Physician Assistant Clinical Knowledge 4

Question 1

A 5-year-old boy is brought in with inspiratory stridor, fever, and a 'steeple sign' on anteroposterior neck X-ray. What is the most likely causative organism?

Accepted Answer

Parainfluenza virus

Answer

Croup (laryngotracheobronchitis) is most commonly caused by parainfluenza virus and produces the classic steeple sign on AP neck X-ray.

Question 2

A 70-year-old woman presents with confusion, constipation, bone pain, and a serum calcium of 13.2 mg/dL. Intact PTH is elevated. What is the most likely diagnosis?

Accepted Answer

Primary hyperparathyroidism

Answer

Elevated PTH with hypercalcemia is diagnostic of primary hyperparathyroidism, most commonly due to a single parathyroid adenoma.

Question 3

A 55-year-old male with type 2 diabetes develops burning pain and numbness in his feet bilaterally in a stocking-glove distribution. Which medication is first-line for diabetic peripheral neuropathy pain?

Accepted Answer

Duloxetine

Answer

Duloxetine (SNRI) and pregabalin are FDA-approved first-line treatments for diabetic peripheral neuropathic pain.

Question 4

A patient presents with acute onset of right lower quadrant pain, fever, and anorexia. On exam, there is rebound tenderness at McBurney's point. Which lab finding most supports the diagnosis of acute appendicitis?

Accepted Answer

Leukocytosis with left shift

Answer

Leukocytosis with a left shift (increased band neutrophils) is the most consistent laboratory finding in acute appendicitis.

Question 5

A 62-year-old male with a 40 pack-year smoking history presents with progressive exertional dyspnea and chronic productive cough for >3 months per year over 2 consecutive years. Spirometry shows FEV1/FVC ratio of 0.62. What is the diagnosis?

Accepted Answer

Chronic obstructive pulmonary disease

Answer

COPD is defined by a post-bronchodilator FEV1/FVC ratio <0.70 with appropriate clinical history; chronic bronchitis meets the symptom criteria.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Clinical Knowledge 4