The Daily PANCE and PANRE (Questions 30-60)
Questions 30-60
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Question 1 |
Which of the following is a recommended treatment for proliferative diabetic retinopathy?
A | Topical corticosteroids Hint: Topical corticosteroids are not used to treat diabetic retinopathy. They may be used to reduce inflammation in the eye in certain conditions, but they do not address the underlying issue of abnormal blood vessel growth in the retina. |
B | Laser photocoagulation |
C | Beta blockers Hint: For hypertension, not PDR. |
D | Oral hypoglycemic agents Hint: Oral hypoglycemic agents are used to control blood sugar levels in patients with diabetes but do not treat the underlying cause of diabetic retinopathy. |
E | Anti-glaucoma eye drops Hint: Beta blockers are used to treat conditions such as hypertension, glaucoma, and migraines, but they are not used to treat diabetic retinopathy. |
Question 1 Explanation:
Laser photocoagulation is a commonly used treatment for proliferative diabetic retinopathy (PDR). It involves using a laser to create small burns on the retina, which causes the abnormal blood vessels to shrink and seal off, reducing the risk of bleeding and further damage to the retina. Anti-VEGF drugs can also be injected into the eye to prevent the growth of new blood vessels. Additionally, managing diabetes, including controlling blood sugar, blood pressure, and cholesterol, as well as regular eye exams, are key to slowing the progression of PDR.
Question 2 |
Which of the following agents is effective in the treatment of Parkinson's?
A | penicillin |
B | amantadine |
C | erythromycin |
D | acyclovir |
E | cephalexin |
Question 2 Explanation:
Amantadine (Symmetrel) is somewhat effective. It is used in treating Influenza A. Another choice is selegiline and levodopa/carbidopa. The other mediations listed here are not useful for Parkinson's.
Know Your Content Blueprint
Parkinson's disease is covered in the NCCPA™ Content Blueprint Neurology (6%)
Learn more about Parkinson's disease, watch the explanatory video (click here) and take the interactive lesson quiz: Parkinson Disease
Question 3 |
Laboratory report: elevated serum free T4 low serum TSH level. Which of the following is the MOST likely diagnosis?
A | primary hypothyroidism Hint: Primary hypothyroidism (Hashimoto's) is low T4 with a high TSH. |
B | secondary hypothyroidism Hint: Secondary hypothyroidism (from pituitary disease) is a low T4 with a low TSH. |
C | T3 thyrotoxicosis |
D | Graves’ disease |
E | chronic Hashimoto's thyroiditis |
Question 3 Explanation:
High T4 (hyperthyroid), with a low TSH, indicates that the pituitary is working normally, and the thyroid is hyperactive i.e. Grave's disease. Primary hypothyroidism (Hashimoto's) is low T4 with a high TSH. Secondary hypothyroidism (from pituitary disease) is a low T4 with a low TSH.
Know Your Content Blueprint
Graves disease is covered in the NCCPA™ Content Blueprint Endocrinology (6%)
16-year-old with ADHD presents with chest pain and exophthalmos
Review Topic: HyperthyroidismQuestion 4 |
The results of a barium esophagram reveal esophageal webbing in a woman with long-standing iron deficiency anemia. Her diagnosis is:
A | Barretts esophagus Hint: Barrett's causes GERD symptoms and dysplasia of the esophageal mucosa. |
B | achalasia Hint: Achalasia is a primary neurologic problem of the esophagus causing dysphagia. |
C | Plummer-Vinson syndrome |
D | Dressler's syndrome |
E | Ogilvie's syndrome |
Question 4 Explanation:
Plummer-Vinson is something to know for those who want a 100% on the exam. There is no need to memorize this. More importantly, webbing in the distal esophagus with no other symptoms but dysphagia would be a Schatzki’s ring (much more common). Barrett's causes GERD symptoms and dysplasia of the esophageal mucosa. Achalasia is a primary neurologic problem of the esophagus causing dysphagia.
