The Audio PANCE and PANRE Physician Assistant Board Review Podcast

Listen to Podcast Episode 109: 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 109 of the Audio PANCE and PANRE Physician Assistant/Associate (PA) Board Review Podcast. Join me today as we cover ten board review questions for your PANCE, PANRE, EOR, and EOC exams. Resources and links from today's episode: View my PANRE-LA Performance Score and see my process for taking PANRE-LA Questions Learn all about the new Smarty PANCE QBank Sign up for our PANCE and PANRE Test-taking Masterclass Sign up for the Entire Blueprint Email Series Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram and 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, Amazon Music, and all podcasting apps. On each episode page, you can listen to all the latest episodes, take interactive quizzes, and download more resources. Interactive Exam to Complement Today's Podcast 1. A 70-year-old man presents for evaluation of poorly controlled hypertension despite adherence to five different classes of antihypertensive medications. His medical history includes coronary artery disease with a myocardial infarction 3 years ago, peripheral artery disease, and type 2 diabetes mellitus. He reports no changes in his medication regimen and denies any recent lifestyle modifications. Physical examination reveals a blood pressure of 190/110 mm Hg in the left arm and 180/100 mm Hg in the right arm. His BMI is 24 kg/m². On auscultation, there is no abnormal heart sound. Which of the following additional findings is most likely to be seen in this patient? A. Elevated serum aldosterone-to-renin ratio B. Continuous murmur over the carotid arteries C. Diminished femoral pulses D. Continuous bruit in the lateral periumbilical area E. Pitting edema in the lower extremities Answer and topic summary The answer is D. Continuous bruit in the lateral periumbilical area Renal artery stenosis is a significant cause of secondary hypertension, particularly in patients with a history of atherosclerotic disease, as seen in this patient with coronary artery disease and peripheral artery disease. Resistant hypertension, uncontrolled despite multiple medications, is a hallmark. A continuous bruit in the lateral periumbilical area indicates turbulent blood flow through a narrowed renal artery, supporting this diagnosis. Incorrect Answers: A. Elevated aldosterone-to-renin ratio suggests primary aldosteronism, less likely given the atherosclerotic history pointing to renal artery stenosis. B. A carotid murmur indicates carotid artery disease, unrelated to this hypertension scenario. C. Diminished femoral pulses align with peripheral artery disease, but don’t explain the resistant hypertension. E. Pitting edema suggests heart failure or venous insufficiency, not specific to renal artery stenosis. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Renal System ⇒ Congenital or structural renal disorders ⇒ Renal vascular disease 2. A 70-year-old woman comes to the emergency department due to sudden-onset chest pain followed by shortness of breath. The pain started 2 hours ago, and she experienced an episode of syncope lasting about 1 minute shortly after the pain began. She has a history of untreated hypertension and hyperlipidemia. Blood pressure is 180/95 mm Hg in both arms; pulse is 110/min and irregular; and respirations are 22/min.

Listen to Podcast Episode 108: 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 108 of the Audio PANCE and PANRE Physician Assistant/Associate (PA) Board Review Podcast. Join me today as we cover ten board review questions for your PANCE, PANRE, EOR, and EOC exams. Resources and links from today's episode: Sign up for our new PANCE and PANRE Test-taking Masterclass Review the Asthma GINA guidelines and the lung cancer screening guidelines Sign up for the Entire Blueprint Email Series Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram and 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, Amazon Music, and all podcasting apps. On each episode page, you can listen to all the latest episodes, take interactive quizzes, and download more resources. Interactive exam to complement today's podcast 1. A 25-year-old woman comes to the office due to fatigue and dizziness for the past several months. She works as a nurse and finds it increasingly difficult to complete her shifts. The patient reports heavy menstrual periods lasting 7-8 days each month. She has no significant medical history and is not on any medications. Blood pressure is 100/60 mm Hg and pulse is 75/min. BMI is 22 kg/m². Physical examination reveals pale conjunctivae and spoon-shaped nails. Hemoglobin is 8.5 g/dL. Which of the following sets of additional laboratory findings is most likely to be seen in this patient? A. Low ferritin, high TIBC, low serum iron B. High ferritin, low TIBC, high serum iron C. Low ferritin, low TIBC, high serum iron D. High ferritin, high TIBC, low serum iron E. Low ferritin, high TIBC, high serum iron Answer and topic summary The answer is A.  Low ferritin, high TIBC, low serum iron The most likely additional laboratory findings in this patient are low ferritin, high total iron-binding capacity (TIBC), and low serum iron, which are indicative of iron deficiency anemia. Her history of heavy menstrual periods and symptoms of fatigue and pallor suggest chronic blood loss leading to iron deficiency. Ferritin is a marker of iron stores, and low levels indicate depletion of iron reserves. High TIBC reflects increased capacity of the blood to bind iron due to low iron levels. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Hematology ⇒ Cytopenias ⇒ Anemias ⇒ Iron deficiency 2. A 4-year-old girl presents with fever and neck pain. She has had a runny nose, cough, and sore throat for the past five days. Two days ago, she developed a high fever and worsening neck pain, and today, she has refused to eat or drink. Her immunizations are up to date. Temperature is 39.5°C (103.1°F), pulse is 130/min, and respirations are 26/min. Examination reveals bilateral anterior cervical lymphadenopathy, a muffled voice, and trismus. The child holds her neck stiffly and resists any movement. The tonsils are erythematous and covered with white exudates. Lateral neck radiograph reveals a widened prevertebral space. Which of the following is the most likely diagnosis? A. Epiglottitis B. Peritonsillar abscess C. Retropharyngeal abscess D. Bacterial tracheitis E. Acute bacterial sinusitis Answer and topic summary The answer is C. Retropharyngeal abscess Retropharyngeal abscess is the most likely diagnosis given the presentation of fever, neck pain, refusal to eat or drink, trismus,

Listen to Podcast Episode 107: This vs. That - PANCE Blueprint Comparisons You Need to Know (Episode 1) In today's session, we will be discussing five questions related to PANCE/PANRE Blueprint topics. These questions will cover similar presentations and crucial comparisons that are important for you to know. These topics are often used by PANCE/PANRE test question writers, so it's essential to learn how to differentiate between them. This is the first part (episode 1) of a series. If you can't see the audio player, click here to listen to the full episode. Links from today's episode: Sign up for our new PANCE and PANRE Test-Taking Masterclass. Check out my first blog in our "This vs. That" Blueprint series: The PANCE Blueprint Showdown: Crohn's Disease vs. Ulcerative Colitis. Want a question of the day that covers the Blueprint - ALL of it? Sign up for the Entire Blueprint Email Series. Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram and Facebook for more daily questions. 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. Interactive exam to complement today's podcast 1. A 32-year-old woman presents with a 6-month history of loose bowel movements, approximately eight per day. Blood has been present in many of them. She has lost 30 pounds. For the past 6 weeks, she has had intermittent fever. She has had no previous gastrointestinal (GI) problems, and there is no family history of GI problems. On examination, the patient looks ill. Her blood pressure is 130/ 70 mm Hg. Her pulse is 108 beats/ minute and regular. There is generalized abdominal tenderness with no rebound. A sigmoidoscopy reveals a friable rectal mucosa with multiple bleeding points. Which of the following is the most likely diagnosis? A) Crohn's Disease B) Ulcerative Colitis C) Infectious Colitis D) Irritable Bowel Syndrome (IBS) E) Ischemic Colitis Answer and topic summary The answer is B) Ulcerative Colitis The patient’s symptoms of chronic bloody diarrhea, weight loss, fever, and the sigmoidoscopy findings of a friable rectal mucosa with multiple bleeding points are consistent with a diagnosis of ulcerative colitis (UC), which is a form of inflammatory bowel disease (IBD). UC typically involves the rectum and may extend proximally to involve other parts of the colon. Incorrect answers: A) Crohn’s Disease: This is another type of IBD. However, Crohn’s usually presents with non-bloody diarrhea, abdominal pain, and may involve any part of the GI tract from mouth to anus, often with skip lesions. In this case, the bloody diarrhea and the findings on sigmoidoscopy are more indicative of ulcerative colitis. C) Infectious Colitis: Although infectious causes can lead to similar symptoms, the duration of this patient’s symptoms (6 months) is much longer than typically seen with infectious colitis. Additionally, fever is less common in infectious colitis. D) Irritable Bowel Syndrome (IBS): IBS is a functional GI disorder characterized by abdominal pain with a change in bowel habit. It does not cause weight loss, fever, or bloody stools. E) Ischemic Colitis: This typically presents acutely in older patients or those with vascular risk factors. The clinical presentation often includes abrupt onset of abdominal pain and bloody diarrhea.

Listen to Podcast Episode 106: Ten PANCE, PANRE, and Rotation Review Questions + Review of Adrenal Insufficiency If you can't see the audio player, click here to listen to the full episode. Welcome to episode 106 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 our new PANCE and PANRE Test Taking Masterclass Sign up for the Entire Blueprint Email Series Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram and Facebook Review adrenal insufficiency and adrenal disorders 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. Interactive exam to complement today's podcast 1. A 22-year-old female with an unknown past medical history presents to the ER with a prolonged seizure lasting more than 5 minutes per EMS. Her airway was supported, and IV access was obtained en route to the ER. Her blood glucose is 120. Her vitals are stable, and laboratory studies are relatively unremarkable. Which of the following would be an appropriate medication to give to this patient? A. Calcium gluconate B. Propofol infusion C. Lorazepam D. Clonidine E. Narcan Answer and topic summary The answer is C. Lorazepam The patient has status epilepticus, which is defined as >5 minutes of continuous seizures or > 2 discrete seizures between which there is incomplete recovery of consciousness. Most episodes of status epilepticus in adults are due to a brain lesion or a toxic/metabolic disturbance (e.g., alcohol withdrawal, hypoglycemia, etc). Immediate management of status epilepticus includes stabilizing the airway, placing pulse oximetry and cardiorespiratory monitors, establishing IV access, and getting a glucose level. The first-line pharmacological agent given is a benzodiazepine (e.g., lorazepam or diazepam). Keppra, valproate, or other anti-seizure medication can be given as well. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Neurology ⇒ Seizure disorders ⇒ Status epilepticus Also covered as part of the Internal Medicine EOR and Emergency Medicine EOR topic list 2. A 41-year-old male presents to the ER after a construction accident that left him with severe right eye pain and decreased visual acuity. On a physical exam, you notice a teardrop-shaped pupil. Which of the following is the most likely diagnosis? A. Globe rupture B. Acute angle-closure glaucoma C. Retinal detachment D. Corneal laceration E. Metallic foreign body Answer and topic summary The answer is A. Globe rupture Mechanical globe injuries occur when there is a laceration or full-thickness rupture through the cornea and/or sclera. Globe rupture (also called an open globe) follows blunt eye injury (e.g., motor vehicle crash, assault, thrown ball, etc). Globe lacerations occur after trauma from a sharp-penetrating object (e.g., knife or high-velocity projectile). PE signs include subconjunctival hemorrhage, irregularly-shaped pupil, hyphema (anterior chamber bleeding), decreased visual acuity, and limited EOM. This is an emergency and a patient should see an ophthalmologist immediately. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint EENT ⇒ Traumatic disorders ⇒ G...

Listen to Podcast Episode 105: 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 105 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 Review systemic lupus erythematosus (SLE) Review the diabetes diagnostic guidelines Review gestational diabetes screening guidelines Review basal cell carcinoma and our comparison tables of the Blueprint dermatologic neoplasms 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. Interactive exam to complement today's podcast 1. A 68-year-old male farmer presents with a flesh-colored papule with a rolled border located on the right side of his forehead. As you examine the lesion closely, you notice something else about the lesion. Which of the following physical exam findings would make you more suspicious of malignancy? A. Telangiectasia B. Nikolsky sign C. Hypopigmentation D. Tenderness to palpation E. Central umbilication Answer and topic summary The answer is A. Telangiectasia The patient has basal cell carcinoma, which is a skin cancer with low metastatic potential. It commonly occurs on the face (70% of the time). There are different types of BCC (nodular vs. superficial vs. infiltrative). However, nodular is the most common (80%) and typical characteristics you may see include a papule with a rolled border, pearly-like look, flesh-colored, and telangiectasia. Risk factors for BCC include UV radiation, certain genes, inherited disorders, etc. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Dermatology ⇒ Dermatologic Neoplasms ⇒ Basal cell carcinoma Also covered as part of the General Surgery EOR and Family Medicine EOR topic list 2. Which of the following is the most common type of elder abuse? A. Neglect B. Emotional abuse C. Physical abuse D. Sexual abuse E. Financial exploitation Answer and topic summary The answer is A. Neglect The most common type of elder abuse is neglect, which refers to the failure of a trusted person to protect an older person from harm or provide for their needs. Self-neglect is also common, which is when an older person can’t proide their own care. Some warning signs include bruising, lacerations, skin tears, spiral fractures, malnutrition, pressure ulcers, and dehydration. If you even suspect an older adult is being neglected, you should report this immediately to adult protective services (or similar agencies) and treat the medical complications immediately. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Psychiatry ⇒ Abuse and Neglect ⇒ Child/elder abuse 3. Which of the following is the most common bacterial cause of a hordeolum? A. Streptococcus pyogenes B. Staphylococcus aureus C. Clostridium perfringens D. Propionibacterium species E. Enterobacter aerogenes Answer and topic summary The answer is B. Staphylococcus aureus A hordeolum (stye) is an abscess of the eyelid ...

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...

