The Daily PANCE PANRE Question 44

An 18-year-old female presents after completing her freshman year at college. Two months ago, she developed "bronchitis" which has persisted. She has become increasingly tired and has frequent night sweats. A chest x-ray today reveals a left mediastinal mass. What is the next step in her evaluation? repeat the chest x-ray in six months ultrasound of the left hemithorax bone scan CT scan of the chest proceed directly to bronchoscopy with biopsy Answer:D CT scan of the chest Any patient presenting with mediastinal nodes should have a CT. This patient may have sarcoid or Hodgkin's or another type of cancer - CT is indicated. If you see hilarlymphadenopathyit is right to think Sarcoidosis, but not always.Here is a rough guide to approaching hilar adenopathy (click here) Young female = Sarcoidosis Young kid with a fever, from Ohio, zookeeper = histoplasmosis An old guy in his 60s works on ceramics = Berylliosis Know Your NCCPAContent Blueprint There are 32 respiratory disorders covered in NCCPA ContentBlueprint Pulmonology System(12%) Browse the Content Blueprint and learn more about sarcoidosis,Hodgkins Lymphomaother causes of hilar lymphadenopathy such as histoplasmosis. Note: * This is part of the Daily PANCE and PANRE in your inbox email series: 60 days of PANCE and PANRE Questions and Answers delivered directly to your inbox. It is a great and fun way to learn! If you haven't already, you can sign up for FREE by clicking Here. Help support The PA Life for FREE! This is provided as an opportunity for anyone who appreciates this email series to help support it painlessly. If you are going to be purchasing anything from Amazon.com (books, school supplies, etc.) simply start your next Amazon.com purchase by clicking here... it's a free way for you to help support the cause! Just click over to Amazon.com then, when you make your purchase, Amazon will send a portion of the proceeds to The Physician Assistant Life. The money goes toward paying for one-time and ongoing costs (like equipment, hosting, backup services, etc.). Thank you for supporting the site and keeping this content free! If you are studying for the PANCE or the PANRE I recommend thesereview books Stephen, Just wanted to let you know that I am enjoying your site very much and believe it is helping more than any other site Ive used thus-far (I have done HippoPA, not bad, and Brian Wallaces site). Will study some more, dont feel ready yet! Im an older PA, practiced for 18 years, have done the at home board tests the last two. I am nervous about taking the test center exam! Thanks again for your site, and the best to you! Rebecca Lynch, PA-C I took my boards for the 7 th time on Monday. I work in pediatrics for the past 20 years. I used your site and a review book to prepare. I think your site is fantastic and a bargain . I just found out I passed.  Thank you! Mark Leinwand, PA-C Thanks for creating the PA life. It has been a great resource for me as I review for my PANRE.   I am recommending the website to my PA staff. Cheriee Slobodsky, MPH, PA-C I took my PANRE and I passed! I really liked your review website. It was very helpful. I only wish I would have discovered it months ago, while preparing for the PANRE. This is my 4th time passing in my career, and I now qualify for not having to recert until 10 years from now. Thank God! but will remember your site and recommend it to others. Thanks again, Maureen Maureen Kilrain PA-C Dear Stephen, I just want to take a moment and let you know how much I appreciate your website and the resources that you have made available to us. As I started preparing for my PANRE I realized it was going to take more than just reading the NCCPA blueprint topic areas. For the last 6 years I focused on being a mom and I chose to push the pause button on my PA career. I am thrilled to say that I passed my PANRE and this was possible because of your question style reviews and testing. This has been my favorite method to prepare for recertification. Ive taken the PANRE 3 times in the last 20 years and this time around I would not have been ready without thePAlife. Thank you for creating a great site thats affordable!! Aida Scanlon PA-C Your review was excellent and helped me pass my PANRE Last month. Thank you Melissa Beck RPAC Just passed my PANRE. I wanted to say that it was entirely due to your review material and podcasts. Thanks! Shaun Johnson PA-C This is my 4th PANRE, I graduated 25 yrs. ago as a surgeon assistant and physician assistant.   I have spent the last 20 years on a H+P service and I started my medical career as a USMC corpsman.   The USMC uses the accolade OUTSTANDING, your entire program is such , the attention to details to the answers, the 230 plus pages on  PDF, the flash cards, your program built my confidence BIG TIME, Jesus has richly blessed my life BECAUSE of you , I never have to take this brutal exam again and can retire at 66 yrs old you played a prodigious part in me passing amen!!! David Gavin PA-C I love your site! Im recertifying soon and your site is so incredibly helpful. Ive been a PA in a niche area for most of my career, so recertifying is always an issue. Thank goodness I found your site!! Kimberly Bastible, MS, PRA-C I want to thank you for everything! I purchased the 3 month membership prior to my PANCE. I just found out I passed! The setup and links to Brian Wallaces podcasts were perfect! Garrett Wilson, PA-C The Daily PANCE PANRE Question 44 An 18 year-old female presents after completing her freshman year at college. Two months ago, she developed "bronchitis" which has persisted. She has become increasingly tired and has frequent night sweats. A chest x-ray today reveals a left mediastinal mass. What is the next step in her evaluation? A. repeat the chest x-ray in six months B. ultrasound of the left hemithorax C. bone scan D. CT scan of the chest E. proceed directly to bronchoscopy with biopsy Answer:D, CT scan of the chest Any patient presenting with mediastinal nodes should have a CT. This patient may have sarcoid or Hodgkin's or another type of cancer - CT is indicated. Help Support The Physician Assistant Life for FREE! This is provided as an opportunity for anyone who appreciates this email series to help support it painlessly. If you are going to be purchasing anything from Amazon.com (books, school supplies, etc.) simply start your next Amazon.com purchase byclicking here... it's a free way for you to help support the cause! Justclick over to Amazon. Then, when you make your purchase, Amazon will send a portion of the proceeds to The Physician Assistant Life. The money goes toward paying for one-time and ongoing costs (like equipment, hosting, backup services, etc.). Thank you for supporting the site and keeping this content free! If you are studying for the PANCE or the PANRE I recommend theseReview Books.