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Physician Assistant Exam For Dummies®, Premier Edition

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Table of Contents

Introduction
About This Book
Conventions Used in This Book
What You’re Not to Read
Foolish Assumptions
How This Book Is Organized
Part I: Scratching the Surface of the PANCE and PANRE
Part II: Getting to the Heart of the Test: Four Foundational Systems
Part III: Reviewing Surgical Topics and Other Organ Systems
Part IV: Pursuing Primary Care, Pharmacology, and Behavioral Health
Part V: The Brain, Blood, Bugs, Skin, and Glands
Part VI: Tackling a PANCE Practice Test
Part VII: The Part of Tens
CD-ROM
Icons Used in This Book
Where to Go from Here
Part I: Scratching the Surface of the PANCE and PANRE
Chapter 1: Becoming a Physician Assistant
Knowing What to Expect as a PA
Training to become a PA
What you do when you’re a PA
Sizing up your prospects
Introducing the Tests
Getting your PANCE on
Reviewing for the PANRE
Chapter 2: Presenting the PANCE and PANRE
Beyond Studying: Preparing to Take the PANCE or PANRE
Applying to take the test
Locating the test center
Chillaxing before the test
Making It through Test Day
Planning for a timely arrival
Getting in the door
Knowing what’s allowed in the testing room
Knowing what to expect before and during the test
Looking at what happens after the test
Understanding How the Exam Is Scored
Familiarizing Yourself with the Test Format
Understanding the test organization
Checking out question topics
Examining the question structures
Knowing conventions
Part II: Getting to the Heart of the Test: Four Foundational Systems
Chapter 3: Tending to the Heart and the Great Vessels
Keeping Blood Pressure in Line
Defining hypertension
Handling essential and resistant hypertension
Helping extremely high pressure
Raising low blood pressure
Analyzing Acute Coronary Syndrome
Sorting out stable versus unstable angina
Reviewing basic criteria for myocardial infarction
Knowing the NSTEMI and STEMI
Treating ACS
Reviewing variant angina
Clarifying Congestive Heart Failure
Seeing and treating systolic heart failure
Diagnosing and treating diastolic heart failure
Muscling In on the Cardiomyopathies
Dealing with dilated cardiomyopathy
Recognizing restrictive cardiomyopathy
Handling hypertrophic cardiomyopathy
Vexing Over Valvular Disorders
Meeting the mitral valve
Assessing the aortic valve
Testing the tricuspid valve
Pushing the pulmonary valve
Diagnosing Congenital Heart Disease
Analyzing atrial septal defect
Persistent patent ductus arteriosus
Viewing ventricular septal defect
The telling tetralogy of Fallot
Going Ga-Ga Over Conduction Disorders
Annihilating atrial flutter and atrial fibrillation
Reviewing some conduction system blocks
Battling bundle branch blocks
Viewing ventricular arrhythmias
Probing the Pericardium
Linking pericarditis to multiple causes
Building up to pericardial effusion
Acting swiftly to relieve cardiac tamponade
Evaluating Endocarditis
The staph: Looking for vegetation with infective endocarditis
The strep: Searching for structural issues with subacute endocarditis
Worrying about the Vascular System
Dissecting the aorta, so to speak
Establishing arterial patency
Evaluating the venous system
Practice Cardiovascular System Questions
Answers and Explanations
Chapter 4: Taking a Deep Breath: The Lungs
Evaluating Obstructive Lung Disease
Ameliorating asthma
Chronic obstruction: Correcting COPD
Dilated air sacs: Beating bronchiectasis
Chasing cystic fibrosis
Reviewing Restrictive Lung Disease
After the dust settles: Exploring occupational exposures
Investigating interstitial lung disease
Sarcoidosis: Gasping about granulomatous disease
Blanketing the Lungs: The Pleura
Fluid around the lungs: Probing the pleural effusion
Clearing the air on pneumothorax
Pleural pain: Not putting up with pleurisy
Investigating Infectious Processes
Knocking out pneumonias
Analyzing acute bronchitis
Investigating influenza
Tuberculosis: Preparing for the TB test
Addressing Childhood Lung Conditions
A barking cough: Catching up with croup
Recognizing emergency epiglottitis
Reacting to respiratory syncytial virus (RSV)
Sizing Up Lung Malignancy
Focusing on small-cell lung cancer
Seeing the bigger picture: Non-small-cell lung cancer
Scrutinizing the lung lesion
Probing the Pulmonary Vasculature
Blood clots: Evaluating the pulmonary embolism
Taking the pressure off pulmonary hypertension
Practice Pulmonary Questions
Answers and Explanations
Chapter 5: Hungering for the Digestive System
Going Down the Esophagus
