,TESTBANK FOR Clinical Medicine for Physician
Assistants Van Rhee
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel sheet
if it exists.
4- We have all what you need, we make update
at every time. There are many new editions
waiting you.
5- If you think you purchased the wrong file You
can contact us at every time, we can replace it
with true one.
Our email:
,Test Bank to Accompany
Clinical
Medicine
for Physician
Assistants
James Van Rhee,
MS, PA-C, DFAAPA
Christine Bruce,
DMSC, MHSA, PA-C,
DFAAPA
Stephanie Neary,
MPA, MMS, PA-C
, 2
Copyright © 2023 Springer Publishing Company, LLC
All Rights Reserved.
This work is protected by U.S. copyright laws and is provided solely for the use of instructors in
teaching their courses and as an aid for student learning. No part of this publication may be sold,
reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise, without the prior permission of Springer
Publishing Company, LLC.
Springer Publishing Company, LLC
11 West 42nd Street
New York, NY 10036
www.springerpub.com
ISBN: 978-0-8261-8298-2
The author and the publisher of this Work have made every effort to use sources believed to be
reliable to provide information that is accurate and compatible with the standards generally ac-
cepted at the time of publication. The author and publisher shall not be liable for any special,
consequential, or exemplary damages resulting, in whole or in part, from the readers’ use of, or
reliance on, the information contained in this book. The publisher has no responsibility for the
persistence or accuracy of URLs for external or third-party Internet websites referred to in this
publication and does not guarantee that any content on such websites is, or will remain, accurate
or appropriate.
© Springer Publishing Company, LLC.
, 3
Contents
Chapter 1: Dermatology 4
Chapter 2: Ocular System 40
Chapter 3: Ear, Nose, and Throat Disorders 74
Chapter 4: Pulmonary System 108
Chapter 5: Cardiovascular System 136
Chapter 6: Hematology 179
Chapter 7: Oncology 217
Chapter 8: Gastrointestinal System 247
Chapter 9: Nutrition 282
Chapter 10: Renal System 289
Chapter 11: Genitourinary System 324
Chapter 12: Reproductive System 353
Chapter 13: Musculoskeletal System 385
Chapter 14: Rheumatology 431
Chapter 15: Neurologic System 466
Chapter 16: Endocrine System 495
Chapter 17: Infectious Diseases 533
Chapter 18: Psychiatry 573
Chapter 19: Care of the Sexual and Gender Minority Patient 614
Chapter 20: Preventative Medicine 645
Chapter 21: Abuse 656
Chapter 22: Surgery 663
Chapter 23: Genetic Disorders 723
© Springer Publishing Company, LLC.
, 4
CHAPTER 1: DERMATOLOGY
1. A patient presents with an ulcerated skin lesion on his face. Which of the following is the most
likely diagnosis?
A. Melanoma @ No. Melanoma does not appear as ulcerated nodules.
B. Dysplastic nevi @ No. Dysplastic nevi do not appear as ulcerated nodules.
C. Paget disease @ No. Paget disease typically involves the breast but can present as a
red, scaly lesion on the genitals, anus, groin, and armpits.
D. Basal cell carcinoma @ No. Basal cell carcinoma does not appear as ulcerated nod-
ules.
*E. Squamous cell carcinoma @ Yes. Squamous cell carcinoma may appear as a hyperk-
eratotic papule, erosion, or nodule that presents as an ulcerated lesion with hard, raised
edges (which may be ulcerated).
2. A 30-year-old male presents with a 1-year history of multiple widely disseminated papules
and plaques. Lesions are also noted on the mucosa membranes in the mouth. The lesions vary in
color from purple to pink and are slightly raised. Some of the lesions are irritated and appear to
have been bleeding. Which of the following condition is most likely related to these skin lesions?
*A. AIDS @ Yes. Kaposi sarcoma is due to infection with herpesvirus type 8. Common
in patients with AIDS, the lesions present as nodules or blotches that vary in color from
red to purple, brown, and black. The lesions are usually papular. Lesions can be located
on the skin, mucous membranes, respiratory system, and GI tract.
B. Melanoma @ No. Melanoma produces lesions that may vary in color and may metas-
tasize to the skin but is not associated with bleeding.
© Springer Publishing Company, LLC.
