Physician Assistant Exam For Dummies, with CD
Overview
The easy way to score high on the PANCE and PANRE
Physician Assistant Exam For Dummies, Premier Edition offers test-taking strategies for passing both the Physician Assistant National Certifying Exam (PANCE) and the Physician Assistant National Recertifying Exam (PANRE). It also offers information on becoming a certified Physician Assistant (PA) and the potential positions within this in-demand career field.
Physician Assistant Exam For Dummies provides you with the information you need to ace this demanding exam and begin your career in one of the fastest growing segments of healthcare.
- Offers an overview of test organization and scoring
- Content review with practice tests for each section of the exam
- Five full-length practice tests
- An interactive CD includes 3 of the 5 practice tests?including one PANRE?a digital slide slow featuring 20 plus images,and more than 300 flashcards covering the 13 official categories of the PANCE and PANRE
Physician Assistant Exam For Dummies, Premier Edition serves as a valuable, must-have resource, desk reference, and study guide for those preparing for either the PANCE or the PANRE.
CD-ROM/DVD and other supplementary materials are not included as part of the e-book file, but are available for download after purchase.
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About The Author
Rich Snyder, DO, is board certified in both internal medicine and nephrology. He teaches, lectures, and works with PA students, medical students, and medical residents.
Barry Schoenborn, coauthor of Medical Dosage Calculations For Dummies, is a long-time technical and science writer.
Sample Chapters
physician assistant exam for dummies, with cd
CHEAT SHEET
When you're preparing to take the PANCE or PANRE, you may feel like you have to know an endless amount of information. How will you ever remember all the details of so many diseases and conditions? Here, you can review some useful mnemonics that will not only help your recall as you prepare for your physician assistant exam but also improve your clinical acumen.
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Physician Assistant Exam
The Physician Assistant Exam (PANCE) will expect you to be familiar with different types of anemia, like macrocytic anemia, normocytic anemia and aplastic anemia. Make sure you know the basics.
Vitamin deficiencies: Macrocytic anemias
Macrocytic anemias are associated with a large MCV, usually > 100 fL. The two most common causes are vitamin B12 and folate (folic acid) deficiencies.
Physician Assistant Exam
Many bacterial infections exist, but for the Physician Assistant Exam (PANCE), there are seven biggies. Bacterial causes of diarrhea, especially food poisoning, can make someone deathly ill. Rheumatic fever isn’t commonly seen, but tests ask about it a lot.
Causes of diarrhea
For most people, diarrhea is merely inconvenient.
Physician Assistant Exam
The Physician Assistant Exam (PANCE) will expect you to understand that lung conditions that affect adults are not the same as the ones that affect the pediatric population. Kids have smaller airways, and their respiratory muscle structure is less developed. Pediatric conditions include croup, epiglottitis, respiratory syncytial virus (RSV), and whooping cough.
Physician Assistant Exam
On the Physician Assistant Exam (PANCE), there are some blood-related questions concerning coagulation problems and their evaluation and management. To prepare for the test, focus on platelets’ coagulation and factor disorders.
Many things can affect platelets’ ability to stick together. Medications, including antiplatelet agents, hinder clotting.
Physician Assistant Exam
When you take the Physician Assistant Exam (PANCE), your task is to recognize common terms used in epidemiology and to interpret some simple population-based data. Epidemiology is the branch of medicine that helps people figure out patterns concerning disease and other health-related conditions as they affect the population at large.
Physician Assistant Exam
The fungal infections covered on the Physician Assistant Exam (PANCE) can be serious, causing bacteremia as well as affecting specific organs, including the lung. Some of the organisms are opportunistic infections. For the PANCE, you should be aware of four different fungal conditions: pneumocystis, histoplasmosis, cryptococcosis, and candidiasis.
Physician Assistant Exam
For the Physician Assistant Exam (PANCE), you will need to know various hematologic malignancies. They include multiple myeloma, amyloidosis, leukemia, and lymphoma. They can occur together, or they can occur separately. They can also affect multiple organs of the body, a big one being the kidney. Co-author Rich sees a lot of these conditions in his clinical practice.
Physician Assistant Exam
The Physician Assistant Exam (PANCE) may ask you about two basic hereditary causes of anemias: glucose-6-phosphate dehydrogenase (G6PD) deficiency and sickle cell anemia. Familiarize yourself with the basics of these.
G6PD deficiency
G6PD deficiency is a hereditary condition in which the body is unable to produce enough glucose-6-phosphate dehydrogenase.
Physician Assistant Exam
Leukemias are high levels of abnormal white cells that overwhelm and overtake the bone marrow. For Physician Assistant Exam (PANCE) purposes, be familiar with four types of leukemias — two acute leukemias and two chronic leukemias. The acutes are acute myeloid leukemia (AML) and acute lymphocytic leukemia (ALL).
Physician Assistant Exam
You will need to know about many neurologic disorders for the Physician Assistant Exam (PANCE). Among them are disorders like myasthenia gravis, multiple sclerosis, Guillain-Barré syndrome, and Tourette’s syndrome.
Myasthenia
Picture a scenario in which a person says he or she becomes weaker as the day wears on.
Physician Assistant Exam
For the Physician Assistant Exam, you will need to be familiar with a few pediatric medical conditions, such as jaundice, rotavirus, Reye’s syndrome, and other medical conditions specific to pediatric care.
Jaundice
You may see a question or two on the test concerning neonatal jaundice. The cause of icterus and jaundice in the neonate is the buildup of bilirubin in the body.
Physician Assistant Exam
A restrictive pattern on a pulmonary function test (PFT) is a reduced diffusion capacity of the lungs for carbon dioxide. The Physician Assistant Exam (PANCE) will question you about these conditions, so you should review lung disease caused by occupational exposure, interstitial lung disease (ILD), and granulomatous diseases, including sarcoidosis.
Physician Assistant Exam
The Physician Assistant Exam (PANCE) will expect you to know the different forms of Rheumatoid arthritis (RA). RA is an autoimmune, symmetric polyarticular arthritis that can be severely debilitating — it affects similar joints on both sides of the body.
Rheumatoid arthritis and osteoarthritis are both very common causes of arthritis, although rheumatoid arthritis occurs more often in women than men.
Physician Assistant Exam
There are multiple skin conditions you will need to be aware of for the Physician Assistant Exam (PANCE). Although there are several more that should be studied, make sure you familiarize yourself with these basics.
Keratosis lesions
You need to be aware of two types of keratosis lesions:
Actinic keratosis: This skin lesion is caused by excessive exposure to the sun or UV light.
Physician Assistant Exam
There are many viral syndromes that you not only need to know about for the Physician Assistant Exam (PANCE), but likely have been exposed to during your life and medical career. Thank the stars for immunity!
Cytomegalovirus
Cytomegalovirus (CMV) is one of those viruses that can affect a lot of organs. From the liver to the eye to the intestine, it can cause much badness, to use professional medical terminology.
Physician Assistant Exam
Problems with the cervix often occur in younger women. It’s important to know the basics for the Physician Assistant Exam. Examples include cervical incompetence during pregnancy, cervicitis, cervical dysplasia, and cervical cancer. For cervical incompetence, prompt diagnosis and management is important. For the latter conditions, especially cervical cancer, routine screening is vital to detect the problem early.
Physician Assistant Exam
Injuries to the ankle are a common reason why people go to the emergency room. The Physician Assistant Exam (PANCE) will ask you about the common cause of these ankle injuries. Many of these injuries are sports injuries or secondary to sports-related injuries.
The soft tissues of the ankle
The most common ankle injury is the ankle sprain.
Physician Assistant Exam
Anxiety is a very broad term that is covered on the Physician Assistant Exam (PANCE). Generally, it concerns how people react to stress. Everyone has anxiety from time to time in response to a particular stressor. Examples include anxiety brought on by the loss of a job, financial worries, or an upcoming certification exam.
Physician Assistant Exam
Asthma is a chronic inflammatory process of the airway and is covered on the Physician Assistant Exam. An asthma attack can be stimulated by a hyperresponsiveness to environmental exposures or other triggers. Asthma is reversible, and it can resolve either on its own or with treatment. Asthma is very common in the younger population, especially African-Americans.
