PANCE – ENT QUESTIONS AND ANSWERS 2022/2023

Candice's PANCE disclaimer: Why Start Looking At This Stuff Now? - Answer - PA School has one main goal - NOT to teach you medicine, but instead how to think like a clinician and how to take the PANCE. SO START NOW :) Trust me, this will help school, rotations and studying for the PANCE a LOT easier!!!! A 42-year-old male truck driver presents with recurring rhinitis and watery eyes during the spring months. What is the best treatment for this patient? A. desloratadine (Clarinex) B. fluticasone(Flonase) C. montelukast (Singulair) D. diphenhydramine (Benadryl) - Answer - Answer is B [Ophthalmology and Otolaryngology]. A. Newer-generation antihistamines have lower rates of drowsiness; desloratine is minimally sedating. However, there is still a risk, especially considering his occupation. B. Evidence-based reviews show that intranasal corticosteroid sprays are more effective and less expensive than nonsedating antihistamines. They are also non sedating. However, there may be a delay in relief of symptoms. C. Antileukotriene agents alone or with antihistamines can help with rhinorrhea, sneezing, and congestion but may cause drowsiness. D. First-generation antihistamines have lower cost, but the highest risk of drowsiness. What is the most common bacterial etiology in otitis media? - Answer - 1. Streptococcus Pneumonia 2. Moraxella Catarrhalis 3. Haemophilus Influenzae An elderly male presents with unilateral hearing loss for 1 day. He denies URI symptoms, fever, or ear pain or discharge. He further denies any dizziness or headaches. Physical exam reveals normal balance, negative Romberg, but evidence of conductive hearing loss in the affected ear. What is the most likely diagnosis? A. barotrauma B. cerumen impaction C. eustachian tube dysfunction D. otitis media - Answer - Answer: B [Ophthalmology and Otolaryngology, Geriatrics]. A. Patients with poor eustachian tube function may be unable to equalize barometric changes on the middle ear when confronted with rapid changes such as with flying, under- water diving, or rapid altitude change. Such barotrauma may present with ear pain and hearing loss related to those activities. B. Cerumen impaction is more common in the elderly due to age-related changes, such as the production of a drier w