Know Your Content Blueprint
Diseases of the esophagus are covered in the NCCPA™ GI and Nutrition Content Blueprint
Review the PANCE/PANRE diseases of the esophagus which covers esophagitis, motility disorders, Mallory Weiss tears, esophageal neoplasms, esophageal strictures, and esophageal varices: Diseases of the Esophagus (PEARLS)
Question 5 |
Which of the following agents has a mechanism of action that does not involve beta-receptors?
A | epinephrine Hint: Ritodrine and epinephrine cause beta sympathetic stimulation |
B | albuterol Hint: Albuterol is a beta agonist. |
C | propranolol Hint: Propranolol is a beta blocker. |
D | prazosin |
E | ritodrine Hint: Ritodrine and epinephrine cause beta sympathetic stimulation |
Question 5 Explanation:
Of these choices, prazosin is an alpha-blocker. Ritodrine and epinephrine cause beta sympathetic stimulation. Albuterol is a beta agonist. Propranolol is a beta blocker.
Know Your Content Blueprint
Prazosin is an alpha-blocker often used in the treatment of BPH. It causes urethral relaxation and rapid symptom relief. This is covered as part of the NCCPA™ Content Blueprint Genitourinary System (6%)
Learn more about benign prostatic hyperplasia and the appropriate treatment options at SMARTY PANCE Benign prostatic hyperplasia
Question 6 |
A 6-year-old male is brought into your office for evaluation of his gait. You note that when ambulatory, the medial aspects of his knees are far apart and his feet are unusually close together. Which of the following best describes this condition?
A | cubitus valgus |
B | cubitus varus |
C | genu valgus Hint: Valgus deformity forms an "L" in the knock-kneed child, and has an "L" in the middle of it (try it, it works) |
D | genu varum |
E | Legg-Calve-Perthes disease |
Question 6 Explanation:
This is genu varum (bow legs). Valgus deformity forms an "L" in the knock-kneed child, and has an "L" in the middle of it (try it, it works)
Know Your Content Blueprint
You can read more about disorders of the knee as part of the NCCPA™ Content Blueprint Musculoskeletal System (10%)
Review Topic: Disorders of the Knee (PEARLS)
Question 7 |
A female presents complaining of a grayish, watery vaginal discharge. The KOH prep does not reveal any hyphae. Clue cells are identified on the wet mount. A paucity of WBCs are noted. What diagnosis is most likely?
A | Gonorrhea |
B | Chlamydia |
C | Candidiasis |
D | bacterial vaginosis |
E | Trichomoniasis |
Question 7 Explanation:
Clue cells mean BV.
Know Your Content Blueprint
Bacterial Vaginosis is covered in the NCCPA™ Content Blueprint Reproductive System (8%)
- FISHY, grey, scant, THIN, STICKY
- PH > 4.5 (BACTERIA = BASIC)
- Wet-prep shows epithelial cells with bacteria coating on surface = “clue cells”
- KOH testing causes the release of amine odor (+ whiff test)
- First Line Treatment:
- Metronidazole: 500 mg PO b.i.d. × 7 days
- Metronidazole gel 0.75%: 5 g intravaginally daily × 5 days
- Clindamycin 2% cream: 5 g intravaginally qhs × 7 days
Question 8 |
You note polygonal, purple, papular lesions involving the flexor surfaces of a patient's wrists. The patient has no other lesions. The lesions appear to follow a linear pattern of distribution. What is this phenomenon?
A | Auspitz sign Hint: Auspitz sign is also present in psoriasis where the scales bleed when removed. |
B | Koebner's phenomenon |
C | Darier's sign Hint: Darier's sign is in allergic patients who develop urticaria when the skin is rubbed. |
D | Gorlin's sign Hint: Gorlin's sign is seen in Ehlers-danlos when a patient can touch the tip of the nose with his tongue (I learn something new every day!!) |
E | Gottron's papules Hint: Gottron's papules are purple papules on the fingers seen in dermatomyositis. |
Question 8 Explanation:
Koebner's phenomenon is described - it suggests psoriasis. Auspitz sign is also present in psoriasis where the scales bleed when removed. Darier's sign is in allergic patients who develop urticaria when the skin is rubbed. Gottron's papules are purple papules on the fingers seen in dermatomyositis. Gorlin's sign is seen in Ehlers-Danlos when a patient can touch the tip of the nose with his tongue (I learn something new every day!!) These last two are not important to know.
