The Audio PANCE and PANRE Board Review Podcast Episode 5

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 created this audio series to help you fill some downtime when you are unable to read (like in the car) with some useful board review. 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. Questions 6 y/o male presents w/ hemarthrosis of the L knee. Coag studies: PT 12.5s (normal12-14 sec), INR 1.0, aPTT 58s (normal 18-28 sec), platelet 430,000/microliter (normal 150,000-450,000/microliter), & bleeding time 4m (normal 2-12m). Which is the best tx option for this pt? A. Desmopressin acetate B. Corticosteroids C. Vitamin K D. Cryoprecipitate Click here to see the answerD. Hemophilia A presents with a prolonged aPTT and normal platelet count and function. Hemophilia A is treated with factor VIII concentrate or cryoprecipitate. HIV+ pt presents w/ worsening dementia, fever, HA, & R hemiparesis. Brain MRI reveals 6 lesions throughout the brain that show ring enhancement & surrounding edema. Which is the tx of choice? A. Sulfadiazine and pyrimethamine B. Trimethoprim-sulfamethoxazole C. Radiation therapy D. Ventricular shunt placement Click here to see the answerA. Toxoplasmosis is commonly noted in HIV positive patients and presents with multiple ring-enhancing lesions. Treatment of choice for possible toxoplasmosis is sulfadiazine and pyrimethamine. On examination of a pregnant patient the physician assistant notes a bluish or purplish discoloration of the vagina and cervix. This is called A. Hegar's sign. B. McDonald's sign. C. Cullen's sign D. Chadwick's sign Click here to see the answerD. Chadwick’s sign is a bluish or purplish discoloration of the vagina and cervix. A 52 year-old female comes to the office because of black stools for the past 3 days. She is afebrile and she has no pertinent physical examination abnormalities. Which of the following is the most appropriate initial diagnostic study? A. Stool for occult blood B. Stool cultures C. Sigmoidoscopy D. Abdominal CT scan Click here to see the answerA. Occult bleeding, as evidenced by the patient’s history of black stools, is initially verified by a positive fecal occult blood test. Which of the following is considered a risk factor for the development of malignant melanoma? A. male gender B. inability to tan C. Japanese ethnicity D. brown-haired individuals Click here to see the answerB. Inability to tan and propensity to burn are risk factors for developing malignant melanoma. A 43 year-old data entry clerk presents with a one-month history of pain and tingling in the right thumb, index finger, and middle finger. Tinel's sign and Phalen's maneuver are positive. The most appropriate intervention at this time is A. methylprednisolone (Medrol) dose pack. B. splint in neutral position. C. observation. D. surgery. Click here to see the answerB. Splinting in neutral position relieves impingement of the median nerve, thus improving symptoms of carpal tunnel. Which of the following is a cause of prerenal azotemia? A. Infection B. Renal toxins C. Poor renal perfusion D. Urinary tract obstruction Click here to see the answerC. Renal hypoperfusion is the cause of prerenal azotemia, which may be rapidly reversible when renal blood flow and glomerular ultrafiltration pressure are restored. Which of the following is the most common cause of secondary hypertension? A. Renal parenchymal disease B. Primary aldosteronism C. Oral contraceptive use D. Cushing's syndrome Click here to see the answerA. Renal parenchymal disease is the most common cause of secondary hypertension. A newborn weighs 8 pounds at birth. On average, what should the infant weigh at 1 year of age? A. 16 pounds B. 20 pounds C. 24 pounds D. 28 pounds