Physician Assistant Formulating a Diagnosis 5

Question 1

A PA is evaluating a 30-year-old woman with episodic hypertension, headaches, palpitations, and diaphoresis. Which secondary cause of hypertension should be included on the differential?

Accepted Answer

Pheochromocytoma

Answer

The triad of episodic hypertension, headache, and diaphoresis with palpitations is classic for pheochromocytoma, a catecholamine-secreting adrenal tumor.

Question 2

Which finding most strongly supports a diagnosis of acute appendicitis in a 25-year-old man with right lower quadrant pain?

Accepted Answer

Migration of pain from periumbilical region to the RLQ with rebound tenderness and fever

Answer

Pain migration from periumbilical to RLQ (McBurney's point), rebound tenderness, and fever represent the classic progression of acute appendicitis.

Question 3

In a patient with polyarthritis, which additional finding shifts the differential strongly toward systemic lupus erythematosus (SLE)?

Accepted Answer

Malar rash, photosensitivity, and oral ulcers

Answer

Malar rash, photosensitivity, and oral ulcers alongside polyarthritis fulfill multiple ACR/EULAR SLE classification criteria, making SLE the leading diagnosis.

Question 4

A PA evaluates two patients with identical presentations but very different pre-test probabilities for pulmonary embolism. How does pre-test probability affect diagnostic reasoning?

Accepted Answer

A positive test result is more meaningful in a high-probability patient, raising post-test probability substantially

Answer

Pre-test probability directly influences post-test probability through Bayes' theorem; the same positive test result carries more weight when disease is more likely before testing.

Question 5

A 58-year-old man with diabetes presents with a painless foot ulcer. His history of peripheral neuropathy is known. Which complication should be highest on the differential?

Accepted Answer

Diabetic neuropathic ulcer with possible underlying osteomyelitis

Answer

Painless foot ulcers in diabetics with neuropathy are hallmarks of diabetic neuropathic ulcers, and osteomyelitis must be excluded given its high prevalence in this context.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Formulating a Diagnosis 5