Inviting inflammation: Esophagitis
Narrowing but not swallowing
Bleeding from the esophagus
Stomaching the Gastric Area
Inviting inflammation yet again: Gastritis
Uncovering the ugly peptic ulcer
Going after gastric cancer
Can I Buy a Bowel?
Identifying irritable bowel syndrome (IBS)
Investigating ischemic bowel
Recognizing inflammatory bowel disease (IBD)
Concerning celiac disease and malabsorption
Diagnosing diverticulosis and diverticulitis
Conquering colon cancer
Putting Up with the Pancreas
Improving acute pancreatitis
Treating chronic pancreatitis
Recognizing pancreatic cancer
Looking at the Liver
Helping people with hepatitis
Keeping cirrhosis in check
Looking at liver cancer
Fixing a Wrecked Rectum
Helping patients with hemorrhoids
Fingering fecal impactions
Reaching for rectal cancer
Probing for perirectal abscess
Figuring out anal fissures
Practice Questions about the Digestive System
Answers and Explanations
Chapter 6: Knowing the Hard Facts about Bones and Joints
Reviewing the Rheumatologic Conditions
Reading up on rheumatoid arthritis
Learning about lupus
Scrutinizing scleroderma
Dry eyes and mouth: Seeking out Sjögren’s syndrome
Managing monoarticular arthritis: Gout and pseudogout
The polys: Affecting the proximal muscles
Obsessing about Three Amigos: The Osteos
Winning over bone thinning: Osteoporosis
Paining over osteoarthritis
Bad to the bone: Opting out of osteomyelitis
We Got Your Back: Conditions of the Spine
Analyzing ankylosing spondylitis
Dangerous curves: Seeing scoliosis
Don’t be a slouch: Keeping up with kyphosis
Helping herniated discs
Sorting out spinal stenosis
Pott’s disease: Looking at TB of the spine
Shouldering the Pain from Fractures
Getting clued in on collarbone fractures
Securing the fractured scapula
Helping the fractured humerus
Forewarned, Forearmed: Advancing to the Elbow and Wrist
Tennis, golfer’s, and Little League elbow: Evaluating epicondylar injury
Elbowing nursemaids: A lift by the wrist
Bettering bursitis
Noting numbing of the nerves of the forearm
Breaking a fall . . . and a wrist
Thumbing through Hand Injuries
Going ganglionic: Ganglion cysts
De Quervain’s tenosynovitis: Teasing tendons at the base of the thumb
Thumbs up: Pointing out sprains and tears of the UCL
Boxer’s fracture: Giving metacarpels the old two-three
Getting Hip to the Jive
Asking about avascular necrosis (AVN)
Reviewing the slipped capital femoral epiphysis
Helping hip fractures and dislocations
Mending a Wounded Knee
Observing Osgood-Schlatter syndrome
Mulling over meniscal tears
Considering cruciate tears
Assessing Ankle Injuries
Studying the soft tissues of the ankle
Testing Achilles
Examining ankle fractures
Figuring Out the Foot
Studying the soft tissues of the foot
Stressing over stress fractures
The bottom of the foot: Finessing fascia
Practice Questions about Bones and Joints
Answers and Explanations
Part III: Reviewing Surgical Topics and Other Organ Systems
Chapter 7: Checking Out Common Surgical Topics
Reviewing Surgical Signs and Symptoms
Asking the right questions about symptoms
Focusing on the patient’s medical history
Performing the physical exam
Evaluating the Pre-Op Patient
Looking at the labs
Assessing the perioperative risk
Caring for the Post-Op Patient
Monitoring for fever
Reducing the clot risk
Understanding fluids and nutrition
Getting on with the Gallbladder
Hot and bothered: Gallbladder inflammation
Stoned: Gallbladder stones
Investigating Common Intestinal Surgeries
Apprehending the inflamed appendix
Dealing with diverticulitis
Intestinal twists: Straightening out volvulus
Helping people with hernias
Removing the spleen
Practice Questions on Surgical Topics
Answers and Explanations
Chapter 8: Exploring Problems of the Eyes, Ears, Nose, and Throat
Knowing Facts about the Nose
Airing your grievances: Sinus problems
Nosing around nasal polyps: Mucosa gone wild
Assessing allergic rhinitis
Stopping nosebleeds: Epistaxis
Removing stuff stuck up the nose
Looking at the Mouth and Throat
Soothing the sore throat
Connecting oral ulcers to other conditions
Feeling around for inflamed glands
Managing Malignancies of the Head and Neck
Open wide for a look at oral cancer
Talking about throat cancer
Examining the Ear
Ear inflammation: Observing otitis of all types
Bracing for vertigo
Does tinnitus ring a bell?
Minding the mastoids
Evaluating ear trauma
Waxing eloquent
Homing in on hearing loss
Eye, Eye, Captain: Looking at Eye Conditions
Clearing up lens conditions
Covering external eye structures
Focusing on the retina
Looking deep into the eyes
Tracking eye movements and muscle conditions
