Listen to Podcast Episode 103: Ten PANRE & PANRE-LA Intervention Complex Practice Question
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Welcome to episode 103 of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast.
Join me today as we cover ten NCCPA-style board review questions for your PANRE and PANRE-LA exams.
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Take the new PANRE & PANRE-LA (Intervention Complex) Practice Exam: Covers all the topics tested within the new PANRE (Intervention Complex) performance expectation with links to Smarty PANCE lessons.
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Here is an interactive exam to complement today's podcast
1. A 65-year-old man presents to your office with complaints of constipation for the past six months. He says that he has difficulty passing stools, which are hard and dry. He also reports occasional abdominal pain and bloating. He denies any weight loss, blood in stools, fever, or night sweats. His medical history is significant for hypertension and type 2 diabetes mellitus. His medications include metformin, lisinopril, and aspirin. He does not smoke or drink alcohol. On physical examination, his vital signs are normal. His abdomen is soft and nontender, with normal bowel sounds. There are no masses or organomegaly palpable. Which of the following is the most appropriate next step in evaluating this patient?
A) Colonoscopy
B) Barium enema
C) Thyroid function tests
D) Stool osmolarity
E) Dietary modification
Answer and topic summary
The correct answer is A) Colonoscopy
Colonoscopy is a procedure that involves inserting a flexible tube with a camera into the colon to visualize the mucosa and detect any abnormalities such as polyps, tumors, inflammation, or bleeding. It is indicated for patients with chronic constipation who are older than 50 years or have any red flag features for colorectal malignancy, such as weight loss, blood in stools, anemia, or a family history of colon cancer. This patient meets the age criterion and should undergo colonoscopy to rule out any serious causes of his constipation.
Answer explanations:
Barium enema is an imaging test that involves injecting a contrast agent (barium sulfate) into the rectum and taking X-rays of the colon. It can show structural abnormalities such as diverticula, strictures, masses, or volvulus. However, it is less sensitive and specific than colonoscopy for detecting colorectal malignancy. Therefore, it is not the preferred test for this patient.
Thyroid function tests are blood tests that measure the levels of thyroid hormones (T3, T4) and thyroid-stimulating hormone (TSH). They can help diagnose thyroid disorders such as hypothyroidism or hyperthyroidism. Hypothyroidism can cause constipation due to decreased gastrointestinal motility. However,