Know Your Content Blueprint
Question 9 |
A 6-year-old female presents complaining of right ear pain. The tympanic membrane cannot be well visualized. She complains of pain when the tragus is manipulated. Several periauricular lymph nodes are easily palpable. Which of the following is the most likely diagnosis?
A | acute otitis media Hint: OM would not cause periauricular nodes and tragal tenderness. |
B | acute otitis externa |
C | eustachian tube dysfunction Hint: Eustachian tube dysfn would cause middle ear pain (like when you're up in a plane). |
D | Ramsey-Hunt syndrome Hint: Ramsey- Hunt is herpes zoster of the ear canal and would be visible. |
E | perforated tympanic membrane Hint: A perforated TM would cause middle ear, not external ear pain (typically). |
Question 9 Explanation:
OE is described here.
- OM would not cause periauricular nodes and tragal tenderness.
- Eustachian tube dysfunction would cause middle ear pain (like when you're up in a plane).
- Ramsey- Hunt is herpes zoster of the ear canal and would be visible.
- A perforated TM would cause middle ear, not external ear pain (typically).
Know Your Content Blueprint
Acute otitis externa is covered in the NCCPA™ Content Blueprint EENT (9%)
Review Topic: Otitis Externa
Question 10 |
A 51-year-old male with renal artery stenosis and an elevated BUN and creatinine is newly diagnosed as hypertensive. Which of the following agents should be avoided?
A | hydrochlorothiazide-triamterene |
B | prazosin |
C | nifedipine |
D | verapamil |
E | furosemide |
Question 10 Explanation:
This is a potassium-sparing diuretic and should be avoided in anyone with renal disease. ACEI should be avoided as well (but none of these are ACEI's).
Know Your Content Blueprint
Renal artery stenosis is covered in the NCCPA™ Content Blueprint Genitourinary System (6%)
Pearl: Renal arteriography is the gold standard for diagnosis
Review Topic: Renal Vascular Disease
Question 11 |
A patient at a Christmas party on a cruise ship develops a terrible headache. His blood pressure is 224/158 mm Hg. Which of the following agents is this patient most likely taking regularly?
A | tricyclic antidepressants |
B | barbiturates |
C | benzodiazepines |
D | monoamine oxidase inhibitors |
E | phenothiazines |
Question 11 Explanation:
This is a typical scenario for MAOI induced malignant hypertension from eating the "wrong" foods, which are frequently found on a Christmas buffet, (cheese, sausages, red wine, etc.).
Know Your Content Blueprint
Malignant hypertension is covered in the NCCPA™ Content Blueprint Cardiology (16%)
Learn more about malignant hypertension and other hypertensive emergencies at SMARTY PANCE Retinal Hypertensive Emergencies
Question 12 |
A patient with known hyperlipidemia, taking clofibrate, presents to your office complaining of severe myalgias and weakness. He has noted a dark color to his urine. The laboratory calls with a panic value CPK of 8500. He was recently started on a new medication, four days earlier. Which of the following is most likely the new medication?
A | lovastatin |
B | hydrochlorothiazide |
C | dexamethasone |
D | phenytoin |
E | ampicillin |
Question 12 Explanation:
Statin + fibrate = suspicion for rhabdomyolysis in a patient with myalgias, ALWAYS order a CPK. (statin alone, or fibrate alone may cause it too, but the combination is most likely)
Know Your Content Blueprint
Hyperlipidemia is covered in the NCCPA™ Content Blueprint Endocrinology (6%)
Learn more about the two endocrine topics covered under lipid disorders and take note of these important "pearls" at SMARTY PANCE Lipid Disorders (PEARLS)
Take The Endocrine Exam: 72 Question Endocrine Exam
Question 13 |
A female patient presents for an evaluation for primary amenorrhea. She is noted to be short of stature and have short fourth metacarpals. What diagnosis do you suspect?
