Conquer the NCCPA- PANCE Exam: The
Ultimate Review Guide
At what age should you order DEXA scans for male? Female? -
\70 for males
65 for females
Give DEXA score for osteopenia? Osteoporosis? -
\Osteopenia = 1 to 2.4 standard deviations, osteoporosis = 2.5 standard deviations or
greater.
What fracture is #1 cause of compartment syndrome? -
\Tibial shaft fracture
A patient's lab work shows positive smith Ab and positive double strand DNA ab. Most
likely diagnosis is? -
\Lupus
Where are Bouchard's nodes found? -
\PIP
[B = Before]
What will XRAY show in acute osteomyelitis? -
\Nothing: bone destruction in chronic osteomyelitis
Best imaging to dx osteomyelitis? -
\Bone scan or MRI will provide diagnosis
A 22 year old male patient presents with what is
clearly a septic knee. You also notice lesions on his
hands and feet. What is the most likely pathogen? -
\Neisseria gonorrhoeae
What would you expect the WBC count to be in the
joint fluid of an infected knee? -
\>50,000 at a minimum and probably
much higher.
A patient presents with a painless mass in her right
wrist. What is the most likely diagnosis? -
\Ganglion cyst
,What is the age range for osteosarcoma? Where
are they most typically found in the body? -
\Osteosarcoma (cancerous) usually occur in
15-25 year old males and are most
commonly found around the knee.
You think a patient may have an osteoid osteoma
due to his complaints of severe night pain. You
set him up for an x-ray, but in the meantime what
medication do you start him on? -
\If it is truly an osteoid osteoma (benign)
ibuprofen will resolve his pain.
Clicking or locking of the knee indicates what
diagnosis? -
\Meniscal tear
A 65 year old presents complaining of severe pain
in his great toe that began when he woke up this
morning. It is swollen, red and very tender. What is
the most likely diagnosis? -
\1. Gout
2. Infection
What uric acid level helps to confirm dx of gout? -
\>7.5
(Normal = 3ish to 7ish?)
What is the medical treatment for gout? -
\Allopurinol, colchicine
Pathology shows positive birefringent crystals. Most likely dx? -
\Pseudogout
Patient with hx of HBV presents with bilateral knee pain, fever, weight loss. Most likely
diagnosis? -
\Polyarteritis nodosa
You suspect a pt has polyarteritis nodosa. What is the test for a definitive diagnosis and
what is treatment? -
\Biopsy, high dose steroids
On physical exam you notice ulnar deviations and swan neck deformities. What is the
most likely diagnosis? -
\Rheumatoid arthritis
,Positive Neer's test indicate what diagnosis? -
\Rotator cuff impingement
List three meds that may cause lupus -
\Procainamide, isoniazid, quinidine
What test do you do for Sjogren's syndrome? -
\Schirmer test
[Sjogren's syndrome] = dry mouth, dry eyes, autoimmune)
A patient with rheumatoid arthritis is heading to OR for ORIF of ankle. What x-rays
should you get? -
\Ankle films
C-spine
Anesthesia will want them d/t concerns about instability of C1+C2
What carpal bone has high rate of nonunion and occult fracture? -
\Scaphoid
[Occult = hidden]
What med is used for patient with lupus? -
\Systemic steroids
Scleroderma limited version has five main characteristics (CREST) -
\Calcinosis
Raynaud's
Esophageal mobility
Sclerodactyly
Telangiectasia
There is a sunbusrt appearance on XRAY. What is most likely diagnosis? -
\osteosarcoma
Anatomically where are 80% of clavicle fractures located? -
\Middle third
A pathology report comes back with negative birefringent crystals. What is most likely
diagnosis? -
\Gout
Four muscles of rotator cuff? -
\SITS
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
, Describe characteristics of lytic lesion on xray -
\Spiculated, elevated periosteum, bone destruction (think bad, very bad)
What ligament is most commonly injured in ankle sprain? -
\Anterior talofibular ligament (ATF)
Vasculitis with HBV history should make you think of what diagnosis? -
\Polyarteritis nodosa
What is most common fracture in children? -
\Clavicle
Fat pad sign on lateral xray of elbow has what significance? -
\Blood in joint indicating fracture even if fracture line can't be seen
Patient presents with progressive neck and muscle weakness. On physical exam you
see reddish purple maculopapular rash. Her lab work shows an anti Jo 1 antibody. What
is most likely diagnosis? -
\Polymyositis
Which way does a Colles fracture angulate: dorsal or volar? -
\DORSAL
Which way does a Smith fracture angulate: dorsal or volar? -
\VOLAR
Tenderness over anatomical snuffbox indicates what fracture? -
\Scaphoid
What is most common fracture in patient with osteoporosis? -
\A compression fracture of a vertebral body followed by hip fractures
15 yo boy w/night pain in pelvis. Xray shows mass with "onion skin appearance". Dx? -
\Ewing sarcoma
(cancer, rare)
What is the name for a 4th and 5th metacarpal
fractures that often result from throwing a punch? -
\Boxer's fracture
A new mother presents with pain over the radial
wrist. She has a positive Finkelstein's test. What is
the most likely diagnosis? -
\de Quervain's tenosynovitis
Ultimate Review Guide
At what age should you order DEXA scans for male? Female? -
\70 for males
65 for females
Give DEXA score for osteopenia? Osteoporosis? -
\Osteopenia = 1 to 2.4 standard deviations, osteoporosis = 2.5 standard deviations or
greater.