Physician Assistant Exam
A lot of pathology and Physician Assistant Exam questions concern the small and large intestines. Here you see conditions such as irritable bowel syndrome (IBS), ischemic bowel, inflammatory bowel disease (IBD), celiac disease, and diverticulitis.
Irritable bowel syndrome (IBS)
Irritable bowel syndrome (IBS) is a diagnosis of exclusion after other conditions have been ruled out.
Physician Assistant Exam
The Physician Assistant Exam (PANCE) will expect you to have a firm grasp on infectious processes like bronchitis and influenza. These are fairly common conditions and affect many people every year.
Acute bronchitis
The most common etiologies of bronchitis are viral, including the adenovirus (also a common viral cause of pharyngitis), respiratory syncytial virus (or RSV), and rhinovirus (the cause of the common cold).
Physician Assistant Exam
The Physician Assistant Exam will expect you to have an understanding of cardiac conduction disorders. Take this example. Rich has been around awhile and has taught both medical residents and physician assistants. Before that, he was a med student. Rich knows that when it comes to cardiology, two of the biggest causes of consternation, angst, and pain are answering physical-exam questions and identifying heart rhythms.
Physician Assistant Exam
The National Commission on Certification of Physician Assistants administers the two tests that are required of Physician Assistants: the PANCE, which certifies you to work as a PA, and the PANRE, which you take every 6 years (or 10 years starting in 2014) for recertification. Here is a quick overview of each test.
Physician Assistant Exam
For both the Physician Assistant Exam and in practice, you need to be aware of the stages of chronic kidney disease, issues with anemia and bone health, and indications for dialysis.Chronic kidney disease (CKD) is a significant health problem in the United States. More than 31 million people have been diagnosed with chronic kidney disease, and the problem is getting worse.
Physician Assistant Exam
Any hepatic process, especially hepatitis or long-standing alcoholism over time, causes cirrhosis of the liver. Cirrhosis is not reversible. For the Physician Assistant Exam (PANCE), you will need to be familiar with various aspects of cirrhosis.
Because the liver is responsible for regulating metabolism, processing medications, and processing the body’s various hormones, many things can change when cirrhosis is present.
Physician Assistant Exam
A good understanding of cardiomyopathy is useful for the Physician Assistant Exam. A cardiomyopathy is an abnormality of heart function secondary to changes in the structure of the heart muscle. The most common cause of congestive heart failure is an ischemic cardiomyopathy.
Note that in many if not all cases, you can make the diagnosis by an echocardiogram interpretation (in addition to a history and physical).
Physician Assistant Exam
In anemia, the body has a reduced quantity of red blood cells. One of the best ways to classify anemia is by the MCV, or mean corpuscular volume, which is expressed in femtoliters (fL). The MCV helps you think about the cause of the anemia and how to evaluate for it:
Microcytic anemias (low MVC, Think TAIL: thalassemia, anemia of chronic disease, iron deficiency anemia, lead poisoning.
Physician Assistant Exam
The Physician Assistant Exam (PANCE) question-makers love clinical triads because they are a great resource for test questions. When you understand common triads, you’re one step ahead of everyone else.
Virchow’s Triad: Thrombosis
Virchow’s triad of stasis, hypercoagulable state, and endothelial dysfunction are thought to be components of or causes of thrombosis.
Physician Assistant Exam
The Physician Assistant Exam (PANCE) will ask questions involving too much clotting of the blood. These problems are often associated with a hypercoagulable or thrombophilic state. Medical conditions that predispose someone to a hypercoagulable state are often abnormalities in one or more aspects of Virchow’s triad: venous stasis, hypercoagulable state, and/or endothelial dysfunction.
Physician Assistant Exam
With the advent of polypharmacy came the danger of significant drug-drug interactions. The Physician Assistant Exam (PANCE) will expect you to know the basics about these drug interactions and the effect on patients.
Warfarin
Nonprofessionals call warfarin a blood thinner. This frequently prescribed anticoagulant is used to treat many conditions, including atrial fibrillation, mechanical heart valves, and deep venous thrombosis/pulmonary embolism.
Physician Assistant Exam
Familiarize yourself with common medication side effects for the Physician Assistant Exam (PANCE). The average person over age 60 takes about nine prescription medications and sees a minimum of four different healthcare providers. The potential for someone to experience the side effects of these medications is huge, as is the potential for significant drug-drug interactions.
Physician Assistant Exam
Some eye conditions can become medical emergencies if not treated. For the Physician Assistant Exam, you will need to know about papilledema, glaucoma, and hyphema, as well as optic neuritis.
Papilledema: Intracranial pressure
Papilledema is swelling of the optic disc due to increased intracranial pressure. Rich has seen this condition in people who present to the hospital with hypertensive emergencies.
Physician Assistant Exam
The retina is a multi-layered structure in the eye, with cones, rods, and blood vessels and the Physician Assistant Exam has questions to test your knowledge. A lot of things can affect the retina, including diseases, occlusions, and aging.
Diseases of the retina
Retinopathy is a general term that refers to some form of noninflammatory damage to the retina of the eye.
Physician Assistant Exam
Back pain is one of the most common, frequent, and ordinary reasons people visit healthcare providers, so the Physician Assistant Exam will expect you to know your stuff. Many cases of back pain are self-limiting; however, you’ll likely see some special cases on the PANCE.
Ankylosing spondylitis
Ankylosing spondylitis (AS), also called a sacroiliitis, is a rheumatologic condition that predominantly affects young men in their late teens to early 40s.
Physician Assistant Exam
You may see questions on the Physician Assistant Exam about conditions that affect the pleura. You will need to review the evaluation and management of pleural effusions, the pneumothorax, and pleurisy.
Fluid around the lungs: Pleural effusion
Normally, the pleura is an empty space; a pleural effusion is simply fluid that occupies that space.
Physician Assistant Exam
Chronic obstructive pulmonary disease (COPD) is a serious condition and the Physician Assistant Exam (PANCE) will expect that you know the basics. COPD is an inflammatory disease of the lungs caused by one of two medical conditions:
Chronic bronchitis: A productive cough for at least 3 months per year for 2 consecutive years
Emphysema: A lung disease characterized by airway inflammation and loss of elasticity of the alveoli over time, secondary to destruction of the walls of the alveoli; continued smoking makes this process worse
How to diagnose COPD
Here are the key points concerning COPD:
The biggest risk for developing COPD is cigarette smoking.
Physician Assistant Exam
The Physician Assistant Exam will expect you to be able to answer questions about the aortic valve. The aortic valve is located between the left ventricle and the aorta. The two major disorders you can see with the aortic valve are aortic stenosis and aortic regurgitation.
Aortic stenosis
Aortic stenosis (AS) refers to a narrowing of the aortic valve area.
Physician Assistant Exam
Eating disorders are very prevalent in society. Familiarize yourself with the basics for the Physician Assistant Exam (PANCE). You don’t want to miss them or some of the clinical signs that can go along with them. This knowledge is valuable both for your clinical practice and for the PANCE. Please note that although these disorders are predominant in women, men can also be affected.
Physician Assistant Exam
For the Physician Assistant Exam (PANCE), it’s important to remember the names and components of specific injuries and orthopedic conditions related to the elbow, forearm, and wrist. This is especially true of fractures.
Epicondylar injury
Epicondylar is a fancy way of saying, “let’s look at the elbow for a second.
Physician Assistant Exam
For the Physician Assistant Exam (PANCE), you should be aware of the differences among the types of epidemiologic studies. The first step is to recognize whether the study is a retrospective study or a prospective study:
Retrospective: A retrospective study means that you’re looking into the past to figure out what happened.
Physician Assistant Exam
Gallbladder surgery is one of the most common types of surgery medical professionals are exposed to during their training. For the Physician Assistant Exam (PANCE), make sure you review common indications for surgery: gallbladder inflammation and gallstones.
Gallbladder inflammation
Anyone who has experienced gallbladder pain knows it can be debilitating.