, 5
C. Contact dermatitis @ No. Contact dermatitis causes erythema or blistering lesions but
does not usually bleed.
D. Staphylococcal infection @ No. Staphylococcal infection can cause a skin rash but
would not persist for a year and would not cause bleeding.
E. Clotting factor deficiency @ No. Clotting factor deficiencies can cause bleeding but
would not cause persistent skin lesions other than purpura.
3. Which of the following disorders is mediated by a type III hypersensitivity reaction?
A. Acne vulgaris @ No. The pathogenesis of acne vulgaris is related to endocrine, famil-
ial, and environmental factors.
B. Dermatomyositis @ No. Dermatomyositis is a humoral-mediated autoimmune disease
in which antigen-specific antibodies are deposited in the microvasculature.
C. Contact dermatitis @ No. Contact dermatitis is a form of eczematous dermatitis. This
is a form of type IV hypersensitivity reaction.
D. Bullous pemphigoid @ No. Bullous pemphigoid is mediated by different types of au-
toantibodies that react with components of desmosomes or hemidesmosomes. This is a
form of type II hypersensitivity reaction.
*E. Discoid lupus erythematosus @ Yes. Discoid lupus erythematosus is the localized cu-
taneous form of systemic lupus erythematosus. Skin lesions are associated with immune
complex deposition along the dermal–epidermal junction. This is a form of type III hy-
persensitivity reaction.
© Springer Publishing Company, LLC.
, 6
4. A 4-week-old male presents with a rash in the diaper area. Physical examination reveals ery-
thematous, slightly scaly patches covering the buttocks and the lower abdomen. Skin creases ap-
pear spared. The baby is otherwise healthy. Which of the following is the most likely diagnosis?
A. Tinea corporis @ No. Tinea corporis is ringworm and due to dermatophyte. It presents
with a rash with raised borders and central clearing.
*B. Irritant contact dermatitis @ Yes. Irritant contact dermatitis, or diaper dermatitis,
presents with erythematous areas in the diaper area due to skin contact with fecal and uri-
nary material, entrapped moisture, and excessive heat.
C. Langerhans cell histiocytosis @ No. Langerhans cell histiocytosis is due to the neo-
plastic proliferation of Langerhans cells. The infant is critically ill with fever and a dif-
fuse scaly rash.
D. Seborrheic dermatitis @ No. Seborrheic dermatitis presents with salmon-colored,
scaly, oily plaques, it most commonly involves the scalp and face.
E. Psoriasis @ No. Psoriasis is characterized by well-demarcated silvery plaques that of-
ten involve skin folds in infants.
5. A 38-year-old female presents with many pigmented lesions on her body. Physical examina-
tion reveals numerous lesions, most prominent on the sun-exposed areas of the skin and scalp.
The lesions are round, slightly asymmetrical, and vary in size from 5 to 10 mm. The patient
states that the lesions have not changed in the past 6 to 8 months. Which of the following is the
most likely diagnosis?
A. Malignant melanomas @ No. Malignant melanoma is asymmetrical in shape and the
color varies more widely than in dysplastic nevi.
© Springer Publishing Company, LLC.
, 7
B. Compound nevi @ No. Compound nevi are usually dark, typically elevated, 3 to 6 mm
lesions with a very regular shape; most patients have about a dozen of these lesions.
*C. Dysplastic nevi @ Yes. Dysplastic nevi are pigmented, mole-like lesions that are
very common. They often grow larger than ordinary moles, they are often flat, but parts
may be raised and may have irregular and indistinct borders. Their color may not be uni-
form and may range from light pink to very dark brown. While not cancerous themselves,
they may progress to melanoma.
D. Halo nevi @ No. Halo nevi are flesh-colored or dark nodules, usually 3 to 5 mm, sur-
rounded by a ring of depigmented skin.
E. Lentigos @ No. Lentigos are flat, with sharp margins, uniformly pigmented, 2 to 4
mm diameter skin lesions.
6. What type of skin cancer is Bowen disease?
A. Basal cell @ No. Bowen disease is not considered to be basal cell cancer.
B. Melanoma @ No. Bowen disease is not melanoma.
*C. Squamous cell @ Yes. Bowen disease is a superficial erythematous patch or plaque,
often with a scale, involvement is limited to the epidermis and is considered to be squa-
mous cell carcinoma in situ.
