be done to evaluate for intraepithelial neoplasm or invasive tumor. 2. A 30 year-old female presents to the emergency department with a syncopal episode. She has a history of irregular menstrual cycles and infertility. She has scanty, persistent vaginal bleeding and sharp pelvic pain. A left adnexal mass is palpated. The most likely diagnosis is A. placenta abruptio. B. ectopic pregnancy. C. pelvic inflammatory disease. D. ruptured ovarian cyst. Click here to see the answer Answer B. ectopic pregnancy. Infertility increases the risk of developing ectopic pregnancy. The onset of vaginal bleeding, pelvic pain, and formation of an adnexal mass makes this the most likely diagnosis. 3. A patient presents complaining of periumbilical pain. Which of the following anatomical sites is this finding associated with? A. Bladder B. Stomach C. Pancreas D. Small bowel Click here to see the answer Answer: D. Small bowel Pain from the small intestine, appendix, or proximal colon causes periumbilical pain. 4. A 53 year-old patient presents with severe pain at the base of the thumb and no other finger involvement. The pain is worse with activity and lasts a short period of time following rest. There is no specific history of trauma to the thumb but the patient admits working with her hands as a typist. Which of the following is the most likely diagnosis? A. Rheumatoid arthritis B. Osteoarthritis C. Hemochromatosis D. Pseudogout Click here to see the answer Answer: B. Osteoarthritis The base of the thumb is typically involved with osteoarthritis as are the DIP joints of the other fingers. 5. A 38 year-old female with history of coarctation of the aorta repair at the age of two presents with fevers for four weeks. The patient states that she has felt fatigued and achy during this time. Maximum temperature has been 102.1 degrees F. She denies cough, congestion, or other associated symptoms. Physical examination reveals a pale tired appearing female in no acute distress. Heart reveals a new grade III-IV/VI systolic ejection border at the apex, and a II/VI diastolic murmur at the right sternal border. What is the most likely diagnosis? A. Acute myocardial infarction