Physician Assistant Physician Assistant 2 — Questions and Answers
Question 1: A 45-year-old male presents with crushing chest pain radiating to the left arm, diaphoresis, and nausea. ECG shows ST elevation in leads II, III, and aVF. Which artery is most likely occluded?
- Left anterior descending artery
- Right coronary artery (Correct answer)
- Left circumflex artery
- Left main coronary artery
Correct answer: Right coronary artery
ST elevation in leads II, III, and aVF indicates an inferior MI, which is most commonly caused by occlusion of the right coronary artery.
Question 2: A PA is treating a patient with type 2 diabetes and hypertension. Which antihypertensive class provides the most renal protection in diabetic nephropathy?
- Calcium channel blockers
- Beta-blockers
- ACE inhibitors (Correct answer)
- Thiazide diuretics
Correct answer: ACE inhibitors
ACE inhibitors reduce proteinuria and slow the progression of diabetic nephropathy by decreasing intraglomerular pressure.
Question 3: Which of the following is the most appropriate initial management for a patient presenting with anaphylaxis?
- IV diphenhydramine
- IV corticosteroids
- Intramuscular epinephrine (Correct answer)
- Nebulized albuterol
Correct answer: Intramuscular epinephrine
Intramuscular epinephrine in the lateral thigh is the first-line treatment for anaphylaxis due to its rapid onset and ability to reverse bronchospasm, vasodilation, and urticaria.
Question 4: A 28-year-old woman presents with a butterfly-shaped rash across her cheeks and nose, joint pain, and fatigue. ANA is positive. What is the most likely diagnosis?
- Rosacea
- Systemic lupus erythematosus (Correct answer)
- Dermatomyositis
- Psoriasis
Correct answer: Systemic lupus erythematosus
The malar (butterfly) rash, arthralgia, fatigue, and positive ANA are classic features of systemic lupus erythematosus.
Question 5: A 60-year-old male smoker presents with hemoptysis, weight loss, and a central lung mass on CT. Biopsy shows small blue cells. Which lung cancer type is this?
- Adenocarcinoma
- Squamous cell carcinoma
- Small cell lung carcinoma (Correct answer)
- Large cell carcinoma
Correct answer: Small cell lung carcinoma
Small cell lung carcinoma presents as a central mass with small blue cells on biopsy and is strongly associated with smoking; it often presents with paraneoplastic syndromes.
Question 6: What is the recommended first-line pharmacotherapy for a patient newly diagnosed with community-acquired pneumonia who is otherwise healthy and has no recent antibiotic use?
- Azithromycin monotherapy (Correct answer)
- Amoxicillin-clavulanate
- Levofloxacin
- Vancomycin
Correct answer: Azithromycin monotherapy
For otherwise healthy outpatients with CAP and no recent antibiotic use, a macrolide such as azithromycin is the recommended first-line agent.
Question 7: A PA supervising a clinical rotation must ensure a medical student documents correctly. Under HIPAA, which entity must have a signed authorization before releasing patient information for non-treatment purposes?
- The treating physician
- The covered entity (healthcare provider) (Correct answer)
- The insurance company
- The state medical board
Correct answer: The covered entity (healthcare provider)
Under HIPAA, the covered entity (the healthcare provider or practice) must obtain a valid patient authorization before releasing protected health information for purposes other than treatment, payment, or healthcare operations.
Physician Assistant Physician Assistant 2
A 45-year-old male presents with crushing chest pain radiating to the left arm, diaphoresis, and nausea.
ECG shows ST elevation in leads II, III, and aVF.
Which artery is most likely occluded?