Physician Assistant Exam
After traveling through the esophagus, your next destination in preparing for the Physician Assistant Exam (PANCE) is the lively gastric area. Containing the cardia, fundus, antrum, and pylorus, this area is just ripe for pathology and future PANCE questions. The stomach is a happening place where much of the digestion takes place.
Physician Assistant Exam
The Physician Assistant Exam will have plenty of questions about pain, including monoarticular arthritis. Talk about pain, and nine times out of ten someone will tell you that three of the most painful things in medicine are childbirth (well, men are just guessing about this), a kidney stone, and an acute gout flare.
Physician Assistant Exam
For the Physician Assistant Exam (PANCE), you should be familiar with some general stuff concerning HIV, specific infections related to HIV, and side effects of certain medications. HIV stands for human immunodeficiency virus. Risk factors for acquiring HIV include high-risk sexual behavior and drug abuse, especially intravenous use with dirty needles.
Physician Assistant Exam
The Physician Assistant Exam (PANCE) will ask questions about conditions affecting the hand and wrist. They range from benign cysts to minor sprains to out-and-out fractures, so make yourself familiar with the basics.
Ganglion cysts
A common soft tissue mass that you can see on the hands and wrists is a ganglion cyst, also known as a bible cyst.
Physician Assistant Exam
Hematuria, which means blood in the urine, is a very common clinical problem and will be covered on the Physician Assistant Exam. Being able to evaluate this condition is important because the causes are many and they affect people of any age or gender. Not fully evaluating the cause of hematuria can have dire consequences for the patient — for example, you may miss a potential cancer or nephritis.
Physician Assistant Exam
You’re likely concerned with your total Physician Assistant Exam (PANCE or PANRE) test score and whether it’s high enough to pass. Each question can yield either a 1 (correct) or a 0 (wrong) — you get 1 point for each correct answer and nothing for wrong or unanswered questions, so there’s no penalty for guessing.
Physician Assistant Exam
In most cases, the logistics of applying for the Physician Assistant Exam tests are straightforward. If your situation is different — for example, if you’re not a recent graduate from a PA program — consult the PANCE pages on the website for the National Commission on Certification of Physician Assistants.
Before you can take the PANCE, you need to graduate from an accredited PA program.
Physician Assistant Exam
A common scenario you deal with clinically and for the Physician Assistant Exam (PANCE) is inadvertently finding a lung lesion on a chest radiograph. You’re looking for something, and bam! There it is. What do you do about it? You assess the lesion on the radiograph:
Check the other lung findings to make sure that you’re just dealing with a pulmonary nodule.
Physician Assistant Exam
You will need to know about problems with gestational bleeding for the Physician Assistant Exam. Three bleeding-related complications that can occur during pregnancy include placenta previa, abruptio placentae, and post-partum hemorrhage.
Placenta previa
Placenta previa is an uncommon cause of bleeding that’s potentially life-threatening to both mom and baby.
Physician Assistant Exam
All is well when the pregnancy proceeds normally without any complications. As the Physician Assistant Exam will cover, unfortunately, complications can and do happen in pregnancy. You should be familiar with some of these conditions, from uncontrolled hypertension to emergent bleeding disorders.
Ectopic pregnancy
Ectopic pregnancy is a pregnancy outside of the uterus.
Physician Assistant Exam
Understanding the evaluation of abnormal calcium and magnesium levels is rather straightforward and important for the Physician Assistant Exam (PANCE). Knowing how to treat these electrolyte abnormalities, especially hypercalcemia, is really important. Calcium metabolism is intricately involved with the parathyroid gland.
Physician Assistant Exam
Colon cancer is a topic you’ll surely be asked about on the Physician Assistant Exam (PANCE), because colorectal cancer is the third most commonly diagnosed cancer in males and the second in females, especially in developed countries.
Watch for risk factors
Risk factors for colon cancer include a low-fiber Western diet, inflammatory bowel disease, and heredity.
Physician Assistant Exam
Endocarditis is an inflammation of the heart valve, and for the purposes of the Physician Assistant Exam (PANCE), you should know some specifics about the different flavors: infective endocarditis and subacute bacterial endocarditis.
The staph: How to find infective endocarditis
Infective endocarditis (IE) is a baddie.
Physician Assistant Exam
The Physician Assistant Exam (PANCE) will ask questions about the pre-op patient. Suppose the surgical team has assessed the patient, and you decide that the patient needs to go to the operating room. This may be an emergent situation or an elective surgery, such as an elective laparoscopic cholecystectomy.
Well, in addition to the H&P you’ve already done, you need to order some baseline labs and also assess how risky it is to take this patient to the OR.
Physician Assistant Exam
In many Physician Assistant Exam questions about kidney disease, the urinalysis (UA) can guide you toward the right answer. Abnormalities of the urine, especially hematuria and proteinuria, are typical question fodder on the PANCE/PANRE. Understanding such urinary abnormalities is vital in differentiating among causes of nephritis as well as in analyzing causes of kidney disease.
Physician Assistant Exam
You know that abnormal blood pressure is a component of many disease conditions that will be covered on the Physician Assistant Exam. Hypertension is the term for high blood pressure, and it’s an epidemic in the United States. Blood pressure is useful for assessing health, too. That’s why along with temperature, heart rate, and respiratory rate, blood pressure is called a vital sign.
Physician Assistant Exam
Hyperthyroidism is a condition the Physician Assistant Exam (PANCE) will cover Hyperthyroidism refers to an overactive thyroid gland. Hyperthyroidism has many causes, but the most common is Graves’ disease. Like Hashimoto’s thyroiditis, Graves’ disease is an autoimmune condition that usually affects young women.
Physician Assistant Exam
The thyroid is a vital organ that the Physician Assistant Exam (PANCE) will expect you to be familiar with. One of its big responsibilities is regulating the basal metabolic rate. If your thyroid gland becomes lethargic, you may have problems with weight gain and extreme fatigue.
Hypothyroidism refers to a thyroid that’s underactive.
Physician Assistant Exam
A lot of medical conditions can affect the ear. The Physician Assistant Exam will expect you to know that otitis (inflammation of the ear) comes in two kinds: otitis externa and otitis media. Although the two conditions share the word otitis, they’re quite different.
Otitis externa (external otitis)
Otitis externa (also called external otitis), as the name suggests, affects the outer ear.
Physician Assistant Exam
Kidney stones (renal calculi) cause pain and hematuria and will be covered on the Physician Assistant Exam. They commonly occur in young and middle-aged men. Here are several big payoff areas dealing with renal calculi.
Signs and symptoms of kidney stones
Many kidney stones pass through the GU tract on their own.
Physician Assistant Exam
Two conditions you don’t want to skip for the Physician Assistant Exam are kidney cancer and bladder cancer. You need to be aggressive in your investigation of possible malignancy because, many times, it presents rather insidiously.
Renal cell carcinoma (RCC)
When you think about kidney cancer, the most common histological cell type you see is renal cell carcinoma (RCC).
Physician Assistant Exam
Clinically, many health professionals see problems with knees in the older population. The Physician Assistant Exam (PANCE) will cover this common ailment. One of the most common causes is osteoarthritis. The more weight that a person is carrying, the more pain the person can feel and the more difficult walking can be.
Physician Assistant Exam
For the Physician Assistant Exam (PANCE), you will need to know about malaria, pinworms, and helminths (flukes, tapeworms, roundworms, and the like). Recall that parasitism is a nonmutual relationship in which the parasite benefits at the expense of the host.
Malaria
Someone contracts malaria after being bitten by an infected mosquito.
Physician Assistant Exam
An APGAR score measures how well a newborn is doing at 1 and 5 minutes after birth. The five factors you evaluate just happen to line up with the last name of the doctor, Dr. Virginia Apgar, who created the scoring system. Here are the APGAR factors:
A = appearance: The skin color should be pinkish.
P = pulse: The pulse should be 140–160 beats per minute.
Physician Assistant Exam
You will need to know a few things about lupus for the Physician Assistant Exam (PANCE). Systemic lupus erythematosus (SLE), or just plain lupus, is a systemic autoimmune disease that can involve multiple organs and body systems, including the joints, heart and pericardium, lungs, brain (in lupus cerebritis), and kidneys.