A | XO |
B | XXY Hint: XXY is the genotype for Klinefelter's (which is a tall, mildly retarded male). |
C | XXX Hint: Trisomy 21 is Down's.
|
D | XXXY |
E | Trisomy 21 |
Question 13 Explanation:
This is the genotype for Turner's syndrome.
- XXY is the genotype for Klinefelter's (which is a tall, developmetally delayed male).
- Trisomy 21 is Down's.
- The other two are not common genotypes.
Know Your Content Blueprint
Amenorrhea is covered in the NCCPA™ Content Blueprint Reproductive System (8%)
Review Topic: Amenorrhea
Question 14 |
An 18-year-old female presents after completing her freshman year at college. Two months ago, she developed "bronchitis" which has persisted. She has become increasingly tired and has frequent night sweats. A chest x-ray today reveals a left mediastinal mass. What is the next step in her evaluation?
A | repeat the chest x-ray in six months |
B | ultrasound of the left hemithorax |
C | bone scan |
D | CT scan of the chest |
E | proceed directly to bronchoscopy with biopsy |
Question 14 Explanation:
Any patient presenting with mediastinal nodes should have a CT. This patient may have sarcoid or Hodgkin's or another type of cancer - CT is indicated.
Know Your Content Blueprint
There are 32 respiratory disorders covered in NCCPA™ Content Blueprint Pulmonology System (12%)
Browse the Content Blueprint and learn more about sarcoidosis, Hodgkin's Lymphoma other causes of hilar lymphadenopathy such as histoplasmosis.
Question 15 |
An elderly patient is recovering from a pneumonia caused by Influenza. Suddenly, the patient's condition deteriorates. You order a chest x-ray that demonstrates an air-fluid level, suggestive of an abscess. You empirically begin treatment for:
A | Streptococcal pneumoniae |
B | Chlamydia |
C | Haemophilus influenzae |
D | Staphylococcus aureus |
E | Legionella pneumophila |
Question 15 Explanation:
Empyema (lung abscess) is almost always staph aureus. While strep pneumo is the most common CAP, when a complication like empyema occurs, it is almost always staph.
Know Your Content Blueprint
There are four types of pneumonia covered in the NCCPA™ Content Blueprint Pulmonary System (12%)
Learn more about these different types of pneumonia and the key terms used to differentiate between the various forms: Pneumonia (PEARLS)
Question 16 |
A 17-year-old male is stabbed in the anterior chest with an ice pick. He quickly becomes hypotensive, tachycardic and obtunded. His breath sounds are equal, his neck veins are distended, and his chest x-ray is normal. What condition is most likely?
A | Simple pneumothorax Hint: The "normal CXR" is what rules out the pneumothorax - another common problem in a stabbing injury.) |
B | Tension pneumothorax Hint: The "normal CXR" is what rules out the pneumothorax - another common problem in a stabbing injury. |
C | Pericardial Tamponade |
D | aortic laceration distal to the origin of the left common carotid artery |
E | inferior vena cava laceration |
Question 16 Explanation:
This is the typical clinical presentation of tamponade (hypotension, JVD). He was stabbed and probably has a mediastinal bleed (so, I think the mediastinum would be widened on his chest film — but the "normal CXR" is what rules out the pneumothorax - another common problem in a stabbing injury.
Know Your Content Blueprint
Pericardial Tamponade is covered in the NCCPA™ Content Blueprint Cardiology System (16%)
Learn more about pericardial tamponade and take the cardiology comprehensive exam at SMARTY PANCE Cardiac Tamponade
Question 17 |
A 48-year-old male presents with crushing chest pain for 45 minutes. He is diaphoretic, nauseous and short of breath. His EKG demonstrates 4 mm of ST segment depression in leads I, aVL, V5 and V6. What is the most likely diagnosis?