Listen to Podcast Episode 103: Ten PANRE & PANRE-LA Intervention Complex Practice Question If you can't see the audio player, click here to listen to the full episode. Welcome to episode 103 of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast. Join me today as we cover ten NCCPA-style board review questions for your PANRE and PANRE-LA exams. Special from today's episode: Take the new PANRE & PANRE-LA (Intervention Complex) Practice Exam: Covers all the topics tested within the new PANRE (Intervention Complex) performance expectation with links to Smarty PANCE lessons. PANRE & PANRE-LA Blueprint 8-Week Schedule and Study Planner Read The New 2023 PANRE and PANRE-LA: Everything you Need to Know Members can try out the newly updated PANRE-LA Smart Search Tool (you must log in to access the search bar) Sign up for the Entire Blueprint Email Series to get daily questions for the next 478 days! 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, and most podcasting apps. You can listen to all the latest episodes, take interactive quizzes, and download more resources on each episode page. Here is an interactive exam to complement today's podcast 1. A 65-year-old man presents to your office with complaints of constipation for the past six months. He says that he has difficulty passing stools, which are hard and dry. He also reports occasional abdominal pain and bloating. He denies any weight loss, blood in stools, fever, or night sweats. His medical history is significant for hypertension and type 2 diabetes mellitus. His medications include metformin, lisinopril, and aspirin. He does not smoke or drink alcohol. On physical examination, his vital signs are normal. His abdomen is soft and nontender, with normal bowel sounds. There are no masses or organomegaly palpable. Which of the following is the most appropriate next step in evaluating this patient? A) Colonoscopy B) Barium enema C) Thyroid function tests D) Stool osmolarity E) Dietary modification Answer and topic summary The correct answer is A) Colonoscopy Colonoscopy is a procedure that involves inserting a flexible tube with a camera into the colon to visualize the mucosa and detect any abnormalities such as polyps, tumors, inflammation, or bleeding. It is indicated for patients with chronic constipation who are older than 50 years or have any red flag features for colorectal malignancy, such as weight loss, blood in stools, anemia, or a family history of colon cancer. This patient meets the age criterion and should undergo colonoscopy to rule out any serious causes of his constipation. Answer explanations: Barium enema is an imaging test that involves injecting a contrast agent (barium sulfate) into the rectum and taking X-rays of the colon. It can show structural abnormalities such as diverticula, strictures, masses, or volvulus. However, it is less sensitive and specific than colonoscopy for detecting colorectal malignancy. Therefore, it is not the preferred test for this patient. Thyroid function tests are blood tests that measure the levels of thyroid hormones (T3, T4) and thyroid-stimulating hormone (TSH). They can help diagnose thyroid disorders such as hypothyroidism or hyperthyroidism. Hypothyroidism can cause constipation due to decreased gastrointestinal motility. However,

Listen to Podcast Episode 102: 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 102 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. Special from today's episode: Read The New 2023 PANRE and PANRE-LA: Everything you Need to Know Members can try out the newly updated PANRE-LA Smart Search (you must log in to access the search bar) 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, and most podcasting apps. You can listen to all the latest episodes, take interactive quizzes, and download more resources on each episode page. Interactive exam to complement today's podcast 1. Which of the following is NOT true about a non-ST elevation myocardial infarction? A. Non-enteric-coated, chewable aspirin 325 mg should be given B. Troponins are elevated C. It happens due to a partially occluded epicardial coronary artery D. Patients need a 12-lead EKG E. You will always see ST depressions Answer and topic summary The answer is E. You will always see ST depressions A non-ST elevation myocardial infarction (NSTEMI) is defined by the absence of persistent ST-elevation with elevated cardiac biomarkers (e.g., troponin I or T, CKMB, etc). It happens due to a partially occluded epicardial coronary artery (leading to subendocardial ischemia). NSTEMI typically presents as pressure-type chest pain. Patients with a suspected NSTEMI should receive a 12-lead EKG within 10 minutes of arrival. ST depression, transient ST-elevation, and/or T-wave inversions may be seen on EKG, but they are NOT required for the diagnosis of NSTEMI. The most important medication to give is non-enteric-coated chewable aspirin 325 mg. Other meds include sublingual nitroglycerin, oxygen as needed, beta-blockers (assuming no C/I), high-intensity statin, ACE inhibitors (if CKD, DM, or EF < 40%), P2Y12 inhibitor (e.g., clopidogrel), anticoagulation, and possibly PCI with stenting or CABG. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Cardiology ⇒ Coronary Heart Disease ⇒ Acute myocardial infarction ⇒ Non-ST-Segment Elevation MI (NSTEMI) Also covered as part of the Family Medicine EOR, Internal Medicine EOR, Emergency Medicine EOR topic list 2. A 22-year-old G1P0 female at 28 weeks gestation with a history of diabetes presents to the clinic with fever, chills, and dysuria. Vitals show tachycardia (115 bpm), tachypnea (22 bpm), and hypotension (90/58 mmHg). Physical exam reveals suprapubic tenderness. Labs reveal leukocytosis, hyponatremia, and hyperglycemia. Urine dipstick is positive for nitrites, blood, glucose, and ketones. Which of the following is the next best step? A. Send home with oral antibiotics and analgesics B. Reassurance and oral rehydration solution C. Admit to hospital for antibiotics, fluids, & insulin D. Order outpatient CT scan of the abdomen E. Refer to an outpatient nephrologist for workup Answer and topic summary The answer is C. Admit to hospital for antibiotics, fluids, & insulin The patient most likely has pyelonephritis, which is an infection of the upper urinary tract and kidneys.

Welcome to episode 101 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, and rotation exams. Special from today's episode: Join the Smarty PANCE Member's Community then sign up for a study group to get updates about upcoming webinars. Check out our updated End of Curriculum™ (EOC) Exam Course 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 I hope you enjoy this free audio component of the examination portion of the Smarty PANCE website. The full board review website includes over 2,000 interactive board review questions, flashcards, and blueprint lessons available to all members of Smarty PANCE. You can download and listen to past FREE episodes here, on iTunes, Spotify, Google Podcasts, Stitcher, and most podcasting apps. You can listen to all the latest episodes, take interactive quizzes, and download more resources on each episode page. Listen to Podcast Episode 101: Ten PANCE, PANRE, and Rotation Review Questions If you can't see the audio player, click here to listen to the full episode. Interactive exam to complement today's podcast 1. A 75-year-female smoker with a history of atrial fibrillation and hypertension presents to the ER complaining of a 2-hour history of right-sided weakness and aphasia that has now resolved. Her physical exam and vital signs are completely unremarkable. CT head is unremarkable. Which of the following is the most likely diagnosis? A. Subarachnoid hemorrhage B. Transient ischemic attack C. Cerebral venous sinus thrombosis D. Multiple sclerosis E. Complicated migraine Answer and topic summary The answer is B. Transient ischemic attack The patient had a transient ischemic attack (TIA), which is characterized by transient neurological symptoms without objective evidence of acute infarction. Symptoms vary, but patients may have hemiparesis, hemiplegia, aphasia, or vision loss. Risk factors include alcohol, hypertension, smoking, diabetes, illicit drug use, and atrial fibrillation. Urgent evaluation is needed in patients with symptoms of TIA (e.g., coagulation studies, TTE, EKG, CT or MRI head, imaging of the cervicocephalic vasculature via carotid US, CTA, or MRA). Treatment for high-risk patients includes dual antiplatelet therapy (ASA + clopidogrel) for 21 days and risk factor management (statin, exercise, etc). Remember the risk of an actual stroke is high after a TIA. View blueprint lesson Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Neurology ⇒ Vascular Disorder ⇒ Transient ischemic attack Also covered as part of the Internal Medicine EOR, Family Medicine EOR, and Emergency Medicine EOR topic list 2. A 26-year-old female presents with a history of miscarriages and recurrent pulmonary embolism. She is diagnosed with antiphospholipid syndrome. Which of the following is the mainstay of treatment for this condition? A. Dual antiplatelet therapy (DAPT) B. Aspirin and heparin C. Dabigatran D. Warfarin E. Heparin Answer and topic summary The answer is D. Warfarin Antiphospholipid syndrome (APS) is an autoimmune disease defined by venous thromboembolism, arterial thrombosis, and obstetric morbidity in the presence of circulating antiphospholipid antibodies (aPLs). It is the most common form of acquired thrombophilia. aPLs include lupus anticoagulant, anticardiolipin, anti-b2-glycoprotein I antibodies. Clinical features include DVTs (32%), thrombocytopenia (22%), livedo reticularis (20%), stroke (13%), PEs (9%), and fetal loss (8%). The mainstay of treatment is warfarin. Other anticoagulants have been found to be less effective than warfarin so far. View blueprint lesson Smarty PANCE Content Blueprint Review:

Welcome to episode one hundred of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast. Join me today as we cover atrial fibrillation for the PANCE, PANRE, and EOR™ exams. Special from today's episode: Join the Smarty PANCE Member's Community then sign up for the Sunday Funday Study Group. Once you have signed up, you can access the Webinar replay of this episode here Check out our updated End of Curriculum™ (EOC) Exam Course (now with orthopedics!) 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 Below you will find the audio of today's podcast. The Audio PANCE/PANRE and EOR PA Board Review Podcast I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of Smarty PANCE. You can download and listen to past FREE episodes here, on iTunes, Spotify, Google Podcasts, Stitcher, and most podcasting apps. You can listen to all the latest episodes, take interactive quizzes, and download more resources on each episode page. Listen to Podcast Episode 100: Atrial Fibrillation for the PANCE and PANRE If you can't see the audio player, click here to listen to the full episode.

Welcome to episode 99 of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast. Join me as I cover ten PANCE, PANRE, and EOR™ review questions from the Smarty PANCE Instagram/Facebook page and the smartypance.com board review website. Special from today's episode: Join the Smarty PANCE Member's Community Check out our all-new End of Curriculum™ (EOC) Exam Course (still in development) Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram Follow Smarty PANCE and The Daily PANCE Blueprint on Facebook Below you will find an interactive exam to complement today's podcast. The Audio PANCE/PANRE and EOR PA Board Review Podcast I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of Smarty PANCE. You can download and listen to past FREE episodes here, on iTunes, Spotify, Google Podcasts, Stitcher, and most podcasting apps. You can listen to the latest episode, take an interactive quiz, and download more resources 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 99: Ten PANCE/PANRE and EOR Topic Blueprint Questions 1. A 42-year-old male on lithium presents with polyuria, nocturia, and polydipsia. Laboratory findings are remarkable for slightly elevated sodium. Which of the following is the most likely diagnosis? A. Neurogenic diabetes insipidus B. Nephrogenic diabetes insipidus C. Type 2 diabetes mellitus D. SIADH E. Adrenal insufficiency Click here to see the answer The answer is B. Nephrogenic diabetes insipidus Nephrogenic diabetes insipidus (DI) is a condition where the kidneys are resistant to the effects of ADH. Nephrogenic DI can occur secondary to lithium toxicity or chronic lithium use, pregnancy, inherited disorders, and electrolyte issues. Clinical features include polyuria, nocturia, and polydipsia. Serum sodium is either normal or high. In this patient, lithium has entered the collecting duct, accumulated, and interfered with ADH’s capacity to increase water permeability. Treatment options for this patient include amiloride or thiazide diuretics. In general, whether or not lithium is discontinued depends on many factors. VIEW BLUEPRINT LESSON Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Endocrinology ⇒ Pituitary Disorders ⇒ Diabetes insipidus Also covered as part of the Internal Medicine EOR and Emergency Medicine PAEA EOR topic list 2. A 50-year-old female presents with poor appetite, low energy, poor concentration, and feelings of hopelessness on most days for the past 3 years. She denies suicidal ideation. She has never had a past manic or hypomanic episode. Which of the following is the best treatment option? A. Haloperidol B. Fluoxetine C. Lorazepam D. Amitriptyline E. Risperidone Click here to see the answer The answer is B. Fluoxetine This patient has dysthymia, or persistent depressive disorder. The DSM V criteria follow: Depressed mood ≥ 2 years on most days At least 2 of the following: appetite changes, sleep changes, low energy, low self-esteem, poor concentration, hopelessness Not without symptoms > 2 months at a time No mania or hypomania episodes, ever Like other psychiatric disorders, symptoms can’t be attributable to drugs, and the symptoms must cause distress/impairment. 1st line treatment is selective serotonin reuptake inhibitors and psychotherapy. VIEW BLUEPRINT LESSON Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Psychiatry ⇒ Depressive disorders ⇒ Persistent depressive disorder (dysthymia) Also covered as part of the Psychiatry EOR, Emergency Medicine EOR, and Pediatric PAEA EOR topic list 3.

Welcome to episode 98 of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast. Join me as I cover ten PANCE, PANRE, and EOR™ review questions from the Smarty PANCE Instagram/Facebook page and the smartypance.com board review website. Special from today's episode: Join the Smarty PANCE Member's CommunityCheck out our all-new End of Curriculum™ (EOC) Exam Course (still in development)Follow Smarty PANCE and The Daily PANCE Blueprint on InstagramFollow Smarty PANCE and The Daily PANCE Blueprint on Facebook Below you will find an interactive exam to complement today's podcast. The Audio PANCE/PANRE and EOR PA Board Review Podcast I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of Smarty PANCE. You can download and listen to past FREE episodes here, on iTunes, Spotify, Google Podcasts, Stitcher, and most podcasting apps.You can listen to the latest episode, take an interactive quiz, and download more resources 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 98: Ten PANCE/PANRE and EOR Topic Blueprint Questions 1. An 81-year-old female presents to the ER with acute onset of low back pain. She complains of bowel dysfunction and loss of sensation over her inner thighs. Physical exam reveals decreased lower extremity reflexes. Which of the following is the best diagnostic test for the likely diagnosis? A. Lumbar radiographsB. MRI of the lumbosacral spineC. CSF fluid analysisD. Scoliosis studiesE. None of the above Click here to see the answer The answer is B. MRI of the lumbosacral spine Cauda equina syndrome is a surgical emergency caused by severe stenosis in the lumbar spine (often due to acute disc herniation). Clinical manifestations include bowel/bladder dysfunction, decreased lower extremity reflexes, sciatica, saddle anesthesia (loss of sensation over the perineum, buttock, medial aspect of thighs), and decreased anal sphincter tone. Symptoms can develop acutely or chronically. An emergent MRI of the lumbosacral spine is the preferred diagnostic test. Surgery is the preferred treatment. Click here to view the Smarty PANCE lesson Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Musculoskeletal ⇒ Spinal Disorders ⇒ Cauda equina syndrome Also covered as part of the Emergency Medicine PAEA EOR topic list 2. Which of the following is the most common cause of Cushing syndrome? A. IatrogenicB. Bronchogenic carcinomaC. Pituitary adenomaD. Adrenal adenomaE. Obesity Click here to see the answer The answer is A. Iatrogenic Cushing syndrome is a condition defined by too much cortisol. The most common cause of Cushing syndrome is exogenous steroid therapy (i.e., medical providers prescribing steroids). Other causes include a pituitary ACTH-secreting adenoma, adrenal tumors, and ectopic ACTH production from neoplasms. Classic clinical features include buffalo hump, moon-facies, purple striae, easy bruising, weight gain, depression, and weakness. Laboratory tests will be remarkable for elevated cortisol. Late night-salivary cortisol or 24-hour urinary free cortisol is typically the initial screening test. A low-dose dexamethasone test can be done. Referral to an endocrinologist is usually done at this point (or even prior). Click here to view the Smarty PANCE lesson Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Endocrinology ⇒ Adrenal Disorders ⇒ Cushing’s syndrome Also covered as part of the Internal Medicine EOR, Family Medicine EOR, and Emergency Medicine PAEA EOR topic list 3. A 73-year-old female presents with facial flushing, wheezing, and watery diarrhea for a few months. Her symptoms are worsened by certain foods.