Physician Assistant Exam
The lymphomas are malignancies that affect the lymphatic system and will be covered on the Physician Assistant Exam (PANCE). The two major groups of lymphoma that you should be familiar with are Hodgkin’s disease and non-Hodgkin’s lymphoma.
Hodgkin’s disease
Hodgkin’s disease (HD) is a type of lymphoma that affects young people, usually in the mid-teen years, but it also occurs in people into their late 40s.
Physician Assistant Exam
There are some basic principles of medical ethics that you should be aware of and may see on the Physician Assistant Exam (PANCE). Medical ethics is a hot-button issue in medicine. Many books have been written about the subject. As a healthcare professional, you deal with ethical issues every day.
Practice ethical principles
Medical ethics come into play with every patient you see.
Physician Assistant Exam
Menstruation, or shedding of the endometrium, is part of a 28-day cycle, and it’s a normal physiologic process as the Physician Assistant Exam will expect you to know. Menarche is the name for the first menstrual period, and it usually takes place between the ages of 10 and 16, with the median age being 12 or 13 years.
Physician Assistant Exam
Microcytic anemias, characterized by a low MCV, usually
Iron-deficiency anemia
Iron-deficiency anemia is the most common type of microcytic anemia. Here are the main causes of this kind of anemia:
Bleeding in the gastrointestinal (GI) tract, usually from the colon: This is the primary cause of iron-deficiency anemia.
Physician Assistant Exam
For the Physician Assistant Exam, you will need to know about the exciting world of the pharynx, the larynx, and other aspects of the mouth. Fasten your seatbelts, because our brief, fast ride down the Grand Canal is about to get wild!
The sore throat
Acute pharyngitis (called “strep throat” by the common folk) can be painful.
Physician Assistant Exam
As the Physician Assistant Exam will emphasize, your nose isn’t on your face just to hold piercings and keep your eyes apart. This protuberance is a vital component of the respiratory mechanism, and it houses cells that are part of the olfactory system. A variety of conditions can affect the nose.
Sinus problems
The sinuses are spaces in the head, and they’re filled with air.
Physician Assistant Exam
The two big medical conditions that can affect the ovaries are ovarian cysts and ovarian cancer. These will be covered on the Physician Assistant Exam. Ovarian cysts can cause abdominal and pelvic discomfort in women, and ovarian cancer is a cause of increased morbidity and mortality in older women. You don’t want to miss these conditions.
Physician Assistant Exam
The pericardium, the outer covering of the heart, can get inflamed and irritated from a variety of conditions. For the Physician Assistant Exam (PANCE) purposes, be familiar with pericarditis, pericardial effusion, and cardiac tamponade.
Pericarditis linked to multiple causes
Pericarditis is simply an inflammation of the pericardium.
Physician Assistant Exam
Many disorders can affect the integrity of the peripheral nerves. For the Physician Assistant Exam (PANCE), make sure you are familiar with peripheral neuropathy and complex regional pain syndrome (CRPS).
Peripheral neuropathies
One of the best examples of a peripheral neuropathy is diabetic neuropathy, a polyneuropathy that affects the hands and feet in a glove-stocking distribution.
Physician Assistant Exam
Before getting into nasty medication side effects, drug-drug interactions, and toxic ingestions, you need to review basic pharmacological principles for the Physician Assistant Exam (PANCE). The body processes a medication in four basic ways: absorption, distribution, metabolism, and elimination. If any of these processes is altered in some way, then bad things can happen.
Physician Assistant Exam
When you're preparing to take the PANCE or PANRE, you may feel like you have to know an endless amount of information. How will you ever remember all the details of so many diseases and conditions? Here, you can review some useful mnemonics that will not only help your recall as you prepare for your physician assistant exam but also improve your clinical acumen.
Physician Assistant Exam
These practice questions are similar to the actual questions you may see on the Physician Assistant Exam (PANCE) exam that have to do with preventive medicine, epidemiology, domestic violence, and ethics.
Example PANCE Questions
You’re seeing a 19-year-old woman who has been sexually active for the past two years.
Physician Assistant Exam
Because musculoskeletal conditions affect millions of Americans, you can bet you’ll see questions about them on the PANCE or PANRE. Many of these conditions can be debilitating, whether you’re talking about rheumatologic conditions (such as rheumatoid arthritis or gout), orthopedic problems (such as osteoarthritis), or hip or knee pain.
Physician Assistant Exam
A lot of pathology concerns the digestive system and you can bet there will be questions about them on the Physician Assistant Exam (known as PANCE). Here are some lively questions about the GI system.
Example PANCE Questions
Which one of the following statements concerning colon cancer screening is correct??
(A) After the age of 50, a person should obtain a sigmoidoscopy every 10 years.
Physician Assistant Exam
The adrenal gland is important physiologically for practice and the Physician Assistant Exam (PANCE). It’s responsible for the production of cortisol, aldosterone, and the sex hormones as well. You don’t want to miss an abnormally functioning adrenal gland, either in clinical practice or on the PANCE.
The hypothalamus-pituitary-adrenal axis is a mini endocrine system that’s well-connected.
Physician Assistant Exam
Bronchiectasis is a chronic condition characterized by dilation of the alveolar air sacs and covered on the Physician Assistant Exam (PANCE). The airways can become huge and dilated, and affected patients can have difficulty clearing mucous.
Bronchiectasis is usually an irreversible condition secondary to long-standing lung inflammation.
Physician Assistant Exam
The Physician Assistant Exam will expect you to understand that many different kinds of blocks can occur along the cardiac conduction system, from the sinus node to the AV node to the bundle of Purkinje fibers. Here you read about the different blocks of the conduction system and how to evaluate them.
First-degree AV block
First-degree AV block is fairly simple.
Physician Assistant Exam
A malabsorption syndrome is an inability to absorb key nutrients in the small intestine. The Physician Assistant Exam (PANCE) will expect you to have a firm grasp on nutritional deficiencies and celiac disease.
Vitamin deficiencies
Your intestine is responsible for the absorption of many vitamins and nutrients.
Physician Assistant Exam
Every medical professional should know about some common abdominal surgeries. For the Physician Assistant Exam (PANCE), you will need to review evaluating and managing appendicitis, diverticulitis, hernias, volvulus, and spleen problems.
The inflamed appendix
You need to know a lot about evaluating and managing acute appendicitis.
Physician Assistant Exam
There are several conditions that affect the ear and the Physician Assistant Exam will expect you to be familiar with the basics. These conditions include everything from vertigo to problems with earwax.
Vertigo
If you’ve ever had vertigo, you know how debilitating the sensation of the room spinning can be. Vertigo can occur by itself, or it can accompany other symptoms, such as decreased hearing or even tinnitus.
Physician Assistant Exam
You should know about several medical conditions affecting the feet that may pop up on the Physician Assistant Exam (PANCE). Your feet are your friends — they get you where you need to go — and you should care about your friends.
The soft tissues of the foot
Sprains and strains of the foot are common, especially among athletes.
Physician Assistant Exam
For the Physician Assistant Exam, you will need to know about issues affecting the conjunctiva, common medical conditions affecting the eyelid and tear ducts, and problems of the orbit, including infection and orbital trauma. You can see a lot of orbital trauma (in an ER or trauma rotation) as a result of motor vehicle accidents.
Physician Assistant Exam
The Physician Assistant Exam will expect you to know about conditions of the eye, including the lens. The lens of the eye can be affected by several conditions, including cataracts, corneal trauma, and foreign bodies. The latter two conditions you likely saw during your time in the ER.
Cataracts — partly cloudy
Cataracts, or cloudy areas, are a very common condition that affects the lens.
Physician Assistant Exam
Cystic fibrosis is an abnormality of exocrine gland function. It’s important for the Physician Assistant Exam (PANCE) that you understand that this is a disorder of the cystic fibrosis transregulator gene and it messes up the normal flow of the chloride channel. Because the movement of chloride also affects the cellular movement of water, the person may have a lot of thick mucus production.
