PANCE Practice Exam with Complete Solution
which type of hypersentitivy rxn is the most severe? requiring emergency tx? Correct Answer:
type 1
Type IV< III< II < I
in an alcoholic pt with global confusion, ataxia (gait imbalance), nystagmus + ocular msl
paralysis Correct Answer: wernicke's encephalopathy
Tx: IV thiamine
which type of hypersensitivity rxn is characterized by antigen -antibody rxns mediated by IgE --
that results in hypotension, shock, urticaria, or angioedema? Correct Answer: type I
best diagnostic test for carpal tunnel syndrome ? Correct Answer: electromyogram
males with early onset of poor gait that is progressively worsening. Plus pseudohypertrophy of
the calves and + Gowers sign (need to lift oneself "climb up" up when getting up) and a positive
fam history
a Muscle bx to confirm this dx would show: Correct Answer: duchenne muscular dystrophy
which tests differentiate between nerve and muscular problems? Correct Answer:
electromyogram and nerve conduction studies
Cushing's syndrome pt should immediately stop which meds? Correct Answer: steroids.
Lambert-Eaton myasthenic syndrome Correct Answer: immune mediated disorder where ACH
is not properly released - this causes weakness in scapular and pelvic girdle muscles. and
difficulty climbing stairs or impotence. deep tendon reflexes are decreased or absent.
overdose cholinesterase inhibitors such as pyridostigmine or neostigmine can cause what ?
(usually prescribed for MG) Correct Answer: cholinergic crisis.
excessive salivation, lacrimation, emesis, urinary incontinence,
gynecomastia, sparse body hair, small soft testes Correct Answer: klinefelters' syndrome (XXY)
retinal a. emboli can cause brief episodes of monocular blindness known as Correct Answer:
amaruosis fugax
inhibition of protein C due to use of warfarin causes what? Correct Answer: skin necrosis
,in wilson's dz which are the only type of contraceptives recommended? Correct Answer:
progestin only pill or levoestregel releasing IUD
how do u differentiate between amphetamine or cocaine high? Correct Answer: time;
amphetamine = 4-6 hrs
cocaine = 2 hrs.
cushings syndrome pts that are not surgical candidates can use what? Correct Answer: oral
ketoconazole
distended neck veins with prominent A or V waves Correct Answer: cor pulmonale
IgA vasculitis that erupts over skin post URI, manifesting as paplaple lesions and pts also present
with hematuria, arthalgia, and abdominal pain and bloody stools.
dx:
best dx tool:
tx: Correct Answer: henoch schonlein purpura
coag studies: should be NEGATIVE!
kidney bx: IgA deposits
tx: supportive as dz is self limiting (NSAIDs, bed rest, hydration)
which restrictive lung dz has increased serum ACE (angiotensin converting enzyme)? Correct
Answer: sarcoidosis
in pts with orthostatic hypotension, how can you differentiate between autonomic insufficiency
or hypovolemia? Correct Answer: in autonomic insufficiency there is no compensatory increase
in HR
which two conditions are associated with:
1. menstrual irregularity
2. androgen exces - hirsutism
3. mood changes
4. insulin resistance - hyperglycemia
5. obesity
how can u differentiate the two? Correct Answer: PCOS and hypercortisolism
***hypercortisolism has obesity in truncal distribution and is assoc with HTN and inc urinary
cortisol.
what are the two most common causes of ACUTE renal failure? Correct Answer: 1. acute
tubular necrosis (due to ischemia, shock, sepsis or cardiac arrest or nephrotoxins)
, 2. prerenal dz (HF or hypovolemia)
what is the BUN/Cr ratio like in acute tubular necrosis? Correct Answer: normal
BUN/Cr ratio only higher in dz with reduced urine outflow = pre/post renal azotemia
BUN/Cr ratio is only lower in severe liver dz.
beriberi, av fistulas, hyperthyroidism, Paget's dz of bone can all cause what kind of HF? Correct
Answer: high cardiac output HF.
how can you differentiate between inflammatory and non-inflammatory diarrhea? Correct
Answer: inflammatory diarrhea can be bloody
shigella, entameoba, capmhylobacter, salmonella, yersinia are all organisms that are more likely
to cause what kind of diarrhea? Correct Answer: inflammatory
norovirus, rotavirus, e.coli, staph aureus, giardia, crytosproridium are all organisms that cause
wht kind of diarrhea? Correct Answer: non-inflammatory.
in a pt with guillan barre, PMH is significant for recent travel and severe diarrhea (enterocolitis)
- what organism can you assume caused this? Correct Answer: camphylobacter.
which organisms are most likely to cause traveler's diarrhea? Correct Answer: e.coli, shigella,
camphylobacter
which organisms are responsible for causing diarrhea from drinking contaminated water? Correct
Answer: giardia, cryptosproridium
stool immunoassay and micro studies to confirm dx.
tx: metronidazole.
extraintestinal manifestations of uveitis, erythema nodosum or pyoderma gangrenosum , large
joint arthritis, and cholangitis can be seen with what? Correct Answer: Ulcerative colitis
in addition to heart burn, GERD can cause what sxs? Correct Answer: water brash, hoarseness,
wheezing, sour taste, sore throat.
best test for GERD dx? Correct Answer: esophageal pH monitoring
how is antiphospholipid antibody syndrome related to pregnancy? Correct Answer: recurrent
spontaneous abortions. and it can cause preecclampsia.