A | esophageal spasm |
B | hiatal hernia |
C | acute lateral wall subendocardial myocardial ischemia |
D | acute inferior wall myocardial subendocardial ischemia Hint: Inferior AMI is leads II, III, avF |
E | acute anterior wall myocardial transmural ischemia Hint: Anterior wall AMI is leads +- VI, with V2-V4, and maybe V5& V6. |
Question 17 Explanation:
It is obvious this patient is having an AMI. The ECG lead abnormalities suggest occlusion of the high lateral and low lateral walls of the LV - typically supplied by the circumflex - there are no Q waves - so subendocardial. Inferior AMI is leads II, III, avF. Anterior wall AMI is leads +- VI, with V2-V4, and maybe V5& V6.
Know Your Content Blueprint
There are two forms of acute MI covered in the NCCPA™ Content Blueprint Cardiology (16%)
Learn more about coronary heart disease, take an EKG rhythm strip quiz, study the cardiology flashcards or take the cardiology comprehensive exam
Question 18 |
A 14-month-old female is brought to your office with a 1-day history of a fever of 101 degrees rectally. Suddenly, today, the parent noted small red spots that became bumps and are now blisters. The majority of the lesions are on the thorax. Each vesicle resides on its own erythematous base. The most likely diagnosis is:
A | shingles |
B | Ramsay-Hunt syndrome |
C | erythema infectiosum |
D | herpes simplex |
E | varicella |
Question 18 Explanation:
This is a typical presentation of varicella (chicken pox).
Know Your Content Blueprint
Varicella (chickenpox) and Herpes Zoster (shingles) are covered in both the NCCPA™ Content Blueprint Dermatology System (5%) as well as NCCPA™ Content Blueprint Infectious Disease (3%)
Learn more about varicella virus infections, check out this summary of PANCE and PANRE dermatology pearls and review ReelDx derm cases such as this detailing Herpes Simplex (ReelDx)
Question 19 |
A 35-year-old male complains of acute left eye pain immediately after he struck a nail with a hammer. On examination, you note that the left pupil is elliptical. What diagnostic test/procedure will most likely confirm your diagnostic suspicion?
A | fluorescein staining of the eye Hint: Fluorescein staining is for a corneal abrasion - it should not be done if the globe is penetrated |
B | pressing on the globe to assess intraocular pressure Hint: See C for explanation |
C | an X-ray of the orbits |
D | testing the extra-ocular eye muscles Hint: See C for explanation |
E | having the patient finger count Hint: See C for explanation |
Question 19 Explanation:
This patient struck a nail (think metal splinter), pain was immediate (as the splinter entered his eye). His pupil is elliptical, indicating penetration of the globe. He needs X-ray of the globe to look for the metal splinter. Fluorescein staining is for a corneal abrasion - it should not be done if the globe is penetrated.
Know Your Content Blueprint
Ocular foreign bodies are covered in NCCPA™ Content Blueprint EENT (9%)
Learn more about ocular foreign bodies and study these 107 ENT PANCE and PANRE Flashcards
Question 20 |
This drug causes gingival hyperplasia and hirsutism. At high doses it can cause nystagmus, ataxia and diplopia. Which drug is best described by these statements
A | aspirin |
B | acetaminophen |
C | acyclovir |
D | phenytoin |
E | valproic acid |
Question 20 Explanation:
Dilantin (phenytoin) causes these typical symptoms.
Know Your Content Blueprint
Phenytoin is used in the treatment of seizure disorder and is covered in NCCPA™ Content Blueprint Neurology (6%)
Learn more about the management of seizure disorder and take the Neurology Comprehensive Exam
Question 21 |
Which of the following choices is associated with meconium staining of the amniotic fluid?
A | bowel obstruction |
B | peeling of the infant's skin |
C | aspiration pneumonitis and respiratory distress syndrome |
D | infection with E. coli |
E | intrauterine cataract formation and sensorineural hearing loss |
Question 21 Explanation:
When the infant has meconium in the amniotic fluid, he has been in distress, and the meconium is frequently aspirated prior to delivery and can cause pneumonitis and respiratory distress syndrome in the neonate.
