Practice Test Geeks(NCCPA) National Commission on Certification of Physician Assistants Practice Test
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Internal 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 Internal Medicine flashcards as text

  1. A 67-year-old man presents with hematuria and a right flank mass. CT shows a 5-cm renal mass with venous thrombus. What is the most likely diagnosis?

    Answer: Renal cell carcinoma

    Renal cell carcinoma classically presents with hematuria, flank pain, and a palpable mass, and commonly invades the renal vein.

  2. A 50-year-old man with alcohol use disorder presents with acute severe epigastric pain radiating to the back, nausea, and serum lipase 1,200 U/L. Which initial management is most appropriate?

    Answer: Aggressive IV fluid resuscitation and NPO

    Aggressive early IV fluid resuscitation (preferably with Lactated Ringer's) and bowel rest are the cornerstones of acute pancreatitis management.

  3. A 38-year-old woman with fatigue, proximal muscle weakness, and a heliotrope rash is found to have elevated CK and aldolase. What is the diagnosis?

    Answer: Dermatomyositis

    Heliotrope rash with proximal muscle weakness and elevated muscle enzymes is diagnostic of dermatomyositis.

  4. A 70-year-old man on warfarin for atrial fibrillation presents with sudden-onset severe headache and altered consciousness. CT shows hyperdense blood in ventricles. INR is 3.8. What is the most urgent reversal agent?

    Answer: 4-factor prothrombin complex concentrate (PCC)

    4-factor PCC provides the fastest and most complete reversal of warfarin in life-threatening bleeding and is superior to FFP for this indication.

  5. A 55-year-old woman with celiac disease presents with fatigue and macrocytic anemia. She adheres to a gluten-free diet. Which deficiency is most likely contributing?

    Answer: Folate deficiency

    Celiac disease causes malabsorption in the proximal small intestine where folate is predominantly absorbed, leading to folate-deficiency macrocytic anemia.

  6. A 58-year-old man with stable angina on metoprolol and aspirin develops worsening symptoms despite optimal medical therapy. Stress test shows significant reversible ischemia. What is the next step?

    Answer: Coronary angiography

    Significant reversible ischemia on non-invasive testing despite optimal medical therapy is an indication for coronary angiography to assess for revascularization.

  7. A 34-year-old woman with recurrent sinopulmonary infections and diarrhea is found to have undetectable serum IgA, IgG, and IgM. B cell count is very low. What is the most likely diagnosis?

    Answer: X-linked agammaglobulinemia (Bruton's disease)

    X-linked agammaglobulinemia causes near-absent B cells and all immunoglobulin classes due to a BTK gene mutation, presenting with recurrent bacterial infections.