Practice Questions on the Eyes, Ears, Nose, and Throat
Answers and Explanations
Chapter 9: Reviewing Reproductive Medicine
Managing Menstrual Disorders
Missing periods: Considering primary and secondary causes of amenorrhea
Painful periods: Diagnosing dysmenorrhea by process of elimination
Premenstrual syndrome
Homing in on Problems of the Breast
Blocked milk ducts: Managing mastitis
Leaking milk: Controlling prolactin to treat galactorrhea
Man boobs: When hormone imbalance leads to gynecomastia
Distinguishing the fibros
Beating breast cancer
Understanding the Uterus
Uterine prolapse: Slipping into the vagina
Ruling out causes for dysfunctional uterine bleeding
Leiomyomas: Bleeding from uterine fibroids
A not-so-silver lining: Evaluating endometriosis
Treating endometrial cancer
Examining the Ovaries
Looking at ovarian cysts and PCOS
Reviewing ovarian cancer
Surveying the Cervix
Dealing with an incompetent cervix
Treating an inflamed cervix
Sorting out sexually transmitted infections
Understanding cervical dysplasia and carcinoma
Reviewing Vulvas and Vaginas
Treating vaginal infections
Recognizing protrusions: Things ending in -cele
Visiting cancer of the vulva
Managing the Normal Pregnancy
Understanding prenatal screening
Moving through the stages of labor and delivery
Dealing with Pregnancy Complications
Gestational bleeding problems
Ectopic pregnancy: Attaching in the wrong place
Sharing spaces with tumors: Gestational trophoblastic disease
Treating blood pressure problems in pregnancy
Watching gestational diabetes
Touching on other complications
Avoiding Unwanted Pregnancy
Understanding Spontaneous and Elective Abortions
Practice Reproductive Medicine Questions
Answers and Explanations
Chapter 10: Understanding the Genitourinary System
Analyzing Urinary Abnormalities
Using urinalysis
Handling hematuria: Blood in the urine
Watching for proteinuria
Exploring Acute Kidney Failure: It Isn’t Cute
Starting out simply: Prerenal azotemia
Analyzing acute tubular necrosis (ATN)
Assessing acute interstitial nephritis (AIN)
Getting it about glomerulonephritis (GN)
Blood vessels of the kidney: Getting inflamed over vasculitis
Obstructive uropathies: Obsessing about urinary blockages
Persisting about polycystic kidney disease (PKD)
Confronting Chronic Kidney Disease (CKD)
Seeing the stages of chronic kidney disease
Understanding how kidney disease affects the blood and the bones
Eliminating Kidney Stones: Pass/Fail
Searching for signs and symptoms of kidney stones
Diagnosing kidney stones with imaging studies
Categorizing kidney stones by type
Treating kidney stones
Getting Excited about Electrolytes
Hyponatremia: Not enough sodium
Hypernatremia: Too much sodium
Hypokalemia: Not enough K
Hyperkalemia: Too much K
Touching Base with Acid-Base
Reviewing some base-ics
Interpreting the arterial blood gas results
Putting Up with the Problematic Prostate
Shrinking benign prostatic hyperplasia (BPH)
Not passing on prostatitis
Prostate cancer
Investigating Urinary Incontinence
Testing the Testes and Surrounding Anatomy
Tales of the twisted testicle: Torsion
Seeking testicular conditions ending in -cele
Priapism: Erections that won’t go away
Evaluating erectile dysfunction (ED)
Inspecting for infection: The -itises
Testicular tumors
Considering Kidney and Bladder Cancer
Reeling in renal cell carcinoma (RCC)
Beating bladder cancer
Practice Genitourinary System Questions
Answers and Explanations
Part IV: Pursuing Primary Care, Pharmacology, and Behavioral Health
Chapter 11: Prepping for Pediatrics
Performing a Newborn Examination
Examining the baby’s body
Checking reflexes
Assigning a score: APGAR, Not AEIOU
Reviewing Childhood Milestones
Vaccinating the Infant
Reviewing Some Pediatric Medical Conditions
Jaundice: Heeding the warning of yellow skin
Reducing the runs: Rotavirus and diarrhea
Keeping up with Kawasaki’s disease
Assessing childhood avascular necrosis
Preventing Reye’s syndrome
Keeping an Infant or Child Safe
Practice Questions for Pediatrics
Answers and Explanations
Chapter 12: Managing Health Maintenance and Medical Ethics
Recalling Preventive Medicine Guidelines
Categorizing prevention types
Screenings: Following preventive medicine guidelines
Population Patterns: Reviewing Epidemiology
Identifying conditions with lab tests: Being positive and negative, sensitive yet specific
Looking at the numbers: Incidence and prevalence of a condition
Studies and trials: Evaluating epidemiological studies
Seeking statistical significance
Dealing with Domestic Violence
Meeting Up with Medical Ethics