Welcome to episode 97 of the Audio PANCE and PANRE PA board review podcast. Today is a bonus episode rounding out this fabulous five-part podcast series with Joe Gilboy PA-C, all about cardiac murmurs. In this week's episode, we continue our discussion of cardiac murmurs with ten PANCE and PANRE murmur questions. We'll cover the ins and outs of all the NCCPA content blueprint valvular disorders and learn how to identify and differentiate them from one another. If you haven't already, make sure to listen to our previous podcast episodes where we covered tricuspid stenosis, aortic valve murmurs, mitral valve murmurs, pulmonic valve murmurs, and HOCM and MVP. Podcast Episode 97: Murmurs Made Incredibly Easy - 10 PANCE and PANRE Murmur Questions Below is a transcription of this podcast episode edited for clarity. You can download and listen to past FREE episodes here, on iTunes, Spotify, Google Podcasts, Stitcher, Amazon Music, and most podcasting apps.You can listen to this latest episode and access even more resources below. [00:00:00] Welcome back, everybody. This is Joe Gilboy. I work with Stephen Pasquini over there at Smarty PANCE. And today is the most dreaded podcast of all because you know what I'm going to do. That's right. I'm going to ask cardiac murmur questions. And I know it's the most dreaded thing in the world. Let's do this together because what I want to try to do here is make sense of it all. So, let's just kind of recap some basic rules before we start going down this thing. You know, the previous lectures, what have I been barking about? What's Joe been saying? First - inspiration, right? Expiration left. [00:00:40] Inspiration, right? Expiration left. So, with inspiration, the right-sided murmurs sound louder. So that's the tricuspid and the pulmonic valve regardless of if it's stenosis or regurgitation. Expiration - left. What am I saying? Everything on the left side sounds louder with expiration, whether it’s aortic or mitral - your call. [00:01:01] It can be stenotic or regurgitation, it doesn't matter, but it'll sound louder. What is squatting? Squatting is a party. So, what are you doing? You're bringing it all the blood flow back home. And so, if I bring all the blood flow back home, just from a laminar flow physics point of view, I bring more blood flow back home to the heart, more blood flow over a valve specifically with a diseased disease valve, it sounds louder. [00:01:29] So, right off the bat, squatting will do what? It's going to make all my murmurs sound louder. That's the whole point to decrease venous return. In other words, take blood flow away from the heart. What do I do? Well, those are going to be Valsalva and standing. So, what am I doing when I do Valsalva and standing? [00:01:56] Taking blood flow away from the heart. So, what's going to happen to all my murmurs when I stand and perform Valsalva? It takes blood flow away from the heart. Exactly. And then hand grip. What did handgrip do? So, in school, what'd you learn about hand grip? Well, it increases afterload, right? So, what they're really saying to you is this, and this is how I want you to visualize it. [00:02:18] When I do hand grip, what I'm really doing is this. You're right. I'm increasing the afterload. But you must stop and think this one out for a second, folks. What’s really in the heart? Which valve must fight afterload? [00:02:39] Say you increase the peripheral vascular resistance for whatever reason. So, you increase the afterload, who fights it? And your answer will be... oh, wait for a second, Joe, that's the aortic valve in the left ventricle. Exactly. So, when I perform handgrip, who am I really challenging? Oh, I'm challenging the aortic valve and everything behind it. [00:03:00] Exactly. So that's the point I need inside your head? Then remember our last podcast was about our low-volume lovers. Who were our low-volume lovers?

Welcome to episode 96 of the Audio PANCE and PANRE PA board review podcast. Today is part five of this fabulous five-part series with Joe Gilboy PA-C, all about cardiac murmurs. In this week's episode of the Audio PANCE and PANRE podcast, we continue our discussion of cardiac murmurs with a focus on Mitral Valve Prolapse (MPV) and Hypertrophic Obstructive Cardiomyopathy (HOCM). We'll cover the ins and outs of these two NCCPA content blueprint murmurs and learn how to identify and differentiate them from other types of murmurs. If you haven't already, make sure to listen to our previous podcast episodes where we covered tricuspid stenosis, aortic valve murmurs, mitral valve murmurs, and pulmonic valve murmurs. HOCM and MVP (a brief introduction) Hypertrophic Obstructive Cardiomyopathy (HOCM) is a cardiac abnormality that leads to the muscle in the wall of the heart growing and thickening to the point that it blocks blood flow exiting the heart. The condition can be mild or severe, and it can lead to a variety of symptoms, including shortness of breath, chest pain, and irregular heartbeat. Complications may include heart failure, an irregular heartbeat, and sudden cardiac death. HOCM is a hereditary condition, and it is usually diagnosed in adulthood. There is no cure for HOCM, but treatments are available to manage the symptoms and help reduce the risk of complications. With proper care, people with HOCM can live long and healthy lives. *Hypertrophic cardiomyopathy is covered under the PANCE cardiology content blueprint -> cardiomyopathy -> hypertrophic cardiomyopathy HOCM is also covered as part of the PAEA EOR pediatric rotation -> cardiovascular topic list -> hypertrophic cardiomyopathy Mitral Valve Prolapse (MPV) is a condition in which the leaflets of the mitral valve bulge or prolapse back into the left atrium during systole. This may cause blood to flow backward into the left atrium, leading to a heart murmur. In some cases, MPV may also cause symptoms such as fatigue, dizziness, chest pain, and shortness of breath. While MPV is usually benign, it can occasionally lead to serious complications such as heart failure or stroke. Treatment for MPV typically involves lifestyle modification and management of symptoms. In severe cases, surgery may be necessary to repair or replace the mitral valve. *Miral valve prolapse is covered under the PANCE cardiology content blueprint -> valvular disorders -> mitral valve prolapse Podcast Episode 96: Murmurs Made Incredibly Easy (Part 5 of 5) – MVP and HOCM Below is a transcription of this podcast episode edited for clarity. You can download and listen to past FREE episodes here, on iTunes, Spotify, Google Podcasts, Stitcher, Amazon Music, and most podcasting apps.You can listen to this latest episode and access even more resources below. Welcome back, everybody out there in the podcast world. This is Joe Gilboy, and I work with Stephen Pasquini at Smarty PANCE. Today is part five of our five-part series covering heart murmurs - one of the most dreaded subjects in PA land. Today we are going to cover what I call the low-volume lovers. And who are the murmurs that like low blood volumes? In other words' low blood volumes make these murmurs sound louder? That is Hypertrophic Obstructive Cardiomyopathy (HOCM) and mitral valve prolapse. Hypertrophic Obstructive Cardiomyopathy (HOCM) So, what is happening with HOCM? Let us go back and view this from a pathophysiology point of view. So what do you have with HOCM? I have this young adult, and he is going to start exercising. So what is the left ventricle going to do on a typical day during exercise? You will stress out the left ventricle, which can lead to hypertrophy.  I want everybody to look in the space you are in right now. Maybe you are in a room. Perhaps you are in a car. I want you to look at the volume of this room or car and look at the wall. ...

Welcome to episode 95 of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast. Join me as I cover ten PANCE, PANRE and EOR review questions from the Smarty PANCE Instagram/Facebook page and the smartypance.com board review website. Special from today's episode: Follow Smarty PANCE and The Daily PANCE Blueprint on InstagramFollow Smarty PANCE and The Daily PANCE Blueprint on Facebook Below you will find an interactive exam to complement today's podcast. The Audio PANCE/PANRE and EOR PA Board Review Podcast I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of Smarty PANCE. You can download and listen to past FREE episodes here, on iTunes, Spotify, on Google Podcasts, Stitcher, and most podcasting apps.You can listen to the latest episode, take an interactive quiz, and download more resources 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 95: Ten PANCE/PANRE and EOR Topic Blueprint Questions 1. A 52-year-old patient is admitted with a lower gastrointestinal bleed. He is given 2 units of packed red blood cells. A few hours later the patient develops a fever but has no other symptoms or changes in vital signs. Lab studies reveal no significant changes. Which of the following is the most likely diagnosis? A. Transfusion-associated circulatory overloadB. Acute immune-mediated hemolytic reactionC. Transfusion-related acute lung injuryD. Febrile non-hemolytic transfusion reactionE. None of the above Click here to see the answer The answer is D. Febrile non-hemolytic transfusion reaction The most common transfusion reaction is a febrile non-hemolytic transfusion reaction (FNHTR). Patients with FNHTR may present with a fever a few hours after receiving packed red blood cells (PRBCs), which is caused by the small number of white blood cells and cytokines that can be found in each unit of PRBCs. Treatment consists of giving acetaminophen and ruling out other causes of fever (e.g., central line infection, urinary tract infection, etc). Incorrect Answers: Transfusion-associated circulatory overload (Choice A) occurs when the volume of the transfused component causes hypervolemia. Acute immune-mediated hemolytic reaction (Choice B) occurs when there are antibodies presented to blood donor antigens. Patients may present with hypotension, fever, or coagulopathic lab abnormalities. Transfusion-related acute lung injury (Choice C) is due to antibodies reacting with antigens leading to the release of mediators that causes edema in the lungs. Symptoms include fever, hypoxia, and dyspnea. VIEW BLUEPRINT LESSON Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Hematology ⇒ Immunologic disorders ⇒ Transfusion reaction 2. Which of the following is not a side effect of lithium? A. HyperparathyroidismB. HypothyroidismC. Cognitive fogD. TremorsE. All are side effects Click here to see the answer The answer is E. All are side effects  Lithium is the first-line treatment for bipolar disorder. It has many side effects that you should remember, such as hypothyroidism, hyperparathyroidism, nephrogenic diabetes insipidus, cognitive fog, and tremors. Lithium levels should be monitored to avoid toxicity. Remember, bipolar disorder is characterized by the symptoms DIG FAST: Distractibility, Irritability, Grandiosity, Flight of ideas, Activity increased, Sleep deficits, and Talkativeness. VIEW BLUEPRINT LESSON Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Psychiatry ⇒ Bipolar and related disorder Also covered as part of the Emergency Medicine EOR, Psychiatry EOR, and Family Medicine PAEA EOR topic list 3. Which of the following best explains the pathophysiology of vasovagal...

Welcome to episode 94 of the Audio PANCE and PANRE PA board review podcast. Today is part four of this fabulous five-part series with Joe Gilboy PA-C, all about cardiac murmurs. In this week's episode of the Audio PANCE and PANRE podcast, we continue our discussion of cardiac murmurs with a focus on the tricuspid valve. We'll cover the ins and outs of tricuspid valve stenosis and learn how to identify it and differentiate it from other types of murmurs. If you haven't already, make sure to listen to our previous podcast episode where we covered aortic valve murmurs and mitral valve murmurs, and pulmonic valve murmurs. The Tricuspid Valve The tricuspid valve, or right atrioventricular valve, is a one-way valve that sits between the right atrium and right ventricle of the heart. It is essential for right ventricular filling and for preventing the backflow of blood from the right ventricle into the right atrium when the right ventricle contracts during systole. When functioning properly, the tricuspid valve is a passive structure that opens and closes in response to the pressure of the blood flowing through the heart. The right atrium receives deoxygenated blood from the superior and inferior vena cava. The tricuspid valve which separates the right atrium from the right ventricle opens during ventricular diastole, allowing the deoxygenated blood to flow from the right atrium into the right ventricle, and closes during ventricular systole preventing the backflow of blood from the right ventricle into the right atrium as the right ventricle contracts to pump blood into the lungs out through the pulmonary artery. Tricuspid Valve Stenosis Tricuspid stenosis is a narrowing of the tricuspid valve or one of its three leaflets. If the tricuspid valve is narrowed or stenotic, it will not open properly during diastole, increasing the volume of blood in the right atrium. When the right ventricle contracts the stiffened tricuspid valve also fails to close completely and tricuspid regurgitation develops. Nearly all cases are caused by rheumatic fever. Podcast Episode 94: Murmurs Made Incredibly Easy (Part 4 of 5) – Tricuspid Valve Stenosis Below is a transcription of this podcast episode edited for clarity. You can download and listen to past FREE episodes here, on iTunes, Spotify, Google Podcasts, Stitcher, Amazon Music, and most podcasting apps.You can listen to the latest episode and access even more resources below. Welcome everybody, this is Joe Gilboy PA-C and I work with Stephen Pasquini at Smarty PANCE. Today, we will continue this series on heart murmurs. Today's topic is tricuspid stenosis. So, sit back, listen to my voice, and try not to take notes. Don't do anything other than just listen and follow my logic. I promise you, when this is all said and done, you'll be looking at heart murmurs and more specifically, tricuspid stenosis in a vastly different light. I want you to view the tricuspid valve. Just think about it. There you are the right atria. The tricuspid valve opens during diastole and closes during systole. There's all your blood in the right ventricle, and it goes out through the pulmonary valve to get oxygenated out in the lungs. So now, I want you to think about this for a second. I have a tricuspid valve that is stenotic. It's stiff and hard to open. When are you going to have problems opening this valve? During diastole? Or during systole? You are going to have problems with this during diastole because that's when the tricuspid valve is supposed to open up. Because it's supposed to be closed during systole. So, it's a diastolic murmur, it's considered a mid-diastolic murmur. Now give this some more thought. Okay, so you're in the right atria - Is it easier or harder to push through this stenotic valve? Oh, it's a lot harder. And so, where's the blood flow going to back up to? Into the right atrium and now that right atrium,

Welcome to episode 93 of the Audio PANCE and PANRE physician assistant/associate board review podcast. Today is part three of this extraordinary five-part series with Joe Gilboy PA-C, all about cardiac murmurs. In this week's episode of the Audio PANCE and PANRE podcast, we continue our discussion of cardiac murmurs with a focus on the pulmonic valve. We'll talk about the different types of murmurs (stenosis and regurgitation) that can occur with the pulmonic valve and how to differentiate them from other types of murmurs. If you haven't already, make sure to listen to our previous podcast episode where we covered the aortic valve murmurs and mitral valve murmurs. The Pulmonic Valve Pulmonic valve stenosis (PVS) and pulmonic valve regurgitation (PVR) are two common heart valve diseases. PVS is a narrowing of the pulmonic valve, while PVR is leakage of blood back through the pulmonic valve. Both conditions can lead to significant heart problems if left untreated. Pulmonic valve stenosis PVS is the most common congenital heart disease, affecting approximately 1 in 1000 people. It can lead to right heart failure and/or pulmonary hypertension (high blood pressure in the lung arteries). PVS is caused by an abnormally thickened pulmonic valve or localized stenosis which means that it has a narrowing of the valve. Pulmonic valve stenosis has several different causes including: Congenital heart disease – this means that the abnormal valve was present from birth but is often undiagnosed until adulthood. For example, children with Down's syndrome or Noonan syndrome are more likely to have an undiagnosed congenital heart defect such as PVS. It commonly is a component of tetralogy of Fallot.Cocaine use in pregnancy – research has shown that there is a link between the use of cocaine in pregnant women and children with PVS, particularly if it is used close to the time of conception or later stages of pregnancy.Infection during pregnancy can cause an inflammatory response which may lead to heart problems for the baby.Autoimmune disease – PVS is sometimes associated with other autoimmune diseases, such as lupus. Symptoms of PVS can vary depending on the type of stenosis that is present and how much it has advanced. Mild cases may not cause any symptoms at all; however, it is common for patients to experience breathlessness, fatigue, chest pain, and palpitations. Heart sounds include increased splitting of S2 and a harsh crescendo-decrescendo ejection murmur heard best at the left parasternal 2nd or 4th intercostal space when the patient leans forward; the murmur grows louder immediately with Valsalva release and with inspiration. People with PVS may need to take some medication to ease their symptoms. For example, diuretics can help remove excess fluid; beta-blockers reduce the workload on the heart and therefore lower blood pressure and heart rate, and long-acting calcium channel blockers can reduce the force of contraction of the heart's left ventricle. Pulmonary valve replacement is an effective treatment for severe PVS, which involves surgically implanting a new pulmonary valve to replace the defective one. Because the valve only affects the blood flow through one part of the heart, this surgery can often be carried out using minimally invasive techniques. For milder cases of PVS that do not cause symptoms then medication or exercise may be prescribed instead. Regular exercise helps to strengthen the left ventricle (the main pumping chamber) which is important for people with PVS. For more information, view our lesson on pulmonary stenosis. Pulmonic valve regurgitation Pulmonic valve regurgitation is leakage of blood back through the pulmonic valve. It can lead to right-sided heart failure and/or pulmonary hypertension (high blood pressure in the lung arteries). This means that it has a leakage of the valve. It can be caused by any condition that impairs cardiac function,

The Audio PANCE/ PANRE Podcast Episode 92. Cardiac Murmurs Made Incredibly Easy Part 2 of 5. Mitral valve stenosis & regurgitation with Joe Gilboy PA-C.

