Practice Test Geeks(NCCPA) National Commission on Certification of Physician Assistants Practice Test
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Clinical Medicine Flashcards

7 cards from real NCCPA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Clinical Medicine flashcards as text

  1. A 15-year-old boy presents with acute onset of severe scrotal pain, nausea, and vomiting. The left testis is elevated and has a horizontal lie. Cremasteric reflex is absent. What is the most appropriate next step?

    Answer: Surgical exploration without delay

    Testicular torsion is a surgical emergency; immediate scrotal exploration is required to save the testis, and delay for imaging risks irreversible ischemia.

  2. A 68-year-old woman with osteoporosis is started on alendronate. Which instruction is most critical to prevent the most serious adverse effect of this medication?

    Answer: Remain upright for at least 30 minutes after taking

    Bisphosphonates must be taken with a full glass of water while remaining upright for ≥30 minutes to prevent esophageal ulceration and stricture.

  3. A 55-year-old man with cirrhosis and ascites presents with fever, abdominal pain, and altered mental status. Paracentesis reveals PMN count of 380 cells/mm³. Which diagnosis is confirmed?

    Answer: Spontaneous bacterial peritonitis

    Spontaneous bacterial peritonitis (SBP) is diagnosed by ascitic fluid PMN count ≥250 cells/mm³ in a cirrhotic patient without an obvious secondary source of infection.

  4. A 22-year-old woman presents with polyuria, polydipsia, and a serum sodium of 154 mEq/L. Water deprivation test fails to concentrate urine, but ADH administration raises urine osmolality to >750 mOsm/kg. What is the diagnosis?

    Answer: Central diabetes insipidus

    Response to exogenous ADH (desmopressin) with urine concentration indicates intact renal response, confirming central (neurogenic) diabetes insipidus due to ADH deficiency.

  5. A 60-year-old man presents with dyspnea, lower extremity edema, and an S3 gallop. Echocardiogram shows EF of 35% with dilated LV. Which medication has been shown to reduce mortality in this condition?

    Answer: Carvedilol

    Beta-blockers such as carvedilol, metoprolol succinate, and bisoprolol are proven to reduce mortality in heart failure with reduced ejection fraction (HFrEF).

  6. A 50-year-old woman presents with symmetric joint pain and swelling in her MCPs and PIPs, morning stiffness lasting 3 hours, and subcutaneous nodules. RF and anti-CCP antibodies are elevated. What is the most appropriate disease-modifying therapy?

    Answer: Methotrexate

    Methotrexate is the anchor DMARD for rheumatoid arthritis due to its efficacy, cost-effectiveness, and decades of safety data.

  7. A 35-year-old man presents after a motor vehicle accident. He is hypotensive, tachycardic, and has a distended neck veins with absent breath sounds on the left and tracheal deviation to the right. What is the immediate intervention?

    Answer: Needle decompression of the left chest

    Tension pneumothorax causes tracheal deviation away from the affected side; immediate needle decompression at the 2nd intercostal space, midclavicular line is life-saving.