Free Physician Assistant VII Questions and Answers — Questions and Answers

Question 1: Which of the following can eventually turn into squamous cell carcinoma?

Actinic keratosis (Correct answer)
Onychomycosis
Psoriasis
Seborrheic keratosis
Impetigo

Correct answer: Actinic keratosis

Actinic keratosis (AK) is a skin condition caused by long-term sun exposure and can develop into squamous cell carcinoma (SCC) over time. AK is characterized by rough, scaly patches of skin that are usually pink or red and may be tender or itchy. While most AKs are benign, some can progress to SCC, a type of skin cancer that can be aggressive and may metastasize (spread to other parts of the body).

Question 2: You are evaluating a 25-year-old woman who has a rash on her face. She says she might be reacting to a recently consumed meal, but she is unsure. The nasolabial fold is not spared, and the rash is reddish and macular on both cheeks. Which of the following would you now order?

Oral prednisone
ANA and complement levels
Oral amoxicillin (Trimox)Oral doxycycline (Vibramycin)
Oral doxycycline (Vibramycin) (Correct answer)
Rheumatoid factor

Correct answer: Oral doxycycline (Vibramycin)

Based on the description of the rash, the patient may be presented with a condition called "malar rash," which is a characteristic finding in systemic lupus erythematosus (SLE). Malar rash is a butterfly-shaped rash that spreads across the cheeks and bridge of the nose but does not spare the nasolabial folds. Given the possibility of SLE, ordering oral doxycycline would not be the appropriate course of action, as this medication is typically used to treat bacterial infections, such as acne or Lyme disease.

Question 3: Which of the following best describes a measles symptom?

Koplik spots (Correct answer)
Coronary artery disease
Slapped-cheek appearance
Pneumonitis
Impetigo

Correct answer: Koplik spots

Koplik spots are a characteristic manifestation of measles, a highly contagious viral infection that primarily affects children. These spots appear as small, white, or grayish-blue spots surrounded by a red ring on the inside lining of the cheeks. They usually appear 1-2 days before the onset of the rash, which is another hallmark feature of measles.

Question 4: Which of the following statements regarding the assessment and treatment of lipomas is true?

They can usually be watched without surgical intervention (Correct answer)
They usually require surgical removal to prevent further complications
They are associated with diabetes mellitus
They are usually painful and tender on examination
They are usually associated with a malignant condition

Correct answer: They can usually be watched without surgical intervention

Lipomas are benign fatty tumors that are usually soft, painless, and slow-growing, so they can typically be observed without surgery. They are not malignant, not painful or tender, not linked to diabetes, and rarely require removal unless they cause symptoms or cosmetic concern.

Question 5: Which one of the following best describes the likely cause of paronychia?

An autoimmune reaction
A prescribed medication
A bacterial infection (Correct answer)
A fungal infection
A viral infection

Correct answer: A bacterial infection

Paronychia is a skin infection affecting the nail bed and surrounding tissues. Bacteria most commonly cause it, typically Staphylococcus aureus, which can invade the area through a small cut or injury to the skin around the nail. A fungal infection or other bacteria can also cause paronychia.

Question 6: Of the following, which one is macrocytic anemia?

Multiple myeloma
Pure red cell aplasia
Anemia of kidney disease
Chronic liver disease (Correct answer)
Myelophthisic anemia

Correct answer: Chronic liver disease

Chronic liver disease is not an example of macrocytic anemia. Macrocytic anemia is a type of anemia characterized by the presence of large red blood cells (RBCs) in the blood. This can occur due to a deficiency in vitamin B12 or folate, which are required for proper RBC production and maturation.

Question 7: What causes a hypercoagulable state the majority of the time?

Nephrotic syndrome
Antiphospholipid antibody syndrome
Prothrombin gene mutation
Factor V Leiden mutation (Correct answer)
Antithrombin III deficiency

Correct answer: Factor V Leiden mutation

The Factor V Leiden mutation is one of the most common genetic causes of a hypercoagulable state. In this genetic condition, a mutation in the Factor V gene leads to a form of the protein resistant to inactivation by activated protein C, which normally helps to prevent blood clotting. This can increase the risk of developing blood clots, especially in the veins (venous thrombosis), which can lead to deep vein thrombosis (DVT) or pulmonary embolism (PE). Other common causes of a hypercoagulable state include deficiencies in anticoagulant proteins such as protein C, protein S, and antithrombin III and acquired conditions such as cancer, pregnancy, and certain medications.

Question 8: You have spent five years researching Condition X. You have located several individuals who have Condition X. You've also found a blood test that, if it returns a positive result, can show that Condition X is present. What word best represents the blood test's capacity to identify people who actually have Condition X in the population?

Sensitivity (Correct answer)
Specificity
Incidence
Prevelance
Statistical significance

Correct answer: Sensitivity

Sensitivity is a term used to describe the ability of a diagnostic test (like the blood test in this case) to correctly identify individuals who have the condition (Condition X in this scenario) among those who truly have it. In other words, it measures the proportion of true positive results among all individuals with the condition.

Question 9: A 25-year-old lady who complains of palpitations is being evaluated by you. You hear a midsystolic click during inspection. Which of the following would you advise in regards to her heart condition assessment?

She should be screened for a bleeding diathesis.
She should be screened for major depressive disorder.
Her murmur would decrease with a Valsalva maneuver.
She should be screened for rheumatic fever. (Correct answer)
She may need a beta blocker if the palpitations continue.

Correct answer: She should be screened for rheumatic fever.