Practicing ethical principles
Abiding by patients’ rights
Practice Health Maintenance and Medical Ethics Questions
Answers and Explanations
Chapter 13: Tending to Behavioral Health
Getting Specific about Anxiety Disorders
Watching for panic attacks: A perceived reason to panic
Generalized anxiety disorder: Experiencing general, ongoing worry
Naming other anxiety disorders
Figuring out phobias
Scrutinizing Schizophrenia
Distinguishing between delusions and hallucinations
Diagnosing schizophrenia
Treating schizophrenia
Probing Personality Disorders
Diagnosing and treating personality disorders
Reviewing common personality disorders
Meeting the Mood Disorders
Overcoming major depression and dysthymia
Understanding bipolar disorder and cyclothymia
Understanding Substance Abuse
Distinguishing between dependence and addiction
Looking at common forms of substance abuse
Evaluating Eating Disorders
Recognizing anorexia
Beating bulimia
Practice Behavioral Health Questions
Answers and Explanations
Chapter 14: Focusing on Pharmacology and Toxicology
Reviewing Basic Pharmacological Principles
Absorbing the medication
Distributing the medication
Metabolizing the medication
Eliminating the medication
Examining Common Medication Side Effects
Coughing up the ACE (inhibitor)
Dealing with digoxin
Sorting out the statin side effects
Bashing the blockers’ side effects
Treating toxic theophylline
Eliminating excess lithium
Negating narcotics
Recognizing Common Drug Interactions
Being careful about warfarin (Coumadin)
Assessing the antiarrhythmic interactions
Having HAART: Interactions with anti-HIV meds
Watching over transplant medications
Seizing the antiseizure medications
Probing serotonin
Being alert to the anticholinergics
Managing the Toxic Ingestions
Being aware of acetaminophen overdoses
Avoiding the aspirin overdose
Treating the toxic alcohols
Messing with methamphetamines
Closing in on cocaine overdoses
Combating carbon monoxide poisoning
Practice Pharmacology/Toxicology Questions
Answers and Explanations
Part V: The Brain, Blood, Bugs, Skin, and Glands
Chapter 15: Evaluating the Endocrine System
Dealing with Diabetes and Other Glucose Problems
Looking at the shared traits of type 1 and type 2 diabetes
Missing insulin: Reviewing type 1 diabetes
Weighing in on type 2 diabetes
Blasting super-high blood glucose
Handling blood glucose when it bottoms out: Hypoglycemia
Discerning Calcium and Magnesium Problems
Hampering hypercalcemia
Getting down with hypocalcemia
Reviewing hypomagnesemia
Helping hypermagnesemia
Pursuing Those Pesky Adrenals
Awakening lazy adrenals
Confronting Cushing’s syndrome
Thinking about the Thyroid
Helping hypothyroidism
Handling hyperthyroidism
Identifying the similarities between Hashimoto’s and Graves’
Throttling thyroid cancer
Looking Over Lipids
Blaming relatives for some forms of hyperlipidemia
Treating hyperlipidemia
Practice Endocrine System Questions
Answers and Explanations
Chapter 16: Keeping Neurology in Mind
Changes in Mental Status: When It’s Not Okay to Change Your Mind
Tracing an altered status to meds or medical conditions
Dealing with dementia
Reviewing Movement Disorders
Stressing over essential tremors
Blaming brain chemistry for Parkinson’s disease
Chorea: Getting a handle on Huntington’s disease
Understanding cerebral palsy
Getting the Upper Hand on Peripheral Nerve Problems
Managing peripheral neuropathies
Relieving the intensity of complex regional pain syndrome
Identifying Brain Infections
Covering meningitis
Getting into encephalitis
Handling Headaches
Managing migraines
Easing tension headaches
Clustering headaches
Losing Consciousness
Fainting: Recovering from syncope
Sorting out seizure types and treatments
Viewing the Brain’s Vascular System
Identifying and preventing the transient ischemic attack
Stroke: Treating the brain attack
Treating the bleeding brain
Reviewing Other Neurological Disorders
Losing power: Mulling over myasthenia
Treating Guillain-Barré syndrome
Looking for the right signals in multiple sclerosis
Understanding Tourette’s syndrome
Concussions: Bruising the brain
Practice Neurology Questions
Answers and Explanations
Chapter 17: Touching on Dermatology
Mastering Skin Malignancies
Keeping up with Kaposi’s sarcoma
Intervening with basal cell carcinoma
Seeing squamous cell carcinoma
Battling malignant melanoma
Inflammation: Examining Eczematous Eruptions
Surveying Skin Infections
Treating bacterial infections
Candida and Dermatophyte: Fending off fungi
Putting a pox on viruses
Looking at Pigmentation, Bumps, and Sores
Spotting pigmentation problems