best diagnostic test for someone with charcoat's triad + Correct Answer: ERCP
which type of hypersentitivy rxn is the most severe? requiring emergency tx? Correct Answer:
type 1
Type IV< III< II < I
in an alcoholic pt with global confusion, ataxia (gait imbalance), nystagmus + ocular msl
paralysis Correct Answer: wernicke's encephalopathy
Tx: IV thiamine
which type of hypersensitivity rxn is characterized by antigen -antibody rxns mediated by IgE --
that results in hypotension, shock, urticaria, or angioedema? Correct Answer: type I
best diagnostic test for carpal tunnel syndrome ? Correct Answer: electromyogram
males with early onset of poor gait that is progressively worsening. Plus pseudohypertrophy of
the calves and + Gowers sign (need to lift oneself "climb up" up when getting up) and a positive
fam history
a Muscle bx to confirm this dx would show: Correct Answer: duchenne muscular dystrophy
which tests differentiate between nerve and muscular problems? Correct Answer:
electromyogram and nerve conduction studies
Cushing's syndrome pt should immediately stop which meds? Correct Answer: steroids.
Lambert-Eaton myasthenic syndrome Correct Answer: immune mediated disorder where ACH
is not properly released - this causes weakness in scapular and pelvic girdle muscles. and
difficulty climbing stairs or impotence. deep tendon reflexes are decreased or absent.
overdose cholinesterase inhibitors such as pyridostigmine or neostigmine can cause what ?
(usually prescribed for MG) Correct Answer: cholinergic crisis.
excessive salivation, lacrimation, emesis, urinary incontinence,
gynecomastia, sparse body hair, small soft testes Correct Answer: klinefelters' syndrome (XXY)
retinal a. emboli can cause brief episodes of monocular blindness known as Correct Answer:
amaruosis fugax
inhibition of protein C due to use of warfarin causes what? Correct Answer: skin necrosis
,in wilson's dz which are the only type of contraceptives recommended? Correct Answer:
progestin only pill or levoestregel releasing IUD
how do u differentiate between amphetamine or cocaine high? Correct Answer: time;
amphetamine = 4-6 hrs
cocaine = 2 hrs.
cushings syndrome pts that are not surgical candidates can use what? Correct Answer: oral
ketoconazole
distended neck veins with prominent A or V waves Correct Answer: cor pulmonale
IgA vasculitis that erupts over skin post URI, manifesting as paplaple lesions and pts also present
with hematuria, arthalgia, and abdominal pain and bloody stools.
dx:
best dx tool:
tx: Correct Answer: henoch schonlein purpura
coag studies: should be NEGATIVE!
kidney bx: IgA deposits
tx: supportive as dz is self limiting (NSAIDs, bed rest, hydration)
which restrictive lung dz has increased serum ACE (angiotensin converting enzyme)? Correct
Answer: sarcoidosis
in pts with orthostatic hypotension, how can you differentiate between autonomic insufficiency
or hypovolemia? Correct Answer: in autonomic insufficiency there is no compensatory increase
in HR
which two conditions are associated with:
1. menstrual irregularity
2. androgen exces - hirsutism
3. mood changes
4. insulin resistance - hyperglycemia
5. obesity
how can u differentiate the two? Correct Answer: PCOS and hypercortisolism
***hypercortisolism has obesity in truncal distribution and is assoc with HTN and inc urinary
cortisol.
what are the two most common causes of ACUTE renal failure? Correct Answer: 1. acute
tubular necrosis (due to ischemia, shock, sepsis or cardiac arrest or nephrotoxins)
, 2. prerenal dz (HF or hypovolemia)
what is the BUN/Cr ratio like in acute tubular necrosis? Correct Answer: normal
BUN/Cr ratio only higher in dz with reduced urine outflow = pre/post renal azotemia
BUN/Cr ratio is only lower in severe liver dz.
beriberi, av fistulas, hyperthyroidism, Paget's dz of bone can all cause what kind of HF? Correct
Answer: high cardiac output HF.
how can you differentiate between inflammatory and non-inflammatory diarrhea? Correct
Answer: inflammatory diarrhea can be bloody
shigella, entameoba, capmhylobacter, salmonella, yersinia are all organisms that are more likely
to cause what kind of diarrhea? Correct Answer: inflammatory
norovirus, rotavirus, e.coli, staph aureus, giardia, crytosproridium are all organisms that cause
wht kind of diarrhea? Correct Answer: non-inflammatory.
in a pt with guillan barre, PMH is significant for recent travel and severe diarrhea (enterocolitis)
- what organism can you assume caused this? Correct Answer: camphylobacter.
which organisms are most likely to cause traveler's diarrhea? Correct Answer: e.coli, shigella,
camphylobacter
which organisms are responsible for causing diarrhea from drinking contaminated water? Correct
Answer: giardia, cryptosproridium
stool immunoassay and micro studies to confirm dx.
tx: metronidazole.
extraintestinal manifestations of uveitis, erythema nodosum or pyoderma gangrenosum , large
joint arthritis, and cholangitis can be seen with what? Correct Answer: Ulcerative colitis
in addition to heart burn, GERD can cause what sxs? Correct Answer: water brash, hoarseness,
wheezing, sour taste, sore throat.
best test for GERD dx? Correct Answer: esophageal pH monitoring
how is antiphospholipid antibody syndrome related to pregnancy? Correct Answer: recurrent
spontaneous abortions. and it can cause preecclampsia.
best diagnostic test for someone with charcoat's triad + Correct Answer: ERCP