Physician Assistant Exam
As the Physician Assistant Exam will expect you to know, chest pain (angina pectoris) and congestive heart failure are two of the biggest reasons people are admitted to the hospital. Acute coronary syndrome encompasses many of the reasons that someone comes to the hospital: stable angina, unstable angina, and the infamous myocardial infarction (heart attack).
Physician Assistant Exam
Diastolic heart failure is a problem with the heart’s relaxing. Your Physician Assistant Exam will ask you questions about its causes and treatments.
Common causes include ischemia and hypertension. A major cause is obesity. Diastolic dysfunction, especially with the current obesity epidemic in the United States, is more common than systolic dysfunction, although the two can coexist.
Physician Assistant Exam
Eczema and dermatitis refer to anything that causes skin inflammation, and the causes are covered on the Physician Assistant Exam (PANCE). Dermatitis is a nonspecific term that refers to skin inflammation. Eczema, a type of dermatitis, has some characteristic skin findings — the skin can be flaky, itchy, scaly, and red.
Physician Assistant Exam
Normal red blood cells live for about 3 to 4 months. An understanding of this is important for Physician Assistant Exam (PANCE) purposes. Hemolysis is the destruction of red blood cells in the circulation way before their life span is over. Hemolysis has many causes; one easy way to think about those causes is whether you’re dealing with extravascular hemolysis or intravascular hemolysis:
Extravascular hemolysis: This hemolysis occurs primarily in the reticuloendothelial system (RES).
Physician Assistant Exam
Various conditions affect the ability of the eye to move as it should. For the Physician Assistant Exam, you will need to know about conditions such as strabismus and nystagmus.
Point the eye in the right direction
Strabismus is a disorder of the muscles of the eyes, preventing both eyes from focusing on the same object at the same time.
Physician Assistant Exam
Make sure you review high blood glucose for the Physician Assistant Eam (PANCE). In people with uncontrolled diabetes mellitus, the blood glucose levels can be super duper high, even >= 1,000 mg/dL. High blood sugars due to uncontrolled diabetes mellitus are usually related to either diabetic ketoacidosis or hyperosmolar hyperglycemic nonketotic coma.
Physician Assistant Exam
Several hip-related conditions make regular appearances on the Physician Assistant Exam (PANCE). You should be able to answer questions and know the basics regarding avascular necrosis, hip fractures, hip dislocation, and the slipped capital epiphysis.
Avascular necrosis (AVN)
When a person has a lack of blood supply to the head of the femur over a period of time, avascular necrosis (AVN) can result.
Physician Assistant Exam
The Physician Assistant Exam (PANCE) will expect you to know that when the patient gets out of the OR, your first consideration is ensuring that the patient is hemodynamically stable. Pay attention to the vital signs.
If the blood pressure is low, then he or she needs volume resuscitation to ensure adequate tissue perfusion.
Physician Assistant Exam
One of the most common conditions the Physician Assistant Exam will question you about occurs in the older population and is termed diverticulosis, which is simply an outpouching or formation of pockets of the colonic mucosa through weaknesses in the intestinal wall. This pouching most commonly occurs in the sigmoid colon.
Physician Assistant Exam
Schizophrenia is a psychosis on the Physician Assistant Exam (PANCE) in which the person has significant problems with thinking. The symptoms become so bad they can overtake a person’s life, and the person experiences a detachment from reality. In addition to confused thinking, the affected person often experiences delusions and/or hallucinations.
Physician Assistant Exam
The two big nervous-system infection types you need to be aware of for the Physician Assistant Exam (PANCE) are meningitis and encephalitis. These conditions can be fatal if not quickly recognized and treated. Not knowing about them for the PANCE can be fatal in another way.
Meningitis on the PANCE
Meningitis is an inflammation of the membrane that blankets the spinal cord and brain.
Physician Assistant Exam
It’s not nice to be bitten by insects or spiders — especially spiders. The Physician Assistant Exam (PANCE) will force you to face any fears you have to investigate the body for bites.
Lice
Lice (singular louse) are insects, and they can be anywhere on the body, especially the head. Some people may remember the elementary school nurse checking the kids for head lice.
Physician Assistant Exam
The first part of the general examination that the Physician Assistant Exam (PANCE) will cover is getting a good look at the newborn. By look, this doesn’t mean seeing how cute the baby is. This means looking at the newborn with a medical eye. For example, does the baby have a good pinkish skin color? Is the baby premature or small in stature?
Physician Assistant Exam
Thrombocytopenia is defined as a platelet count of
ITP: Platelet production problems
Idiopathic thrombocytopenic purpura (ITP) is a common cause of low platelets. Only the platelets are affected. The affected person usually has a normal WBC and Hgb/HCT.
When you think about ITP, differentiate between two types: one found in adults and one found in children.
Physician Assistant Exam
On the PANCE, expect to see common clinical scenarios involving very high blood pressure. Be aware of two basic scenarios concerning high blood pressure: hypertensive urgencies and hypertensive emergencies.
Hypertensive urgency concerns someone who presents with really high blood pressure: a systolic blood pressure >= 180 mmHg or a diastolic blood pressure >= 110 mmHg.
Physician Assistant Exam
The Physician Assistant Exam will expect you to be familiar with conditions of the kidney. The kidneys can become inflame in multiple areas so you will need to be familiar with nephritis and vasculitis.
Acute interstitial nephritis (AIN)
Many commonly prescribed medications can cause a type of inflammatory response in the kidney, leading to acute interstitial nephritis (AIN).
Physician Assistant Exam
The Physician Assistant Exam will expect you to be aware of some common causes of renal failure. Acute renal failure (ARF) (or acute kidney injury — AKI) is defined as an abrupt rise in the creatinine (Cr) level or an abrupt decrease in the glomerular filtration rate (GFR) from baseline.
Prerenal azotemia
The easiest kidney-failure-related condition to diagnose is prerenal azotemia.
Physician Assistant Exam
Passing out is never a good thing. When you’re evaluating a Physician Assistant Exam (PANCE) question involving someone who has lost consciousness, you often need to figure out whether the person had a syncopal episode or a seizure.
Fainting: How to recover from syncope
Syncope (fainting) is a condition in which a person loses consciousness and will recover, often spontaneously, without any kind of assistance.
Physician Assistant Exam
The Physician Assistant exams will ask about low blood pressure, along with questions about high blood pressure. Hypotension has many causes, including infection, volume depletion, adrenal insufficiency, anemia, blood pressure medications, and so forth. Because of the depth of this topic, your focus for test purposes should be on the main causes of low blood pressure.
Lung cancer is a leading cause of morbidity and mortality. For the Physician Assistant Exam (PANCE), be familiar with the evaluation, characteristics, and management of lung cancer. The two major types of lung cancer you need to know are small-cell lung cancer and non-small-cell lung cancer.
Lung cancer can manifest in various ways.
Physician Assistant Exam
You should be familiar with the evaluation and treatment of some major mood disorders for the Physician Assistant Exam (PANCE). Mood disorders involve major changes in a person’s emotions. You’re not simply dealing with a “moody individual.”
Major depression and dysthymia
Depression is a very common mood disorder, and it’s one of the main complaints elicited during outpatient visits to one’s primary care provider.
Physician Assistant Exam
For Physician Assistant Exam (PANCE) purposes, the four fundamental types of movement disorders are essential tremors, Parkinson’s disease, Huntington’s disease, and cerebral palsy. Different types of neurologic conditions can present with different types of problems. Some disorders, such as the peripheral neuropathies, present with a sensory type of neuropathy.
Physician Assistant Exam
You should be familiar with the nuts and bolts of myocardial infarction (MI for short) for your Physician Assistant Exams. A person is said to be having an MI if there’s a positive enzyme leak in the blood and accompanying ECG changes. The clinical presentation may not always be reliable. For example, you may miss an MI in a person with diabetes and bad neuropathy.
Physician Assistant Exam
Some conditions cause a narrowing of the esophagus, making swallowing difficult. Here are five conditions that you may encounter on the Physician Assistant Exam (PANCE) and when treating patients in your practice.
Achalasia
Achalasia refers to a failure of the lower esophageal sphincter to relax and failure of the lower esophagus to have meaningful peristalsis.
