Episodios

  • Episode 109: The Audio PANCE and PANRE Board Review Podcast

    Episode 109: The Audio PANCE and PANRE Board Review Podcast
    Mar 12 2025
    Listen to Podcast Episode 109: Ten PANCE, PANRE, and Rotation Review Questions If you can't see the audio player, click here to listen to the full episode. Welcome to episode 109 of the Audio PANCE and PANRE Physician Assistant/Associate (PA) Board Review Podcast. Join me today as we cover ten board review questions for your PANCE, PANRE, EOR, and EOC exams. Resources and links from today's episode: View my PANRE-LA Performance Score and see my process for taking PANRE-LA Questions Learn all about the new Smarty PANCE QBank Sign up for our PANCE and PANRE Test-taking Masterclass Sign up for the Entire Blueprint Email Series Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram and Facebook Join the Smarty PANCE Member's Community, then sign up for a study group to get updates about upcoming webinars I hope you enjoy this free audio component of the examination portion of this site. Smarty PANCE includes over 2,000 interactive board review questions, along with flashcards, ReelDx cases, integrated Picmonics, and lessons covering every blueprint topic available to all Smarty PANCE members. You can download and listen to past FREE episodes here, on iTunes, Spotify, Amazon Music, and all podcasting apps. On each episode page, you can listen to all the latest episodes, take interactive quizzes, and download more resources. Interactive Exam to Complement Today's Podcast 1. A 70-year-old man presents for evaluation of poorly controlled hypertension despite adherence to five different classes of antihypertensive medications. His medical history includes coronary artery disease with a myocardial infarction 3 years ago, peripheral artery disease, and type 2 diabetes mellitus. He reports no changes in his medication regimen and denies any recent lifestyle modifications. Physical examination reveals a blood pressure of 190/110 mm Hg in the left arm and 180/100 mm Hg in the right arm. His BMI is 24 kg/m². On auscultation, there is no abnormal heart sound. Which of the following additional findings is most likely to be seen in this patient? A. Elevated serum aldosterone-to-renin ratio B. Continuous murmur over the carotid arteries C. Diminished femoral pulses D. Continuous bruit in the lateral periumbilical area E. Pitting edema in the lower extremities Answer and topic summary The answer is D. Continuous bruit in the lateral periumbilical area Renal artery stenosis is a significant cause of secondary hypertension, particularly in patients with a history of atherosclerotic disease, as seen in this patient with coronary artery disease and peripheral artery disease. Resistant hypertension, uncontrolled despite multiple medications, is a hallmark. A continuous bruit in the lateral periumbilical area indicates turbulent blood flow through a narrowed renal artery, supporting this diagnosis. Incorrect Answers: A. Elevated aldosterone-to-renin ratio suggests primary aldosteronism, less likely given the atherosclerotic history pointing to renal artery stenosis. B. A carotid murmur indicates carotid artery disease, unrelated to this hypertension scenario. C. Diminished femoral pulses align with peripheral artery disease, but don’t explain the resistant hypertension. E. Pitting edema suggests heart failure or venous insufficiency, not specific to renal artery stenosis. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Renal System ⇒ Congenital or structural renal disorders ⇒ Renal vascular disease 2. A 70-year-old woman comes to the emergency department due to sudden-onset chest pain followed by shortness of breath. The pain started 2 hours ago, and she experienced an episode of syncope lasting about 1 minute shortly after the pain began. She has a history of untreated hypertension and hyperlipidemia. Blood pressure is 180/95 mm Hg in both arms; pulse is 110/min and irregular; and respirations are 22/min.
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    38 m
  • Podcast Episode 108: Did You Miss Us? The Audio PANCE and PANRE is Back!

    Podcast Episode 108: Did You Miss Us? The Audio PANCE and PANRE is Back!
