Table Of ContentA Comprehensive Review
for the Certification and
Recertification Examinations
for Physician Assistants
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A Comprehensive Review
for the Certification and
Recertification Examinations
for Physician Assistants
Fifth Edition
Published in Collaboration with AAPA and PAEA
Editor
Claire Babcock O’Connell, MPH, PA-C
Associate Professor
Rutgers Biomedical and Health Sciences
School of Health Related Professions
Physician Assistant Program
Piscataway, NJ
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Fifth Edition
Copyright © 2015 Wolters Kluwer Health.
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Wolters Kluwer business. Copyright © 2004, 1999 by Lippincott Williams & Wilkins.
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9 8 7 6 5 4 3 2 1
Library of Congress Cataloging-in-Publication Data
O’Connell. — Fifth edition.
p. ; cm.
“Published in collaboration with AAPA and PAEA.”
Includes index.
ISBN 978-1-4511-9109-7
I. O’Connell, Claire Babcock, editor of compilation. II. American Academy of Physician Assistants, issuing body. III. Physician
Assistant Education Association, issuing body.
[DNLM: 1. Physician Assistants—Examination Questions. 2. Certifi cation—Examination Questions. W 18.2]
R697.P45
610.76—dc23
2013043800
DISCLAIMER
Care has been taken to confi rm the accuracy of the information present and to describe generally accepted practices. However, the
authors, editors, and publisher are not responsible for errors or omissions or for any consequences from a pplication of the information
in this book and make no warranty, expressed or implied, with respect to the currency, c ompleteness, or accuracy of the contents of
the publication. Application of this information in a particular situation remains the professional r esponsibility of the practitioner; the
clinical treatments described and recommended may not be considered absolute and u niversal recommendations.
The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are
in accordance with the current recommendations and practice at the time of publication. However, in view of ongoing r esearch,
changes in government regulations, and the constant fl ow of information relating to drug therapy and drug reactions, the reader is
urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions.
This is particularly important when the recommended agent is a new or infrequently employed drug.
Some drugs and medical devices presented in this publication have Food and Drug Administration (FDA) clearance for limited
use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or de-
vice planned for use in their clinical practice.
LWW.com
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In memory of my parents, Thomas G. Babcock, Jr. and
Claire Smith Babcock, RN, MEd
—Claire Babcock O’Connell
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Acknowledgments
Once again, the effort required to revise and update this writers, and reviewers; the personnel at Lippincott Williams
comprehensive review has been tremendous. However, & Wilkins; and the leadership of the Physician Assistant
the assistance, support, and encouragement from excellent Education Association and American Academy of Physician
colleagues have guided those efforts and succeeded in pro- Assistants. Sarah F. Zarbock continues to be an excellent
ducing a high-quality text and review book. I am indebted mentor and instrumental in guiding me throughout such a
to my program directors, Ruth Fixelle and Jill Reichman, large task—and I thank her for diligence and inspiration.
and my fellow faculty at the Rutgers Biomedical and Health Finally, I wish to thank my family for their endless patience
Sciences. Their confi dence in me has been a constant pres- and constant support and love.
ence throughout my career as a physician assistant and
educator. I am also grateful to the contributing authors, item —Claire Babcock O’Connell
vi
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Preface
Taking certifi cation and recertifi cation examinations are a and rewritten to refl ect changes in clinical practice. The test
fact of life for physician assistants (PAs). The certifi cation items, both pretest and posttest, are new and revised, m aking
examination is taken upon graduation from an accredited the fi fth edition even more comprehensive and able to be
physician assistant program, and the recertifi cation examina- used as a quick and easy-to-read reference. In other words,
tion is taken every 10 years thereafter. The National Com- this book is a practical, “real-time” educational tool for busy
mission on Certifi cation of Physician Assistants (NCCPA), practitioners—a handy resource to be used on the front line
using test data from the National Board of Medical Exam- of patient care.
iners (NBME) as well as the experience and aptitude of The chapters are carefully formatted to give general
test-item writers, develops the two examinations and refi nes characteristics of diseases (e.g., incidence, pathophysiology,
them on an annual basis to keep current with clinical prac- prognosis), clinical signs and symptoms, diagnostic and labo-
tice and medical advances. ratory evaluation, and treatment. These chapters, as well as
Traditionally, test-preparation books have consisted of the accompanying questions and their explanations, closely
practice questions, answers, and explanations. This format mirror the body of knowledge that is tested on the certifi ca-
provided the opportunity for both new and experienced PAs tion examinations and is needed for the reality of clinical
to improve their test-taking skills by becoming more accus- practice. Regardless of their practice setting, PAs can use
tomed to the test experience, and, by reading the answers this book to review and test themselves on the material most
and explanations provided with each question, the candidate likely to be included in either examination. For instance,
could learn from his or her successes and mistakes. more extensive information and questions are provided in
This edition continues to include both a pretest and a post- cardiology because patients with cardiac problems are more
test. The pretest continues to be available in printed format; common in clinical practice.
