NCCPA Diagnostic Studies 3

Question 1

A 35-year-old woman has a hemoglobin of 9 g/dL, MCV of 72 fL, low serum ferritin, and elevated TIBC. What is the most likely diagnosis?

Accepted Answer

Iron deficiency anemia

Answer

Low ferritin with elevated TIBC and microcytic anemia is the classic pattern of iron deficiency anemia.

Question 2

Spirometry shows FEV1/FVC ratio of 0.60 with no significant bronchodilator response. Which pattern does this represent?

Accepted Answer

Obstructive lung disease

Answer

An FEV1/FVC ratio below 0.70 indicates airflow obstruction; lack of bronchodilator response suggests fixed obstruction as in COPD.

Question 3

A patient with suspected pulmonary embolism has a Wells score of 7. What is the next appropriate step?

Accepted Answer

CT pulmonary angiography

Answer

A Wells score ≥5 indicates high pre-test probability for PE; CT pulmonary angiography (CTPA) is the definitive diagnostic test.

Question 4

Which lab finding best differentiates prerenal azotemia from acute tubular necrosis?

Accepted Answer

Fractional excretion of sodium < 1%

Answer

FeNa < 1% indicates the tubules are intact and avidly reabsorbing sodium, consistent with prerenal azotemia rather than ATN.

Question 5

A 50-year-old male has a PSA of 5.2 ng/mL. What is the most appropriate next step?

Accepted Answer

Transrectal ultrasound-guided prostate biopsy

Answer

An elevated PSA (>4 ng/mL) warrants further evaluation with prostate biopsy to rule out prostate cancer.

(NCCPA) National Commission on Certification of Physician Assistants Practice Test