A 67-year-old woman comes to the clinic with a slight nosebleed, which ceases with the application of pressure and an ice pack. Her vital signs are normal, and her blood pressure is 120/84. She is taking warfarin based on International Normalizing Ratio (INR) results for treatment of atrial fibrillation. (Her usual dose is 5 mg daily.) When asked about her other medications, the patient states that she takes omeprazole, 20 mg daily, for gastroestophageal reflux disease (GERD), and amiodarone for atrial fibrillation. She also states she just started taking ginkgo biloba about two weeks ago to improve her memory. The patient’s INR is 3.8. Just prior to taking ginkgo, it was 2.4, according to her medical records, and it had stayed between 2 and 3 for more than a year. The patient does not know the dose of ginkgo she is taking, but she said she followed the label’s instructions. She is taking one tablet in the morning and one at night. What would you tell this patient regarding taking the gingko supplement?

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The material on the PANCE and PANRE is organized by the NCCPA into two dimensions, as indicated in the content blueprint for the examination. - Organ systems and the diseases, disorders and medical assessments physician assistants encounter within those systems; and - The knowledge and skills physician assistants should exhibit when confronted with those diseases, disorders and assessments. Medical Content Categories % Allocation: Cardiovascular System 13% Dermatologic System 5% Endocrine System 7% Eyes, Ears, Nose, and Throat 7% Gastrointestinal System/Nutrition 9% Genitourinary... Show more

A 67-year-old woman comes to the clinic with a slight nosebleed, which ceases with the application of pressure and an ice pack. Her vital signs are normal, and her blood pressure is 120/84. She is taking warfarin based on International Normalizing Ratio (INR) results for treatment of atrial fibrillation. (Her usual dose is 5 mg daily.) When asked about her other medications, the patient states that she takes omeprazole, 20 mg daily, for gastroestophageal reflux disease (GERD), and amiodarone for atrial fibrillation. She also states she just started taking ginkgo biloba about two weeks ago to improve her memory. The patient’s INR is 3.8. Just prior to taking ginkgo, it was 2.4, according to her medical records, and it had stayed between 2 and 3 for more than a year. The patient does not know the dose of ginkgo she is taking, but she said she followed the label’s instructions. She is taking one tablet in the morning and one at night. What would you tell this patient regarding taking the gingko supplement?






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