however, the posttest as well as the pretest are now available The American Academy of Physician Assistants (AAPA)
online to simulate the computer format of the certifi cation and the Physician Assistant Education Association (PAEA)
and recertifi cation examinations. Both tests have been writ- have continued their close collaboration in the development
ten by experienced, NBME-trained PA educators and com- of this book. This partnership serves to enhance the value
piled using the proportions per subject area and skill areas as and credibility of the book and to ensure that it meets certi-
delineated in the NCCPA guidelines. Each test question also fi cation and continuing medical education needs of the PA
is written according to the NCCPA structure for multiple- constituency.
choice format, an especially important feature of the last We believe that you will fi nd this book helpful in preparing
three editions. For further information and explanation of the to take either of the NCCPA examinations. Equally impor-
NCCPA subject and skill areas, see http://www.nccpa.net. tant however, we hope that you use this book as a quick and
In addition to the practice questions and answers, this valuable reference in clinical practice. We encourage you
book provides, in a condensed outline format, all the neces- to make the book a permanent addition to your library not
sary information not only to take and successfully complete only upon graduation and every 10 years thereafter but also
either of the tests but also to refer to, on a day-to-day basis, in on a daily basis for the most important use of all—providing
clinical practice. Each chapter has been completely reviewed q uality care to your patients.
vii
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Contributors
Frank Acevedo, PA-C, MS Susan LeLacheur, DrPH, PA-C
Assistant Professor Associate Professor
New York Institute of Technology Department of Physician Assistant Studies
Old Westbury, NY School of Medicine & Health Sciences
Surgical Intensive Care Physician Assistant George Washington University
Winthrop-University Hospital Washington, DC
Mineola, NY
William H. Marquardt, PhD, PA-C
Michael Cirone, PA-C Associate Professor
Lead Physician Assistant Associate Dean for Physician Assistant Education
Beacon Occupational Health and Safety Services Physician Assistant Program
Prudhoe Bay, AK Nova Southeastern University
Fort Lauderdale, FL
Edward D. Huechtker, PhD, MPA, PA, DFAAPA
CWO-4 United States Coast Guard (retired) Stephen Patrick McKenzie, MS, PA-C
University of Alabama at Birmingham (retired) Assistant Professor
Ono Harbor, Ono Island Rutgers Biomedical and Health Sciences
Orange Beach, AL School of Health Related Professions
Physician Assistant Program
Zaiba Iqbal Jetpuri, DO, MBA Piscataway, NJ
Assistant Professor
Family Medicine Matthew A. McQuillan, MS, PA-C
University of Texas Southwestern Medical Center Associate Professor
Dallas, TX Assistant Director, Clinical Education
Rutgers Biomedical and Health Sciences
Michael A. Johnson, MPAS, PA-C School of Health Related Professions
Assistant Professor Physician Assistant Program
Physician Assistant Department Piscataway, NJ
Nova Southeastern University
Fort Lauderdale, FL Claire Babcock O’Connell, MPH, PA-C
Associate Professor
Jennifer Joseph, MS, PA-C Rutgers Biomedical and Health Sciences
Assistant Professor School of Health Related Professions
Rutgers Biomedical and Health Sciences Physician Assistant Program
School of Health Related Professions Piscataway, NJ
Physician Assistant Program
Piscataway, NJ Deanna J. Oliver, MSPAS, PA-C
Instructor of Family Medicine
Kathy Kemle, MS, PA-C, DFAAPA Geriatrics Division
Assistant Professor Mercer University School of Medicine
Mercer University School of Medicine Macon, GA
Assistant Director, Geriatrics Division
Department of Family Medicine
Medical Center of Central Georgia
Macon, GA
viii
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Contributors ix
Patti Pagels, MPAS, PA-C Melanie Trecartin, MS, PA-C
Assistant Professor Assistant Professor
Director of Community Outreach Rutgers Biomedical and Health Sciences
Department of Family and Community Medicine School of Health Related Professions
University of Texas Southwestern Medical Center Physician Assistant Program
Dallas, TX Piscataway, NJ
Lori Parlin Palfreyman, MS, PA-C Eric H. Vangsnes, PhD, PA-C
Assistant Professor Chair and Professor
Rutgers Biomedical and Health Sciences Physician Assistant Department
School of Health Related Professions Western Michigan University
Physician Assistant Program Kalamazoo, MI
Piscataway, NJ
Erich Vidal, MS, PA-C
Allan Platt, PA-C, MMSc Assistant Professor
Academic Co-Coordinator Rutgers Biomedical and Health Sciences
Physician Assistant Program School of Health Related Professions
Department of Family and Preventive Medicine Physician Assistant Program
Emory University School of Medicine Piscataway, NJ
Atlanta, GA
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