Smarty PANCE Practice Exam Stuff I Got Wrong

Question 1

WBC > 20,000
lymphocytes > 5,000

Answer 1

CLL

Question 2

first line tx for htn in pregnancy

Answer 2

labetalol

Question 3

normal methylmalonic acid
increased homocysteine

Answer 3

folic acid deficiency

Question 4

increased methylmalonic acid
increased homocysteine

Answer 4

B12 deficiency

Question 5

common s.e of SSRIs in elderly and CKD pt’s

Answer 5

SIADH -> hyponatremia

Question 6

what is hutchinson’s sign

Answer 6

shingles on the tip of the nose -> suggests corneal involvement -> urgent ophthalmologist referral

Question 7

best screening method for ADPKD

Answer 7

renal US

Question 8

what type of tumor is a carcinoid tumor

Answer 8

neuroendocrine

Question 9

hallmark presentation of botulism

Answer 9

blurry vision and vertical diplopia after prodromal GI sx

Question 10

pathophys of botulism infxn

Answer 10

Ach antagonism

Question 11

weird way Smarty PANCE described gout crystals

Answer 11

yellow crystals in parallel to the polarization filter

Question 12

dyspareunia and dental caries

Answer 12

sjorgens

Question 13

anti-DNA topoisomerase

Answer 13

scleroderma

Question 14

anti microsomal abs

Answer 14

hashimoto thyroiditis

Question 15

anti-Ro abs

Answer 15

sjorgens

Question 16

anti-La abs

Answer 16

sjorgens

Question 17

bloody diarrhea pathogens

Answer 17

salmonella
e.coli
entamoeba
campylobacter
shigella
yersinia

Question 18

gradual progressive proximal muscle weakness and elevated creatinine phosphokinase

Answer 18

polymyositis

Question 19

any increase in sputum production reported by a pt w. a hx of COPD requires

Answer 19

abx

Question 20

eggshell calcifications of hilar lymph nodes

Answer 20

silicosis

Question 21

interstitial fibrosis and pleural thickening

Answer 21

asbestos

Question 22

what type of AKI are eosinophils associated w.

Answer 22

AIN

Question 23

HIV pt w. CD4 count < 50, cough, fever, and hepatomegaly

Answer 23

myobacterium avium complex

Question 24

early vs late signs of RA

Answer 24

early: soft tissue swelling, osteopenia, erosions, joint space narrowing

late: ulnar deviation, boutonniere/swan neck, ankylosis

Question 25

joints most commonly affected by RA

Answer 25

PIP MCP MTP

Question 26

if the DIP is involved you can probs rule out

Answer 26

RA

Question 27

ABI that indicates need for immediate surgical consult

Answer 27

<0.41

Question 28

s.e to know of macrolides

Answer 28

QT prolongation

Question 29

elevated ALP, sclerotic/lytic lesions on XR

Answer 29

paget dz of the bone

Question 30

3 indicaitons for IVC obstruction w. varicocele what would you order if you see any of these 3 things

Answer 30

right sided bilat failure to disappear when lying down order a CT abd

Question 31

steps in management of refractory familial hypercholesterolemia

Answer 31

1. high intensity statin 2. ezetimibe 3. PCSK9 inhibitor

Question 32

management of an incidental pulmonary nodule in non smoking pt's based. onage

Answer 32

<35 yo: CT >35 yo: needle bx

Question 33

4 hallmark features of delirium

Answer 33

fluctuating level of consciousness hallucinations disorientation abnl vitals

Question 34

3 mcc of myocarditis

Answer 34

adenovirus coxsackie B parvovirus B19

Question 35

triad for reactive arthritis (reiter's syndrome)

Answer 35

urethritis arthritis conjunctivitis

Question 36

first line tx for reactive arthritis

Answer 36

nsaids

Question 37

4 pathogens mc associated w. reactive arthritis

Answer 37

salmonella shigella yersinia campylobacter

Question 38

2 mcc of dilated cardiomyopathy

Answer 38

ischemia long standing htn

Question 39

tx for refractory ITP w. PLT counts < 20,000 x 6 weeks

Answer 39

splenectomy

Question 40

2 mcc of mitral regurgitation

Answer 40

1. MVP 2. posterior MI

Question 41

23 yo AA M w. cc of limp - he has pain his left groin that worsens with walking and has become worse over the past few months - he has had a history of painful attacks that occur once or twice a year and also involve his hands and back

Answer 41

SSA

Question 42

pulmonary artery pressure consistent w. dx of pulmonary fibrosis

Answer 42

>/= 25

Question 43

CSF findings associated w. guillain barre

Answer 43

glucose: normal WBC count: normal protein: elevated

Question 44

asymptomatic pt of meditearranean origin w. isolated microcytic anemia

Answer 44

beta thalassemia minor

Question 45

electrophoresis findings of beta thalassemia minor

Answer 45

Hgb A

Question 46

thalassemia is associated with what 2 types of cells

Answer 46

target teardrop

Question 47

fever, microangiopathic hemolytic anemia, thrombocytopenia w. petechiae, renal dysfxn, AMS

Answer 47

thrombotic thrombocytopenic purpura

Question 48

tx for tetanus

Answer 48

tetanus immune globulin + tetanus toxoid + metronidazole

Question 49

with cirrhosis, what causes palmar erythema, gynecomastia, spider angiomas, and testicular atrophy

Answer 49

hyperestrinism *cirrhosis leads to elevated circulating estrogens*

Question 50

what test evaluates the excitability of the myocardium and is able to reproduce vtach

Answer 50

electrophysiology studies

Question 51

2 abs associated w. hashimoto's

Answer 51

anti thyroid peroxidase (anti-microsomal) anti thyroglobulin

Question 52

what abs are associated w. SLE

Answer 52

ANAs: dsDNA anti-SM

Question 53

what lab value is elevated in 50-60% of SSA cases

Answer 53

ACE

Question 54

mc virus of solid organ transplant recipients

Answer 54

CMV