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PANRE


Physician Assistant National Recertifying Exam


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Question: 60

A patient comes to the office presenting with paroxysmal or sustained hypertension, severe headaches, palpitations, flushing, heat intolerance, and hyperglycemia. Further laboratory results reveal that the patient’s levels of

epinephrine and norepinephrine are excessive. Based on these findings, the patient is most likely diagnosed with:


  1. Hypothyroidism

  2. Hyperthyroidism

  3. Pheochromocytoma

  4. Addison’s disease


Answer: C


Pheochromocytoma is a catecholamine-producing hormone, which is manifested by the increased levels of epinephrine and norepinephrine in the system. Without appropriate treatment, pheochromocytoma can cause hypertensive retinopathy, nephropathy, and cardiac enlargement, resulting in congestive heart failure.


Question: 61

Which of the following laboratory findings support the diagnosis of

hypoparathyroidism?

  1. Serum calcium = 10.0 mg/dL; Serum potassium = 5.5 mg/dL

  2. Serum calcium = 8.7 mg/dL; Serum potassium = 3.0 mg/dL

  3. Serum calcium = 11.0 mg/dL; Serum phosphorus =2.0 mg/dL

  4. Serum calcium = 7.5 mg/dL; Serum phosphorus = 5.5 mg/dL


Answer: D


A patient with hypoparathyroidism has hypocalcemia and hyperphosphatemia. The other options are not correct.


Question: 62

Which of the following is not a typical sign and symptom of renal cell carcinoma?


  1. Abdominal mass

  2. Hematuria

  3. Flank pain

  4. Oliguria


Answer: D


Renal cell carcinoma is the most common malignancy of the kidney. Renal tumors in the early stages are asymptomatic. A presentation of abdominal mass may indicate renal cell carcinoma. The symptoms of renal cell carcinoma include hematuria, flank pain, and palpable flank mass.


Question: 63

A patient is scheduled to undergo needle biopsy of the kidney. Which of the

following is an important consideration before letting the patient undergo this procedure?


  1. Adequate fasting for at least 8 hours prior to procedure

  2. Establish an IV line for hydration

  3. Monitoring vital signs

  4. Ensure that coagulation studies have been carried out


Answer: D

Preparations must be done before the patient undergoes biopsy. The most important is the suspension of anticoagulant medications at least one week before the procedure. Anticoagulant studies should be carried out at least two weeks before the procedure. IV line, vital signs, and fasting are also important preparations, but ensuring that coagulation studies are normal is more significant.


Question: 64

The Bartholin gland is responsible for secreting mucus to lubricate the vagina.

Where is it specifically located?


  1. Anterior wall of the vagina

  2. Above the urethral and vaginal opening

  3. Below and to the left and right of the vaginal opening

  4. Extends from the vulva to the cervix


Answer: C


The Bartholin gland is located below and to the left and right of the vaginal opening. Option A refers to the Skene’s gland, option B refers to the clitoris, while option D refers to the vagina.


Question: 65

The clinical feature of interstitial cystitis includes all of the following, except:


  1. Continuous bladder pain

  2. Nocturia

  3. Frequent urinary urgency

  4. Bacterial infection


Answer: D


Interstitial cystitis is the inflammation of the bladder in the absence of bacterial infection. It is believed to be caused by an autoimmune process that alters the cells of the bladder lining. The disease is characterized by frequent urination, dysuria, nocturia, and continuous perineal, vaginal, or suprapubic pain.