The Final Step PANCE Review Questions and Answers Updated 2026

The Final Step PANCE Review
Questions and Answers Updated
2026
15AyoAboyAw/nightApainAinApelvis.AXrayAshowsAmassAwithA"onionAskinAappearance".ADx?A
-AAnswerAEwingAsarcoma
(cancer,Arare)


95AyoAFApresentsAtoAERAafterAfallAinAherAhome.AHerAleftAlegAisAshortenedAandAexternallyA
rotated.AWhatAisAmostAlikelyAdiagnosis?A-AAnswerAHipAfracture


AA14AyearAoldAfieldAhockeyAplayerApresentsAwith
prominentAadenopathy,AwhiteApurpleAexudatesAin
theAthroatAandAaApalpableAspleen.AWhatAisAtheAmost
likelyAdiagnosis?A-AAnswerAMononucleosis


AA16AyearAoldAhasAjustAmovedAschools.AHeAisAquiet,
moodyAandAnotAlikeAhimselfAatAall.AWithinAsix
monthsAheAseemsAtoAhaveAcompletelyAchangedAback
toAhisApreviousApersonality.AWhatAisAtheAmostAlikely
diagnosis?A-AAnswerAAdjustmentAdisorder


AA19AyearAoldAmaleAtookAanAelbowAtoAtheAfaceAwhile
playingAbasketballAthisAmorning.ATheAwholeAleftAside
ofAhisAfaceAisAswollenAandAheAcan'tAlookAup.AWhatAis
theAmostAlikelyAdiagnosis?A-AAnswerAOrbitalAfracture


AA22AyearAoldAmaleApatientApresentsAwithAwhatAis
clearlyAaAsepticAknee.AYouAalsoAnoticeAlesionsAonAhis
handsAandAfeet.AWhatAisAtheAmostAlikelyApathogen?A-AAnswerANeisseriaAgonorrhoeae


AA3AyearAoldAboyApresentsAwithAhematuriaAandAa
painlessApalpableAabdominalAmass.AWhatAisAthe

,mostAlikelyAdiagnosis?A-AAnswerAWilmsAtumor


AA34AyearAoldApresentsAsymptomsAwhichAare
relapsingAandAremittingAoverAtheApastAfewAweeks.
TheseAincludeAvisualAproblemsAandAweaknessAinAher
rightAarm.AWhatAisAtheAmostAlikelyAdiagnosis?A-AAnswerAMultipleASclerosis


AA35AyearAoldAfemaleApresentsAwithAheat
intolerance,AweightAlossAandApalpitations.AWhatAis
theAmostAlikelyAdiagnosis?A-AAnswerAHyperthyroidism


AA35AyearAoldApatientAcomesAtoAyourAofficeAbecause
hisAwifeAmadeAhim.AHeAhasAbeenAincreasingly
irritableAandAmoody.ASheAhasAalsoAnoticedAthatAhe
isAveryArestless.AYouAorderAaACTAscanAwhichAshows
cerebralAatrophyAasAwellAasAatrophyAofAtheAcaudate
nucleus.AWhatAisAtheAmostAlikelyAdiagnosis?A-AAnswerAHuntington'sAdisease


AA45AyearAoldAfemaleAcomplainsAofAfeelingAthe
groundArollingAunderAherAfeetAatAtimes.AWhatAisAthe
mostAlikelyAdiagnosis?A-AAnswerAVertigo


AA46AyoAmaleAcomesAintoAERAlimpingAaAlittleAonAtheArightAside.AHeAstatesAthatAitAfeltAas
AthoughAhe
wasAkickedAinAtheAbackAofAtheAlegAduringAaAsoccer
game,AbutAclearlyAnoAoneAwasAbehindAhim.AWhatAis
theAmostAlikelyAdiagnosis?A-AAnswerAAchillesAtendonArupture


AA6AyearAoldAboyAseemsAtoAhaveAallAofAthe
symptomsAofAADDAwhileAatAschool,AbutAatAhomeAhe
hasAnoAproblems.ADoesAheAhaveAADD?A-AAnswerANo,AsymptomsAmustAoccurAinAboth
settingsAforAdiagnosis.