Welcome to episode 91 of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast. Today is part one of an extraordinary five-part series with Joe Gilboy PA-C, all about cardiac murmurs. It's time to throw away everything you have ever learned that made you hate cardiac murmurs (you know those crazy line diagrams) and let Joe hard-wire your brain for success. I promise you that by the end of this podcast, you will no longer be afraid of murmurs, but you will welcome them into your brain with a whole heart, open arms, and the need to share this podcast with all your classmates. Below is a transcription of this podcast episode slightly edited for clarity. You can download and listen to past FREE episodes here, on iTunes, Spotify, on Google Podcasts, Stitcher, Amazon Music, and most podcasting apps.You can listen to the latest episode and access even more resources below. Welcome, everybody. This is Joe Gilboy PA-C, and today is part one of a five-part series on the two most dreaded words that every pa student and recert PA hates. Are you ready for the two words? Heart murmurs! Today we're going to start talking about heart murmurs, and we are going to break this down into a five-part series: The first part is going to be on the aortic valve (today’s episode)The second part will cover the mitral valveThe third will be all about the pulmonic valveThe fourth part will be about the tricuspid valveAnd then, in the fifth part of this series, we're going to wrap this all together We're going to cover each valve one at a time. We will look at it and try to really make sense of it all. Because I know what you did in PA school, you had that little diagram that you made, you know, systolic or diastolic murmurs. You've memorized certain things. And then you get to that test question, and you're completely clueless on it, you're like, “I have no idea what they just said, Joe, I have no idea.” And then you're back to scrambling, looking for some word that's going to trigger you. And that's the key point- all the trigger words, all those high-value trigger words, they're gone. That's what the creators of the PANCE did about two to three years ago. They took all the trigger words out. Key point: Don’t rely on keywords (trigger words) for your PANCE because they’re gone! So now, let's look at this differently. You did it your way. How did it work out? Probably not so well. So, guess what, we're going to do it my way. And that's what I want to do here. Let's start with the aortic valve. So, think about it for a second. I want you to picture the aortic valve. Opening during systole, closing during diastole. That's really what it's supposed to do. Go ahead and picture that in your head. And for those who are in a safe place, close your eyes because it makes more sense. The valve is going to be open during systole and is going to be closed during diastole. Now, who gets fed right after the aortic valve? Well, that'd be the coronary arteries. If I'm lacking blood flow to my coronary arteries, how's that feel? I’ve got chest pain. What's the second thing that gets fed after the aortic valve? Well, that'd be my internal and external carotid arteries. If I lack blood flow to my internal or external carotids, how will I feel? Lightheaded with syncope and dizziness. Where does blood flow third? That would be my left subclavian artery, and if I lack blood flow, then I get left arm pain. And then, of course, everything down south after that. Aortic Stenosis Okay, so let's start with the first one—aortic stenosis. So, think about this for a second. Stop memorizing. Start thinking. I have this stenotic aortic valve, and it can’t open up. So that's my question to you. When are you going to have problems with this valve? During systole or diastole? It is supposed to open during systole. And it won't. It’s too stenotic.

Welcome to episode 90 of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast. Join me as I cover ten PANCE, PANRE and EOR review questions from the Smarty PANCE Instagram/Facebook page and the smartypance.com board review website. Special from today's episode: Follow Smarty PANCE and The Daily PANCE Blueprint on InstagramFollow Smarty PANCE and The Daily PANCE Blueprint on Facebook Below you will find an interactive exam to complement today's podcast. The Audio PANCE/PANRE and EOR PA Board Review Podcast I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of Smarty PANCE. You can download and listen to past FREE episodes here, on iTunes, Spotify, on Google Podcasts, Stitcher, and most podcasting apps.You can listen to the latest episode, take an interactive quiz, and download more resources 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 90: Ten PANCE/PANRE and EOR Blueprint Questions 1. A 32-year-old male presents with acute ascending symmetrical paralysis and diminished reflexes in his bilateral lower extremities. He has a history of bloody diarrhea a few days ago. What did he likely eat that led to his symptoms? A. Uncooked rice B. Mayonnaise C. Uncooked chicken D. Soft unpasteurized cheese E. None of the above Click here to see the answer C. Uncooked Chicken This patient has Guillain-Barré Syndrome (GBS), an acute immune-mediated polyneuropathic disorder. Clinical features include ascending symmetrical paralysis, diminished tendon reflexes, and respiratory muscle weakness. GBS is typically precipitated by an infection. Campylobacter jejuni infection is the most common precipitant of GBS. It is commonly found in uncooked poultry. Cerebrospinal fluid analysis helps confirm the diagnosis. Treatment includes plasmapheresis and IV immune globulin. View lesson: Guillain-Barré Syndrome 2. Which of the following disorders is characterized by a scaly, rough erythematous patch that appears on sun-exposed areas? A. Seborrheic keratosis B. Keratosis pilaris C. Actinic keratosis D. Lichen planus E. Pityriasis rosea Click here to see the answer Answer: C. Actinic keratosis Actinic keratosis (AK) is a skin lesion that results from atypical keratinocyte proliferation. Risk factors include UV radiation, fair skin, and sunburns. AK can present in various ways, but classically you will see an erythematous, scaly macule, papule, or plaque. A shave or punch biopsy can confirm the diagnosis. However, AK is often diagnosed clinically. Treatment depends on the location and extent of the condition. Options include cryotherapy, fluorouracil, and imiquimod. It is important to remember that AK can develop into SCC. View Lesson: Actinic keratosis (AK) 3. A 42-year-old male is admitted for typical pneumonia. He is given IV azithromycin and ceftriaxone. His QT interval becomes prolonged and he develops a polymorphic ventricular tachycardia. Which of the following is the most appropriate pharmacological management? A. Intravenous calcium gluconate B. Intravenous magnesium sulfate C. Intramuscular epinephrine D. Oral amiodarone E. Oral procainamide Click here to see the answer B. Intravenous magnesium sulfate The patient developed torsades de pointes (Tdp), which is a specific type of polymorphic ventricular tachycardia in patients with a long QT interval. It is a ventricular dysrhythmia characterized by rapid (>100 bpm), irregular, wide QRS complexes that vary in size and shape. Diagnosis is made via EKG. Examples of meds that prolong the QT interval include antiarrhythmics (amiodarone, sotalol), antimicrobials (fluoroquinolones, macrolides),

Welcome to episode 89 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE, PANRE and EOR review questions from the Smarty PANCE Instagram/Facebook page and the smartypance.com board review website.

This is part two of a special three-part podcast series by Joe Gilboy PA-C on becoming a better PA. Part one was all about building better relationships with our nurses and ancillary staff. In part two we cover essential strategies on how to stay off the medical staff radar and get the medical staff, administrators, and supervisors on your side. Let's jump right into this special episode of The Audio PANCE and PANRE Podcast. You can listen to the podcast below and read the summarized (and edited version) of the transcript or listen in your podcast player of choice. The Audio PANE/PANRE Podcast Episode 86: How to be a Better PA (Part 2 of 3) You can also click here to listen to or download this episode. Episode Transcript and Summary This episode was recorded by Joe Gilboy PA-C and edited for clarity and readability by Stephen Pasquini PA-C. Welcome, everybody. This is Joe Gilboy, and this is a podcast to have a series of three podcasts on how to become a better PA. Today, we're going to talk about medical staff, our administrators, and our supervisors, whether a nursing supervisor, PA supervisor, or possibly physician supervisor. What I will be teaching you here in this podcast is how to interact with them and how to deal with them. And most importantly, how to have you make a better reputation for yourself and how to make you a better PA. First, we're going to talk about the medical staff, which is a big group of people. Second, we need to learn how to deal with administrators. These can also be the office managers at the clinics where you work.And then your supervisors, these are the people above you, whether a nurse, a PA, or a doc.Lastly, we will covering how to deal with (or leave) a toxic job So, let's talk about all these three people we're going to have to interact with. How to be a Better PA with Medical Staff Let me explain who medical staff really are, not whom you think there are, but I'm going to show you who they really are. I've been a physician assistant in the emergency room for 35 years. You would think that after 35 years, I've developed some tough skin. But there's one group of people that I fear the most, and you will begin to fear them as well. Who are they? The medical staff! Everybody has a boss. For example, you have a boss, and your boss has a boss, they have a boss, everybody has a boss. But there's one person who's at the very top of this pyramid. That's medical staff. So, when medical staff asked for something, when do you get it done? Now? Yes, right now, like yesterday was too late. So, the medical staff has asked for your ACLs card, PALS card, NCCPA card, or DEA number. They want a TB test, a flu shot, or they want your antibody titer for chickenpox. When are we getting it done? Now! No, literally right now. Because you see, the last people you want to be on the radar is medical staff. Let me share with you who medical staff really is. What's their job? Are you ready for this? I hope you're sitting down? Their job is to fire you. Yeah, you heard me. They want to find a problem. That's their job. So, when they start asking for things, they're looking for a problem. So, let's just say a young physician assistant is working in urgent care that we will call Betty. So, here's Betty, the new PA working at the urgent care. Medical staff wants something, and she's like, well, you know, I'll get to it tomorrow. I have a birthday party to go to this weekend. And you know, and then it's my parents, wedding anniversary, I'm going to have that. And then my boyfriend's taking me to this. And you know, I'll get back to it when I get back in town. And as this time has gone by, Tick-tock, tick-tock. She's getting these new emails in her inbox from the medical staff. They've sent one, they've sent two, they sent three. Now they send one to her, and they're saying, hey, if you don't get this done in 10 days,

Welcome to episode 87 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten internal medicine rotation EOR content blueprint questions from the Smarty PANCE physician assistant board and rotation review website. Special from today's episode: Check out the updated Smarty PANCE Internal Medicine Rotation (EOR) Review CourseDownload your Free Trello Smarty PANCE PAEA Internal Medicine EOR Tracking TemplateMembers can take the all-new Internal Medicine Rotation Practice ExamView the interactive Smarty PANCE Internal Medicine Rotation (EOR) Topic List Below you will find an interactive exam to complement the podcast. The Audio PANCE/PANRE and EOR PA Board Review Podcast I hope you enjoy this free audio component to the examination portion of this site. The full board review course includes over 2,000 interactive board review questions and is available to all members of Smarty PANCE. You can download and listen to past FREE episodes here, on iTunes, Spotify, on Google Play Music or Stitcher.You can listen to the latest episode, take an interactive quiz, and download more resources 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 87: Ten Internal Medicine EOR Pulmonology Questions The following questions are linked to PAEA Content Blueprint lessons from the Smarty PANCE and PANRE Board Review Website. If you are a member, you will be able to login and view this interactive video lesson. 1. A 67-year-old man with a long history of constipation presents with steady left lower quadrant pain. Physical exam reveals low-grade fever, mid abdominal distention, and lower left quadrant tenderness. Stool guaiac is negative. An absolute neutrophilic leukocytosis and a shift to the left are noted on the CBC. Which of the following is the most accurate test for this patient's condition? A Barium enemaB ColonoscopyC CT scanD. Sigmoidoscopy Click here to see the answer Answer: C CT scan Diverticulitis presents with left lower quadrant abdominal pain, systemic symptoms (such as fever), nausea, vomiting, and leukocytosis on lab values. It typically occurs in a patient with a history of diverticulosis. The most accurate test for diverticulitis is a CT scan. Colonoscopy is contraindicated as it could cause rupture. Further management is keeping the patient NPO and administering ciprofloxacin, metronidazole, and IV fluids. Patients who can not tolerate oral antibiotics should be started on IV antibiotics. (Review topic: Diverticular disease) Barium enema is contraindicated in diverticulitis as it could cause irritation. A barium enema is the most accurate test in diverticulosis. Colonoscopy and sigmoidoscopy are contraindicated in diverticulitis as they could cause rupture. Colonoscopy is an accurate test for diverticulosis. 2. A 42-year-old homeless man presents to the emergency department with fever, painful muscle spasms in his arms and legs, and difficulty eating because of painful spasms in his jaw muscles. Until a week ago, he was wandering around the city looking for food and work and taking shelter in a commercial construction site. He reports not having seen a medical professional in more than 15 years. Examination of his feet reveals shoes with holes in the soles and a small, puncture-type wound on the bottom of the right foot. It is surrounded by erythema and somewhat tender to touch. The patient is uncertain what he may have stepped on. X-ray is negative for any radiopaque foreign body. In addition to hospital admission, which of the following is the first-line therapy for this patient? A Tetanus immune globulin and tetanus toxoidB Tetanus immune globulin and metronidazoleC Tetanus toxoid and penicillinD Tetanus immune globulin, tetanus toxoid, and metronidazole Click here to see the answer The answer is D Tetanus immune globulin, tetanus toxoid,

This is part one of a special three-part podcast series by Joe Gilboy PA-C on becoming a better PA. Part one is all about building amazing relationships with our nurses and ancillary staff. You may be thinking to yourself, "Hey Stephen, I thought this podcast was about the PANCE and PANRE." "How does talking about nurses and ancillary make me a better PA or help me pass my boards?" If you asked this question, then you have come to the right place. Because as anybody who has ever worked as part of a healthcare team can tell you, the key to your success as a PA has little to do with you and a lot more to do with how you treat other people. So how do you become a better PA? Let's jump right into this unique episode of The Audio PANCE and PANRE Podcast. You can listen to the podcast below and read the summarized (and edited version) of the transcript or listen in your podcast player of choice. The Audio PANE/PANRE Podcast Episode 86: How to be a Better PA (Part 1 of 3) You can also click here to listen to or download this episode. Episode Transcript and Summary This episode was recorded by Joe Gilboy PA-C and edited for clarity and readability by Stephen Pasquini PA-C. I've been a PA in the emergency department for 35 years. And you can imagine, I've had a lot of interaction with nurses and ancillary staff. I want to pass on some wisdom and guidelines to help you deal with the nurses and ancillary staff. This will help you become the best PA you can become and help you immensely in your career and, most importantly, with your reputation. Become Best Friends with the Nurses The first group of people we're going to talk about is the nurses. And this is a big one, folks, my God, how big is this! So, to all my new graduates out there, I really need you to listen to me, stop what you're doing, and let this bounce around in your head for a second. As a new graduate, your nurses will know more than you. That's right, you heard me, they will know more than you. So, let's say you're working at an urgent care family practice clinic or working in a neurology clinic. There you are seeing your patients, and the nurse will know more than you on how this patient needs to be worked up, which labs or imaging tests to order, and what the doctor likes. So, what I always tell my new graduates to do, and what you need to do, is become best friends with the nurses because sometimes (a lot of times), they're going to know more than you! As time goes on and as you become more experienced and more seasoned, yes, you will know more than the nurses, which is just a byproduct of time and experience. I can't fast forward time, but I can tell you that the nurses will know more than you initially, so follow them. They're going to point you in the right direction. They will say, "Hey, you know Dr. Smith likes it this way, or Dr. Jones likes it that way or, whoever the person that you're working with, this is how I like to work with them" Follow them, and if they like you, they will lead you in the right direction.  Make the Nurses Part of Your Team The second thing you need to understand about the nurses is that they like to be part of the team. They like to feel like they're part of the team and know that you recognize their experience and expertise when working up the patient. The worst thing you can ever say to a nurse is this: "I'm the PA; you're the nurse; you must do what I say." As soon as you say this, there are two things you should do: Sign your organ donation cardPick up the phone and call The Legacy Group, you know, that's the organ donation team that we have here in California, and they're going to come and harvest your organs, and you will be dead. And that's what's going to happen. Don't ever say that to the nurses! What should you say instead? Ask for Input from the Nurses What you should say to the nurses goes something like this: "hey,

