The Audio PANCE and PANRE Board Review Podcast Episode 17
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Welcome to episode 17 of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast.

The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode.

I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy.

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  • You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below.

You can download a Free PDF Transcript of the Questions and Answers

Listen Carefully Then Take The Quiz

Questions 1-10

The Audio PANCE and PANRE Episode 17

1. A 64 year-old male presents complaining of new onset of fatigue, weight gain, constipation, erectile dysfunction, and loss of body hair. Laboratory investigation demonstrates: TSH less than 0.5 microunits/mL (normal range 0.5-5.0 microU/mL); Thyroxine (T4) 2 mcg/dL (normal range 5-12 mcg/dL); Prolactin 10 nanograms/ml (normal 2 – 18 ng/mL.) What is the most likely diagnosis?

A. Primary hypothyroidism
B. Excessive dosing of levothyroxine (Synthroid)
C. Hypopituitarism
D. Subacute thyroiditis

Click here to see the answer
C. The low trophic and target hormone levels combined with symptoms of hypogonadism indicate this patient has hypopituitarism.

2. A 15 year-old male was seen last week with complaints of sore throat, headache, and mild cough. A diagnosis of URI was made and supportive treatment was initiated. He returns today with complaints of worsening cough and increasing fatigue. At this time, chest x-ray reveals bilateral hilar infiltrates. A WBC count is normal and a cold hemagglutinin titer is elevated. The most likely diagnosis is

A. tuberculosis.
B. mycoplasma pneumonia.
C. pneumococcal pneumonia.
D. staphylococcal pneumonia.

Click here to see the answer
B. The insidious onset of symptoms, the interstitial infiltrate on chest x-ray, and elevated cold hemagglutinin titer make this diagnosis the most likely.

3. Which of the following clinical manifestations is common in candidal vulvovaginitis?

A. Extreme vulvar irritation
B. Firm, painless ulcer
C. Tender lymphadenopathy
D. Purulent discharge

Click here to see the answer
A. Candida infection presents with pruritus, vulvovaginal erythema, and white, cheese-like (curd) discharge that may be malodorous.

4. A 63 year-old female presents with a complaint of chest pressure for one hour, noticed upon awakening. She admits to associated nausea, vomiting, and shortness of breath. 12 lead EKG reveals ST segment elevation in leads II, III, and AVF. Which of the following is the most likely diagnosis?

A. Aortic dissection
B. Inferior wall myocardial infarction
C. Acute pericarditis
D. Pulmonary embolus

Click here to see the answer
B. Myocardial infarction often presents with chest pressure and associated nausea and vomiting. ST segment elevation in leads II, III, and AVF are classic findings seen in acute inferior wall myocardial infarction.

5. An 18 year-old woman presents to the clinic complaining of fatigue. She reports a past history of lifelong frequent nosebleeds and bleeding gums. She also has menorrhagia. Her mother and maternal grandfather have a similar bleeding history. Initial lab results are as follows: WBC 9,500/mm3, Hgb 10.9 g/dL, HCT 33%, MCV 69 fL, MCHC 26 pg and platelets 284,000/mm3. Which of the following tests should be ordered to evaluate this patient’s diagnosis?

A. Hemoglobin electrophoresis
B. Bleeding time and platelet aggregometry
C. Bone marrow aspiration
D. PT and aPTT

Click here to see the answer
B. The patient’s presentation is consistent with a congenital qualitative platelet disorder, most likely von Willebrand’s Disease, necessitating a bleeding time and evaluation of platelet function.

6. A 35 year-old patient has recurrent seasonal rhinitis and a history of mild asthma. Which of the following should be included for first-line management?

A. Immunotherapy
B. Decongestants
C. Corticosteroid inhalers
D. Cromolyn sodium (Intal)

Click here to see the answer
C. Regular use of corticosteroid nasal spray and oral inhalers prior to the allergy season is among the best means of preventing allergies.

7. A 35-year-old female presents with multiple ulcerative lesions on her labia and perineum. A Tzanck preparation of one of the lesions reveals multinucleated giant cells. Which of the following is the most likely diagnosis?

A. Herpes Simplex Virus (HSV)
B. Molluscum Contagiosum Virus (MCV)
C. Human Papilloma Virus (HPV)
D. Syphilis

Click here to see the answer
A. The presentation seen on the Tzanck preparation is characteristic of HSV.

8. Small grayish vesicles and punched-out ulcers in the posterior pharynx in a child with pharyngitis is representative of which organism?

A. Epstein-Barr virus
B. Group C Streptococcus
C. Coxsackievirus
D. Gonorrhea

Click here to see the answer
C. Coxsackievirus presents with small grayish vesicles and punched-out ulcers in the posterior pharynx.

9. A 53 year-old female has a diagnosis of migraine headaches. She had been using sumatriptan (Imitrex) to abort her headaches, but she is now having one or two headaches per week. The most appropriate preventive therapy is

A. zolmitriptan (Zomig).
B. promethazine (Phenergan).
C. propranolol (Inderal).
D. fluoxetine (Prozac).

Click here to see the answer
C. Propanolol is useful in preventing migraine headaches and may be maintained indefinitely.

10. Which of the following primitive reflexes should begin to disappear at about 2 months of age in a normal infant?

A. Moro
B. Grasp
C. Tonic neck
D. Parachute

Click here to see the answer
B. The grasp reflex starts to disappear at about 2-3 months of age.

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