Facing acne
Horny growths: Examining keratosis lesions
Papules and scales: Putting up with papulosquamous diseases
Blistering bullous pemphigoid
Sweating over hidradenitis
Leaving lipomas alone
Eliminating hives
Pilonidal cyst: Looking at the buttocks
Bedsores: Scanning the sacrum to detect decubitus ulcers
Inspecting the Body for Insects and Arachnids
Lice aren’t so nice
Treating the mite-y scabies
Sorting out spider bites
Remaining Sensitive to the Loss of Skin or Hair
Losing the top layer of skin: Desquamating diseases
Assessing and staging burns
Alopecia: Where did the hair go?
Practice Dermatology Questions
Answers and Explanations
Chapter 18: Handling Hematology and Oncology
Analyzing Anemia
Mastering the microcytic anemias
Vitamin deficiencies: Mastering macrocytic anemias
Narrowing in on normocytic anemias
Ameliorating aplastic anemia
Harping on hemolysis: The destruction of red blood cells
Handling hereditary anemias
Probing Polycythemia Vera: The Opposite of Anemia
Getting the Lowdown on Platelets: Testing for Thrombocytopenia
Looking for ITP: Platelet production problems
Homing in on heparin-induced thrombocytopenia (HIT)
Dealing with disseminated intravascular coagulation (DIC)
Testing for thrombotic thrombocytopenic purpura (TTP)
Helping kids with hemolytic uremic syndrome
Sequestering platelets in the spleen
Confronting Coagulation Disorders
Viewing von Willebrand disease: Mucous membrane bleeding
Handling hemophilia
Kicking it with vitamin K: The clotting pathway
Clamoring Over Clotting Problems
Reviewing some hereditary causes
Evaluating some acquired causes of thrombophilia
Understanding Hematologic Malignancies
Mastering multiple myeloma
Asking about amyloidosis
Looking at the leukemias
Examining the lymphomas
Practice Hematology and Oncology Questions
Answers and Explanations
Chapter 19: Dealing with Bugs and Drugs: Infectious Diseases
Keeping Spirochetes and Rocky Mountain Spotted Fever from Spiraling Out of Control
Ticking off key points on Rocky Mountain spotted fever
Hitting the bull’s-eye with Lyme disease
Knowing the progression of syphilis
Beating Bacterial Infections
Causes of diarrhea: When what goes in comes out too fast
Rheumatic fever: Reviewing a rare disease
Botulism: An illness patients can avoid
Tetanus: Getting the lowdown on lockjaw
Diphtheria: A disease on the decline
Figuring Out the Fungus among Us
Knowing pneumocystis
Digging into histoplasmosis
Sticking your neck out to diagnose cryptococcus
Correcting candidiasis
Viewing the Viral Syndromes
Contemplating cytomegalovirus
Minimizing herpes recurrences
Identifying varicella’s painful lesions
Knowing what Epstein-Barr leads to
Keeping up with kids’ viruses
Handling HIV
Looking at Parasites That Worm Their Way In
Meeting malaria
Eliminating pinworms
Facing creepy, crawly helminths
Practice Infectious Disease Questions
Answers and Explanations
Part VI: Tackling a PANCE Practice Test
Chapter 20: PANCE Practice Test
Answer Sheet for PANCE Practice Test
Block 1
Block 2
Block 3
Block 4
Block 5
Chapter 21: PANCE Practice Test Answers and Explanations
Block 1
Block 2
Block 3
Block 4
Block 5
Answer Key
Part VII: The Part of Tens
Chapter 22: The Top Ten (Plus a Bonus) Medical Triads
Virchow’s Triad: Thrombosis
Charcot’s Two Triads: Ascending Cholangitis or Multiple Sclerosis
Beck’s Triad: Cardiac Tamponade
Saint’s Triad: Gallstones, Hiatal Hernia, Diverticular Disease
Whipple’s Triad: Insulinoma
Dieulafoy’s Triad: Acute Appendicitis
Sampter’s Triad: Aspirin Sensitivity
Waddell’s Triad: High-Impact Childhood Trauma
Cushing’s Triad: Head Trauma
Bergmann’s Triad: Fat Embolism
Chapter 23: Ten Important Medical Abbreviations
Delineating DIC from TTP in Thrombocytopenia
Figuring Out Fever of Unknown Origin (FUO)
Treating Sexually Transmitted Infections (STIs)
Understanding the Differential Diagnosis (DDx) of Really High Blood Pressure (HBP)
Minding Mean Corpuscular Volume (MCV)
Learning the Lumbar Puncture (LP)
Treating Tuberculosis (TB)
Controlling Congestive Heart Failure (CHF)
Identifying Inflammatory Bowel Disease (IBD)
Confronting Chronic Obstructive Pulmonary Disease (COPD)
Chapter 24: Ten Mistakes that Test-Takers Make
Taking Too Much Time on One Question
Passing on an Answer
Approaching Questions Randomly
Reading the Part and Not the Whole
Not Eliminating the Question’s Excess
Not Knowing Common Traps in Questions
Misunderstanding the Question’s Essence
Not Knowing Key Relationships
Not Going with Your Gut
Not Memorizing Key Points
Appendix A: About the CD
Practice tests
Flashcards
Slideshow
PDFs
Cheat Sheet

