Physician Assistant (PA) PAEA EOC Exam 2026 –
700 Questions with Bolded Answers & Rationales |
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A 46-year-old female presents with pain to her left wrist. She
complains that it is painful and swollen as she points to the volar
aspect of the wrist on the radial side. On examination, there is a
small, soft bump on the dorsum of her wrist with a jelly-like
consistency. What is the most likely diagnosis?
A Cancerous tumor
B Fracture
C Ganglion cyst
D Hematoma
E Lipoma
Ganglion Cyst
C Ganglion cysts commonly occur on the dorsal or volar aspect of
the wrist. They result when a joint capsule or tendon sheath is
damaged, allowing synovial fluid to escape producing a one-way
valve, which allows fluid into the cyst, but not back out. The
accumulating fluid forms the ganglion cyst. These cysts may or may
not be tender and can fluctuate in size depending on activity level
of the affected extremity. Cancerous tumors would tend to be much
more firm, but also may be relatively pain free. Fractures would
generally be exquisitely tender and if the bump is due to a
displaced bone, it would be much more firm than a ganglion cyst.
Hematomas are generally associated with acute trauma and would
be tender and ecchymotic in many situations. Lipomas are benign
fatty tumors that are more commonly seen on the thenar eminence
than the dorsum of the wrist and their size does not change based
on activity level.
,A 65-year-old male presents with pain and swelling to his right knee
without any history of injury. He has had this type of pain and
swelling before, and does recall that he had fluid drained out of the
knee several years ago. On examination the patient has a swollen,
tender knee with a palpable effusion. There is decreased range of
motion to the joint secondary to the effusion. An arthocentesis is
performed, and the analysis of the fluid reveals calcium
pyrophosphonate crystals. Based on these findings, what is the most
likely diagnosis?
A Septic arthritis
B Acute synovitis
C Hemarthoma
D Pseudogout
Psuedogout
D Pseudogout is also known as Calcium Pyrophosphate Deposition
Disease (CPDD) and most commonly affects patients over the age
of 65. The knee joint is most commonly affected with the wrist joint
second most common. An examination of synovial fluid aspirated
from the affect joints, will reveal calcium pyrophosphate crystal.
Ankle joints are rarely affected by pseudogout but are fairly
common locations for gout caused by urate crystal deposition. The
first metatarsal phalangeal joint is the classic location for gout
(sometimes referred to as podagra), but it is not a typical
pseudogout location. The glenohumeral joint of the shoulder is
affected by pseudogout much more than gout. Distal
interphalangeal joints of the hand are rare locations for either gout
or pseudogout, but are classic locations to see signs and symptoms
of osteoarthritis. When pseudogout does affect the hands it is
generally seen in the metacarpophalangeal joints.
,An 18-year-old woman is transferred to your emergency
department from a local college infirmary. She presented yesterday
with a complaint of headache but became confused and is now
febrile. You notice a petechial rash on physical examination and her
cerebrospinal fluid comes back with increased WBCs, increased
protein, and decreased glucose. What is the most likely organism
responsible for her meningitis?
A Haemophilus influenzae
B cytomegalovirus
C Neisseria meningitidis
D Mycobacterium tuberculosis
E coxsackievirus B
Neisseria meningitis
C Neisseria meningitidis and Streptococcus pneumoniae are the
most common etiologic agents for bacterial meningitis in this
patient's age group. So much so that many colleges and universities
require a vaccine for students who live in dormitories. Her fever and
the cerebrospinal fluid values are consistent with a bacterial and not
a viral infectious source for the meningeal irritation.
, A 24-year-old HIV-positive man comes to the emergency
department complaining of severe left-sided chest discomfort,
which radiates through to the left trapezius region. On coming into
the room, you note that he is sitting up and hunched forward. On
physical examination, the patient's blood pressure is 135/78, with a
pulse of 85 bpm, and a pericardial friction rub is noted. Laboratory
findings demonstrate elevated serum creatine kinase levels and
normal serial troponin levels. His EKG demonstrates peaked T
waves. His CXR demonstrates a "water bottle" cardiac silhouette.
Which of the following diagnostic studies would be considered the
most appropriate next step in management of this patient?
A Cardiac catheterization
B Transthoracic echocardiography
C CT of the thorax
D VQ scan
TTE
B Choice B, transthoracic echocardiography, would allow for
monitoring of a patient with acute pericarditis, to determine if a
pericardial effusion and/or cardiac tamponade develops. Choice A,
cardiac catheterization, would be appropriate in a patient with
acute myocardial infarction. Choice C, CT of the thorax, is not as
effective or specific as transthoracic echocardiography for the
development of a pericardial effusion and/or tamponade. Choices
D and E would be appropriate diagnostic studies if pulmonary
embolism is suspected, but not as the next step in management of
this patient with pericarditis
700 Questions with Bolded Answers & Rationales |
A 46-year-old female presents with pain to her left wrist. She
complains that it is painful and swollen as she points to the volar
aspect of the wrist on the radial side. On examination, there is a
small, soft bump on the dorsum of her wrist with a jelly-like
consistency. What is the most likely diagnosis?