    Aug 14 2024
    Listen to Podcast Episode 108: Ten PANCE, PANRE, and Rotation Review Questions If you can't see the audio player, click here to listen to the full episode. Welcome to episode 108 of the Audio PANCE and PANRE Physician Assistant/Associate (PA) Board Review Podcast. Join me today as we cover ten board review questions for your PANCE, PANRE, EOR, and EOC exams. Resources and links from today's episode: Sign up for our new PANCE and PANRE Test-taking Masterclass Review the Asthma GINA guidelines and the lung cancer screening guidelines Sign up for the Entire Blueprint Email Series Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram and Facebook Join the Smarty PANCE Member's Community, then sign up for a study group to get updates about upcoming webinars. I hope you enjoy this free audio component of the examination portion of this site. Smarty PANCE includes over 2,000 interactive board review questions, along with flashcards, ReelDx cases, integrated Picmonics, and lessons covering every blueprint topic available to all Smarty PANCE members. You can download and listen to past FREE episodes here, on iTunes, Spotify, Amazon Music, and all podcasting apps. On each episode page, you can listen to all the latest episodes, take interactive quizzes, and download more resources. Interactive exam to complement today's podcast 1. A 25-year-old woman comes to the office due to fatigue and dizziness for the past several months. She works as a nurse and finds it increasingly difficult to complete her shifts. The patient reports heavy menstrual periods lasting 7-8 days each month. She has no significant medical history and is not on any medications. Blood pressure is 100/60 mm Hg and pulse is 75/min. BMI is 22 kg/m². Physical examination reveals pale conjunctivae and spoon-shaped nails. Hemoglobin is 8.5 g/dL. Which of the following sets of additional laboratory findings is most likely to be seen in this patient? A. Low ferritin, high TIBC, low serum iron B. High ferritin, low TIBC, high serum iron C. Low ferritin, low TIBC, high serum iron D. High ferritin, high TIBC, low serum iron E. Low ferritin, high TIBC, high serum iron Answer and topic summary The answer is A. Low ferritin, high TIBC, low serum iron The most likely additional laboratory findings in this patient are low ferritin, high total iron-binding capacity (TIBC), and low serum iron, which are indicative of iron deficiency anemia. Her history of heavy menstrual periods and symptoms of fatigue and pallor suggest chronic blood loss leading to iron deficiency. Ferritin is a marker of iron stores, and low levels indicate depletion of iron reserves. High TIBC reflects increased capacity of the blood to bind iron due to low iron levels. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Hematology ⇒ Cytopenias ⇒ Anemias ⇒ Iron deficiency 2. A 4-year-old girl presents with fever and neck pain. She has had a runny nose, cough, and sore throat for the past five days. Two days ago, she developed a high fever and worsening neck pain, and today, she has refused to eat or drink. Her immunizations are up to date. Temperature is 39.5°C (103.1°F), pulse is 130/min, and respirations are 26/min. Examination reveals bilateral anterior cervical lymphadenopathy, a muffled voice, and trismus. The child holds her neck stiffly and resists any movement. The tonsils are erythematous and covered with white exudates. Lateral neck radiograph reveals a widened prevertebral space. Which of the following is the most likely diagnosis? A. Epiglottitis B. Peritonsillar abscess C. Retropharyngeal abscess D. Bacterial tracheitis E. Acute bacterial sinusitis Answer and topic summary The answer is C. Retropharyngeal abscess Retropharyngeal abscess is the most likely diagnosis given the presentation of fever, neck pain, refusal to eat or drink, trismus,
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    35 m
  • Podcast Episode 107: This vs. That – PANCE Blueprint Comparisons You Need to Know (Part 1)

    Podcast Episode 107: This vs. That – PANCE Blueprint Comparisons You Need to Know (Part 1)
    Aug 15 2023
    Listen to Podcast Episode 107: This vs. That - PANCE Blueprint Comparisons You Need to Know (Episode 1) In today's session, we will be discussing five questions related to PANCE/PANRE Blueprint topics. These questions will cover similar presentations and crucial comparisons that are important for you to know. These topics are often used by PANCE/PANRE test question writers, so it's essential to learn how to differentiate between them. This is the first part (episode 1) of a series. If you can't see the audio player, click here to listen to the full episode. Links from today's episode: Sign up for our new PANCE and PANRE Test-Taking Masterclass. Check out my first blog in our "This vs. That" Blueprint series: The PANCE Blueprint Showdown: Crohn's Disease vs. Ulcerative Colitis. Want a question of the day that covers the Blueprint - ALL of it? Sign up for the Entire Blueprint Email Series. Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram and Facebook for more daily questions. Join the Smarty PANCE Member's Community, then sign up for a study group to get updates about upcoming webinars. I hope you enjoy this free audio component of the examination portion of this site. Smarty PANCE includes over 2,000 interactive board review questions, along with flashcards, ReelDx cases, integrated Picmonics, and lessons covering every blueprint topic available to all Smarty PANCE members. You can download and listen to past FREE episodes here, on iTunes, Spotify, Google Podcasts, Stitcher, Amazon Music, and all podcasting apps. You can listen to all the latest episodes, take interactive quizzes, and download more resources on each episode page. Interactive exam to complement today's podcast 1. A 32-year-old woman presents with a 6-month history of loose bowel movements, approximately eight per day. Blood has been present in many of them. She has lost 30 pounds. For the past 6 weeks, she has had intermittent fever. She has had no previous gastrointestinal (GI) problems, and there is no family history of GI problems. On examination, the patient looks ill. Her blood pressure is 130/ 70 mm Hg. Her pulse is 108 beats/ minute and regular. There is generalized abdominal tenderness with no rebound. A sigmoidoscopy reveals a friable rectal mucosa with multiple bleeding points. Which of the following is the most likely diagnosis? A) Crohn's Disease B) Ulcerative Colitis C) Infectious Colitis D) Irritable Bowel Syndrome (IBS) E) Ischemic Colitis Answer and topic summary The answer is B) Ulcerative Colitis The patient’s symptoms of chronic bloody diarrhea, weight loss, fever, and the sigmoidoscopy findings of a friable rectal mucosa with multiple bleeding points are consistent with a diagnosis of ulcerative colitis (UC), which is a form of inflammatory bowel disease (IBD). UC typically involves the rectum and may extend proximally to involve other parts of the colon. Incorrect answers: A) Crohn’s Disease: This is another type of IBD. However, Crohn’s usually presents with non-bloody diarrhea, abdominal pain, and may involve any part of the GI tract from mouth to anus, often with skip lesions. In this case, the bloody diarrhea and the findings on sigmoidoscopy are more indicative of ulcerative colitis. C) Infectious Colitis: Although infectious causes can lead to similar symptoms, the duration of this patient’s symptoms (6 months) is much longer than typically seen with infectious colitis. Additionally, fever is less common in infectious colitis. D) Irritable Bowel Syndrome (IBS): IBS is a functional GI disorder characterized by abdominal pain with a change in bowel habit. It does not cause weight loss, fever, or bloody stools. E) Ischemic Colitis: This typically presents acutely in older patients or those with vascular risk factors. The clinical presentation often includes abrupt onset of abdominal pain and bloody diarrhea.
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    31 m
  • Podcast Episode 106: Ten PANCE, PANRE, and Rotation Questions + Review of Adrenal Insufficiency

    Podcast Episode 106: Ten PANCE, PANRE, and Rotation Questions + Review of Adrenal Insufficiency
    Jun 14 2023
    Listen to Podcast Episode 106: Ten PANCE, PANRE, and Rotation Review Questions + Review of Adrenal Insufficiency If you can't see the audio player, click here to listen to the full episode. Welcome to episode 106 of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast. Join me today as we cover ten board review questions for your PANCE, PANRE, EOR, and EOC exams. Links from today's episode: Sign up for our new PANCE and PANRE Test Taking Masterclass Sign up for the Entire Blueprint Email Series Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram and Facebook Review adrenal insufficiency and adrenal disorders Join the Smarty PANCE Member's Community, then sign up for a study group to get updates about upcoming webinars. I hope you enjoy this free audio component of the examination portion of this site. Smarty PANCE includes over 2,000 interactive board review questions, along with flashcards, ReelDx cases, integrated Picmonics, and lessons covering every blueprint topic available to all Smarty PANCE members. You can download and listen to past FREE episodes here, on iTunes, Spotify, Google Podcasts, Stitcher, Amazon Music, and all podcasting apps You can listen to all the latest episodes, take interactive quizzes, and download more resources on each episode page. Interactive exam to complement today's podcast 1. A 22-year-old female with an unknown past medical history presents to the ER with a prolonged seizure lasting more than 5 minutes per EMS. Her airway was supported, and IV access was obtained en route to the ER. Her blood glucose is 120. Her vitals are stable, and laboratory studies are relatively unremarkable. Which of the following would be an appropriate medication to give to this patient? A. Calcium gluconate B. Propofol infusion C. Lorazepam D. Clonidine E. Narcan Answer and topic summary The answer is C. Lorazepam The patient has status epilepticus, which is defined as >5 minutes of continuous seizures or > 2 discrete seizures between which there is incomplete recovery of consciousness. Most episodes of status epilepticus in adults are due to a brain lesion or a toxic/metabolic disturbance (e.g., alcohol withdrawal, hypoglycemia, etc). Immediate management of status epilepticus includes stabilizing the airway, placing pulse oximetry and cardiorespiratory monitors, establishing IV access, and getting a glucose level. The first-line pharmacological agent given is a benzodiazepine (e.g., lorazepam or diazepam). Keppra, valproate, or other anti-seizure medication can be given as well. