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Tuesday, June 30, 2026
Infectious DiseaseHard
A 55-year-old man with candidemia from an infected central line is treated with line removal and an echinocandin. Repeat blood cultures clear after 4 days, but on hospital day 10 he reports new floaters and blurred vision in the right eye. Visual acuity is 20/80 OD. Dilated funduscopic exam shows a creamy white chorioretinal lesion with overlying vitreous haze. Which of the following is the most likely complication of his candidemia?
AEndocarditis
BMeningitis
CHepatosplenic candidiasis
DEndophthalmitis
Reveal the answer & full explanation
Correct answer: D — Endophthalmitis
AEndocarditis
BMeningitis
CHepatosplenic candidiasis
DEndophthalmitis✓
Why Endophthalmitis is correct
Candida endophthalmitis is a well-recognized metastatic complication of candidemia, occurring in roughly 1–10% of patients
Presents with floaters, blurred vision, and pain
Classic findings on dilated funduscopy are fluffy white chorioretinal lesions that can extend into the vitreous as 'fluff balls'
IDSA recommends a dilated eye exam in all patients with candidemia within the first week because of this risk
Treatment requires an antifungal with good ocular penetration (fluconazole or voriconazole), often with intravitreal amphotericin or voriconazole for vitritis; echinocandins penetrate the eye poorly
Why the others are wrong
Endocarditis — from Candida is rare but devastating, presenting with persistent candidemia, large vegetations, and embolic events, not isolated unilateral visual loss with a chorioretinal lesion
Hepatosplenic candidiasis — occurs primarily in neutropenic patients recovering counts and produces fever and bullseye liver/spleen lesions on imaging, not ocular findings
Meningitis — Candida meningitis is uncommon in adults outside neurosurgical patients and presents with headache, fever, and CSF pleocytosis rather than focal retinal lesions
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Every day, FirstPassPA publishes one free, board-style question modeled on the PANCE (Physician Assistant National Certifying Exam) and PANRE. Each one is a clinical vignette with a single best answer and a full explanation — including why the other options are wrong — so a two-minute daily habit steadily builds the pattern recognition the boards reward.
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How to use it
Read the vignette, commit to an answer before you reveal it, and then read the explanation even when you get the question right — the reasoning for the distractors is usually where the real learning is. Rotate through the daily questions to keep every organ system fresh, and when your exam date gets closer, layer in longer, blueprint-weighted question blocks in the app.
Yes. FirstPassPA publishes one free board-style question every day — the full vignette, the correct answer, and a complete explanation — with no email address or account required. A free 7-day trial unlocks the full 5,500+ question bank, all eight EOR rotations, flashcards, and an AI tutor.
How is the Question of the Day chosen?
It is drawn from the same clinician-reviewed FirstPassPA bank the PANCE and PANRE draw from — mapped to the NCCPA blueprint and rotated across organ systems so you see a broad mix over time. It is the same question posted to our social channels and daily email.
Does the Question of the Day help for the PANRE too?
Yes. The PANCE and PANRE cover the same NCCPA content blueprint, so daily board-style practice builds the recall and reasoning both exams test. Recertifying PAs can use the same daily habit.
How should I use a question of the day to study?
Attempt it before revealing the answer, then read the full explanation even when you get it right — the reasoning for why the distractors are wrong is where most of the learning is. Pair the daily habit with focused, blueprint-weighted question blocks as your exam date approaches.
Educational use only. This question is a study aid for PA students and is not medical advice or a substitute for clinical judgment. FirstPassPA is an independent study tool and is not affiliated with, endorsed by, or sponsored by NCCPA. PANCE® and PANRE® are registered trademarks of the National Commission on Certification of Physician Assistants.