Welcome to episode 85 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). Special from today's episode: Download your copy of the Free Trello Smarty PANCE NCCPA™ Blueprint Study Plan Make the Audio PANCE and PANRE an Alexa Skill 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. Below you will find an interactive exam to complement the podcast. The Audio PANCE/PANRE and EOR PA Board Review Podcast I hope you enjoy this free audio component to the examination portion of this site. The full board review course 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 more resources 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 85: Ten MIXED PANCE and PANRE Board Review Questions 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 14-hour-old boy has failed to pass stool and is vomiting greenish fluid. He was born at 40 weeks gestation with no complications during delivery or pregnancy. His temperature is 97.6°F (36.4°C), blood pressure is 64/34 mmHg, pulse is 140/min, respirations are 33/min, and oxygen saturation is 98% on room air. The child is currently breastfeeding and appears irritable. Physical exam is notable for a distended and non-tender abdomen. The rectal exam is unremarkable. An abdominal radiograph demonstrates distended loops of bowel. What is the most likely diagnosis? Cystic fibrosis Hirschsprung disease Jejunal atresia Pyloric stenosis Tracheoesophageal fistula Click here to see the answer Answer: A. Cystic fibrosis Cystic fibrosis (CF) commonly presents with meconium ileus, characterized by bilious vomiting, distended loops of bowel on radiography, and failure to pass meconium. CF is an autosomal recessive disease and is common in Caucasians. Neonates with CF commonly present with failure to thrive, respiratory compromise, and meconium ileus. In meconium ileus, abnormally thick meconium results in bowel obstruction, perforation, or volvulus. CF is diagnosed by the sweat chloride test or genetic testing. Radiography in ileus can demonstrate distended loops of bowel from the obstruction. Hirschsprung disease would present with abdominal pain with chronic constipation. There would be an absence of stool in the rectal vault on rectal exam and a positive squirt sign on physical exam (expulsion of stool/flatus on rectal exam). Jejunal atresia is characterized by the “triple bubble” sign on abdominal radiographs as well as bilious vomiting. Pyloric stenosis presents with non-bilious and projectile vomiting with a palpable mass on abdominal exam. This diagnosis can be confirmed with an ultrasound. The patient should first be rehydrated and have their electrolytes repleted prior to imaging. Tracheoesophageal fistula presents with coughing and choking with feeding. This breastfeeding and asymptomatic child in terms of his respiratory status suggests against this. Review NCCPA Blueprint Topic: Cystic fibrosis 2. A 34-year-old female presents to her ophthalmologist with 6 hours of blurry vision in her right eye. She reports severe pain with eye movement that has not been relieved with NSAIDs.

Welcome to episode 84 of the Audio PANCE and PANRE PA Board Review Podcast Today we welcome back PA board review expert Joe Gilboy PA-C as he covers the exceptionally important topic of cardiac pharmacology. Below you will find a downloadable audio version of this podcast as well as links to resources mentioned in today's episode. Members of Smarty PANCE can sign in and listen to the second half of Joe's lecture as well as part two of this high-yield cardiac pharmacology lecture series by clicking here. Not a Smarty PANCE member? You can gain instant access to this lecture as well as all the Smarty PANCE resources instantly by clicking here. From today's episode: To listen to the second half of this lecture as well as cardiac pharmacology part 2 with Joe Gilboy sign in to Smarty PANCE then click here. Listen to Joe's previous podcast episodes: How to Answer The Hardest PANCE and PANRE Test Questions Part 1 How to Answer Tricky PANCE and PANRE Test Questions Part 2 How to Study for Your PANCE Podcast Episode 65: Hepatitis B Breakdown Content Blueprint PANCE/PANRE Review Course and EOR (Rotation) Courses The Audio PANCE and PANRE Board Review Podcast Episode 84: Cardiac Pharmacology I hope you enjoy this free audio component to the examination portion of this site. The full board review course 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, Spotify, Google Play Music, Stitcher, or just search "The Audio PANCE and PANRE" in your favorite podcast listening app. If you can't see the audio player click here to listen to the full episode. Looking for all the podcast episodes? This FREE podcast series is often limited to every other episode, you can download and enjoy the complete audio series by becoming a Smarty PANCE member. Additional Resources Check out our new PANCE + PANRE + EOR All in One Search and Sort (2,075 topics) Take the FREE Internal Medicine Rotation Cardiovascular Practice Exam Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram Follow Smarty PANCE and The Daily PANCE Blueprint on Facebook My list of recommended PANCE and PANRE review books Interactive PANCE and PANRE NCCPA Exam Content Blueprints Sign up for the FREE Daily PANCE and PANRE email series Join the Smarty PANCE NCCPA Content Blueprint Website Get your free Trello PANCE study schedule Get 20% of any Picmonic membership by using this link Smarty PANCE members get 50% off Osmosis (link in the member's area) This Podcast is available on all platforms Just search for "The Audio PANCE and PANRE" in your favorite podcasting program or use the following links. iTunes The Audio PANCE and PANRE on Spotify Stitcher Radio Google Play Download The Content Blueprint Checklist Follow this link to download your FREE copy of the PANCE Content Blueprint Checklist Print it up and start crossing out the topics you understand, marking the ones you don't, and making notes of key terms you should remember. The PDF version is interactive and linked directly to the individual lessons on Smarty PANCE. Download for PANCE Download for PANRE

In this second podcast of the series, Joe Gilboy PA-C discusses tips for answering tricky PANCE and PANRE test questions that make answering even the most difficult PANCE Board review questions a breeze

In this podcast episode, Joe Gilboy PA-C discusses best practices for answering hard PANCE and PANRE test questions that make answering even the toughest NCCPA PANCE Board review questions a breeze

Welcome to episode 81 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten internal medicine rotation EOR content blueprint questions from the Smarty PANCE physician assistant board and rotation review website. Special from today's episode: Check out the new Smarty PANCE Internal Medicine Rotation (EOR) Review Course Download your Free Trello Smarty PANCE PAEA Internal Medicine EOR Tracking Template Take the FREE Internal Medicine Rotation Cardiovascular Practice Exam View the interactive Smarty PANCE Internal Medicine Rotation (EOR) Topic List Below you will find an interactive exam to complement the podcast. The Audio PANCE/PANRE and EOR PA Board Review Podcast I hope you enjoy this free audio component to the examination portion of this site. The full board review course 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 more resources 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 81: Ten Internal Medicine EOR Cardiology Questions The following questions are linked to PAEA 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. 55-year-old woman is admitted to the hospital because she has shortness of breath and pain on both sides of her chest with deep breathing which has worsened over the past 5 days. In recent weeks, she has been feeling fatigued and has had low-grade fevers and night sweats, and was found to have a new cardiac murmur on examination. Her temperature is 38.1°C (100.6°F), pulse is 106/min, respirations are 26/min, and blood pressure is 136/88 mm Hg. She appears diaphoretic and is in mild respiratory distress. Cardiac auscultation reveals a faint systolic murmur heard over the lower left sternal border. Her neck veins are distended and abdominal examination shows hepatomegaly. Which of the following is the most likely cause of her clinical presentation? A. Fat embolism B. Infective endocarditis C. Myocardial infarction D. Rheumatic fever E. Small cell lung cancer Click here to see the answer Answer: B, Infective endocarditis Infective endocarditis (IE) is an infection of the endocardial surfaces of the heart, most commonly the heart valves. IE occurs when a microorganism begins to invade the heart valves causing an inflammatory reaction that damages the valve – sometimes leading to stenosis and sometimes leading to regurgitation. This patient developed a new cardiac murmur in recent weeks that is described as a faint systolic murmur heard over the lower left sternal border. This is most consistent with tricuspid regurgitation. She also has distended neck veins and hepatomegaly, both of which suggest right-sided heart failure which can result from tricuspid regurgitation. Small infectious emboli can break away from the primary lesion on the tricuspid valve and go into the pulmonary vasculature causing shortness of breath and pleuritic chest pain. Most cases of IE are caused by Staphylococcus aureus and Viridans streptococci, and diagnosis is confirmed by obtaining multiple blood cultures that show that there is continuous bacteremia. Fat embolism to the pulmonary circulation almost always occurs with major trauma, including surgical procedures like intramedullary nailing of long bones. Fat emboli can occlude the microvasculature, triggering a systemic inflammatory response. The woman did not have recent trauma, and a fat embolism would not explain her cardiac murmur. Clinical presentation of myocardial infarction most often includes substerna...

Podcast Episode 79: How to Study for Your PANCE Welcome to episode 79 of the Audio PANCE and PANRE PA Board Review Podcast. In this episode 35-year PA veteran and PANCE/PANRE board review expert Joe Gilboy PA-C shares his top tips on how to best prepare for the Physician Assistant National Certification Exam Special Links From Today's Episode: View the Transcript, Table of contents and Summary of Key Points Download your copy of the Free Trello Smarty PANCE NCCPA™ Blueprint Study Plan Download your FREE Smarty PANCE Interactive NCCPA™ content blueprint Smarty PANCE members can enjoy 50% off Osmosis (link in members dashboard) 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 Smarty PANCE. You can download and listen to past FREE episodes here, on iTunes, on Google Play Music or Stitcher Radio. Looking for all the podcast episodes? This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy + SMARTYPANCE I will be releasing new episodes every few weeks. Smarty PANCE is discounted, so sign up now. Table of Contents and Key Points from this episode: Start Preparing One Year Before Your Exam Date Consider Forming a Study Group Print out the Blueprint Jot Down Quick Notes From Memory The Simple Answer Is Usually The Correct Answer In a 51/49 Split Choose The 51% Look For The Hook! Control Your X-Factors: I.E., Don’t Add Stress Where You Don’t Need It Practice Your Questions In Tutor Mode Correct Yourself in Real-Time Only Start Timing Yourself Towards The End Only Use High-Quality Questions Do 20-25 Questions Max Per Day The Best Textbooks for PANCE Prep The Best Websites for PANCE Prep Summary and Recommendations Podcast Transcript and Timestamps If you can't see the audio player click here to listen to the full episode. 0:00 Welcome, PA, world. My name is Joe Gilboy, PA-C. I work with Stephen Pasquini with the smarty PANCE website. Today's podcast is going to be on how to prepare for the PANCE, which is a very big subject and a very important subject to a lot of you guys out there. So come on guys, let's get this game roll, and let's learn how to prepare for the PANCE. 0:33 Hello, PA podcast world. My name is Joe Gilbert. I've been a PA for about 35 years, with all my time being in the emergency room. I'm a graduate of the Duke University PA program from 1984. I started helping students prepare for the PANCE and PANRE starting in 1990. So, as you can imagine, I've had a lot of students come through my hands. The answer is greater than 10,000. I've taught in several schools here in California I teach at several schools in Nevada. I also help in Tennessee. I help in Ohio, I help in Georgia, so I am around in a lot of different places, but for today, let's get you ready to take the PANCE. So I know a lot of ways to get students prepared. So, let's start. 1:14 So, today's podcast is actually going to be on how to prepare for the PANCE. So before we get going into the very specifics, let's look at so just come some basic guidelines as a student as you're getting ready to take the PANCE. So, the first thing that we need to actually do is study! I now I know this sounds a little oxymoronic, but you'd be surprised how many students I've met along the way, do really well in PA school, you know, they do well in their grades they do well in their End of Rotation Exams, they feel like they don't need to study. This couldn't be farther from the truth. 1:44 Start Preparing One Year Before Your Exam Date So usually what I tell most students to do is start preparing for this exam literally about a year before it comes.

Welcome to episode 77 of the Audio PANCE and PANRE PA Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the Smarty PANCE course content following the NCCPA™ content blueprint (download the FREE cheat sheet). Special from today's episode: Download your copy of the Free Trello Smarty PANCE NCCPA™ Blueprint Study PlanFollow The Daily PANCE Blueprint on InstagramFollow The Daily PANCE Blueprint on Facebook 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 77: 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 10-month-old girl was admitted to the hospital for cardiac catheterization. Her history included cyanosis noted at about 6 weeks of age, increasing over the last 7 months and becoming more severe with crying or physical activity. The chest x-ray demonstrates a "boot-shaped heart." A presumptive diagnosis of tetralogy of Fallot (TOF) was made on admission. TOF has 4 components, which of the following below is NOT PART of the diagnosis? A. Pulmonary valve stenosisB. VSDC. Overriding aortaD. Right ventricular hypertrophyE. ASD Click here to see the answer Answer: E, ASD In 1888, Fallot described a congenital heart defect composed of four characteristics (a) large ventricular septal defect (VSD) (b) right ventricular outflow obstruction (pulmonary valve stenosis) (c) overriding aorta (d) right ventricular hypertrophy. The main characteristic of TOF is cyanosis. Hypercyanotic spells or “tet spells” are paroxysmal episodes in which the cyanosis acutely worsens. Crying, feeding, or defecating can bring on these episodes. Review NCCPA Blueprint Topic: Tetralogy of Fallot 2. A 65-year-old man presents with pain in his right knee. He says he fell and “banged it up fairly bad” approximately 6 months ago but that it had since recovered spontaneously and provided no further trouble until now. On examination, his temperature is 37.5 °C and his blood pressure is 125/70 mm Hg. He has an inflamed, tender, swollen right knee. No other joints are affected. No other abnormalities are found on physical examination. A plain radiographic examination of the right knee reveals streaking of the surrounding soft tissue with calcium deposits (chondrocalcinosis). What is the definitive diagnostic test of choice for this patient's disease A. A plasma levelB. A random urine testC. A 24-hour urineD. A synovial fluid analysisE. Gram stain plus culture and sensitivity Click here to see the answer The answer is D: A synovial fluid analysis A definitive diagnosis of gout is made by demonstrating negatively birefringent, needle-shaped monosodium urate crystals under a polarizing microscope. Although an elevated serum uric acid concentration is often seen in acute gout, it is neither as sensitive nor as specific a test as the demonstration of uric acid crystals in the synovial fluid under a microscope. Serum uric acid levels can be normal in patients with acute gouty arthritis.

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.