D. Actinic keratosis @ No. Bowen disease is not actinic keratosis.
E. Seborrheic keratosis @ No. Bowen disease is not seborrheic keratosis.
7. A 55-year-old male presents with a 1-month history of sores in the mouth and on the skin. The
sores started as blisters and then ruptured. The patient states the affected areas are painful, but no
© Springer Publishing Company, LLC.
, 8
pruritis is noted. Physical examination demonstrates multiple painful erosions on the oral mucosa
and tongue. On the trunk there are raw. Three are a few flaccid bullae noted. Rubbing of the skin
near an affected area easily detaches the superficial part of the epidermis from the underlying
skin. No target-like lesions are seen. Which of the following is the most likely diagnosis?
A. Bullous pemphigoid @ No. Bullous pemphigoid presents with tense bullae that do not
rupture easily. Mucosal involvement is rare.
*B. Pemphigus vulgaris @ Yes. Pemphigus vulgaris is an autoimmune skin disorder that
presents with blistering and painful erosions involving the mucous membranes and skin.
Nikolsky sign is a helpful diagnostic clue. Pemphigus tends to begin in the mouth.
C. Dermatitis herpetiformis @ No. Dermatitis herpetiformis presents with pruritic vesi-
cles, papules, and urticarial lesions on the extensor surfaces.
D. Stevens–Johnson syndrome @ No. Stevens–Johnson syndrome presents with severe,
blistering and a history of drug ingestion or infection.
E. Toxic epidermal necrolysis @ No. Toxic epidermal necrolysis is an extension of
Stevens–Johnson syndrome and presents with widespread flaccid blisters and in-
volves >20% to 30% of the skin.
8. A 3-year-old girl presents with some new skin lesions. The patient has been itching the lesion
and some are red and swollen. On the patient’s abdomen, there are about 15 to 20 flesh-colored,
pearly papules with a central umbilication. Which of the following is the most likely diagnosis?
A. Varicella @ No. Varicella is due to the varicella-zoster virus. It commonly affects
children between the ages of 5 and 9. It presents with maculopapular lesions, vesicles,
and scabs in various stages, low-grade fever, and malaise.
© Springer Publishing Company, LLC.
Assistants Van Rhee
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel sheet
if it exists.
4- We have all what you need, we make update
at every time. There are many new editions
waiting you.
5- If you think you purchased the wrong file You
can contact us at every time, we can replace it
with true one.
Our email:
,Test Bank to Accompany
Clinical
Medicine
for Physician
Assistants
James Van Rhee,
MS, PA-C, DFAAPA
Christine Bruce,
DMSC, MHSA, PA-C,
DFAAPA
Stephanie Neary,
MPA, MMS, PA-C
, 2
Copyright © 2023 Springer Publishing Company, LLC
All Rights Reserved.
This work is protected by U.S. copyright laws and is provided solely for the use of instructors in
teaching their courses and as an aid for student learning. No part of this publication may be sold,
reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise, without the prior permission of Springer
Publishing Company, LLC.
Springer Publishing Company, LLC
11 West 42nd Street
New York, NY 10036
www.springerpub.com
ISBN: 978-0-8261-8298-2
The author and the publisher of this Work have made every effort to use sources believed to be
reliable to provide information that is accurate and compatible with the standards generally ac-
cepted at the time of publication. The author and publisher shall not be liable for any special,
consequential, or exemplary damages resulting, in whole or in part, from the readers’ use of, or
reliance on, the information contained in this book. The publisher has no responsibility for the
persistence or accuracy of URLs for external or third-party Internet websites referred to in this
publication and does not guarantee that any content on such websites is, or will remain, accurate
or appropriate.
© Springer Publishing Company, LLC.
, 3
Contents
Chapter 1: Dermatology 4
Chapter 2: Ocular System 40
Chapter 3: Ear, Nose, and Throat Disorders 74
Chapter 4: Pulmonary System 108
Chapter 5: Cardiovascular System 136
Chapter 6: Hematology 179
Chapter 7: Oncology 217
Chapter 8: Gastrointestinal System 247
Chapter 9: Nutrition 282
Chapter 10: Renal System 289
Chapter 11: Genitourinary System 324
Chapter 12: Reproductive System 353
Chapter 13: Musculoskeletal System 385
Chapter 14: Rheumatology 431
Chapter 15: Neurologic System 466
Chapter 16: Endocrine System 495
Chapter 17: Infectious Diseases 533
Chapter 18: Psychiatry 573
Chapter 19: Care of the Sexual and Gender Minority Patient 614
Chapter 20: Preventative Medicine 645
Chapter 21: Abuse 656
Chapter 22: Surgery 663
Chapter 23: Genetic Disorders 723
© Springer Publishing Company, LLC.
