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 48-year-old woman presents with fatigue, cold intolerance, constipation, dry skin, and a TSH of 12 mIU/L with low free T4. Anti-TPO antibodies are markedly elevated. What is the most likely diagnosis?

    Answer: Hashimoto's thyroiditis

    Hashimoto's thyroiditis is the most common cause of hypothyroidism in the US, characterized by elevated anti-TPO antibodies and lymphocytic infiltration of the thyroid.

  2. A 65-year-old man with known coronary artery disease presents with crushing substernal chest pain for 45 minutes. ECG shows ST-elevation in leads V1-V4. Troponin is pending. What is the most time-critical intervention?

    Answer: Perform percutaneous coronary intervention (PCI) within 90 minutes

    Primary PCI within 90 minutes of first medical contact is the preferred reperfusion strategy for STEMI, superior to thrombolytics when available.

  3. A 19-year-old college student presents with fever, pharyngitis, lymphadenopathy, and profound fatigue for 2 weeks. CBC shows lymphocytosis with atypical lymphocytes. Heterophile antibody test is positive. Which complication warrants specific activity restriction?

    Answer: Splenic rupture

    Splenic enlargement occurs in infectious mononucleosis, and contact sports must be avoided for at least 3–4 weeks to prevent life-threatening splenic rupture.

  4. A 70-year-old woman on warfarin for atrial fibrillation presents with sudden painless vision loss in her right eye. Fundoscopy shows a 'blood and thunder' appearance with diffuse flame hemorrhages and dilated tortuous veins. What is the diagnosis?

    Answer: Central retinal vein occlusion

    Central retinal vein occlusion (CRVO) produces the classic 'blood and thunder' fundoscopic appearance with diffuse flame hemorrhages in all four quadrants.

  5. A 55-year-old man with COPD presents with worsening dyspnea. Spirometry shows FEV1/FVC ratio of 0.58 (post-bronchodilator). FEV1 is 55% of predicted. According to GOLD criteria, what stage is this COPD?

    Answer: GOLD 2 (Moderate)

    GOLD 2 (Moderate) COPD is defined by FEV1/FVC <0.70 and FEV1 50–79% of predicted after bronchodilator.

  6. A 40-year-old woman presents with abrupt onset of severe 'thunderclap' headache she describes as 'the worst headache of my life.' Neurological exam is normal. CT head is negative. What is the next diagnostic step?

    Answer: Lumbar puncture for xanthochromia

    A negative CT does not rule out subarachnoid hemorrhage; lumbar puncture demonstrating xanthochromia is required to exclude SAH when CT is negative.

  7. A 32-year-old woman develops rash, fever, and joint pain 2 weeks after starting trimethoprim-sulfamethoxazole. Skin biopsy shows dermal perivascular infiltrates. She develops hematuria and rising creatinine. What is the most likely diagnosis?

    Answer: Acute interstitial nephritis

    Acute interstitial nephritis (AIN) is a classic hypersensitivity reaction to sulfonamides presenting with fever, rash, eosinophilia, and acute kidney injury.