PA 608 Week 5 Error Pattern Write-Up Example

Error Pattern Write-Up: Kidney Function Not Carried Into the Drug Decision, Lab Values Read Without the Printed Range and First-Line Against Second-Line Choices, With Member Questions and the Patterns I Rejected

Student Name

Chamberlain University

PA 608: Transition to Practice I

Instructor Name

Month Day, Year

Error Pattern Write-Up: Kidney Function Not Carried Into the Drug Decision, Lab Values Read Without the Printed Range and First-Line Against Second-Line Choices, With Member Questions and the Patterns I Rejected

Name the Mechanism, Not the Topic

A pattern named "renal" or "pharmacology" says where a miss sits, not why it happened. Each pattern below is named for the mechanism that produced the misses, so it can be tested on the next exam.

Pattern 1: Kidney Function Not Carried Into the Drug Decision

Members: questions 37, 78, 158, 196, 211, 238 and 265 (7).

Argument: in all seven, the stem gave a creatinine clearance or an estimated filtration rate below 30, and the correct answer depended on it: avoiding a drug, such as nitrofurantoin or metformin, or reducing a dose, such as for gabapentin or an anticoagulant. In each case I chose the answer that would be right for normal kidney function. Six were labeled pharmaceutical therapeutics on the report and one was labeled renal.

Spread: the seven come from five organ systems, renal, infectious diseases, endocrine, hematologic and neurologic. A pattern that crosses systems is a mechanism, not a topic.

Pattern 2: Lab Values Read Without the Printed Range

Members: questions 5, 47, 145, 217 and 246 (5).

Argument: each stem gave a result alongside the lab's own normal limits, and I judged the value against the range I remembered rather than the one printed. Question 145 printed an upper limit for ALT of 33; I treated 41 as normal.

Spread: liver, thyroid, hematologic and renal panels.

The mechanism here is close to Pattern 1: in both, information printed in the stem was replaced by something I carried in from memory. Keeping them as separate patterns is justified by the different kind of information involved, a lab threshold in one and a drug adjustment in the other, but I note the shared root.

Pattern 3: First-Line Against Second-Line Choices

Members: questions 35, 133, 159, 211, 241 and 250 (6).

Argument: in each, I narrowed to two correct-sounding drugs and chose the one that is right later in treatment rather than first. Question 211 is also in Pattern 1, which is allowed: one miss can have two contributing mechanisms.

Spread: heart failure, diabetes, hypertension, asthma and depression.

Keep the Rejects

Rejected pattern: "endocrine." Ten endocrine misses looked like a cluster, but on review they had four different causes, so there was no shared mechanism. Rejected pattern: "long stems." I thought I missed long questions more often, but the testing software's word counts showed missed and correct stems were about the same length.

The Remainder Counts

The three patterns cover 17 different questions, since one sits in two patterns. That leaves 73 of 90 misses outside any pattern. Most of those are single knowledge gaps spread across the blueprint, which matches a content distribution set by the blueprint itself (National Commission on Certification of Physician Assistants, 2025). Saying so is important: the patterns are real but explain only about a fifth of my misses.

Patterns that explain a fifth of misses are still useful, because they are the part of the misses most likely to repeat on the real exam. A single knowledge gap may never be tested again; a mechanism will show up wherever its trigger does.

References

National Commission on Certification of Physician Assistants. (2025). PANCE content blueprint [Exam blueprint]. National Commission on Certification of Physician Assistants.