A Cancerous tumor
B Fracture
C Ganglion cyst
D Hematoma
E Lipoma
Ganglion Cyst
C Ganglion cysts commonly occur on the dorsal or volar aspect of
the wrist. They result when a joint capsule or tendon sheath is
damaged, allowing synovial fluid to escape producing a one-way
valve, which allows fluid into the cyst, but not back out. The
accumulating fluid forms the ganglion cyst. These cysts may or may
not be tender and can fluctuate in size depending on activity level
of the affected extremity. Cancerous tumors would tend to be much
more firm, but also may be relatively pain free. Fractures would
generally be exquisitely tender and if the bump is due to a
displaced bone, it would be much more firm than a ganglion cyst.
Hematomas are generally associated with acute trauma and would
be tender and ecchymotic in many situations. Lipomas are benign
fatty tumors that are more commonly seen on the thenar eminence
than the dorsum of the wrist and their size does not change based
on activity level.
,A 65-year-old male presents with pain and swelling to his right knee
without any history of injury. He has had this type of pain and
swelling before, and does recall that he had fluid drained out of the
knee several years ago. On examination the patient has a swollen,
tender knee with a palpable effusion. There is decreased range of
motion to the joint secondary to the effusion. An arthocentesis is
performed, and the analysis of the fluid reveals calcium
pyrophosphonate crystals. Based on these findings, what is the most
likely diagnosis?
A Septic arthritis
B Acute synovitis
C Hemarthoma
D Pseudogout
Psuedogout
D Pseudogout is also known as Calcium Pyrophosphate Deposition
Disease (CPDD) and most commonly affects patients over the age
of 65. The knee joint is most commonly affected with the wrist joint
second most common. An examination of synovial fluid aspirated
from the affect joints, will reveal calcium pyrophosphate crystal.
Ankle joints are rarely affected by pseudogout but are fairly
common locations for gout caused by urate crystal deposition. The
first metatarsal phalangeal joint is the classic location for gout
(sometimes referred to as podagra), but it is not a typical
pseudogout location. The glenohumeral joint of the shoulder is
affected by pseudogout much more than gout. Distal
interphalangeal joints of the hand are rare locations for either gout
or pseudogout, but are classic locations to see signs and symptoms
of osteoarthritis. When pseudogout does affect the hands it is
generally seen in the metacarpophalangeal joints.
,An 18-year-old woman is transferred to your emergency
department from a local college infirmary. She presented yesterday
with a complaint of headache but became confused and is now
febrile. You notice a petechial rash on physical examination and her
cerebrospinal fluid comes back with increased WBCs, increased
protein, and decreased glucose. What is the most likely organism
responsible for her meningitis?
A Haemophilus influenzae
B cytomegalovirus
C Neisseria meningitidis
D Mycobacterium tuberculosis
E coxsackievirus B
Neisseria meningitis
C Neisseria meningitidis and Streptococcus pneumoniae are the
most common etiologic agents for bacterial meningitis in this
patient's age group. So much so that many colleges and universities
require a vaccine for students who live in dormitories. Her fever and
the cerebrospinal fluid values are consistent with a bacterial and not
a viral infectious source for the meningeal irritation.
, A 24-year-old HIV-positive man comes to the emergency
department complaining of severe left-sided chest discomfort,
which radiates through to the left trapezius region. On coming into
the room, you note that he is sitting up and hunched forward. On
physical examination, the patient's blood pressure is 135/78, with a
pulse of 85 bpm, and a pericardial friction rub is noted. Laboratory
findings demonstrate elevated serum creatine kinase levels and
normal serial troponin levels. His EKG demonstrates peaked T
waves. His CXR demonstrates a "water bottle" cardiac silhouette.
Which of the following diagnostic studies would be considered the
most appropriate next step in management of this patient?
A Cardiac catheterization
B Transthoracic echocardiography
C CT of the thorax
D VQ scan
TTE
B Choice B, transthoracic echocardiography, would allow for
monitoring of a patient with acute pericarditis, to determine if a
pericardial effusion and/or cardiac tamponade develops. Choice A,
cardiac catheterization, would be appropriate in a patient with
acute myocardial infarction. Choice C, CT of the thorax, is not as
effective or specific as transthoracic echocardiography for the
development of a pericardial effusion and/or tamponade. Choices
D and E would be appropriate diagnostic studies if pulmonary
embolism is suspected, but not as the next step in management of
this patient with pericarditis
