Physician Assistant Physician Assistant 4

Question 1

A 25-year-old male athlete presents with sudden severe headache described as 'the worst headache of his life' after exertion. CT head is negative. What is the next most appropriate step?

Accepted Answer

Lumbar puncture

Answer

A thunderclap headache with a negative CT requires lumbar puncture to rule out subarachnoid hemorrhage, as CT misses up to 2% of cases in the first 6 hours.

Question 2

Which of the following best describes the PA profession's scope of practice in the United States?

Accepted Answer

Defined by state law, clinical training, and institutional policy

Answer

PA scope of practice is determined by a combination of state law, the PA's education and experience, the supervising physician's delegation, and institutional policies.

Question 3

A 58-year-old male presents with progressive difficulty swallowing solids, then liquids, and an 18 lb weight loss over 3 months. What is the most likely diagnosis?

Accepted Answer

Esophageal carcinoma

Answer

Progressive dysphagia starting with solids then progressing to liquids combined with significant weight loss in an older adult is the classic presentation of esophageal carcinoma.

Question 4

A PA prescribes a medication that inhibits HMG-CoA reductase. A patient on this medication begins taking clarithromycin for an infection. What adverse effect is most concerning?

Accepted Answer

Rhabdomyolysis

Answer

Clarithromycin inhibits CYP3A4, increasing statin plasma levels and dramatically raising the risk of rhabdomyolysis when co-administered with statins metabolized by CYP3A4.

Question 5

Which vaccine is contraindicated in a 26-year-old pregnant woman at 20 weeks gestation?

Accepted Answer

MMR vaccine

Answer

MMR is a live attenuated vaccine and is contraindicated during pregnancy due to theoretical risk of fetal infection; it should be given postpartum.

Physician Assistant Practice Test

Physician Assistant Practice Test

Physician Assistant Physician Assistant 4