FREE Physician Assistant History and Physical Examination Questions and Answers

Question 1

A 22-year-old collegiate soccer player presents with acute right knee pain after an opponent tackled her during a game, causing a valgus force and external rotation of her tibia. She reports hearing a 'pop' and feeling immediate instability. On physical examination, the Lachman test reveals significant anterior translation of the tibia with a soft endpoint compared to the contralateral knee. Which ligament is most likely injured?

Accepted Answer

Anterior cruciate ligament (ACL)

Answer

The Lachman test is the most sensitive and specific physical examination maneuver for an anterior cruciate ligament (ACL) tear. The history of a 'pop' with a rotational or valgus force injury mechanism, coupled with a feeling of instability and a positive Lachman test (anterior tibial translation with a soft endpoint), is classic for an ACL rupture.

Question 2

A physical examination finding of weakness when shrugging the shoulders against resistance would indicate a deficit in which cranial nerve?

Accepted Answer

CN XI (Accessory)

Answer

Cranial nerve XI, the spinal accessory nerve, provides motor innervation to the trapezius and sternocleidomastoid muscles. The trapezius muscle is primarily responsible for elevating, or shrugging, the shoulders. Therefore, weakness in this action points to a deficit in CN XI.

Question 3

A 19-year-old male presents with a 24-hour history of periumbilical pain that has now localized to the right lower quadrant. He reports anorexia and nausea. On examination, he has a low-grade fever and tenderness to palpation at McBurney's point. When the examiner palpates deeply in the left lower quadrant, the patient experiences sharp pain in the right lower quadrant. What is the name of this physical exam sign?

Accepted Answer

Rovsing's sign

Answer

Rovsing's sign is pain felt in the right lower quadrant upon palpation of the left lower quadrant. This sign is suggestive of peritoneal irritation in the right lower quadrant, as seen in acute appendicitis. Murphy's sign is associated with cholecystitis, while the Psoas and Obturator signs are other maneuvers used to detect appendicitis.

Question 4

Which of the following fundoscopic examination findings is the hallmark of proliferative diabetic retinopathy, distinguishing it from the non-proliferative stage?

Accepted Answer

Neovascularization

Answer

The defining characteristic of proliferative diabetic retinopathy (PDR) is the development of new, abnormal blood vessels, a process known as neovascularization. These new vessels are fragile and can bleed, leading to severe vision loss. Microaneurysms, hard exudates, and cotton-wool spots are all findings associated with non-proliferative diabetic retinopathy (NPDR).

Question 5

A 35-year-old female presents with a 3-month history of weight loss despite an increased appetite, heat intolerance, anxiety, and palpitations. On examination, she is tachycardic, her skin is warm and moist, and a fine tremor is noted in her outstretched hands. Based on this history and physical examination, which of the following is the most likely diagnosis?

Accepted Answer

Hyperthyroidism

Answer

This patient's constellation of symptoms—including weight loss with increased appetite, heat intolerance, tachycardia, anxiety, and tremors—is classic for a hypermetabolic state caused by an overactive thyroid gland, or hyperthyroidism. Hypothyroidism would present with opposite symptoms (weight gain, cold intolerance), while Cushing's and Addison's disease involve the adrenal glands and have different clinical presentations.

Physician Assistant Practice Test

Physician Assistant Practice Test

FREE Physician Assistant History and Physical Examination Questions and Answers