The Audio PANCE and PANRE Physician Assistant Board Review Podcast Welcome to episode 73 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. 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 73: 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 45-year obese female (BMI=36.7 ) presents to your clinic with a random serum glucose level of 242.  You diagnose the patient with type II diabetes and place her on metformin 500 mg twice daily and ask that she check her glucose first thing in the morning and again late at night. The patient states that her glucose first thing in the morning is 424 and by the evening it is 96.  Which of the following tests would you like to order to confirm your diagnosis? ACTH levelHgA1C24 collection of VMADexamethasone suppression testCortisol levels Click here to see the answer Answer: D. Dexamethasone suppression test This patient is presenting with elevated glucose levels in the morning and normal levels at night. This is due to the dawn phenomenon or secreting too much cortisol first thing in the morning which is very common in patients with Cushing syndrome. The diagnostic test of choice for Cushing syndrome is a dexamethasone suppression test. While it is true that the cortisol levels will be elevated this does not diagnose Cushing’s syndrome. Review NCCPA Blueprint Topic: Cushing’s syndrome 2. A 49-year-old male is admitted to the hospital with a diagnosis of pneumonia. He has had a cough and fever up to 101.2 °F for five days.  The patient states that his cough is productive and he is also complaining of sharp right-sided chest pain. On physical exam, you note diminished breath sounds on the right as well as dullness to percussion.  The chest x-ray demonstrates a right lower lobe infiltrate. Which of the following bacteria would be the most likely cause of this patient's pneumonia? MycoplasmaPneumococcalH. FluLegionnaires Chlamydia Click here to see the answer Answer: B. Pneumococcal Pneumococcal pneumonia is the most common form of pneumonia in an adult that is greater than 40. It usually presents as lobar pneumonia with dullness to percussion and diminished breath sounds. There is also a vaccination available. Mycoplasma is the most common form of pneumonia in young adults and those less than 40. Review NCCPA Blueprint Topic: Bacterial pneumonia (ReelDx) 3. A 21-year-old male is brought into the emergency room by his fraternity brothers. He appears confused and is agitated. He has a temperature of 100.5 F, horizontal nystagmus, muscular rigidity and at times becomes incredibly combative. His laboratory evaluation shows a CPK level of 8000 and his blood alcohol level is 0. Which of the following drugs most likely explains this patient's symptoms? MethamphetaminesLSDPCPEcstasy Marijuana Click here to see the answer Answer: C. PCP

The Audio PANCE and PANRE Physician Assistant Board Review Podcast Welcome to episode 71 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. 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 71: 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 52-year-old male presents complaining of urinary frequency, with hesitancy, and nocturia for the past few months. During his physical examination, you note a nontender, non-enlarged prostate with an isolated right posterior lobe nodule. Which of the following options is most appropriate? order a serum acid phosphatase levelinitiate prazosin and schedule a follow-up appointment in 6 weeksrefer the patient for an ultrasound of the prostate and order a PSA levelreassure the patient and schedule a follow-up appointment in six monthsinitiate norfloxacin therapy for seven days and schedule follow-up in two weeks Click here to see the answer Answer: C. refer the patient for an ultrasound of the prostate and order a PSA level This patient has an isolated nodule of the prostate gland — cancer until proven otherwise. You should order an ultrasound and a PSA. BPH will present as diffuse enlargement and not a discrete nodule. Review NCCPA Blueprint Topic: Prostate disorders (PEARLS) 2. Which of the following is a major contraindication to curative surgical resection of a lung tumor? A. Liver metastasesB. Vagus nerve involvementC. Non-malignant pleural effusionD. Chest wall invasion of the tumor Click here to see the answer Answer: A. Liver metastases Distant metastases, except for solitary brain and adrenal metastases are an absolute contraindication for pulmonary resection. Other absolute contraindications include MI within the past 3 months, superior vena cava syndrome due to a metastatic tumor, bilateral endobronchial tumor, contralateral lymph node metastases, and malignant pleural effusion. Review NCCPA Blueprint Topic: Pulmonary Neoplasms (PEARLS) 3. A 23-year-old female complains of fever and genital pain. Examination reveals the presence of lymphadenopathy in the groin and the presence of vulvar vesicles surrounded by erythematous skin. The diagnosis may be confirmed by A. A culture of a vesicle using blood agar mediumB. The presence of similar lesions on the fingers and handsC. A Gram stain of a scraping from the base of the lesionD. The presence of giant multinucleated cells on Tzanck smear Click here to see the answer Answer: D. The presence of giant multinucleated cells on Tzanck smear – A Tzanck smear is the standard laboratory test to confirm the herpes virus as an etiologic agent of a vesicular lesion on an erythematous base. A. Herpes virus will not grow on blood agar medium. B. Herpes genitalis occurs in skin that comes into contact with the herpes virus. Usually, the infection is localized. C.

The Audio PANCE/PANRE Board Review Exam Questions Welcome to episode 69 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. 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 69: 10 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. Which of the following is the most common cause of acute myocardial infarction? A. Occlusion caused by coronary microemboliB. Thrombus development at a site of vascular injuryC. Congenital abnormalitiesD. Severe coronary artery spasm Click here to see the answer B. Thrombus development at a site of vascular injury – Acute myocardial infarction occurs when a coronary artery thrombus develops rapidly at a site of vascular injury. In most cases, infarction occurs when an atherosclerotic plaque fissures, ruptures, or ulcerates and when conditions favor thrombogenesis so that a mural thrombus forms at the site of rupture and leads to coronary artery occlusion. A. Coronary microemboli occlusion is a rare cause of acute myocardial infarction. C. Congenital abnormalities are rare causes of acute MI. D. Severe coronary artery spasm is more likely to result in Prinzmetal’s angina rather than true infarction. Review NCCPA Blueprint Topic: Acute myocardial infarction (PEARLS) (Lesson) 2. Endotracheal intubation should be performed with caution in patients with which of the following underlying conditions due to the propensity to cause subluxation of C1 on C2? A. Rheumatoid arthritisB. OsteoarthritisC. GoutD. Pseudogout Click here to see the answer A. Rheumatoid arthritis – Patients with advanced rheumatoid arthritis will have synovitis of the atlantoaxial joint (C1-C2) which may damage the transverse ligament of the atlas, producing a forward displacement of the atlas on the axis (atlantoaxial subluxation). B. Although patients with osteoarthritis may have neck pain and stiffness, there is no predilection for the atlantoaxial joints. C. Patients with gout are likely to have involvement of peripheral joints rather than spinal joints. D. Patients with pseudogout are more likely to have involvement of the knees, wrist, shoulder, ankle, elbow, and hands rather than the cervical spine. Review NCCPA Blueprint Topic: Rheumatoid arthritis (Lecture) (Lesson) 3. Which of the following interventions is the treatment of choice for an actinic keratosis? A. Mohs surgeryB. CryotherapyC. Acid peelsD. Radiation therapy Click here to see the answer B. Cryotherapy – Cryotherapy is the treatment of choice for isolated superficial actinic keratosis. A. Mohs surgery and radiation therapy are not indicated in the treatment for actinic keratosis. C. Acid peels can be used to treat actinic keratosis but are not the treatment of choice. Review NCCPA Blueprint Topic: Actinic keratosis 4. A 55-year-old secretary presents with ongoing pain and numbness in her hand.

Ten Mixed PA Board Review Questions The Audio PANCE/PANRE - Ten PA Board Review Exam Questions Welcome to episode 67 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 Blueprint.  Below you will find an interactive exam to complement the 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 SMARTYPANCE which are now bundled together into one very low price. 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 67: 10 Question PANCE and PANRE Podcast Quiz The following questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE & PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson. A 26-year-old female presents with several pruritic lesions on her dorsal forearms. The lesions are erythematous with vesicles, with a few beginning to weep. She works in a photography laboratory but denies any other possible exposures. Which of the following is the most useful diagnostic test? A. VDRL serologyB. KOH prepC. Patch testingD. Gram's stain Click here to see the answer C. Patch testing with a suspected agent is usually positive in cases of allergic contact dermatitis A. VDRL serology is useful in the diagnosis of syphilis, not contact dermatitis B. KOH prep is used for diagnosis of fungal infections, not contact dermatitis D. Gram’s stain is useful in the diagnosis of bacterial infections, not contact dermatitis 2. An elderly female presents for evaluation of exertional syncope, dyspnea, and angina. She admits that previous to these symptoms she had insidious progression of fatigue that caused her to curtail her activities. Which of the following is the most likely diagnosis? A. Aortic stenosisB. Aortic regurgitationC. Mitral stenosisD. Mitral valve prolapse Click here to see the answer A. The major symptoms of aortic stenosis are exertional syncope, dyspnea, and angina. Symptoms do not become apparent for a number of years and usually are not present until the valve is narrowed to less than 0.5 cm to 2 cm of the valve surface area. B. Patients with aortic regurgitation are likely to complain of an uncomfortable awareness of their heart, especially when lying down. These patients develop sinus tachycardia with exertion and complain of palpitations and head pounding with activity. C. The symptoms related to mitral stenosis are related to increased pulmonary pressure after the left atrium can no longer overcome the outflow obstruction. D. Patients with mitral valve prolapse are typically asymptomatic throughout their lives, although a wide range of symptoms is possible. When symptoms do occur, palpitations from arrhythmias are most common along with lightheadedness. Syncope is not part of this disease process. 3. A 40-year-old female G5P5 complains of small quantities of urine leaking when she coughs, sneezes, or laughs. Her genitourinary examination is unremarkable and her urinalysis is normal. At this time, which of the following is the most appropriate management plan? A. Refer for a cystoscopyB. Recommend Kegel exercisesC. Refer for surgical correctionD. Recommend hormone replacement therapy Click here to see the answer B.

NCCPA™ PANCE Content Blueprint - The ABC's of Hepatitis +The Hepatitis B Breakdown Welcome to episode 65 of the Audio PANCE and PANRE PA Board Review Podcast. In today's episode, I welcome my friend, exclusive smartypance lecturer, and PA board review extraordinaire Joe Gilboy PA-C who will be breaking down Hepatitis B as you've never seen it before. This is a recorded lecture featured on my smartypance.com board review website covering Hepatitis A, B, and C testing with twelve follow up questions at the end. Below you will find an interactive exam to complement the podcast. I hope you enjoy this free audio component to the examination portion of the site. The full board review covers the entire NCCPA Content Blueprint, all indexed, searchable, and now available with Joe’s Gilboy's priceless lectures. To top it off you can sign up today for the free 60-day board review email series which includes Joe’s audio explanations. If you enjoyed this podcast episode: You can download and listen to past FREE episodes here, on iTunes, Google Play Music, or Stitcher Radio. 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 65: Hepatitis PANCE/PANRE Podcast Quiz The following questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE & PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson. 1. A patient presents wanting to be tested to see if they presently have Hepatitis A which labs would you order? a. Anti-HAV (IgG) b. Anti-HAV (IgA) c. Anti-HAV (IgM) d. Anti-HAV (IgE) Click here to see the answer c. Anti-HAV (IgM) 2. Which lab result would a PA and an IV drug abuser both have that are positive? a. Anti-HBs b. Anti-HBe c. Anti-HBc d. HBeAg Click here to see the answer a. Anti-HBs 3. Which positive lab tells you a person is currently actively infected with hepatitis B? a. HBsAg b. HBsAb c. HBcAg d. HBeAg Click here to see the answer d. HBeAg 4. Which of the following lab result would a chronic hepatitis B patient have that is positive? a. HBsAg b. HBsAb c. HBcAg d. HBeAg Click here to see the answer a. HBsAg 5. Immunoglobulin is given within two weeks for family members and close contacts when they are exposed to hepatitis A. Which immunoglobulin is given? a. IgM b. IgG c. IgA d. IgE Click here to see the answer b. IgG 6. Hepatitis D needs what part of hepatitis B to exist? a. HBsAg b. HBsAb c. HBcAg d. HBeAg Click here to see the answer a. HBsAg 7. Hepatitis E is transmitted by which vector? a. IV drug abuse b. Homosexual sex c. Fecal-oral d. Blood transfusion Click here to see the answer c. Fecal-oral 8. What is the 1st evidence of infection with hepatitis B? a. HBcAg b. HBeAg c. Anti-HBs d. HBsAg Click here to see the answer c. Anti-HBs 9. What is the lab test to indicate a diagnosis of acute hepatitis B? a. Anti-HBs b. Anti-HBe c. Anti-HBc d. HBeAg Click here to see the answer c. Anti-HBc 10. What is the lab test that indicates viral replication and infectious Hepatitis B? a. HBcAg b. HBeAg c. Anti-HBs d. HBsAg Click here to see the answer b. HBeAg 11. Which of the following is the first sign of a patient with an elevated conjugated bilirubin (direct)? a. Icteric sclera b. Jaundice c. Acholic stool d. Tea-colored urine Click here to see the answer d. Tea-colored urine 12. A 52-yo male with upper abdominal pain and an elevated aminotransferase(AST) >10,000 u/l is consistent with which problem? a. Gallstones b. Alcoholic liver disease c. Bile duct stones d. Viral Hepatitis Click here to see the answer d. Viral Hepatitis Looking for all the podcast episodes? This FREE series is limited to every other episode,

Ten Mixed NCCPA™ PANCE Content Blueprint Multiple Choice Questions Welcome to episode 63 of the FREE Audio PANCE and PANRE Physician Assistant 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 Blueprint.  Below you will find an interactive exam to complement the 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 SMARTYPANCE which are now bundled together into one very low price. 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. Episode 63 - General PANCE/PANRE Podcast Quiz The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content. 1. A 24-year-old male presents complaining of a 9-month history of increasing shortness of breath, dyspnea on exertion, and a cough productive of white sputum, mostly in the mornings. He denies orthopnea, PND, peripheral edema, fever, chills, night sweats, recent changes in weight, palpitations, chest pain, food intolerances, or other complaints. Patient has a history of recurrent lung infections. He states that his father had chronic pulmonary problems and died at age 42 from unknown lung disease. The patient denies smoking, alcohol or illicit drug use. On physical examination, the respiratory rate is 22 breaths per minute, a pulse of 98 bpm, a temperature of 98.7 degrees. Pulmonary exam reveals end-expiratory wheezes bilaterally and hyperresonance to percussion. His cardiac exam is normal. Chest X-ray shows decreased lung markings. ECG is normal. Pulmonary function tests show an FEV1 63% of expected and residual capacity is 123% of expected. Which of the following is the most likely diagnosis? A. Emphysema B. Pulmonary fibrosis C. Ventricular septal defect D. Congestive heart failure Click here to see the answer Answer: A. Emphysema This person has an obstructive lung disease based on PFTs. Emphysema is the most likely diagnosis and may be related to alpha-1 antitrypsin deficiency based on family history and lack of smoking history and young age. Emphysema is covered as part of the NCCPA Pulmonary Blueprint (12%) B. The PFTs from a person with pulmonary fibrosis would be consistent with a restrictive pattern. This patient has an obstructive pattern of lung disease. C. Ventricular septal defect will have a systolic murmur associated with it. D. Congestive heart failure might explain some of the symptoms of this patient (increasing shortness of breath and DOE), he denies other common symptoms, such as orthopnea and peripheral edema. CHF should not result in changes in the PFTs. 2. A male patient complains of chronic dysuria, frequency, and urgency with associated perineal pain. The most likely diagnosis is A. cystitis B. gonococcal urethritis C. epididymitis D. prostatitis Click here to see the answer Answer: D. prostatitis Some patients are asymptomatic, but low back or perineal pain, fever, chills, and irritative urinary symptoms are common in prostatitis. Prostatitis is covered as part of the NCCPA PANCE Genitourinary Blueprint A. Cystitis is characterized by dysuria without urethral discharge. B. Initially, there is burning on urination and serous or milky ...