Physician Assistant Exam
The Physician Assistant Exam (PANCE) will expect you to be familiar with personality disorders. One of the marks of a personality disorder is behaviors or thought processes that are very different from societal norms. The person isn’t making it in life. In addition, the person doesn’t see the behaviors as inappropriate.
Physician Assistant Exam
For Physician Assistant Exam (PANCE) purposes, you should be familiar with routine health prevention screening measures. Many of the cancer screening recommendations, especially for breast and prostate cancer, have been debated. Here are the current general preventive medicine guidelines for cancer and other conditions:
Breast cancer screening: Women under 40 should have a breast examination performed every 3 years by a licensed medical professional and annually after they turn 40.
Physician Assistant Exam
From infection to malignancy, many medical problems can affect the breast. For the Physician Assistant Exam, you will need to know about some breast-related medical conditions and their evaluation and management.
Blocked milk ducts: Mastitis
Mastitis is a bacterial infection in the milk ducts. The most common cause is Staphylococcus aureus.
Physician Assistant Exam
Pulmonary embolism and pulmonary hypertension are two pulmonary circulation conditions that are high-yield for the Physician Assistant Exam (PANCE). And for good reason, too — you see these conditions clinically time and time again.
Blood clots: The pulmonary embolism
As the name suggests, a pulmonary embolism (PE) is an obstruction of the pulmonary artery or one of its many branches due to embolus.
Physician Assistant Exam
The rectum and anus can be sources of Physician Assistant Exam (PANCE) questions. Many of these conditions affecting the rectum and anus are also painful, so when someone says something is “a pain in the butt,” it’s not just an expression.
Patients with hemorrhoids
Hemorrhoids may be external or internal. The ones that can hurt — and the ones that you can see on examination — are the external hemorrhoids.
Physician Assistant Exam
Hypertension comes in two types and both are covered on the Physician Assistant Exam. The first is the essential, or run-of-the-mill, hypertension. The second type of hypertension is resistant hypertension, which refers to high blood pressure that’s resistant to treatment using environmental and lifestyle measures.
Scleroderma, also known as progressive systemic sclerosis (PSS), an autoimmune disease that affects the connective tissues, will be covered on the Physician Assistant Exam (PANCE). The skin is predominantly involved, although various organs, including the lungs and kidneys, can be affected as well. The skin actually becomes tight due to collagen buildup.
Physician Assistant Exam
Pretty much everyone knows what it’s like to hurt the shoulder or upper arm, so it’s important to know for the Physician Assistant Exam (PANCE). Doing much of anything can be difficult, especially if the pain or injury affects the dominant arm. You should know about different derangements of the shoulder and upper arm, namely fractures.
Physician Assistant Exam
For the Physician Assistant Exam (PANCE), you will need to review some very serious and potentially life-threatening stuff: skin conditions where you can lose the outer layer, the epidermis of the skin. Make sure you review desquamating diseases, burns, and a very nonfatal skin condition, alopecia.
Desquamating diseases
Desquamation is the loss or shedding of the outermost layers of the skin.
Physician Assistant Exam
Systolic heart failure is a failure of the heart to work well as a pump. Your Physician Assistant Exam will expect you to know about this type of heart failure. On an echocardiogram, you see this failure as a reduced ejection fraction. Assuming that the heart has a normal ejection fraction of 65 percent, anything less than 50 percent is thought to represent some degree of a pump problem.
Physician Assistant Exam
The Physician Assistant Exam will expect you to know about the kidneys and their job of regulating potassium levels. When the kidneys are not functioning correctly, the body can end up with an excess or shortage of potassium.
Hypokalemia: Not enough K
Hypokalemia (a low potassium level) is a common electrolyte abnormality that can derive from a variety of causes, such as diuretics and diarrhea.
Physician Assistant Exam
The kidneys, of course, regulate electrolyte concentrations. If you work in a hospital setting or are taking the Physician Assistant Exam, no matter what your specialty, you’re interacting with patients who have electrolyte abnormalities, including abnormalities of sodium balance (hyponatremia and hypernatremia) and potassium balance (hypokalemia and hyperkalemia).
Physician Assistant Exam
Lipids are important for the Physician Assistant Exam (PANCE) because any person who goes to see a healthcare provider gets a lipid panel done as part of a comprehensive workup. Most lipid panels show levels for high-density lipoprotein, low-density lipoprotein, triglyceride, and total cholesterol. Author Barry loves reading his own labs, because the computer printout shows the normal range and flags any results that are out of range.
Physician Assistant Exam
Pregnancy is an important topic for Physician Assistant Exam questions. You will need to know about the standard of care for pregnant women as well as about normal labor and delivery.
Prenatal screening
You can find many guidelines for prenatal screening. For the PANCE, think of the screening recommendations in terms of each trimester of the pregnancy.
Physician Assistant Exam
With rheumatologic conditions, Physician Assistant Exam (PANCE) questions focus on discerning one proximal muscle condition from another. Two conditions that sound somewhat similar are polymyositis and polymyalgia rheumatica (PMR). Although both can affect the proximal muscles and have somewhat similar presentations, there are important differences between the two conditions.
Physician Assistant Exam
A lot of health conditions can affect the testes and these will be covered on the Physician Assistant Exam. Not only are the conditions important clinically, but they’re also high-yield for tests. From torsion to cancer to infection, be aware of these conditions.
Torsion
Testicular torsion is a condition you wouldn’t wish on your worst enemy.
Physician Assistant Exam
Cardiovascular doesn’t refer to just the heart; it also refers to the blood vessels. Guess what! For the Physician Assistant Exam (PANCE), you have to worry about the arteries and veins as well as the heart.
The aorta
One scenario you never want to miss is the person with a history of uncontrolled hypertension who presents to the emergency room with acute chest pain radiating to the back or with acute abdominal pain radiating to the back.
Physician Assistant Exam
For the Physician Assistant Exam, it is important that you know about tissues that enter the vaginal canal when they shouldn’t, infections and cancer that affects the vulva. These conditions affect many women and therefore will be covered on the PANCE.
How to treat vaginal infections
Bacterial vaginosis (BV) is caused by bacterial overgrowth, most commonly Gardnerella vaginalis.
Physician Assistant Exam
The Physician Assistant Exam (PANCE) will want you to be aware of the vascular system. Two of the most common vascular problems are transient ischemic attack, so stroke and you can count on them being covered on the PANCE.
The transient ischemic attack
Welcome to the world of the mini-stroke, the transient ischemic attack.
Physician Assistant Exam
As a more common problem, the Physician Assistant Exam (PANCE) will expect you to know the difference between type 1 and type 2 diabetes. Diabetes mellitus (DM) is due to abnormal insulin metabolism in the body. In type 1 diabetes mellitus, the pancreas doesn’t produce insulin, and in type 2, the body resists the actions of insulin.
Physician Assistant Exam
Acne is a common issue that affects many people and will be covered on the Physician Assistant Exam (PANCE). Acne comes in two basic flavors for the test: acne rosacea and acne vulgaris.
Acne rosacea
Acne rosacea is a maculopapular rash on the face and cheeks that can turn the affected area bright red. It’s more common in young to middle-aged females.
Physician Assistant Exam
Hyper- and hypo-pigmentation conditions will be covered on the Physician Assistant Exam (PANCE). There are a number of causes of pigmentation issues. For instance, adrenal insufficiency is a medical condition that can cause hyperpigmentation. Read on to get familiar with a few other pigmentation issues that are likely to be on the PANCE.
Physician Assistant Exam
Behavioral health is an important component of overall health, so you’ll see some questions on the Physician Assistant Exams (PANCE/PANRE) concerning behavioral disorders. These practice questions are similar to the PANCE behavioral health questions.
Example PANCE Questions
You’re examining a 35-year-old man who is exhibiting acute psychotic behavior.
Physician Assistant Exam
Cardiovascular doesn’t refer to just the heart; it also refers to the blood vessels. For the Physician Assistant Exam (known as PANCE), you have to worry about the arteries and veins as well as the heart. These practice questions are similar to the PANCE cardiology and vascular system questions.
