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.

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  1. A 58-year-old man with chronic kidney disease has a serum potassium of 6.2 mEq/L. Which ECG finding is most characteristic of hyperkalemia?

    Answer: Peaked T waves

    Peaked (tall, narrow, symmetric) T waves are the earliest ECG manifestation of hyperkalemia.

  2. A 45-year-old woman presents with fatigue, constipation, and a serum calcium of 11.8 mg/dL. PTH is elevated. Which is the most likely diagnosis?

    Answer: Primary hyperparathyroidism

    Elevated PTH with hypercalcemia in an asymptomatic or mildly symptomatic outpatient is classic for primary hyperparathyroidism.

  3. A patient with COPD exacerbation has an ABG showing pH 7.30, PaCO2 62 mmHg, HCO3 29 mEq/L. Which acid-base disorder is present?

    Answer: Acute-on-chronic respiratory acidosis

    The elevated bicarbonate indicates partial compensation, suggesting chronic retention with an acute worsening superimposed.

  4. A 62-year-old man with diabetes and hypertension develops proteinuria >300 mg/day and creatinine 2.1 mg/dL. Which medication class best slows progression of diabetic nephropathy?

    Answer: ACE inhibitors or ARBs

    RAAS blockade with ACE inhibitors or ARBs reduces intraglomerular pressure and proteinuria, slowing CKD progression in diabetic nephropathy.

  5. Which finding best differentiates restrictive cardiomyopathy from constrictive pericarditis on echocardiography?

    Answer: Septal bounce and respiratory variation in mitral inflow

    Constrictive pericarditis shows a septal bounce and exaggerated respiratory variation in mitral/tricuspid inflow on echo, unlike restrictive cardiomyopathy.

  6. A 50-year-old woman with rheumatoid arthritis on methotrexate presents with macrocytic anemia and oral ulcers. Which supplement is indicated?

    Answer: Folic acid

    Methotrexate inhibits dihydrofolate reductase, causing folate deficiency; folic acid supplementation prevents mucosal and hematologic toxicity.

  7. A 70-year-old man has a serum sodium of 122 mEq/L, urine osmolality 600 mOsm/kg, and urine sodium 45 mEq/L. He takes a thiazide diuretic. What is the most likely cause?

    Answer: Thiazide-induced hyponatremia

    Thiazides impair urinary dilution and can cause profound hyponatremia, especially in elderly women, mimicking SIADH biochemically.