What fracture is #1 cause of compartment syndrome? -
\Tibial shaft fracture
A patient's lab work shows positive smith Ab and positive double strand DNA ab. Most
likely diagnosis is? -
\Lupus
Where are Bouchard's nodes found? -
\PIP
[B = Before]
What will XRAY show in acute osteomyelitis? -
\Nothing: bone destruction in chronic osteomyelitis
Best imaging to dx osteomyelitis? -
\Bone scan or MRI will provide diagnosis
A 22 year old male patient presents with what is
clearly a septic knee. You also notice lesions on his
hands and feet. What is the most likely pathogen? -
\Neisseria gonorrhoeae
What would you expect the WBC count to be in the
joint fluid of an infected knee? -
\>50,000 at a minimum and probably
much higher.
A patient presents with a painless mass in her right
wrist. What is the most likely diagnosis? -
\Ganglion cyst
,What is the age range for osteosarcoma? Where
are they most typically found in the body? -
\Osteosarcoma (cancerous) usually occur in
15-25 year old males and are most
commonly found around the knee.
You think a patient may have an osteoid osteoma
due to his complaints of severe night pain. You
set him up for an x-ray, but in the meantime what
medication do you start him on? -
\If it is truly an osteoid osteoma (benign)
ibuprofen will resolve his pain.
Clicking or locking of the knee indicates what
diagnosis? -
\Meniscal tear
A 65 year old presents complaining of severe pain
in his great toe that began when he woke up this
morning. It is swollen, red and very tender. What is
the most likely diagnosis? -
\1. Gout
2. Infection
What uric acid level helps to confirm dx of gout? -
\>7.5
(Normal = 3ish to 7ish?)
What is the medical treatment for gout? -
\Allopurinol, colchicine
Pathology shows positive birefringent crystals. Most likely dx? -
\Pseudogout
Patient with hx of HBV presents with bilateral knee pain, fever, weight loss. Most likely
diagnosis? -
\Polyarteritis nodosa
You suspect a pt has polyarteritis nodosa. What is the test for a definitive diagnosis and
what is treatment? -
\Biopsy, high dose steroids
On physical exam you notice ulnar deviations and swan neck deformities. What is the
most likely diagnosis? -
\Rheumatoid arthritis
,Positive Neer's test indicate what diagnosis? -
\Rotator cuff impingement
List three meds that may cause lupus -
\Procainamide, isoniazid, quinidine
What test do you do for Sjogren's syndrome? -
\Schirmer test
[Sjogren's syndrome] = dry mouth, dry eyes, autoimmune)
A patient with rheumatoid arthritis is heading to OR for ORIF of ankle. What x-rays
should you get? -
\Ankle films
C-spine
Anesthesia will want them d/t concerns about instability of C1+C2
What carpal bone has high rate of nonunion and occult fracture? -
\Scaphoid
[Occult = hidden]
What med is used for patient with lupus? -
\Systemic steroids
Scleroderma limited version has five main characteristics (CREST) -
\Calcinosis
Raynaud's
Esophageal mobility
Sclerodactyly
Telangiectasia
There is a sunbusrt appearance on XRAY. What is most likely diagnosis? -
\osteosarcoma
Anatomically where are 80% of clavicle fractures located? -
\Middle third
A pathology report comes back with negative birefringent crystals. What is most likely
diagnosis? -
\Gout
Four muscles of rotator cuff? -
\SITS
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
, Describe characteristics of lytic lesion on xray -
\Spiculated, elevated periosteum, bone destruction (think bad, very bad)
What ligament is most commonly injured in ankle sprain? -
\Anterior talofibular ligament (ATF)
Vasculitis with HBV history should make you think of what diagnosis? -
\Polyarteritis nodosa
What is most common fracture in children? -
\Clavicle
Fat pad sign on lateral xray of elbow has what significance? -
\Blood in joint indicating fracture even if fracture line can't be seen
Patient presents with progressive neck and muscle weakness. On physical exam you
see reddish purple maculopapular rash. Her lab work shows an anti Jo 1 antibody. What
is most likely diagnosis? -
\Polymyositis
Which way does a Colles fracture angulate: dorsal or volar? -
\DORSAL
Which way does a Smith fracture angulate: dorsal or volar? -
\VOLAR
Tenderness over anatomical snuffbox indicates what fracture? -
\Scaphoid
What is most common fracture in patient with osteoporosis? -
\A compression fracture of a vertebral body followed by hip fractures
15 yo boy w/night pain in pelvis. Xray shows mass with "onion skin appearance". Dx? -
\Ewing sarcoma
(cancer, rare)
What is the name for a 4th and 5th metacarpal
fractures that often result from throwing a punch? -
\Boxer's fracture
A new mother presents with pain over the radial
wrist. She has a positive Finkelstein's test. What is
the most likely diagnosis? -
\de Quervain's tenosynovitis