Physician Assistant Exam For Dummies®, Premier Edition

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About the Authors

Dr. Rich Snyder, DO, is an osteopathic physician who resides in Easton, Pennsylvania. He’s a kidney specialist, board-certified in both internal medicine and nephrology. He did his internal medicine residency at Abington Memorial Hospital and completed both clinical and research fellowships in nephrology at the Hospital of the University of Pennsylvania. He also has experience in graduate medical education. As a former associate program director and osteopathic program director at Easton Hospital, he was responsible for both the administration and education of medical residents and medical students.

In addition to maintaining a full-time clinical practice at Lehigh Valley Nephrology Associates, he has authored and co-authored several articles in peer-reviewed journals, including the American Journal of Kidney Disease and Kidney International. He has also presented at national meetings, including the National Kidney Foundation’s Annual Meeting. In addition to being a coauthor of Medical Dosage Calculations For Dummies, he has written the books What You Must Know about Kidney Disease: A Practical Guide to Using Conventional and Complementary Treatments and What You Must Know about Dialysis: Ten Secrets to Surviving and Thriving on Dialysis.

He’s also been interviewed regionally and nationally on radio and television about integrative medicine and kidney disease. He can be heard weekly on his show, Improve Your Kidney Health, on VoiceAmerica Radio Health & Wellness channel.

Barry Schoenborn lives in Nevada City, California. He’s a longtime technical and science writer with more than 35 years of experience. He’s written hundreds of user manuals. In the past, Barry’s technical writing company worked with the State of California agency CalRecycle to teach scientists and administrators how to write clearly.

Barry’s the co-author of Technical Math For Dummies, Medical Dosage Calculations For Dummies, and Storage Area Networks: Designing and Implementing a Mass Storage System.

He was a movie reviewer for the Los Angeles Herald-Dispatch newspaper and wrote a monthly political newspaper column for The Union newspaper of Grass Valley, California, for seven years. Barry’s publishing company, Willow Valley Press, published Dandelion Through the Crack: The Sato Family Quest for the American Dream, which won the 2008 William Saroyan International Prize for Writing.

Dedications

Rich Snyder: This book I dedicate to my mother, Nancy Snyder, a registered nurse and constant source of inspiration and encouragement.

I also dedicate this book to Patty Paul, RN. I speak for everyone at Lehigh Valley Nephrology Associates when I say that you live on in our hearts and minds. Your daughter-in-law, Donielle Paul, PA-C, embodies those same important qualities: kindness, compassion, and a commitment to medical excellence. We are lucky to have her with us in LVNA.

I finally dedicate this book to physician assistants everywhere. Thank you for your decision to work in the medical profession. It is a noble profession, and we thank you.

Barry Schoenborn: I dedicate this book to Frances H. Kakugawa, perhaps the most inspiring person I’ve ever met. She’s the author of ten books, three of which (Breaking the Silence: A Caregiver’s Voice, Mosaic Moon: Caregiving Through Poetry, and Wordsworth Dances the Waltz) have helped hundreds of Alzheimer’s caregivers find courage and strength.

This excellent author-poet conducts classes in poetry and journaling for caregivers. In her unique way, she has improved the quality of care for countless Alzheimer’s sufferers.

Authors’ Acknowledgments

Rich Snyder: I would not have been able to write this book without the heroic efforts of Barry Schoenborn. He is a gifted writer, and his brilliance is outshined only by his great sense of humor. I want to thank Vicki Adang for her help and guidance as well as all of the great editors we had the privilege of working with. I also want to thank Matt Wagner of Fresh Books for being in our corner.

Finally, I would like to thank everyone at Lehigh Valley Nephrology Associates for being the great people they are to work with. Many happy years to come!

Barry Schoenborn: This book wouldn’t have been possible without the Herculean efforts of co-author Rich Snyder. It’s amazing how much he knows! We were supported by a great team at John Wiley & Sons (Vicki Adang, Danielle Voirol, Jessica Smith, and Tracy Boggier) who worked hard to make this book a reality. They’re very talented and also happen to be the nicest people you’ll ever meet! Many thanks to our technical editors, Antoinette Polito and Jennifer Snyder. A big thanks, too, to Matt Wagner of Fresh Books Literary Agency, who presented us to Wiley.

Rich and I also are grateful to Intermountain Healthcare and Frank G. Yanowitz, MD, professor of medicine, University of Utah School of Medicine, and medical director, ECG Department, LDS Hospital, Salt Lake City, Utah, for their generosity and permission to use the electrocardiogram materials.

Publisher’s Acknowledgments

We’re proud of this book; please send us your comments at http://dummies.custhelp.com. For other comments, please contact our Customer Care Department within the U.S. at 877-762-2974, outside the U.S. at 317-572-3993, or fax 317-572-4002.

Some of the people who helped bring this book to market include the following:

Acquisitions, Editorial, and Vertical Websites

Senior Project Editor: Victoria M. Adang

Acquisitions Editor: Tracy Boggier

Senior Copy Editor: Danielle Voirol

Copy Editor: Jessica Smith

Assistant Editor: David Lutton

Editorial Program Coordinator: Joe Niesen

Technical Editors: Antoinette M. Polito, MHS, PA-C; Jennifer A. Snyder, PA-C, DFAAPA

Vertical Websites: Laura Moss-Hollister, Rich Graves, Shawn Patrick

Editorial Manager: Michelle Hacker

Editorial Assistants: Rachelle Amick, Alexa Koschier

Art Coordinator: Alicia B. South

Cover Photo: © iStockphoto.com/Maksim Belyy; © iStockphoto.com/rzdeb

Cartoons: Rich Tennant (www.the5thwave.com)

Composition Services

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Layout and Graphics: Carl Byers, Carrie A. Cesavice

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Indexer: Potomac Indexing, LLC

Publishing and Editorial for Consumer Dummies

Kathleen Nebenhaus, Vice President and Executive Publisher

David Palmer, Associate Publisher

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Publishing for Technology Dummies

Andy Cummings, Vice President and Publisher

Composition Services

Debbie Stailey, Director of Composition Services

Introduction

You couldn’t ask for a better career than that of a physician assistant (PA). The PA’s importance has increased and will continue to increase as healthcare expands. This is especially true in the United States, where people express great concern about provid- ing affordable healthcare for everyone. The doctors can’t get there without physician assistants.

