PANCE prep high yield

Question 1

Labs will show high K, high Ca, low Glc, high BUN in a kid who is feeling fatigued

Answer 1

Addison’s disease

Question 2

Kid with purpura on legs following URI

Answer 2

Hemolytic Uremic Syndrome- expect hematuria

Question 3

Most likely cause of interstitial nephritis

Answer 3

NSAIDs

Question 4

How to treat acute gouty attack in pt with kidney disease

Answer 4

Prednisone (cant give indomethacin or Colchicine)

Question 5

olive-shaped mass in the belly of a baby- dx

Answer 5

pyloric stenosis

Question 6

Pt with HTN and cirrhosis on lisinopril and cyclosporine presents with hematuria- which drug caused it?

Answer 6

cyclosporine

Question 7

normal EKG with an early QRS, what’s the arrhythmia?

Answer 7

Premature Atrial Complex

Question 8

EKG with no p waves, or inverted p waves, what’s the arrythmia?

Answer 8

Junctional Rhythm

Question 9

EKG with p to qrs interval longer than ? suggests 1st degree heart block?

Answer 9

5 small boxes (1 big)

Question 10

EKG with pronounced R and ST depressions in V1, V2

Answer 10

Posterior wall MI

Question 11

EKG with large ventricular complexes and irregular rhythm. Rate will be >100

Answer 11

Atrial fibrillation with rapid ventricular response (rate)

Question 12

60F recent loss of relative has crazy EKG and echo showing “apical hyperinflation”…diagnosis?

Answer 12

Takashubo (stress) cardiomyopathy

Question 13

Pt with hypertension and pulseless lower extremity?

Answer 13

coarctation of the aorta

Question 14

What murmur would you expect to find in coarctation of the aorta?

Answer 14

None

Question 15

Kid presents with hypertension and no hair on the lower extremity?

Answer 15

coarctation of the aorta

Question 16

IVDU with endocarditis, what’s the bug?

Answer 16

S. Aureus

Question 17

pain in limb. On exam it becomes pulseless on adduction, what’s the dx?

Answer 17

thoracic outlet syndrome

Question 18

Pt presents with tearing chest pain and hypotension, what study should you get?

Answer 18

CXR will work. Thoracic and abdominal CT would be better. Abdominal imaging WILL NOT SEE it.

Question 19

Gangly marfan’s pt, what’s the ocular sequela?

Answer 19

lens subluxation

Question 20

Genetic counseling for parents when Dad has Ehler’s-Danlos- likelihood of having a child with it?

Answer 20

50%. It’s an autosomal dominant disorder.

Question 21

Blowing diastolic murmur is likely…

Answer 21

aortic regurgitation. The only other thing it could be is pulmonary regurge (which is rare and caused by pulm HTN). Mitral stenosis is diastolic but has an opening “snap”

Question 22

Systolic murmur, low frequency, with mid-systolic click. What’s the murmur, what makes it louder?

Answer 22

Mitral valve prolapse. Louder with valsalva. Click alone is diagnostic.

Question 23

Lady with “string of pearls” on pelvic xray, what are the complications she is at risk for?

Answer 23

hyperglycemia, hyperlipidemia, VTE, coronary artery disease

Question 24

AIDS patient with pneumonia with bilateral perihilar opacities, interstitial promeinence, and hyperlucent cystic lesions (or bilateral, diffuse “granular opacities”) . What’s the treatment?

Answer 24

TMP-SMX for Pneumocystis Jerovecci

Question 25

Red cervix with mucopurulent dyscharge, dx?

Answer 25

chlamydia

Question 26

1 week old infant with pneumonia, what’s the etiology?

Answer 26

chlamydia trachomatis

Question 27

Pt cannot laterally deviate eye (eye is fixed medial), what’s the cranial nerve?

Answer 27

CN 4 (trochlear) (remember LR4 SO6)

Question 28

Etiology of bullous myringitis?

Answer 28

Mycoplasma

Question 29

Pt with liquid but not solid dysphagia, tx

Answer 29

Schatzki ring- bougey (balloon) dilation

Question 30

Tx of achalasia

Answer 30

bougey (balloon) dilation

Question 31

EKG finding in hypothermia

Answer 31

“Osborne wave”

Question 32

Most important question in new onset heart failure?

Answer 32

Do you drink etOH?

Question 33

How to treat bortadella pertussis?

Answer 33

Macrolides (arithro, clarithro)

Question 34

EKG with biphasic r-waves in V1 or V2? What other pattern will in have?

Answer 34

Right bundle branch block. Also expect an RSR (not QRS) appearance of qrs in lead V1- suggests (V1, v2 are right chest leads)

Note LBBB will have biphasic QRS (less rabbit-ears like) in V5 or V6 (left chest leads)

Question 35

Fracture of proximal 1/3 of ulna from forced pronation or direct blow over posterior ulna.

Answer 35

Monteggia fracture

Question 36

Hallux valgus

Answer 36

Great toe pointed in from high heels (hammer toe)

Question 37

Fracture of distal third of radius with dislocation of radial-lunar joint. From injury to dorsilateral wrist or fall.

Answer 37

Geleazzi fracture

Question 38

Tx for a big gallstone?

Answer 38

Immediate surgery referral.

Question 39

Tx for tremors

Answer 39

EtOH- benzos,

Essential- Beta blockers

Question 40

Kid given amoxicillin for URI and gets a rash all over face trunk, what did he have?

Answer 40

EBV- infectious mononucleosis

Question 41

Ligament in gamekeepers thumb?

Answer 41

Ulnar collateral ligament

Question 42

SCFE pathology, complication, presentation

Answer 42

physial fracture of femoral head. Leg presents abducted/externally rotated.

Common complication is avascular necrosis if it is not repaired.

Question 43

Blood in anterior chamber of eye- name

Answer 43

hyphema

Question 44

What problems does niacin deficiency cause, and in which organ systems?

Answer 44

Wet beriber- Confusion, muscle atrophy, edema, tachycardia, cardiomegaly, CHF, peripheral neuropathy

Dry beriberi- Neuropathy, encephalopathy, wasting

Question 45

Drug of choice for OCD

Answer 45

Sertraline