Know Your Content Blueprint
Respiratory distress syndrome is covered in the NCCPA™ Content Blueprint Pulmonary System (12%)
Learn more about ARDS as well as Hyaline membrane disease and take the 143 question PANCE and PANRE pulmonary exam
Question 22 |
A 32-year-old male presents after slipping and falling off the roof of his home and striking his head. He suffered a brief loss of consciousness. Since that time, he has noted increasing urination and thirst. His serum chemistries reveal an elevated sodium level. His urine specific gravity is 1.003. Which of the following is the most likely diagnosis?
A | cerebral contusion |
B | subarachnoid hemorrhage |
C | epidural hematoma |
D | diabetes insipidus |
E | renal contusion |
Question 22 Explanation:
Diabetes insipidus (ADH deficiency) can occur after acute head trauma. ADH is secreted by the posterior pituitary gland and causes the body to retain fluid (to increase volume). In a patient who has damaged the posterior pituitary, ADH is not secreted, so the body urinates "water". There is frequent large volume urination with a very low specific gravity, and will cause hypernatremia unless the patient is given large quantities of water to drink.
Know Your Content Blueprint
Diabetes insipidus is covered in the NCCPA™ Content Blueprint Endocrinology (6%)
Learn more about diabetes insipidus, watch the ReelDX patient video case and take the lesson quiz at SMARTYPANCE Diabetes Insipidus
Question 23 |
You are educating a patient that has just been advised that he has "polyps" in his colon. Which of the following statements is FALSE?
A | The larger the colonic polyp, the greater the risk of malignant transformation |
B | Villous adenomas have a 30-70% risk of malignant transformation |
C | The greater the number of concomitant colonic polyps, the greater the risk of malignant transformation |
D | The majority of colonic polyps are hyperplastic in origin |
E | The majority of colonic polyps are > 3 cm in size |
Question 23 Explanation:
Most polyps are, in fact, quite small. All the rest of these statements are true.
Know Your Content Blueprint
Colonic polyps are covered in the NCCPA™ Content Blueprint GI and Nutrition System (10%)
Learn more about the management of colonic polyps as well as colon cancer and take the lesson quiz at SMARTY PANCE Polyps
Take the Comprehensive 142 Question GI and Nutrition Exam
Question 24 |
Wolf-Parkinson-White (WPW) and Lown-Ganong-Levine (LGL) syndrome are both characterized by:
A | left ventricular dysfunction |
B | a shortened PR interval |
C | the presence of delta waves |
D | large pericardial effusions |
E | marked left ventricular hypertrophy |
Question 24 Explanation:
WPW & LGL both have short PR intervals. WPW also has a "delta wave" and predisposes the patient to supraventricular tachyarrhythmias.
Know Your Content Blueprint
Wolff-Parkinson White is covered in the NCCPA™ Content Blueprint Cardiology System (16%)
Review Topic: Paroxysmal Supraventricular Tachycardia
Question 25 |
A patient that you are examining for carpal tunnel syndrome reveals that her paresthesias occur in all five digits. Which digit does NOT experience paresthesias with median nerve neuropathy?
A | first (thumb) |
B | second (index) |
C | third (long) |
D | fourth (ring) |
E | fifth (pinky) |
Question 25 Explanation:
The fifth finger is ALWAYS innervated by the ulnar nerve, and would not be affected in a true carpal tunnel syndrome.
Know Your Content Blueprint
Carpal tunnel syndrome is part of the NCCPA Content Blueprint Musculoskeletal System (10%)
Watch appropriate diagnostic exams, watch the ReelDx patient video and review lesson flashcards at SMARTY PANCE Soft tissue injuries of the forearm, wrist, and hand
Question 26 |
A 22-year-old female complains of vaginal bleeding for 24 hours. Her last menstrual cycle was seven weeks ago. She has had an IUD, but currently uses no form of contraception. Her HCG is positive. She denies fever, chills and vaginal discharge, prior to the onset of the vaginal bleeding. You order a pelvic ultrasound to rule out:
A | cervicitis. |
B | pelvic inflammatory disease. |
C | dysfunctional uterine bleeding. |
D | an ectopic pregnancy. |
E | vaginitis. |
Question 26 Explanation:
Any patient with an IUD, or with a tubal ligation, or known obstruction of a tube, who has a positive HCG needs an ultrasound to r/o ectopic pregnancy.