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Neurology ⇒ Seizure disorders ⇒ Status epilepticus Also covered as part of the Internal Medicine EOR and Emergency Medicine EOR topic list 2. A 41-year-old male presents to the ER after a construction accident that left him with severe right eye pain and decreased visual acuity. On a physical exam, you notice a teardrop-shaped pupil. Which of the following is the most likely diagnosis? A. Globe rupture B. Acute angle-closure glaucoma C. Retinal detachment D. Corneal laceration E. Metallic foreign body Answer and topic summary The answer is A. Globe rupture Mechanical globe injuries occur when there is a laceration or full-thickness rupture through the cornea and/or sclera. Globe rupture (also called an open globe) follows blunt eye injury (e.g., motor vehicle crash, assault, thrown ball, etc). Globe lacerations occur after trauma from a sharp-penetrating object (e.g., knife or high-velocity projectile). PE signs include subconjunctival hemorrhage, irregularly-shaped pupil, hyphema (anterior chamber bleeding), decreased visual acuity, and limited EOM. This is an emergency and a patient should see an ophthalmologist immediately. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint EENT ⇒ Traumatic disorders ⇒ G...
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    29 m
  • Podcast Episode 105: Ten PANCE, PANRE, and Rotation Review Questions

    Podcast Episode 105: Ten PANCE, PANRE, and Rotation Review Questions
    May 8 2023
    Listen to Podcast Episode 105: Ten PANCE, PANRE, and Rotation Review Questions If you can't see the audio player, click here to listen to the full episode. Welcome to episode 105 of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast. Join me today as we cover ten board review questions for your PANCE, PANRE, EOR, and EOC exams. Links from today's episode: Sign up for the Entire Blueprint Email Series Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram Follow Smarty PANCE and The Daily PANCE Blueprint on Facebook Review systemic lupus erythematosus (SLE) Review the diabetes diagnostic guidelines Review gestational diabetes screening guidelines Review basal cell carcinoma and our comparison tables of the Blueprint dermatologic neoplasms Join the Smarty PANCE Member's Community, then sign up for a study group to get updates about upcoming webinars. I hope you enjoy this free audio component of the examination portion of this site. Smarty PANCE includes over 2,000 interactive board review questions, along with flashcards, ReelDx cases, integrated Picmonics, and lessons covering every blueprint topic available to all Smarty PANCE members. You can download and listen to past FREE episodes here, on iTunes, Spotify, Google Podcasts, Stitcher, Amazon Music, and all podcasting apps You can listen to all the latest episodes, take interactive quizzes, and download more resources on each episode page. Interactive exam to complement today's podcast 1. A 68-year-old male farmer presents with a flesh-colored papule with a rolled border located on the right side of his forehead. As you examine the lesion closely, you notice something else about the lesion. Which of the following physical exam findings would make you more suspicious of malignancy? A. Telangiectasia B. Nikolsky sign C. Hypopigmentation D. Tenderness to palpation E. Central umbilication Answer and topic summary The answer is A. Telangiectasia The patient has basal cell carcinoma, which is a skin cancer with low metastatic potential. It commonly occurs on the face (70% of the time). There are different types of BCC (nodular vs. superficial vs. infiltrative). However, nodular is the most common (80%) and typical characteristics you may see include a papule with a rolled border, pearly-like look, flesh-colored, and telangiectasia. Risk factors for BCC include UV radiation, certain genes, inherited disorders, etc. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Dermatology ⇒ Dermatologic Neoplasms ⇒ Basal cell carcinoma Also covered as part of the General Surgery EOR and Family Medicine EOR topic list 2. Which of the following is the most common type of elder abuse? A. Neglect B. Emotional abuse C. Physical abuse D. Sexual abuse E. Financial exploitation Answer and topic summary The answer is A. Neglect The most common type of elder abuse is neglect, which refers to the failure of a trusted person to protect an older person from harm or provide for their needs. Self-neglect is also common, which is when an older person can’t proide their own care. Some warning signs include bruising, lacerations, skin tears, spiral fractures, malnutrition, pressure ulcers, and dehydration. If you even suspect an older adult is being neglected, you should report this immediately to adult protective services (or similar agencies) and treat the medical complications immediately. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Psychiatry ⇒ Abuse and Neglect ⇒ Child/elder abuse 3. Which of the following is the most common bacterial cause of a hordeolum? A. Streptococcus pyogenes B. Staphylococcus aureus C. Clostridium perfringens D. Propionibacterium species E. Enterobacter aerogenes Answer and topic summary The answer is B. Staphylococcus aureus A hordeolum (stye) is an abscess of the eyelid ...
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    26 m
  • Podcast Episode 104: Ten PANCE, PANRE, and Rotation Review Questions

    Podcast Episode 104: Ten PANCE, PANRE, and Rotation Review Questions
    Mar 20 2023
    Listen to Podcast Episode 104: Ten PANCE, PANRE, and Rotation Review Questions If you can't see the audio player, click here to listen to the full episode. Welcome to episode 104 of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast. Join me today as we cover ten board review questions for your PANCE, PANRE, EOR, and EOC exams. Links from today's episode: Sign up for the Entire Blueprint Email Series Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram Follow Smarty PANCE and The Daily PANCE Blueprint on Facebook Join the Smarty PANCE Member's Community, then sign up for a study group to get updates about upcoming webinars. I hope you enjoy this free audio component of the examination portion of this site. Smarty PANCE includes over 2,000 interactive board review questions, along with flashcards, ReelDx cases, integrated Picmonics, and lessons covering every blueprint topic available to all Smarty PANCE members. You can download and listen to past FREE episodes here, on iTunes, Spotify, Google Podcasts, Stitcher, Amazon Music, and all podcasting apps You can listen to all the latest episodes, take interactive quizzes, and download more resources on each episode page. Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants. Interactive exam to complement today's podcast When is screening for gestational diabetes done? A. 16 weeks B. 22 weeks C. 24 weeks D. 32 weeks E. 34 weeks Answer and topic summary The answer is C. 24 weeks Prenatal care is extremely important. Screening for gestational diabetes is routinely done in pregnant patients at 24 weeks of gestation (typically until 28 weeks). Pregnancy is associated with insulin resistance, mostly because of the placenta’s secretion of human placental lactogen. There are bad consequences of gestational diabetes, so it is critical it is diagnosed and treated adequately. The initial test is a one-hour 50-gram oral glucose tolerance test (GTT). A positive test >135 mg/dL. If a patient tests positive, they need to undergo the second test, which is a three-hour 100 mg oral GTT. The cut-offs are debated, but generally, the following are positive results: fasting > 95 mg/dL, 1 hour>180 mg/dL, 2 hours>155 mg/dL, 3 hours>140 mg/dL. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Reproductive System ⇒ Complicated Pregnancy ⇒ Gestational diabetes Also covered as part of the Women’s Health EOR topic list 2. A 60-year-old male with a history of alcohol abuse and esophageal varices is brought to the ER with lethargy, delirium, weakness, and nausea. He is normotensive and afebrile. On physical exam, he is ill-appearing with jaundice, spider angiomas, a distended abdomen, and 3+ pretibial pitting edema. Based on his history and clinical presentation, which of the following electrolyte abnormalities would you expect to see in this patient? A. Hyponatremia B. Hypocalcemia C. Hypercalcemia D. Hyperphosphatemia E. Hypermagnesemia Answer and topic summary The answer is A. Hyponatremia The patient has hypervolemic hyponatremia secondary to cirrhosis. The causes of hypervolemic hyponatremia are cirrhosis, nephrotic syndrome, and CHF. Symptoms include nausea, headache, lethargy, and seizures. It’s important to have an approach to hyponatremia since it is the most common electrolyte abnormality in the hospital. First, it’s important to rule out pseudohyponatremia due to proteins, glucose, or mannitol. Also, make sure it’s not a diuretic causing hyponatremia. Next, consider the volume status – are they hypervolemic, hypovolemic, or euvolemic? Hypovolemic causes are more obvious (emesis, hemorrhage, etc.); however, urinary sodium can help differentiate between hypovolemia and euvolemia. If uNA < 20, then this means the renin-angiotensin-aldosterone system is on and trying...