, 4
CHAPTER 1: DERMATOLOGY
1. A patient presents with an ulcerated skin lesion on his face. Which of the following is the most
likely diagnosis?
A. Melanoma @ No. Melanoma does not appear as ulcerated nodules.
B. Dysplastic nevi @ No. Dysplastic nevi do not appear as ulcerated nodules.
C. Paget disease @ No. Paget disease typically involves the breast but can present as a
red, scaly lesion on the genitals, anus, groin, and armpits.
D. Basal cell carcinoma @ No. Basal cell carcinoma does not appear as ulcerated nod-
ules.
*E. Squamous cell carcinoma @ Yes. Squamous cell carcinoma may appear as a hyperk-
eratotic papule, erosion, or nodule that presents as an ulcerated lesion with hard, raised
edges (which may be ulcerated).
2. A 30-year-old male presents with a 1-year history of multiple widely disseminated papules
and plaques. Lesions are also noted on the mucosa membranes in the mouth. The lesions vary in
color from purple to pink and are slightly raised. Some of the lesions are irritated and appear to
have been bleeding. Which of the following condition is most likely related to these skin lesions?
*A. AIDS @ Yes. Kaposi sarcoma is due to infection with herpesvirus type 8. Common
in patients with AIDS, the lesions present as nodules or blotches that vary in color from
red to purple, brown, and black. The lesions are usually papular. Lesions can be located
on the skin, mucous membranes, respiratory system, and GI tract.
B. Melanoma @ No. Melanoma produces lesions that may vary in color and may metas-
tasize to the skin but is not associated with bleeding.
© Springer Publishing Company, LLC.
, 5
C. Contact dermatitis @ No. Contact dermatitis causes erythema or blistering lesions but
does not usually bleed.
D. Staphylococcal infection @ No. Staphylococcal infection can cause a skin rash but
would not persist for a year and would not cause bleeding.
E. Clotting factor deficiency @ No. Clotting factor deficiencies can cause bleeding but
would not cause persistent skin lesions other than purpura.
3. Which of the following disorders is mediated by a type III hypersensitivity reaction?
A. Acne vulgaris @ No. The pathogenesis of acne vulgaris is related to endocrine, famil-
ial, and environmental factors.
B. Dermatomyositis @ No. Dermatomyositis is a humoral-mediated autoimmune disease
in which antigen-specific antibodies are deposited in the microvasculature.
C. Contact dermatitis @ No. Contact dermatitis is a form of eczematous dermatitis. This
is a form of type IV hypersensitivity reaction.
D. Bullous pemphigoid @ No. Bullous pemphigoid is mediated by different types of au-
toantibodies that react with components of desmosomes or hemidesmosomes. This is a
form of type II hypersensitivity reaction.
*E. Discoid lupus erythematosus @ Yes. Discoid lupus erythematosus is the localized cu-
taneous form of systemic lupus erythematosus. Skin lesions are associated with immune
complex deposition along the dermal–epidermal junction. This is a form of type III hy-
persensitivity reaction.
© Springer Publishing Company, LLC.
, 6
4. A 4-week-old male presents with a rash in the diaper area. Physical examination reveals ery-
thematous, slightly scaly patches covering the buttocks and the lower abdomen. Skin creases ap-
pear spared. The baby is otherwise healthy. Which of the following is the most likely diagnosis?
A. Tinea corporis @ No. Tinea corporis is ringworm and due to dermatophyte. It presents
with a rash with raised borders and central clearing.
*B. Irritant contact dermatitis @ Yes. Irritant contact dermatitis, or diaper dermatitis,
presents with erythematous areas in the diaper area due to skin contact with fecal and uri-
nary material, entrapped moisture, and excessive heat.
C. Langerhans cell histiocytosis @ No. Langerhans cell histiocytosis is due to the neo-
plastic proliferation of Langerhans cells. The infant is critically ill with fever and a dif-
fuse scaly rash.