The presence of a midsystolic click during inspection can be indicative of mitral valve prolapse (MVP). Mitral valve prolapse is a condition where the valve between the left atrium and the left ventricle doesn't close properly during systole and bulges back into the atrium. It can sometimes produce a clicking sound. <br> <br> Mitral valve prolapse is often benign and may not require treatment in many cases. However, it can be associated with other complications, and one of them is the increased risk of infective endocarditis, especially in patients with a history of rheumatic fever. Rheumatic fever is a condition caused by an untreated or inadequately treated streptococcal infection, and it can damage the heart valves, leading to mitral valve prolapse.

Question 10: A 35-year-old man who is displaying severe psychotic symptoms is being examined by you. He also experiences hallucinations and delusions. Additionally, he has a history of hypertrophic cardiomyopathy. Which of the following drugs would you be extremely hesitant to administer to this patient?

Haloperidol (Haldol) (Correct answer)
Diazepam (Valium)
Olanzapine (Zyprexa)
Lithium carbonate (Lithobid)
Oxazepam (Serax)

Correct answer: Haloperidol (Haldol)

Given the patient's history of hypertrophic cardiomyopathy and severe psychotic symptoms, administering haloperidol (Haldol) would be extremely hesitant. Haloperidol belongs to a class of antipsychotic medications known as typical antipsychotics, and it has the potential to cause significant cardiac side effects, including arrhythmias, QT prolongation, and sudden cardiac death. These effects can be particularly risky for patients with pre-existing cardiac conditions such as hypertrophic cardiomyopathy.

Question 11: A 35-year-old man with a headache walks into your office and is being evaluated. His blood pressure reading during a physical examination was 240/120 mmHg. You discover papilledema during the fundoscopic examination. What is the underlying diagnosis of this person?

Hypertensive emergency (Correct answer)
Stage III hypertension
Hypertensive urgency
Stage I hypertension
Prehypertension

Correct answer: Hypertensive emergency

The patient's blood pressure reading of 240/120 mmHg is significantly elevated and falls within the range of a hypertensive emergency. Hypertensive emergency is a severe and acute elevation in blood pressure that requires immediate medical attention to prevent potential organ damage or life-threatening complications. The presence of papilledema during the fundoscopic examination indicates that the elevated blood pressure is causing increased intracranial pressure, which can be dangerous.

Question 12: Which of the ensuing antidotes best suits the toxicity at its core?

Benzodiazepines — naloxone (Narcan)
Narcotics — flumazenil (Romazicon)
Ethylene glycol — ethanol (booze)
Acetaminophen — fomepizole (4-methylpyrazole) (Correct answer)
High carboxyhemoglobin — methylene blue

Correct answer: Acetaminophen — fomepizole (4-methylpyrazole)

Fomepizole is the antidote for toxicity caused by ethylene glycol or methanol, not acetaminophen. It is used to treat poisoning from these substances by inhibiting the enzymes that metabolize ethylene glycol and methanol into toxic byproducts.

Question 13: You are examining a 78-year-old man whose heart rate is between 140 and 150 beats per minute when he arrives at the emergency room. Although you can observe a narrow-complex tachycardia on the monitor, the underlying rhythm cannot be identified. When you massage the carotid arteries, the patient starts to have a typical sinus rhythm. What rhythm was probably the original?

Atrial fibrillation
Atrial flutter
Ventricular tachycardia
Sinus tachycardia
Supraventricular tachycardia (Correct answer)

Correct answer: Supraventricular tachycardia

When the patient's heart rate is between 140 and 150 beats per minute with a narrow-complex tachycardia, and the rhythm is converted to a typical sinus rhythm by carotid sinus massage, the most likely original rhythm was supraventricular tachycardia (SVT).

Question 14: Which of the following might be a result of long-term phenytoin (Dilantin) use?

Hypercalcemia
Leukocytosis
Increased liver function levels
Hyponatremia
Hypovitaminosis D (Correct answer)

Correct answer: Hypovitaminosis D

Long-term phenytoin (Dilantin) use can lead to a condition called hypovitaminosis D, which refers to a deficiency of vitamin D in the body. Phenytoin can interfere with the metabolism and activation of vitamin D, leading to lower levels of active vitamin D (calcitriol) in the blood.

Question 15: Which of the following therapies would be applied to treat a peripheral neuropathy brought on by heavy metal toxicity?

Dialysis
Chelation (Correct answer)
A good colonic
Electromyography
B12 supplementation

Correct answer: Chelation

Chelation therapy is used to treat peripheral neuropathy brought on by heavy metal toxicity. Chelation involves the administration of specific chelating agents, such as EDTA (ethylenediaminetetraacetic acid) or DMSA (dimercaptosuccinic acid), which bind to heavy metals in the body and form complexes that can be excreted through urine.

Question 16: You are assessing a 45-year-old lady who has undergone a solid organ transplant in the past. She appears with a fever and a change in mental status while taking immunosuppressive. She lacks arousal and has lost all energy. It's debatable whether she experienced a seizure at home. Hemorrhagic alterations and enhanced enhancement in the temporal lobe were visible on an MRI. Which of the following is she currently in need of?

Plasmapheresis
Intravenous acyclovir (Zovirax) (Correct answer)
Intravenous methylprednisolone (Medrol)
Intravenous azithromycin (Zithromax)
Oral amoxicillin (Trimox)

Correct answer: Intravenous acyclovir (Zovirax)

The patient is exhibiting signs and symptoms suggestive of herpes simplex virus encephalitis (inflammation of the brain caused by the herpes simplex virus), which is a medical emergency. The MRI findings of hemorrhagic alterations and enhanced enhancement in the temporal lobe are consistent with this condition.

Free Physician Assistant VII Questions and Answers

Which of the following can eventually turn into squamous cell carcinoma?