Episode 109: The Audio PANCE and PANRE Board Review Podcast

Listen to Podcast Episode 109: Ten PANCE, PANRE, and Rotation Review Questions If you can't see the audio player, click here to listen to the full episode. Welcome to episode 109 of the Audio PANCE and PANRE Physician Assistant/Associate (PA) Board Review Podcast. Join me today as we cover ten board review questions for your PANCE, PANRE, EOR, and EOC exams. Resources and links from today's episode: View my PANRE-LA Performance Score and see my process for taking PANRE-LA Questions Learn all about the new Smarty PANCE QBank Sign up for our PANCE and PANRE Test-taking Masterclass Sign up for the Entire Blueprint Email Series Follow Smarty PANCE and The Daily PANCE Blueprint on Instagram and Facebook Join the Smarty PANCE Member's Community, then sign up for a study group to get updates about upcoming webinars I hope you enjoy this free audio component of the examination portion of this site. Smarty PANCE includes over 2,000 interactive board review questions, along with flashcards, ReelDx cases, integrated Picmonics, and lessons covering every blueprint topic available to all Smarty PANCE members. You can download and listen to past FREE episodes here, on iTunes, Spotify, Amazon Music, and all podcasting apps. On each episode page, you can listen to all the latest episodes, take interactive quizzes, and download more resources. Interactive Exam to Complement Today's Podcast 1. A 70-year-old man presents for evaluation of poorly controlled hypertension despite adherence to five different classes of antihypertensive medications. His medical history includes coronary artery disease with a myocardial infarction 3 years ago, peripheral artery disease, and type 2 diabetes mellitus. He reports no changes in his medication regimen and denies any recent lifestyle modifications. Physical examination reveals a blood pressure of 190/110 mm Hg in the left arm and 180/100 mm Hg in the right arm. His BMI is 24 kg/m². On auscultation, there is no abnormal heart sound. Which of the following additional findings is most likely to be seen in this patient? A. Elevated serum aldosterone-to-renin ratio B. Continuous murmur over the carotid arteries C. Diminished femoral pulses D. Continuous bruit in the lateral periumbilical area E. Pitting edema in the lower extremities Answer and topic summary The answer is D. Continuous bruit in the lateral periumbilical area Renal artery stenosis is a significant cause of secondary hypertension, particularly in patients with a history of atherosclerotic disease, as seen in this patient with coronary artery disease and peripheral artery disease. Resistant hypertension, uncontrolled despite multiple medications, is a hallmark. A continuous bruit in the lateral periumbilical area indicates turbulent blood flow through a narrowed renal artery, supporting this diagnosis. Incorrect Answers: A. Elevated aldosterone-to-renin ratio suggests primary aldosteronism, less likely given the atherosclerotic history pointing to renal artery stenosis. B. A carotid murmur indicates carotid artery disease, unrelated to this hypertension scenario. C. Diminished femoral pulses align with peripheral artery disease, but don’t explain the resistant hypertension. E. Pitting edema suggests heart failure or venous insufficiency, not specific to renal artery stenosis. Smarty PANCE Content Blueprint Review: Covered under ⇒ PANCE Blueprint Renal System ⇒ Congenital or structural renal disorders ⇒ Renal vascular disease 2. A 70-year-old woman comes to the emergency department due to sudden-onset chest pain followed by shortness of breath. The pain started 2 hours ago, and she experienced an episode of syncope lasting about 1 minute shortly after the pain began. She has a history of untreated hypertension and hyperlipidemia. Blood pressure is 180/95 mm Hg in both arms; pulse is 110/min and irregular; and respirations are 22/min.

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Episode 109: The Audio PANCE and PANRE Board Review Podcast is an episode from The Audio PANCE AND PANRE Physician Assistant Board Review Podcast by Smarty PANCE | The PA Life.

This episode is 38:12 long.

This episode was published on Mar 12, 2025.

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