Ten Mixed NCCPA™ Content Blueprint Multiple Choice Questions Welcome to episode 61 of the FREE Audio PANCE and PANRE Physician Assistant 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 Blueprint.  Below you will find an interactive exam to complement the 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 SMARTYPANCE which are now bundled together into one very low price. 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. Episode 5 - General PANCE/PANRE Podcast Quiz The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content. 1. An 18-year-old male presents with pain in his wrist after he fell off of a moving motorcycle. Physical examination reveals tenderness in the anatomic snuffbox. No fracture is noted on plain radiography of the wrist. Which of the following is the recommended treatment for this patient? A. An ace wrap of the wrist B. Closed reduction of the fracture site C. Thumb spica cast application D. Open reduction of the fracture site Click here to see the answer Answer: C. Thumb spica cast application Even with normal initial radiographs, patients with a consistent history and tenderness in the anatomical snuffbox are treated as a stable fracture with immobilization in a thumb spica cast. Casting is recommended for all presumed nondisplaced scaphoid fractures. Scaphoid fractures covered in fractures and dislocation of the forearm, wrist, and hand and are part of the NCCPA Endocrinology Musculoskeletal Blueprint (10%) 2. A solitary pulmonary nodule is found on a pre-employment screening chest x-ray in a 34-year-old non-smoking male. There are no old chest x-rays to compare. Which of the following is the most appropriate next step in the evaluation? A. CT scan of the chest B. Needle biopsy of the lesion C. Positron emission tomography of the chest D. Fiberoptic bronchoscopy Solitary pulmonary nodules are covered as part of the NCCPA PANCE Blueprint Pulmonary (12%) Content Blueprint (12%) Click here to see the answer Answer: A. CT scan of the chest In the absence of old x-rays in a nonsmoking individual less than 35 years old, CT scan of the chest is the next step in the evaluation of a solitary pulmonary nodule. B. A needle biopsy would be indicated for a person greater than 35 years old and/or with a history of smoking to evaluate a solitary pulmonary nodule. C. Positron emission tomography (PET scan) would be indicated if the CT scan was nonconclusive. D. Fiberoptic bronchoscopy would be indicated only in the presence of a history of tobacco use or if the lesion was suggestive of malignancy. 3. Early clues to impending delirium tremens include A. agitation and decreased cognition. B. visual hallucinations and diaphoresis. C. autonomic hyperactivity and dehydration. D. mental confusion and sensory hyperacuity. Delirium tremens is covered as part of the NCCPA Psychiatry content blueprint (6%) under the topic of withdrawal Click here to see the answer Answer: A. agitation and decreased cognition. Anxiety, decreased cognition, tremulousness,

The Audio PANCE/PANRE PA Board Review Podcast Welcome to episode 59 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten Emergency Medicine End of Rotation Exam (EOR) review questions from the SMARTYPANCE course content following the NCCPA™ and PAEA content blueprint (download the FREE cheat sheet). This week we will be covering ten emergency medicine end of rotation exam questions based on the NCCPA PANCE and PANRE Content Blueprint.  Below you will find an interactive exam to complement the 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 SMARTYPANCE which are now bundled together into one very low price. 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. Members can take Emergency medicine EOR 1 (200 questions) and Emergency Medicine EOR 2 (184 questions) Listen Carefully Then Take The Practice Exam If you can't see the audio player click here to listen to the full episode. Episode 59 - Emergency Medicine EOR Podcast Quiz The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content. 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 answer Answer: C. 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. A. Fracture of the medial orbital wall is associated with diplopia from medial rectus impingement, orbital emphysema, and epistaxis. B. Prolapse of orbital soft tissue, including inferior rectus muscle, inferior oblique muscle, orbital fat, and connective tissue results in enophthalmos, ptosis, diplopia, anesthesia of the ipsilateral cheek and upper lip, and limitation of upward gaze and is seen with fractures of the orbital floor. D. Orbital emphysema is seen with fractures of the medial orbital wall or floor of the orbit into the maxillary and ethmoid sinuses respectively. It will not lead to proptosis. Blowout fractures are covered as part of the NCCPA EENT Content Blueprint which accounts for 9% of your exam. 2. A 29-year-old male presents with a complaint of substernal chest pain for 12 hours. The patient states that the pain 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 S4. There is a friction rub noted. Lungs are clear to auscultation. EKG shows diffuse ST-segment elevation. What is the treatment of choice for this patient? A. Pericardiocentesis B. Nitroglycerin C. Percutaneous coronary intervention D. Indomethacin (Indocin) Click here to see the answer Answer: D. Indomethacin Indomethacin, a nonsteroidal anti-inflammatory medication, is the treatment of choice in a patient with acute pericarditis. A. Pericardiocentesis is the treatment of choice in a patient with...

The Audio PANCE/PANRE PA Board Review Podcast Welcome to episode 57 of the FREE Audio PANCE and PANRE Physician Assistant 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 endocrinology board review questions based on the NCCPA PANCE and PANRE Content Blueprint.  Below you will find an interactive exam to complement the 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 SMARTYPANCE which are now bundled together into one very low price. 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. Episode 57 - Endocrinology PANCE/PANRE Podcast Quiz The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content. 1. A 53-year-old Hispanic woman comes to your clinic for her annual physical exam. She is obese, does not exercise, and regularly eats fried foods. A random blood glucose is 249 mg/dL. Her hemoglobin A1C is 9.5. Which of the following treatments would be weight neutral or cause weight loss in this patient? A. Glargine B. Glyburide C. Actos D. Metformin E. Glipizide Diabetes Mellitus Type 2 is covered as part of the NCCPA Endocrinology Content Blueprint which accounts for 6% of your exam. Click here to see the answer Answer: D. Metformin The patient in this vignette most likely has type II diabetes. Of the given treatments, only metformin is weight neutral in the majority of cases (i.e. it does not cause significant weight gain/loss). Metformin is a first-line treatment for type II DM in most patients. Although the exact mechanism is unknown, it appears to decrease gluconeogenesis and increase insulin sensitivity. There is no risk of hypoglycemia or weight gain (though some patients even lose weight). The most high yield side effect involves lactic acidosis, particularly in patients with renal insufficiency.  A. Glargine, a long-acting insulin, can cause weight gain. B. Glyburide, a second-generation sulfonylurea, can cause weight gain. C. Actos, a thiazolidinedione, can cause weight gain. E. Glipizide, a second-generation sulfonylurea, can cause weight gain. 2. A solitary thyroid nodule is noted on physical examination. The TSH level is normal. The next step in the evaluation is: A. measurement of T4 and free T3 levels. B. a radionuclide thyroid scan. C. a fine needle biopsy. D. a surgical excision. Solitary thyroid nodule is covered as part of thyroid neoplastic disease in the NCCPA Endocrinology Content Blueprint which accounts for 6% of your exam. Click here to see the answer Answer: C. a fine needle biopsy Fine needle aspiration (FNA) is the first step in the evaluation of a solitary nodule with a normal TSH level. FNA has a high level of accuracy in diagnosing benign versus malignant nodules in this setting. A. Measurement of T4 and T3 levels would not be of benefit in the evaluation of a solitary thyroid nodule with a normal TSH level. B. A thyroid scan would be the next step if there were a low TSH level. D. Surgical excision would be the final step after determination of malignancy or suspicion of malignancy by FNA. 3. An 18-year-old male with a past medical history of type I diabetes presents to the emergency room with polyuria, polydipsia,

Welcome to episode 55 of the FREE Audio PANCE and PANRE Physician Assistant 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 Blueprint.  Below you will find an interactive exam to complement the 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 SMARTYPANCE which are now bundled together into one very low price. 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 Quiz If you can't see the audio player click here to listen to the full episode. Episode 55 PANCE and PANRE Podcast Quiz The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content. 1. Which of the following physical examination findings would be consistent with a pleural effusion? A. Hyperresonance to percussion B. Increased tactile fremitus C. Unilateral lag on chest expansion D. Egophony Pleural effusions are covered as part of the NCCPA Content Blueprint Pulmonology section which accounts for 10% of the exam View this ReelDx patient video case of a 68-year-old female complaining of bilateral chest pain and difficulty breathing. Included in this lesson is the Picmonic explaning Light's Criteria. Click here to see the answer Answer: C. Unilateral lag on chest expansion A lag on chest expansion may be seen in the presence of a pleural effusion. A. Hyperresonance to percussion would be suggestive of emphysema or pneumothorax. B. Increased tactile fremitus would be consistent with a consolidation. D. The presence of egophony would be consistent with a consolidation. 2. A 55 year-old female presents with complaints of stiffness, aching, and pain in the muscles of her neck, shoulders, lower back, hips, and thighs. There is no associated weakness associated with the stiffness and achiness. Laboratory evaluation shows an elevated C reactive protein and erythrocyte sedimentation rate. Which of the following medications is used to treat this condition immediately and will also serve to prevent a known complication from this disorder? A. Glucocorticoids B. Cyclophosphamide (Cytoxan) C. Methotrexate (Rheumatrex) D. Azathioprine (Imuran) This condition is covered as part of the NCCPA Musculoskeletal Content Blueprint and accounts for 10% of the exam Click here to see the answer Answer: A. Glucocorticoids This patient has polymyalgia rheumatica and treatment with glucocorticoids can relieve discomfort and prevent the associated ischemic temporal arteritis, which threatens vision. B. Cyclophosphamide is an immunosuppressant used in the treatment of acute leukemia. C. Methotrexate is a folate inhibitor used to treat rheumatoid arthritis, not polymyalgia rheumatica. D. Azathioprine is an immunosuppressant that is used to treat rheumatic disease and inflammatory bowel disease, not polymyalgia rheumatica. 3. A 35 year-old pregnant patient presents with fever, chills, and left-sided flank pain. On physical examination left-sided CVA tenderness is noted. Urinalysis reveals numerous white blood cells and white blood cell casts. Which of the following is the most appropriate treatment? A. Oral ciprofloxacin (Cipro) B. Oral trimethoprim-sulfamethoxazole (Bactrim) C. IV gentamicin (Garamycin) D. IV ceftriaxone (Rocephin)

Welcome to episode 53 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet) and the PAEA End of Rotation™ Exams Blueprints & Topic Lists. This week we will be covering ten General Surgery End of Rotation Exam Questions that are now part of the SMARTYPANCE website.  Below you will find an interactive exam to complement the 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 SMARTYPANCE which are now bundled together into one very low price. 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 Quiz If you can't see the audio player click here to listen to the full episode. Episode 51: General Surgery Endo of Rotation Exam Podcast Quiz The following 10 questions are linked to NCCPA™ Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content. 1. An 18-year-old patient has a tibia/fibula fracture following a motorcycle crash. Twelve hours later the patient presents with increased pain despite adequate doses of analgesics and immobilization. Which of the following is the most likely diagnosis? A. avascular necrosis B. myositis ossificans C. compartment syndrome D. reflex sympathetic dystrophy Click here to see the answer Answer: C. Compartment syndrome Compartment syndrome is characterized by a pathological increase of pressure within a closed space and results from edema or bleeding within the compartment. It may occur as an early local complication of fracture. A. Avascular necrosis occurs primarily in muscles post-traumatically and may not arise for several months after an injury. B. Myositis ossificans is a late complication of fracture resulting from disruption of the blood supply to the bone. D. Reflex sympathetic dystrophy is characterized by painful wasting of the hand muscles that may be secondary to injury and could occur as a late complication. 2. A 25-year-old male presents to the ED with left calf pain and cramping, as well as nausea and vomiting. He admits to "partying with cocaine all night". He describes his urine as a dark brown color. Serum creatinine kinase (CK) is 1325 IU/L (Normal Range 32-267 IU/L). Which of the following is the initial mainstay of therapy for this condition? A. IV rehydration B. Fasciotomy C. Toradol (Ketorolac) D. Hydrotherapy Click here to see the answer Answer: A. IV rehydration IV rehydration with crystalloids for 24 to 72 hours is the mainstay of therapy for rhabdomyolysis. B. Fasciotomy is indicated for compartment syndrome. C. NSAIDs, such as Toradol (Ketorolac), should not be used due to the vasoconstrictive effects on the kidneys. D. Hydrotherapy is not useful or indicated for Rhabdomyolysis 3. A 42-year-old male presents complaining of a sudden onset of a severe intermittent pain originating in the flank and radiating into the right testicle. He also complains of nausea and vomiting. On examination, the patient is afebrile but restless. Examination of the abdomen reveals tenderness to palpation along the right flank with no rebound or direct testicular tenderness. Urinalysis reveals a pH of 5.4 and microscopic hematuria but is otherwise unremarkable. Which of the following is the most likely diagnosis? A. Bladder cancer B. Nephrolithiasis C. Acute appendicitis D. Acute epididymitis Click here to see the answer Answer: B.

Welcome to episode 51 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE Board review questions from the Academy 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 Blueprint.  Below you will find an interactive exam to complement the 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 SmartyPANCE which are now bundled together into one very low price. 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 Quiz If you can't see the audio player click here to listen to the full episode. Episode 51 PANCE and PANRE Podcast Quiz The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content. 1. A 42-year-old male with a history of constipation presents with complaints of severe pain with defecation described as feeling like he is "tearing apart." He has also noted occasional small amounts of blood on toilet paper. External examination of the rectum is unremarkable and an internal rectal exam cannot be performed due to severe pain when attempted. Which of the following is the most likely diagnosis? A. Proctitis B. Anal fissure C. Rectal prolapse D. Internal hemorrhoids Anal fissures are covered as part of the NCCPA Content Blueprint GI and Nutrition which accounts for 10% of the exam View this ReelDx patient video case of a 51-year-old with rectal bleeding and abdominal pain (proctitis) Click here to see the answer Answer: B. Anal fissures Anal fissures are easily diagnosed from history alone with the classic finding of severe pain upon defecation. Constipation is also a common cause of the trauma that leads to the development of a fissure. A. Proctitis is usually caused by anorectal infections that produce symptoms of anorectal discomfort, tenesmus, constipation, and discharge from the rectum. C. Rectal prolapse is commonly seen in elderly females with complaints that include an anal mass, rectal bleeding and a change in bowel habits. D. While internal hemorrhoids may cause rectal bleeding, tearing pain is an uncommon complaint unless there is evidence of thrombosis of irreducible tissue. 2. What type of chest pain is most commonly associated with a dissecting aortic aneurysm? A. Squeezing B. Dull, aching C. Ripping, tearing D. Burning Dissecting aortic aneurysm is covered as part of the NCCPA Cardiology Content Blueprint and accounts for 16% of the exam Click here to see the answer Answer: C. A dissecting aortic aneurysm often presents with a very severe ripping, tearing like pain. A dissecting aortic aneurysm often presents with a very severe ripping, tearing like pain. A. Squeezing pain is more characteristic of angina or esophageal pain. B. Dull, aching pain is more characteristic of chest wall pain, possibly angina, or anxiety. D. Burning pain is more characteristic of esophageal reflux, esophagitis, or tracheobronchitis. 3. A 15-year-old softball player presents after jamming the distal tip of her finger into severe flexion. She is unable to extend the distal phalanx and she has pain on palpation of the distal interphalangeal joint. X-ray of the hand fails to reveal any associated avulsion fracture. Which of the following is the treatment of choice? A. Open reduction and internal fixation B.