,AA60AyearAoldAmaleApresentsAtoAtheAEDAwithAsevere
dizzinessAandAbackApain.AHisAbloodApressureAis
droppingAandAyouAcanAfeelAanAabdominalApulsatile
massAonAphysicalAexam.AWhatAisAtheAmostAlikely
diagnosis?A-AAnswerARupturedAaorticAaneurysm


AA65AyearAoldAmaleApresentsAwithAfrequency.AOn
digitalArectalAexamAyouAfeelAanAelasticAmoderately
enlargedAprostate.AWhatAisAtheAmostAlikely
diagnosis?A-AAnswerABPH


AA65AyearAoldApresentsAcomplainingAofAsevereApain
inAhisAgreatAtoeAthatAbeganAwhenAheAwokeAupAthis
morning.AItAisAswollen,AredAandAveryAtender.AWhatAis
theAmostAlikelyAdiagnosis?A-AAnswerA1.AGout
2.AInfection


AA66AyearAoldAfemaleApatientApresentsAwithAbouts
ofAnausea,AweightAlossAandAvagueAabdominalApain.
WhatAisAtheAmostAlikelyAdiagnosis?A-AAnswerAOvarianAcancer


AAbambooAspineAindicatesA-AAnswerAanklyosingAspondylitis


AAbarrelAchestAshouldAmakeAyouAthinkAofAwhat
diagnosis?A-AAnswerAEmphysema


AAbetaAnatriureticApeptideAbelowAwhatAlevelArules
outACHF?A-AAnswerA<A100


AAbiphasicAPAwaveAshouldAmakeAyouAthinkAofAwhat
diagnosis?A-AAnswerATheAbundleAofAKent

, AABlalockAprocedureAisAusedAtoAcorrectAwhat
congenitalAheartAcondition?A-AAnswerATetralogyAofAFallot


AAblockageAofAwhichAarteryAcausesAaAlateralAwallAMI?A-AAnswerALeftAcircumflexAartery


AAblockageAofAwhichAarteryAcausesAanAanteriorAwall
MI?A-AAnswerALeftAanteriorAdescendingAartery


AAbootAshapedAheartAonAchestAx-rayAshouldAmake
youAthinkAofAwhatAcongenitalAheartAcondition?A-AAnswerATetralogyAofAFallot


AAbootAshapedAheartAonACXRAshouldAmakeAyouAthink
ofAwhatAdiagnosis?A-AAnswerATetralogyAofAFallot


AAchestAx-rayAshowsAaA"3"AsignAwithAnotchingAofAthe
ribs.AWhatAisAtheAmostAlikelyAdiagnosis?A-AAnswerACoarctationAofAtheAaorta.


AAchildApresentingAwithAanAerythematousAsandpaper
rashAshouldAmakeAyouAthinkAofAwhatAdiagnosis?A-AAnswerAScarletAfever


AAchildApresentsAwithApainfulAulcersAinAhisAmouth.
OnAphysicalAexamAyouAfindAmoreAofAtheAsameAtype
ofAulcersAonAhisAfeetAandAhands.AWhatAvirusAisAmost
likelyAcausisymptoms?A-AAnswerACoxsackieAvirusngAthese


AAchildApresentsAwithAparoxysmalAabdominalApain,
nausea,AvomitingAandAdiarrhea.AWhatAisAtheAmost
likelyAdiagnosis?A-AAnswerAIntussusception


AAchildAwithAaAfeverAlastingAlongerAthanAfiveAdays
shouldAmakeAyouAthinkAofAwhatAdiagnosis?A-AAnswerAKawasakiAsyndrome