To become a physician assistant, you have to pass the Physician Assistant National Certifying Examination (the PANCE). Established PAs must periodically take the Physician Assistant National Recertifying Examination (the PANRE). That’s why we wrote this book.

The vast majority of medical diagnostic and treatment scenarios are simple when you’re in command of the facts, but you see a lot of overlap in symptoms and alternate choices in treatment. And in the practice of medicine, there’s a lot to watch out for. For example, even the noblest treatment may produce electrolyte imbalances or other unforeseen conditions. Even the most effective medications may have unwanted side effects.

Our goal is to give you the best collection of review and test-preparation information you need to pass the PANCE or PANRE without excessive stress and strain. A valuable bonus is that we’ve included lots of excellent information you can use in your everyday practice.

About This Book

Physician Assistant Exam For Dummies, Premier Edition, puts out a lot of medical information in just a few chapters and in very compact form. This book is a reference, so you can jump in anywhere you like. It’s also a repair manual, because it can fill voids you may have in your scholastic background. You can find some unique features here:

check.png This book uses language you’ll understand. When Dr. Rich Snyder says, “This is a bad thing,” you immediately get the message. Many medical terms come with brief definitions. Those terms include symptoms, conditions, bacteria and viruses, generic and brand-name medication names, technical words, slang, and abbreviations.

check.png We cover symptoms, diagnosis, testing, and dosing in the context of both test preparation and clinical practice. The emphasis is on test prep, but we wouldn’t be doing our job if we didn’t talk about real life. We cover countless useful techniques, such as ordering that additional definitive test, ordering the best imaging, knowing first-line and second-line treatments, and following a patient’s progress on various meds. The scenarios we describe are based on classic presentations and are likely to appear on the PANCE or PANRE. Many examples are based on real-life experiences.

Nonetheless, this book is a test-preparation book. We’ve put in huge amounts of information applicable to daily clinical practice, but in the main, we’ve focused on your managing the PANCE or PANRE. You’ll see numerous conditions in clinical practice over the years, but if they aren’t likely to appear on the test, we’ve had to omit them.

check.png We include practice questions to test your knowledge in nearly every chapter. After answering a question, make sure to read the answer explanation, even if you chose the correct answer, because this book educates through wrong answers as well as correct ones. We’ve put in abundant information about why the wrong answers are wrong.

check.png We give you one complete practice exam in the book and four additional digital full-length tests. These tests, which are available on the CD accompanying this book or via download (if you’re using a digital version of this book), provide you with even more practice so you’re ready to go on test day.

check.png You see an insight or two from a doctor, who (sadly) treats patients with advanced conditions. Many of these patients are older, with multiple afflictions. Barry will be the first to tell you that he wouldn’t trade places with Rich for the proverbial million bucks.

check.png This book isn’t dull (we hope), as other test prep books tend to be. Because it’s a For Dummies book, you can be sure that it’s relatively lively and easy to read. The only reason this book doesn’t have a lot of light moments is that so much in medicine isn’t funny. When people may die, we don’t make jokes.

Conventions Used in This Book

We designed this book to be user-friendly, maybe even user-affectionate. The subject matter is quite challenging, so we don’t think you need a book that’s hard to read. We use the following conventions:

check.png When talking about exam topics, we often use PANCE as shorthand to refer to both the PANCE and the PANRE. Reading “PANCE or PANRE” all the time gets a little tedious.

check.png Italic type highlights new terms, bacteria names, and virus names. Once in a great while, we use italics for emphasis.

check.png Whenever possible, we provide alternate names for disease conditions, signs, or tests. For example, otitis externa is also known as external otitis and swimmer’s ear.

check.png Each drug name appears first with its generic name and then with a commercial brand name in parentheses. For example, we say “hydrocodone (Vicodin)” to show you both the generic name and the brand name. In some cases, only the generic form is available. However, when you take the PANCE or PANRE, the questions include only the generic drug name, so make sure you know generic names as well as you know your own.

check.png We usually write numbers as numerals, not words. For example, the text says “vaccinate at ages 3 months and 6 months,” not “vaccinate at ages three months and six months.” The same idea applies to units. We write “g,” not “gram.” We write “dL,” not “deciliter,” wherever possible. And we also include the greater-than and less-than symbols in text. Why? Because we want to give you the numbers and units as you’ll see them every day in your career.

check.png Web addresses are in monofont. If the address breaks across two lines of text, no extra characters indicate the break. Just type what you see into your browser.

What You’re Not to Read

We’d love you to read all the words in this book in the order in which they appear, but life is short. You don’t have to read chapters that don’t interest you. This book is a reference book, and it’s designed to let you read only the parts you need.

Sidebars (that’s what they’re called in publishing) are the blocks of text that have a gray background. They’re interesting and highly useful in your understanding of the main text, but they contain info that isn’t essential to the topic at hand. You’re under no obligation to read them.