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    24 m
  • Podcast Episode 103: Ten PANRE & PANRE-LA Intervention Complex Practice Questions

    Podcast Episode 103: Ten PANRE & PANRE-LA Intervention Complex Practice Questions
    Mar 8 2023
    Listen to Podcast Episode 103: Ten PANRE & PANRE-LA Intervention Complex Practice Question If you can't see the audio player, click here to listen to the full episode. Welcome to episode 103 of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast. Join me today as we cover ten NCCPA-style board review questions for your PANRE and PANRE-LA exams. Special from today's episode: Take the new PANRE & PANRE-LA (Intervention Complex) Practice Exam: Covers all the topics tested within the new PANRE (Intervention Complex) performance expectation with links to Smarty PANCE lessons. PANRE & PANRE-LA Blueprint 8-Week Schedule and Study Planner Read The New 2023 PANRE and PANRE-LA: Everything you Need to Know Members can try out the newly updated PANRE-LA Smart Search Tool (you must log in to access the search bar) Sign up for the Entire Blueprint Email Series to get daily questions for the next 478 days! Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram Follow Smarty PANCE and The Daily PANCE Blueprint on Facebook Join the Smarty PANCE Member's Community, then sign up for a study group to get updates about upcoming webinars I hope you enjoy this free audio component of the examination portion of this site. Smarty PANCE includes over 2,000 interactive board review questions, along with flashcards, ReelDx cases, integrated Picmonics, and lessons covering every blueprint topic available to all Smarty PANCE members. You can download and listen to past FREE episodes here, on iTunes, Spotify, Google Podcasts, Stitcher, and most podcasting apps. You can listen to all the latest episodes, take interactive quizzes, and download more resources on each episode page. Here is an interactive exam to complement today's podcast 1. A 65-year-old man presents to your office with complaints of constipation for the past six months. He says that he has difficulty passing stools, which are hard and dry. He also reports occasional abdominal pain and bloating. He denies any weight loss, blood in stools, fever, or night sweats. His medical history is significant for hypertension and type 2 diabetes mellitus. His medications include metformin, lisinopril, and aspirin. He does not smoke or drink alcohol. On physical examination, his vital signs are normal. His abdomen is soft and nontender, with normal bowel sounds. There are no masses or organomegaly palpable. Which of the following is the most appropriate next step in evaluating this patient? A) Colonoscopy B) Barium enema C) Thyroid function tests D) Stool osmolarity E) Dietary modification Answer and topic summary The correct answer is A) Colonoscopy Colonoscopy is a procedure that involves inserting a flexible tube with a camera into the colon to visualize the mucosa and detect any abnormalities such as polyps, tumors, inflammation, or bleeding. It is indicated for patients with chronic constipation who are older than 50 years or have any red flag features for colorectal malignancy, such as weight loss, blood in stools, anemia, or a family history of colon cancer. This patient meets the age criterion and should undergo colonoscopy to rule out any serious causes of his constipation. Answer explanations: Barium enema is an imaging test that involves injecting a contrast agent (barium sulfate) into the rectum and taking X-rays of the colon. It can show structural abnormalities such as diverticula, strictures, masses, or volvulus. However, it is less sensitive and specific than colonoscopy for detecting colorectal malignancy. Therefore, it is not the preferred test for this patient. Thyroid function tests are blood tests that measure the levels of thyroid hormones (T3, T4) and thyroid-stimulating hormone (TSH). They can help diagnose thyroid disorders such as hypothyroidism or hyperthyroidism. Hypothyroidism can cause constipation due to decreased gastrointestinal motility. However,