Welcome to episode 49 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover ten PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will be covering 10 general board review questions based on the NCCPA PANCE and PANRE Content Blueprint.  Below you will find an interactive exam to complement the 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 SmartyPANCE. You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio. You can listen to the latest episode, take an interactive quiz and download your results below. Listen Carefully Then Take The Quiz If you can't see the audio player click here to listen to the full episode. Episode 49 PANCE and PANRE Podcast Quiz The following 10 questions are linked to NCCPA Content Blueprint lessons from the SmartyPANCE PANCE and PANRE board review website. If you are a member and login you will be able to view this content. 1. Which of the following clinical findings would be seen in a patient with food poisoning caused by Staphylococcus aureus? A. Ingestion of mayonnaise-based salads 48 hours earlier B. Bloody diarrhea with mucus for one week C. Abdominal cramps and vomiting for 48 hours D. High fever for 1 week Staphylococcus aureus food poisoning is part of the NCCPA Content Blueprint GI and Nutrition which accounts for 10% of the exam Click here to see the answer Answer: C. Abdominal cramps and vomiting for 48 hours Abdominal cramps, nausea, vomiting, and watery diarrhea typically last 1-2 days with staphylococcal food poisoning. A. A preformed toxin causes staphylococcal food poisoning; it has a short incubation period of 1-8 hours. B. Because Staphylococcus aureus does not invade the mucus, blood and mucus are not seen with this noninflammatory cause of food poisoning. D. Staphylococcal food poisoning may be associated with low-grade fever or subnormal temperature. 2. Which of the following diagnostic tests should be ordered initially to evaluate for suspected deep venous thrombosis A. Venogram B. Arteriogram C. Duplex ultrasound D. Impedance plethysmography Venous thrombosis is part of the NCCPA Cardiology Content Blueprint and represents 16% of the exam Click here to see the answer Answer: C. Duplex ultrasound Ultrasound is the technique of choice to detect deep venous thrombosis in the leg. A. Venogram has been replaced by noninvasive tests due to discomfort, cost, technical difficulties, and complications, such as phlebitis. B. Thrombophlebitis is a venous problem, not an arterial one. Any unnecessary invasive procedure is potentially harmful. D. Impedance plethysmography is equivalent to ultrasound in detecting thrombi of the femoral and popliteal veins, but it may miss early, nonocclusive thrombi. 3. A patient presents with signs and symptoms of Cushing's syndrome. Extensive diagnostic evaluation reveals an ACTH-secreting pituitary adenoma. First-line therapy should consist of A. pituitary radiation B. medical adrenalectomy C. transsphenoidal resection of the tumor D. amiloride (Midamor) Cushings disease is part of the NCCPA Content Blueprint Endocrinology which represents 6% of your exam Click here to see the answer Answer: C. transsphenoidal resection of the tumor Transsphenoidal resection of the tumor cures about 80% of patients. The remainder can be given a combination of pituitary radiation and medical adrenalectomy with one or more drugs. If these procedures fail, the last option is bilateral adrenalectomy. 4. A 26-year-old man is stung by a bee, and shortly thereafter,

Welcome to episode 47 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will be covering 10 general board review questions based on the NCCPA PANCE and PANRE Content Blueprint.  Below you will find an interactive exam to complement the podcast. I hope you enjoy this free audio component to the examination portion of this site. The full genitourinary board review includes over 72 GU specific questions and is available to all members of the PANCE and PANRE Academy and SmartyPANCE You can download and listen to past FREE episodes here, on iTunes or Stitcher Radio. You can listen to the latest episode, take an interactive quiz and download your results below. Listen Carefully Then Take The Quiz If you can't see the audio player click here to listen to the full episode. Episode 47 PANCE and PANRE Podcast Quiz The following 10 questions are linked to NCCPA Content Blueprint lessons from the SmartyPANCE PANCE and PANRE board review website. If you are a member and login you will be able to view this content. 1. To relieve dependent edema in a pregnant patient, which of the following should be instituted as treatment? Limit fluid intake Elevate the legs Prescribe thiazide diuretics Strict avoidance of sodium Uncomplicated pregnancy is part of the NCCPA Content Blueprint Reproductive System which is 8% of the exam Click here to see the answer Answer: B. Elevate the legs. Dependent edema is a common and rarely serious complication of pregnancy due to impedance of venous return. Leg elevation improves circulation A. Limitation of fluid is not indicated and may be harmful. C. Thiazide diuretics are contraindicated and could be harmful. D. Edema due to impedance of venous return will not respond to sodium restriction. 2. To further assess ascites in a patient, the physician assistant instructs the patient to turn onto one side while performing percussion. Which of the following is the reason for this maneuver? Testing for shifting of dullness on percussion Shifting of internal organs making percussion easier Trying to elicit any pain while moving Trying to produce a caput medusae Ascites is a common complication of liver disease. Disorders of the liver is part of the NCCPA GI and Nutrition Content Blueprint and represents 10% of the exam Click here to see the answer Answer:  A. Testing for shifting of dullness on percussion. In ascites, dullness shifts to the more dependent side as the fluid relocates into dependent space, while tympany shifts to the top as the gas-filled organs float to the top of the ascitic fluid C. Pain with movement is associated with peritonitis and not ascites. D. Caput medusae is the dilation of the superficial abdominal veins due to increased intra abdominal fluid accumulation. It is visible with the patient standing and does not need a special maneuver for identification. 3.  A 7-year-old child with a history of type 1 diabetes mellitus for 3 years presents for routine follow-up. The mother states that the child has been having nightmares and night sweats. Additionally, his average morning glucose readings have risen from an average of 100 mg/dL to 145 mg/dL over the past week. This child is most likely experiencing a growth spurt emotional problems the Somogyi effect the dawn phenomenon Diabetes mellitus type 1 is part of the NCCPA Content Blueprint Endocrinology which represents 6% of your exam Click here to see the answer Answer: C. the Somogyi effect. This refers to nocturnal hypoglycemia, which stimulates counterregulatory hormone release resulting in rebound hyperglycemia A. Nightmares and night sweats are not associated with growth spurts. B.

Welcome to episode 45 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Today we are going to take a brief detour away from 10 daily questions and instead cover the murmurs you need to know for your PANCE and PANRE exam. I have still included an 11 question exam at the end of this post so make sure you scroll down after you listen to the podcast. There are a total of 17 cardiac conditions that may present on exam day in the form of a descriptive sound/murmur. You will often be given supporting evidence such as the location of auscultation or radiation which you can use to narrow down your options. There are total of 51 cardiac topics in the  NCCPA™ Cardiology PANCE and PANRE Content Blueprint which represents 16% of the PANCE and PANRE exam. (click here to download the FREE NCCPA Content Blueprint cheat sheet) These cardiac conditions and their associated murmurs cover a whopping 33% of the cardiology section of the PANCE and PANRE exam! Take a listen to this week's podcast episode If you can't see the audio player click here to listen to the full episode. Let's break this all down: Each of the links below opens the corresponding lesson on SmartyPANCE and is available to members (you must be logged in or join now) There are 9 valvular disorders associated with murmurs: Valvular Disorders (PEARLS and Flashcards) Aortic stenosis (ReelDx) Aortic regurgitation (Diastolic Murmur) Mitral stenosis (Diastolic) Mitral regurgitation Mitral valve prolapse Tricuspid stenosis Tricuspid regurgitation Pulmonary stenosis Pulmonary regurgitation Five congenital heart diseases that have corresponding murmurs Congenital Heart Diseases (PEARLS) Atrial septal defect Coarctation of the aorta Patent ductus arteriosus Tetralogy of Fallot Ventricular septal defect One murmur associated with cardiomyopathy Hypertrophic cardiomyopathy And a pair of conditions nested under the label of "other forms of heart disease" that have associated murmurs/heart sounds worth mentioning Other Forms of Heart Disease (PEARLS) Acute and subacute bacterial endocarditis Acute pericarditis Making Sense of Murmurs Let's start with the valvular disorders: You have 4 heart valves with two main conditions - half are diastolic murmurs and half are systolic murmurs. Here is a helpful mnemonic: Recalling Common Systolic Heart Murmurs: MR PASS M itral R egurgitation P hysiologic (also known as functional, systolic flow murmur, a heart murmur heard in the absence of cardiac abnormality) A ortic S tenosis S ystolic - All the above murmurs are heard during systole. MR PASS wins the Most Valuable Player award. M itral V alve P rolapse - Add MVP as another systolic murmur. MR PASS often hangs around with MS ARD. M itral S tenosis A ortic R egurgitation D iastolic - All the above murmurs are heard during diastole. Here are the nine valvular murmurs and their associated descriptions Remember which are systolic and diastolic this can be very helpful at ruling out or ruling in a condition come exam day. Aortic Stenosis - Systolic harsh ejection crescendo decrescendo murmur at RUSB (aortic area) with radiation to the neck and apex Aortic Regurgitation - diastolic - soft high pitched blowing at LSB with patient sitting leaning forward and exhaling Mitral stenosis - diastolic - low pitched decrescendo rumbling with opening snap at the APEX (the mitral area) enhanced by expiration Mitral regurgitation - blowing holosystolic murmur loudest at the APEX (the mitral area) with a split S2 that radiates to the axilla and is increased by squatting, handgrip and expiration Tricuspid Stenosis - diastolic - mid diastolic rumbling at LLSB (tricuspid area) with opening snap Tricuspid regurgitation - High pitched holosystolic blowing murmur that radiates to the LSB (tricuspid area) ...

Welcome to episode 43 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint (download the FREE cheat sheet). This week we will continue to take a break from topic specific board review and covering 10 general board review questions. Below you will find an interactive exam to complement the podcast. I hope you enjoy this free audio component to the examination portion of this site. The full genitourinary board review includes over 72 GU specific questions and 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, take an interactive quiz and download your results below. Listen Carefully Then Take The Quiz If you can't see the audio player click here to listen to the full episode. Episode 43 PANCE and PANRE Podcast Quiz 1. A mother brings in her five-year-old boy for his school physical. She voices some concerns about his readiness for school, saying he seems to be socially immature. She has noticed he does not interact with other children well, and that when he plays with them, he has a tendency to "place them" and then run around them as if they were statues. He rarely cries when he is hurt, and he shrugs off any attempt to hug him. He has good attention to details, and will sit and draw the same geometric shapes over and over again, but does not seem interested in learning the alphabet. He avoids eye contact with anyone. Which of the following is the most likely diagnosis? Normal 5 year-old Social phobia Autism Avoidant personality Click here to see the answer Answer: C. Autism Children with autism do not tend to make eye contact, and even avoid it. They do not accept comfort when hurt and stiffen up when hugged. They do not tend to play with others, and do not tend to imitate grown-ups in play. They approach play in a more mechanical way, using others as props rather than interacting with them. Explanations A. This behavior is not normal for a child this age. B. Social phobia is an excessive and persistent fear of social situations in which the person may be scrutinized by others. D. Avoidant personality disorder is characterized by timidity, social awkwardness, and a pervasive sense of inadequacy and fear of criticism. 2. A 3-week-old male infant presents with recurrent regurgitation after feeding that has progressed to projectile vomiting in the last few days. The mother states that the child appears hungry all of the time. She denies any diarrhea in the child. Which of the following clinical findings is most likely? Bile-stained vomitus Hemoccult positive stools Olive-sized mass in the right upper abdomen Sausage-shaped mass in the upper-mid abdomen Click here to see the answer Answer: C. Olive-sized mass in the right upper abdomen An olive-sized mass may be palpated in the right upper abdomen in pyloric stenosis and if found, is pathognomonic for pyloric stenosis. Explanations D. A sausage-shaped mass may be noted in intussusception, not pyloric stenosis. A. Gastric obstruction, such as that seen with pyloric stenosis, causes vomiting that is not bilious. B. Blood-streaked vomitus, but not hemoccult positive stools, may be seen in pyloric stenosis. 3. A 65 year-old with COPD receiving their first pneumococcal polysaccharide PPSV23 vaccination should be revaccinated in 1 year 3 years 5 years Never Click here to see the answer Answer: D. Never People who are first vaccinated with PPSV23 at age 65 years or older should receive only 1 dose, regardless of their underlying medical condition. ACIP recommendations for revaccination remain unchanged from the 1997 recommendations.

Welcome to episode 41 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I cover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA™ content blueprint. This week we will be taking a break from topic specific board review and covering 10 general board review questions. Below you will find an interactive exam to complement the podcast. I hope you enjoy this free audio component to the examination portion of this site. The full genitourinary board review includes over 72 GU specific questions and 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, take an interactive quiz and download your results below. Listen Carefully Then Take The Quiz If you can't see the audio player click here to listen to the full episode. Episode 41 PANCE and PANRE Podcast Quiz 1. A mother brings her 6-year-old boy for evaluation of school behavior problems. She says the teacher told her that the boy does not pay attention in class, that he gets up and runs around the room when the rest of the children are listening to a story, and that he seems to be easily distracted by events outside or in the hall. He refuses to remain in his seat during class, and occasionally sits under his desk or crawls around under a table. The teacher told the mother this behavior is interfering with the child's ability to function in the classroom and to learn. The mother states that she has noticed some of these behaviors at home, including his inability to watch his favorite cartoon program all the way through. Which of the following is the most likely diagnosis? Antisocial disorder Dysthymic mood disorder Obsessive-compulsive disorder Attention deficit hyperactivity disorder Click here to see the answer Answer: D. Attention deficit hyperactivity disorder Attention deficit hyperactivity disorder is characterized by inattention, including increased distractibility and difficulty sustaining attention; poor impulse control and decreased self-inhibitory capacity; and motor over activity and motor restlessness, which are pervasive and interfere with the individual’s ability to function under normal circumstances. Explanations Antisocial behavior disorder is characterized by disregard for rights of others; a defect in the experience of compunction or remorse for harming others. Dysthymic mood disorder is characterized by chronic, sad mood occurring for at least 2 years in an adult (one year in a child). Behavioral problems are not part of this disorder. Obsessive-compulsive disorder is characterized by recurrent obsessions and compulsions that result in anxiety and disruptive behaviors related to those compulsions. 2. Which of the following is the treatment of choice for a torus (buckle) fracture involving the distal radius? A. Open reduction and internal fixation B. Ace wrap or anterior splinting C. Closed reduction and casting D. Corticosteroid injection followed by splinting Click here to see the answer Answer: B. Ace wrap or anterior splinting A torus or buckle fracture occurs after a minor fall on the hand. These fractures are very stable and are not as painful as unstable fractures. They heal uneventfully in 3-4 weeks. 3. Which of the following can be used to treat chronic bacterial prostatitis? A. Penicillin B. Cephalexin (Keflex) C. Nitrofurantoin (Macrobid) D. Levofloxacin (Levaquin) Click here to see the answer Answer: D. Levofloxacin (Levaquin) Chronic bacterial prostatitis (Type II prostatitis) can be difficult to treat and requires the use of fluoroquinolones or trimethoprim-sulfamethoxazole, both of which penetrate the prostate. 4. A 25 year-old male with history of syncope presents for evaluation. The patient admits to intermittent episodes of rapid...

Welcome to episode 39 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue to cover topic specific PANCE and PANRE review from the Academy course content following the NCCPA™ content blueprint. Click here to download my interactive content blueprint checklist This week we will be covering 10 topic specific OBGYN/reproductive board review questions. The reproductive system accounts for 8% of your PANCE/PANRE board exam.   Below you will find an interactive exam to complement the podcast. I hope you enjoy this free audio component to the examination portion of this site. The full reproductive review includes over 107 reproductive system content blueprint specific questions and is available to all members of the PANCE and PANRE Academy or my new site SMARTY PANCE!! You can download and listen to past FREE episodes here, on iTunes, Google Play and Stitcher Radio. You can listen to the latest episode, take an interactive quiz and download your results below. Listen Carefully Then Take The Quiz If you can't see the audio player click here to listen to the full episode. Reproductive System PANCE and PANRE Podcast Quiz You can take the interactive quiz by clicking here Looking for all the podcast episodes? This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joining The PANCE and PANRE Exam Academy. I will be releasing new episodes every few weeks. The Academy is discounted, so sign up now. Resources and Show Notes: Reproductive system PANCE and PANRE content blueprint course on Smarty PANCE Reproductive System Contentent Blueprint 107 question exam on Smarty PANCE (members only) Download my free interactive content blueprint checklist My list of recommended PANCE and PANRE review books USE CODE “PALIFE” TO GET 10% OFF THE RUTGERS PANCE AND PANRE REVIEW COURSE This Podcast is also available on iTunes and Stitcher Radio for Android iTunes: The Audio PANCE AND PANRE Podcast iTunes Google Play: The Audio PANCE and PANRE Podcast Google Play Stitcher Radio: The Audio PANCE and PANRE Podcast Stitcher