Foolish Assumptions

In writing this book, we had to make a few assumptions about you:

check.png You’re getting ready to take the PANCE or PANRE. You’re nearing completion of a two-year or three-year PA program, and all indications are that you’ll successfully complete your coursework and are ready to sit for the PANCE. Or if you’re already working as a PA, we assume that it’s time for you to take the PANRE.

check.png You got a full exposure to medical concepts via your textbooks, your lectures, and your rotations. If you’re prepping for the PANCE, we assume you’ve had a quality education. If you’re going to take the PANRE, we assume you’ve been in the trenches for several years.

check.png You have access to detailed medical texts. Remember, this book is largely a review. We can’t stuff all things medicine into one volume, so consult your texts when you need to.

check.png You want to take some practice exams. We include a printed exam in the book and four addition digital exams on the companion CD or via download (if you have a digital version of this book).

How This Book Is Organized

This book has seven parts. After the introductory chapters, we concentrate on all major body organ systems. Some chapters are longer than others because the PANCE and PANRE devote more questions to them.

Part I: Scratching the Surface of the PANCE and PANRE

Part I gives you an overview of the PA exams. It deals with test-taking procedures and strategies you can use to ensure success. We describe the importance of the tests and what you need to do after the test to become a fully certified and licensed PA. Then we offer tips for preparing for the test and tell you what to expect on test day. We also give you some insights into the test — the breakdown of the questions, how the test is scored, that kind of stuff.

Part II: Getting to the Heart of the Test: Four Foundational Systems

Four topics — cardio, pulmonary, the gastrointestinal system, and bones and joints — make up approximately half the questions on the PANCE, so we devote Part II to these vital organ systems.

Part III: Reviewing Surgical Topics and Other Organ Systems

Part III contains chapters about surgery; the genitourinary system; the eyes, ears, nose, and throat; and reproductive medicine. These topics yield a fair number of questions on the test, though not quite as many as the topics in Part II.

Part IV: Pursuing Primary Care, Pharmacology, and Behavioral Health

Part IV addresses special medical topics: pediatrics, health maintenance and medical ethics, behavioral health and psychiatry, and pharmacology and toxicology. You’ll likely encounter a couple of questions on each of these topics on the test.

Part V: The Brain, Blood, Bugs, Skin, and Glands

Part V provides a review of the endocrine system, hematology and oncology, neurology, dermatology, and infectious diseases. These topics won’t constitute a big portion of the exam, but they’ll be represented.

Part VI: Tackling a PANCE Practice Test

When you’re ready to tackle PANCE questions, flip to Part VI. You find a complete 300- question PANCE practice examination in Chapter 20. Chapter 21 explains the correct answers and why the other answer choices are incorrect.

Part VII: The Part of Tens

The three chapters in the Part of Tens are filled with useful information in compact form. We cover medical triads, common medical abbreviations, and mistakes that test-takers make.

CD-ROM

The companion CD contains four practice tests: three PANCEs and one PANRE. You can take timed versions of all four tests to simulate the real testing experience, or you can take untimed versions of two of the PANCE practice tests for extra practice and review of the material. We’ve also included more than 300 flashcards that cover facts related to each of the 13 categories tested on the PANCE. Finally, you can find a slideshow of dermatologic conditions that you should be able to identify on sight. We give you more detailed information about the CD in the appendix. Note: If you’re using a digital version of this book, please go to http://booksupport.wiley.com for access to the additional content.

Icons Used in This Book

Icons are the drawings in the margins of this book, and we use several icons to call out special kinds of information.

example_gre.eps Examples are sample test questions that appear at the ends of sections and that highlight particular conditions or diseases. We provide an answer and explanation immediately after the question. (And there’s more — at the end of a chapter, you usually find six numbered sample questions, which we don’t mark with the icon because they’re in their own practice-questions section.)

remember.eps The Remember icon points out something you should keep in mind, whether you’re taking the exam or examining and treating a patient.

tip.eps A Tip is a suggestion that usually points out a trick for remembering information for the test or a quick and easy way to get things done.

warning_bomb.eps The Warning icon flags a serious situation where you should exercise care and perhaps seek additional advice. Numerous diagnostic situations can be critical to the well-being of the patient, and you need to be aware of them.

Where to Go from Here

You can go to any chapter from here. The book isn’t linear, so you can start anywhere. First, check the table of contents for the names of the parts and the chapters. Then pick any chapter you’re interested in. If you can’t decide, begin with Chapter 1 — it includes broad concepts about the PANCE and PANRE and becoming a PA, and you’ll probably need to read it at some point. If you have a particular body organ system you want to concentrate on, such as the cardiovascular system (Chapter 3) or the genitourinary system (Chapter 10), go straight to it. We give you an index, too, at the back of the book. Or, if you’d like, you can take one of the tests to see how well you do and figure out what you need to brush up on.

Part I

Scratching the Surface of the PANCE and PANRE

9781118115565%20pp0101.eps

In this part . . .

Part I is an overview of the PANCE and PANRE. Chapter 1 describes steps to becoming a physician assistant and the importance of the exams. Chapter 2 gives you details about the process of preparing for and taking the test. It includes the basic techniques for succeeding with test questions.