Example PANCE Questions
You’re evaluating a 78-year-old man who presents to the emergency room with a heart rate of about 140–150 beats per minute.
Physician Assistant Exam
From rashes to eczema and bacterial infections to viral exanthems, these practice questions are similar to the dermatology questions on the Physician Assistant Exam (PANCE).
Example PANCE Questions
Which one of the following can develop into squamous cell carcinoma over time?
(A) Onychomycosis
(B) Actinic keratosis
(C) Seborrheic keratosis
(D) Psoriasis
(E) Impetigo
You’re evaluating a 25-year-old woman who presents with a rash on her face.
Physician Assistant Exam
The endocrine system is made up of different organs located in separate parts of the body. These practice questions are similar to the Physician Assistant Exam (PANCE) endocrinology questions.
Example PANCE Questions
Which of the following can be used in the evaluation of Addison’s disease?
(A) 24-hour urinary free cortisol
(B) Low-dose dexamethasone suppression test
(C) High-dose dexamethasone suppression test
(D) Morning cortisol level
(E) MRI of the brain
You are seeing a 50-year-old man who has been treated with a diuretic for hypertension and edema.
Physician Assistant Exam
Although the genitourinary system can be complex, it’s actually pretty easy to get a handle on what you need to know for the Physician Assistant Exam (PANCE). Instead of trying to memorize thousands of facts, aim to understand basic principles and recognize key words or phrases in the test questions. The practice questions here give you a sense of what to expect of PANCE GU questions.
Physician Assistant Exam
These practice questions give you a sense of what to expect of hematology and oncology questions on the Physician Assistant Exam (PANCE). They also address important subject areas you need to be familiar with, without regard to the test.
Example PANCE Questions
You’re evaluating a 43-year-old man who presents to the ER with an abnormal complete blood count (CBC).
Physician Assistant Exam
On the Physician Assistant Exams (PANCE/ PANRE), you need to know about nasty bugs known as microorganisms that can wreak havoc on our bodies, as well as their effects, and the drugs used to treat them. These practice questions are similar to the PANCE infectious disease questions.
Example PANCE Questions
You’re evaluating a 35-year-old man who presents with arthritis, fever, urethritis, and conjunctivitis.
Physician Assistant Exam
These practice questions cover many important neurologic subject areas you see on the Physician Assistant Exams (PANCE/PANRE), including headaches, seizures, movement disorders, delirium, and the cerebrovascular accident (CVA).
Example PANCE Questions
You’re evaluating a 50-year-old man who presents with a headache.
Physician Assistant Exam
As a student, you’ve likely seen and evaluated patients with toxic ingestions, fatal or near-fatal drug overdoses, or drug-drug interactions that adversely affected their health. These practice questions are similar to the Physician Assistant Exams (PANCE or PANRE) pharmacology and toxicology questions.
Example PANCE Questions
Which one of the following is true concerning salicylate intoxication?
Physician Assistant Exam
To do well on the Physician Assistant Exams (PANCE or PANRE), you need a good sense of broad-based surgical concepts, not encyclopedic knowledge about a specific topic. One vital area is the surgical signs and symptoms that you’d focus on when performing a history and physical (H&P). You need to know the essentials of a thorough pre-operative assessment (including pre-operative risk) and how to care for the post-operative patient.
Physician Assistant Exam
From sinusitis to orbital cellulitis, there’s a plethora of EENT disorders, and any one of them can surface on the Physician Assistant Exams (PANCE/PANRE). These practice questions are similar to the PANCE questions you may see about eye, ear, nose, and throat conditions.
Example PANCE Questions
You’re evaluating a 34-year-old woman who presents with dizziness, vertigo, and tinnitus in the right ear.
Physician Assistant Exam
Pulmonary embolism and pulmonary hypertension are two pulmonary circulation conditions that are high-yield for the Physician Assistant Exam (known as PANCE). And for good reason, too — you see these conditions clinically time and time again. These practice questions are similar to the PANCE questions about pulmonary matters.
Physician Assistant Exam
More complex pediatric conditions are covered in other disciplines on the Physician Assistant Exam (PANCE) like cardiology, infectious disease, and pulmonary. These practice questions are similar to the ones you may see on the PANCE about pediatric development and conditions confined to pediatric practice.
Example PANCE Questions
Which one of the following is a risk factor for sudden infant death syndrome (SIDS)?
Physician Assistant Exam
Reproductive medicine is a broad topic that covers many obstetric and gynecologic issues, so there will be several questions on the Physician Assistant Exam (PANCE) about this area of medical practice. These practice questions are similar to the reproductive medicine questions you may encounter on the PANCE.
Example PANCE Questions
Which one of the following is true concerning the evaluation of ovarian cysts?
Physician Assistant Exam
As a healthcare professional, you may be evaluated on how well you adhere to preventive medicine guidelines. The Physician Assistant Exam (PANCE) will certainly expect you to know about preventive medicine.
Benjamin Franklin said it best when he said, “An ounce of prevention is worth a pound of cure.” Health maintenance involves different types of prevention, namely primary, secondary, and tertiary prevention.
Physician Assistant Exam
The Physician Assistant Exam will expect you to know the basic problem areas for the prostate. The three basic prostate problems you should be familiar are benign prostatic hyperplasia (BPH), prostatitis, and prostate cancer.
Benign prostatic hyperplasia (BPH)
Benign prostate hyperplasia (BPH) occurs because the prostate gets so big it can block urinary flow by squashing the urethra.
Physician Assistant Exam
You should be familiar with proteinuria for the Physician Assistant Exam. Proteinuria, or protein in the urine, is the single most significant prognostic factor in determining the risk of future kidney disease. The cause of the proteinuria is important, as is the quantity of protein that the kidney excretes.
When evaluating a question concerning proteinuria, keep these points in mind:
In a test question, tipoffs that proteinuria may be present include the appearance of frothy or bubbly urine and/or presence of edema seen on the patient’s exam.
Physician Assistant Exam
Sjögren’s syndrome is an autoimmune condition covered on the Physician Assistant Exam (PANCE). It’s characterized by dry eyes and dry mouth or just dry mouth. Antibodies actually form against the salivary and lacrimal glands.
Sjögren’s syndrome can also affect other organs, including the kidneys — it can cause a form of renal tubular acidosis and low potassium levels.
Physician Assistant Exam
For the Physician Assistant Exam (PANCE), you need to be familiar with various types of skin infections, from bacterial infections to viral infections to cutaneous fungal infections. You’ll see many of these conditions clinically.
How to treat bacterial infections
Most skin infections are caused by Strep or Staph bacteria and can be treated with antibiotics.
Physician Assistant Exam
Skin cancer is a common finding that is covered on the Physician Assistant Exam (PANCE), and it’s usually identified by a person’s primary care provider. The four cutaneous malignancies you should know about for the PANCE/PANRE are Kaposi’s sarcoma, basal cell carcinoma, squamous cell cancer, and melanoma.
Kaposi’s sarcoma
Kaposi’s sarcoma is a purplish maculopapular rash on the extremities and mucous membranes of the body.
Physician Assistant Exam
A physician assistant (PA) is a well-educated healthcare professional who is nationally certified and licensed by the state in which he or she practices. The PA practices medicine under the supervision of a physician. A physician assistant can have a large degree of autonomy, depending on his or her experience and the doctor’s willingness to delegate.
Physician Assistant Exam
The spirochete-related diseases can be debilitating and disabling to the max if they aren’t detected early, as the Physician Assistant Exam (PANCE) will expect you to know. The spirochetes are Gram-negative bacteria. Rocky Mountain spotted fever is also covered, which is caused by a Gram-negative coccobacillus, not a spirochete.
Physician Assistant Exam
You’re sure to see substance abuse questions on the Physician Assistant Exam (PANCE). Substance abuse is a form of substance-related disorder. An excessive or off-purpose use of a substance can be classified as abuse. In many cases, the result is dependence or addiction. In some cases, the result is degeneration of the abuser, leading to illness and death.