D. Seborrheic dermatitis @ No. Seborrheic dermatitis presents with salmon-colored,
scaly, oily plaques, it most commonly involves the scalp and face.
E. Psoriasis @ No. Psoriasis is characterized by well-demarcated silvery plaques that of-
ten involve skin folds in infants.
5. A 38-year-old female presents with many pigmented lesions on her body. Physical examina-
tion reveals numerous lesions, most prominent on the sun-exposed areas of the skin and scalp.
The lesions are round, slightly asymmetrical, and vary in size from 5 to 10 mm. The patient
states that the lesions have not changed in the past 6 to 8 months. Which of the following is the
most likely diagnosis?
A. Malignant melanomas @ No. Malignant melanoma is asymmetrical in shape and the
color varies more widely than in dysplastic nevi.
© Springer Publishing Company, LLC.
, 7
B. Compound nevi @ No. Compound nevi are usually dark, typically elevated, 3 to 6 mm
lesions with a very regular shape; most patients have about a dozen of these lesions.
*C. Dysplastic nevi @ Yes. Dysplastic nevi are pigmented, mole-like lesions that are
very common. They often grow larger than ordinary moles, they are often flat, but parts
may be raised and may have irregular and indistinct borders. Their color may not be uni-
form and may range from light pink to very dark brown. While not cancerous themselves,
they may progress to melanoma.
D. Halo nevi @ No. Halo nevi are flesh-colored or dark nodules, usually 3 to 5 mm, sur-
rounded by a ring of depigmented skin.
E. Lentigos @ No. Lentigos are flat, with sharp margins, uniformly pigmented, 2 to 4
mm diameter skin lesions.
6. What type of skin cancer is Bowen disease?
A. Basal cell @ No. Bowen disease is not considered to be basal cell cancer.
B. Melanoma @ No. Bowen disease is not melanoma.
*C. Squamous cell @ Yes. Bowen disease is a superficial erythematous patch or plaque,
often with a scale, involvement is limited to the epidermis and is considered to be squa-
mous cell carcinoma in situ.
D. Actinic keratosis @ No. Bowen disease is not actinic keratosis.
E. Seborrheic keratosis @ No. Bowen disease is not seborrheic keratosis.
7. A 55-year-old male presents with a 1-month history of sores in the mouth and on the skin. The
sores started as blisters and then ruptured. The patient states the affected areas are painful, but no
© Springer Publishing Company, LLC.
, 8
pruritis is noted. Physical examination demonstrates multiple painful erosions on the oral mucosa
and tongue. On the trunk there are raw. Three are a few flaccid bullae noted. Rubbing of the skin
near an affected area easily detaches the superficial part of the epidermis from the underlying
skin. No target-like lesions are seen. Which of the following is the most likely diagnosis?
A. Bullous pemphigoid @ No. Bullous pemphigoid presents with tense bullae that do not
rupture easily. Mucosal involvement is rare.
*B. Pemphigus vulgaris @ Yes. Pemphigus vulgaris is an autoimmune skin disorder that
presents with blistering and painful erosions involving the mucous membranes and skin.
Nikolsky sign is a helpful diagnostic clue. Pemphigus tends to begin in the mouth.
C. Dermatitis herpetiformis @ No. Dermatitis herpetiformis presents with pruritic vesi-
cles, papules, and urticarial lesions on the extensor surfaces.
D. Stevens–Johnson syndrome @ No. Stevens–Johnson syndrome presents with severe,
blistering and a history of drug ingestion or infection.
E. Toxic epidermal necrolysis @ No. Toxic epidermal necrolysis is an extension of
Stevens–Johnson syndrome and presents with widespread flaccid blisters and in-
volves >20% to 30% of the skin.
8. A 3-year-old girl presents with some new skin lesions. The patient has been itching the lesion
and some are red and swollen. On the patient’s abdomen, there are about 15 to 20 flesh-colored,
pearly papules with a central umbilication. Which of the following is the most likely diagnosis?
A. Varicella @ No. Varicella is due to the varicella-zoster virus. It commonly affects
children between the ages of 5 and 9. It presents with maculopapular lesions, vesicles,
and scabs in various stages, low-grade fever, and malaise.
© Springer Publishing Company, LLC.