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    35 m
  • Podcast Episode 102: Ten PANCE, PANRE, and Rotation Review Questions

    Podcast Episode 102: Ten PANCE, PANRE, and Rotation Review Questions
    Feb 9 2023
    Listen to Podcast Episode 102: Ten PANCE, PANRE, and Rotation Review Questions If you can't see the audio player, click here to listen to the full episode. Welcome to episode 102 of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast. Join me today as we cover ten board review questions for your PANCE, PANRE, EOR™, and EOC™ exams. Special from today's episode: Read The New 2023 PANRE and PANRE-LA: Everything you Need to Know Members can try out the newly updated PANRE-LA Smart Search (you must log in to access the search bar) Sign up for the Entire Blueprint Email Series Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram Follow Smarty PANCE and The Daily PANCE Blueprint on Facebook Join the Smarty PANCE Member's Community then sign up for a study group to get updates about upcoming webinars. I hope you enjoy this free audio component of the examination portion of this site. Smarty PANCE includes over 2,000 interactive board review questions, along with flashcards, ReelDx cases, integrated Picmonics, and lessons covering every blueprint topic available to all Smarty PANCE members. You can download and listen to past FREE episodes here, on iTunes, Spotify, Google Podcasts, Stitcher, and most podcasting apps. You can listen to all the latest episodes, take interactive quizzes, and download more resources on each episode page. Interactive exam to complement today's podcast 1. Which of the following is NOT true about a non-ST elevation myocardial infarction? A. Non-enteric-coated, chewable aspirin 325 mg should be given B. Troponins are elevated C. It happens due to a partially occluded epicardial coronary artery D. Patients need a 12-lead EKG E. You will always see ST depressions Answer and topic summary The answer is E. You will always see ST depressions A non-ST elevation myocardial infarction (NSTEMI) is defined by the absence of persistent ST-elevation with elevated cardiac biomarkers (e.g., troponin I or T, CKMB, etc). It happens due to a partially occluded epicardial coronary artery (leading to subendocardial ischemia). NSTEMI typically presents as pressure-type chest pain. Patients with a suspected NSTEMI should receive a 12-lead EKG within 10 minutes of arrival. ST depression, transient ST-elevation, and/or T-wave inversions may be seen on EKG, but they are NOT required for the diagnosis of NSTEMI. The most important medication to give is non-enteric-coated chewable aspirin 325 mg. Other meds include sublingual nitroglycerin, oxygen as needed, beta-blockers (assuming no C/I), high-intensity statin, ACE inhibitors (if CKD, DM, or EF < 40%), P2Y12 inhibitor (e.g., clopidogrel), anticoagulation, and possibly PCI with stenting or CABG. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Cardiology ⇒ Coronary Heart Disease ⇒ Acute myocardial infarction ⇒ Non-ST-Segment Elevation MI (NSTEMI) Also covered as part of the Family Medicine EOR, Internal Medicine EOR, Emergency Medicine EOR topic list 2. A 22-year-old G1P0 female at 28 weeks gestation with a history of diabetes presents to the clinic with fever, chills, and dysuria. Vitals show tachycardia (115 bpm), tachypnea (22 bpm), and hypotension (90/58 mmHg). Physical exam reveals suprapubic tenderness. Labs reveal leukocytosis, hyponatremia, and hyperglycemia. Urine dipstick is positive for nitrites, blood, glucose, and ketones. Which of the following is the next best step? A. Send home with oral antibiotics and analgesics B. Reassurance and oral rehydration solution C. Admit to hospital for antibiotics, fluids, & insulin D. Order outpatient CT scan of the abdomen E. Refer to an outpatient nephrologist for workup Answer and topic summary The answer is C. Admit to hospital for antibiotics, fluids, & insulin The patient most likely has pyelonephritis, which is an infection of the upper urinary tract and kidneys.
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    22 m
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