Physician Assistant Exam
Doing a thorough history and physical (H&P) is important in practice and for the Physician Assistant Exam (PANCE). Any medical professional should be able to pick up more than 90 percent of the information needed to diagnose the underlying medical condition from the H&P. The key is asking the patient the right historical questions and paying close attention to detail on the physical examination.
Physician Assistant Exam
The Physician Assistant Exam (PANCE) will expect you to know the basics for thyroid cancer. As with thyroid disease in general, thyroid cancer affects women more often than men. The most common clinical presentation is a thyroid nodule.
Other symptoms can include hoarseness and difficulty swallowing. Ask about any prior radiation exposure, especially to the neck area.
Physician Assistant Exam
As the cliché goes, too much of anything is not good. As you should know for the Physician Assistant Exam (PANCE), this rings especially true when you talk about toxic ingestions. Here we’re talking mainly about toxic reactions to nonprescription medications. That includes over-the-counter drugs, street drugs, and a few substances that amount to poison.
Physician Assistant Exam
Many of the Physician Assistant Exam questions concerning acute coronary syndrome involve evaluation, treatment, or both. Because the treatment of acute coronary syndrome overlaps so much with so many conditions, much of the focus is on recognizing clinical presentation and ECG changes. Here are some key points for treating different aspects of acute coronary syndrome:
The standard of care treatment for a STEMI is a trip to the cardiac catheterization lab for an emergent cardiac catheterization, with angioplasty and possible stent.
When you're treating a non-ST elevation myocardial infarction (an NSTEMI), keep OH BATMAN in mind. The mnemonic works for treating unstable angina, too.
O = oxygen: Ischemia implies oxygen deprivation, which leads to increased myocardial oxygen demand and increased myocardial work. The goal of treatment is to reduce the workload of the heart.
Physician Assistant Exam
Many types of congenital heart disease exist. There are certain conditions you’re likely to see on the Physician Assistant Exam (PANCE). Many of the congenital heart diseases you read about here are detected at birth and have telltale signs and features that you need to know.
Atrial septal defect
In atrial septal defect (ASD), someone has a defect or opening in the atrial septum between the right and left atria.
Physician Assistant Exam
Dementia essentially refers to brain degeneration, and it’s irreversible. The Physician Assistant Exam (PANCE) will expect you to know about it because it’s a significant problem, especially in the older population. Alzheimer’s is on the rise, and with the epidemic of obesity, diabetes, and hypertension, you’ll see more and more cases of vascular dementia.
Physician Assistant Exam
For Physician Assistant test-taking purposes, you need to be aware of various conditions that affect the esophagus, like inflammation. Esophagitis is inflammation of the esophagus. You need to know various causes in both immunocompetent and immunocompromised patients.
GERD
Gastrosophageal reflux disease (GERD) reflects a problem with the lower esophageal sphincter (LES).
Physician Assistant Exam
Headaches are a common reason people visit a healthcare provider, and at their worst, headaches can be debilitating. For Physician Assistant Exam (PANCE) purposes, be familiar with migraine headaches, tension headaches, and cluster headaches.
Migraines
Migraine headaches are probably one of the most common forms of headache.
Physician Assistant Exam
On the Physician Assistant Exam (PANCE), you’ll likely be asked to discern not only the pattern of liver injury based on the labs and clinical exam but also the cause and prognosis of that cause. Many of the causes of hepatitis that you’ll see on the test are viral hepatitis.
Hepatitis A
Hepatitis A is a viral form of hepatitis that has a fecal-oral route of transmission and is usually spread through eating contaminated food or water, or coming into direct contact with a person who has hepatitis A.
Physician Assistant Exam
There are different types of myeloproliferative disorders, but for the Physician Assistant Exam (PANCE), focus on polycythemia vera Polycythemia vera is a myeloproliferative disorder (MPD). Myeloproliferative disorders are diseases of the bone marrow that involve increased cell turnover..
Polycythemia is the exact opposite of anemia — too many red blood cells are being produced.
Physician Assistant Exam
Physician Assistant Exam (PANCE or PANRE) questions cover about 18 topics, depending on how you classify them. The approximate mix of questions on the test is well-documented. Some subject areas require more preparation because the test includes more questions about them. You need understanding and knowledge in these two broad categories:
Body organ systems: Know the disorders of the major organ systems, including causative factors, significant labs, and treatment.
Physician Assistant Exam
The three big ventricular problems you need to be aware of and understand for the Physician Assistant Exam (PANCE) are premature ventricular contractions (PVCs), ventricular tachycardia, and ventricular fibrillation. The latter two are life-threatening.
Premature ventricular contractions
Premature ventricular contractions (PVCs) occur commonly.
Physician Assistant Exam
The Physician Assistant Exam will expect you to understand that without the uterus, reproduction couldn’t occur. Several medical problems can affect the uterus. The organ may move out of place, bleed, or contain abnormal tissue growth.
Uterine prolapse
The uterus and other pelvic structures are supported by pelvic muscles and ligaments.
Physician Assistant Exam
You can use the alphabetic classification system to evaluate melanoma, the most aggressive form of skin cancer. This guide helps you determine whether a skin lesion is malignant. The mnemonic is the first five letters of the English alphabet — A, B, C, D, and E. Here are the warning signs:
A = asymmetry: If one side of the lesion differs from the other, the lesion is more likely to be malignant.
Physician Assistant Exam
The most common valvular issues you’ll likely be tested on for your Physician Assistant Exam are problems with the mitral and aortic valves. The other valves are important as well, but the good stuff occurs with the first two valves. Not only should you be familiar with the clinical presentations and causes of some of these valvular problems, but you need to know the pertinent clinical exam findings for each.
Physician Assistant Exam
Many viruses affect children, especially if they haven’t been immunized. Although adults can acquire these viruses, for the Physician Assistant Exam (PANCE), think of them as causing childhood diseases, because that is where they do the most damage.
Measles: Measles is a highly contagious viral syndrome characterized by certain clinical findings.
Physician Assistant Exam
There are several items you will need to make sure you have for test day. Checking in to take the PANCE or PANRE is roughly equivalent to boarding a commercial airline flight, except you don’t have to submit to a random search.
When you arrive at the test center, you must show two forms of valid, current identification.
Physician Assistant Exam
In your practice and for the Physician Assistant Exam you’ll likely deal with the bones a lot. You should know about three big bone disorders, namely osteoporosis, osteoarthritis, and osteomyelitis.
Bone thinning: Osteoporosis
Osteoporosis, which is a loss of bone density, occurs most commonly in women after menopause.
Physician Assistant Exam
A condition that you may encounter is bleeding from the esophagus. For the Physician Assistant Exam (PANCE), be aware of the three types of esophageal bleeding — Mallory-Weiss tears, Boerhaave’s syndrome, and esophageal varices.
Mallory-Weiss tears
Mallory-Weiss tears are tears or lacerations in the distal part of the esophagus.
Physician Assistant Exam
Broadly speaking, pneumonia is an inflammation of the lung, the alveoli in particular. The different types will be covered on the Physician Assistant Exam (PANCE). It’s typically caused by an infection, with bacteria as the most popular players. Pneumonia is highly treatable, but remains a leading killer in some areas of the Third World.
Physician Assistant Exam
The Physician Assistant Exam (PANCE) will expect you to know that the causative organism of tuberculosis (TB) is Mycobacterium tuberculosis. It is transmitted from person to person, usually by respiratory droplets.
Initial symptoms of TB can show a cough that gets progressively worse. There can also be type B constitutional symptoms.
Physician Assistant Exam
The pancreas is an important organ that has many functions in the body, both endocrine and exocrine and will be covered on the Physician Assistant Exam (PANCE). Concerning endocrine function, the pancreas produces insulin, glucagon, and somatostatin (or it’s supposed to). Concerning exocrine function, the pancreas secretes digestive enzymes such as the proteases, lipase, and amylase.
Physician Assistant Exam
The veins are a little easier to deal with than the arteries. For the Physician Assistant Exam (PANCE), be familiar with four venous system conditions: superficial venous thrombophlebitis, varicose veins, venous insufficiency, and deep venous thrombosis.
Superficial venous thrombophlebitis
Superficial venous thrombophlebitis is an infection of a superficial vein.
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