Listen to Podcast Episode 104: Ten PANCE, PANRE, and Rotation Review Questions
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Welcome to episode 104 of the Audio PANCE and PANRE Physician Assistant/Associate Board Review Podcast.
Join me today as we cover ten board review questions for your PANCE, PANRE, EOR, and EOC exams.
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Interactive exam to complement today's podcast
When is screening for gestational diabetes done?
A. 16 weeks
B. 22 weeks
C. 24 weeks
D. 32 weeks
E. 34 weeks
Answer and topic summary
The answer is C. 24 weeks
Prenatal care is extremely important. Screening for gestational diabetes is routinely done in pregnant patients at 24 weeks of gestation (typically until 28 weeks). Pregnancy is associated with insulin resistance, mostly because of the placenta’s secretion of human placental lactogen. There are bad consequences of gestational diabetes, so it is critical it is diagnosed and treated adequately.
The initial test is a one-hour 50-gram oral glucose tolerance test (GTT). A positive test >135 mg/dL. If a patient tests positive, they need to undergo the second test, which is a three-hour 100 mg oral GTT. The cut-offs are debated, but generally, the following are positive results: fasting > 95 mg/dL, 1 hour>180 mg/dL, 2 hours>155 mg/dL, 3 hours>140 mg/dL.
Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Reproductive System ⇒ Complicated Pregnancy ⇒ Gestational diabetes
Also covered as part of the Women’s Health EOR topic list
2. A 60-year-old male with a history of alcohol abuse and esophageal varices is brought to the ER with lethargy, delirium, weakness, and nausea. He is normotensive and afebrile. On physical exam, he is ill-appearing with jaundice, spider angiomas, a distended abdomen, and 3+ pretibial pitting edema. Based on his history and clinical presentation, which of the following electrolyte abnormalities would you expect to see in this patient?
A. Hyponatremia
B. Hypocalcemia
C. Hypercalcemia
D. Hyperphosphatemia
E. Hypermagnesemia
Answer and topic summary
The answer is A. Hyponatremia
The patient has hypervolemic hyponatremia secondary to cirrhosis. The causes of hypervolemic hyponatremia are cirrhosis, nephrotic syndrome, and CHF. Symptoms include nausea, headache, lethargy, and seizures. It’s important to have an approach to hyponatremia since it is the most common electrolyte abnormality in the hospital.
First, it’s important to rule out pseudohyponatremia due to proteins, glucose, or mannitol. Also, make sure it’s not a diuretic causing hyponatremia.
Next, consider the volume status – are they hypervolemic, hypovolemic, or euvolemic?
Hypovolemic causes are more obvious (emesis, hemorrhage, etc.); however, urinary sodium can help differentiate between hypovolemia and euvolemia. If uNA < 20, then this means the renin-angiotensin-aldosterone system is on and trying...