Know Your Content Blueprint
Ectopic pregnancy is part of the NCCPA Content Blueprint Reproductive System (8%)
Review Topics: complicated pregnancy (pearls) and ectopic pregnancy
Question 27 |
The examination of a 26-year-old male demonstrates a "bag of worms" consistency within the left hemiscrotum. This finding is suggestive of a(n):
A | acute case of balanitis |
B | varicocele |
C | hydrocele Hint: Hydrocele is just a water collection in the scrotum. |
D | spermatocele Hint: Spermatocele is just a fluid collection which happens to contain sperm (sperm are not palpable). |
E | paraphimosis |
Question 27 Explanation:
This is a description of varicocele (varicose veins of the scrotum). Hydrocele is just a water collection in the scrotum. Spermatocele is just a fluid collection which happens to contain sperm (sperm are not palpable).
Know Your Content Blueprint
Hydrocele and Varicocele are part of the NCCPA Content Blueprint Genitourinary System (6%)
Learn more about GU tract conditions and watch a ReelDx patient video at Hydrocele/Varicocele (ReelDx)
Question 28 |
A patient presents with a recurrent history of swelling on the right side of the jaw that begins while eating and subsides within two hours postprandially. You suspect:
A | hypochondriasis |
B | sialolithiasis |
C | parotitis Hint: Parotitis would be inflammation and infection of the parotid gland (usually due to a stone that is stuck in the duct). A parotitis patient would be acutely ill with redness of the gland and fever. |
D | an abscessed tooth |
E | conjunctivitis manibularis |
Question 28 Explanation:
Sialo(salivary gland) lithiasis (stone) is described in this question. Parotitis would be inflammation and infection of the parotid gland (usually due to a stone that is stuck in the duct). A parotitis patient would be acutely ill with redness of the gland and fever.
Know Your Content Blueprint
Sialolithiasis and Sialadenitis are part of the NCCPA Content Blueprint EENT (9%).
Brush up on your PANCE/PANRE mouth and throat disorders (pearls) and review the treatment of sialadenitis.
Question 29 |
Which of the following is the earliest manifestation of diabetic nephropathy?
A | proteinuria |
B | a progressive decline in the creatinine clearance |
C | an elevated serum haptoglobin |
D | renal insufficiency |
E | microalbuminuria |
Question 29 Explanation:
Tiny amounts of albumin (microalbumin) show up first - but need a special test ordered to detect it. Intervention at this point with an ACEI prolongs the length of time before the patient progresses to albuminuria (noted on a typical urine "dip").
Know Your Content Blueprint
Diabetes mellitus and its complications are part of the NCCPA Content Blueprint Endocrine System (6%)
Review diabetes mellitus pearls and flip through the high yield flashcards
Question 30 |
Fluid from a thoracentesis is grossly purulent. The effusion from which this fluid was aspirated is best described as a(n):
A | loculated effusion |
B | chylothorax Hint: Chylo thorax suggest a transudative effusion (not purulent). |
C | empyema |
D | hydrothorax Hint: hydro thorax suggest a transudative effusion (not purulent). |
E | hemothorax Hint: hemothorax is blood. |
Question 30 Explanation:
A grossly purulent tap would suggest staph (empyema).
- Loculated effusion does not describe either a trans or exudative effusion.
- Chylo and hydro thorax suggest a transudative effusion (not purulent).
- And hemothorax is blood.
Know Your Content Blueprint
Pleural effusion is covered in the NCCPA Content Blueprint Pulmonary (12%)
Learn more about the NCCPA Content Blueprint topic pleural diseases (pearls) and read up on pleural effusions
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