SMARTY PANCE EXAM QUESTIONS AND ANSWERS
A 40 year-old female presents with a Pap smear abnormality revealing atypical
glandular cells (AGUS). What is the most appropriate intervention? - Answers -
Colposcopy and endometrial sampling
(Colposcopy and endometrial sampling are important to perform in patients with AGUS
Pap results because glandular cells are associated with squamous and glandular
precursor lesions and carcinoma.)
A 75 year-old female with history of coronary artery disease and dyslipidemia presents
for routine follow-up. Physical examination reveals loss of hair on the lower extremities
bilaterally with thinning of the skin. Femoral pulses are +2/4 bilaterally, pedal pulses are
diminished bilaterally. Ankle brachial index is reduced. Which of the following signs or
symptoms is this patient most likely to have? - Answers - calf pain with walking
You are following a patient in labor at term. You evaluate the fetal monitoring tracing
and note the presence of variable, repetitive decelerations in the heart rates. The
contractions have a sharp deceleration slope. What is the recommended treatment for
these decelerations? - Answers - change maternal position
An otherwise healthy college student presents with complaints of cough, malaise, fever,
yellow-green nasal discharge and headache for the past 3 weeks. She complains of
facial pain over the cheeks and while chewing. On examination, the nasal turbinates are
erythematous and edematous nearly obstructing the nares bilaterally. She has not been
previously evaluated. What is the most appropriate antibiotic in this patient? - Answers -
Trimethoprim/sulfamethoxazole (Bactrim)
(Acute bacterial rhinosinusitis (sinusitis) is associated with S. pneumoniae, H.
Influenzae, and less commonly S. Aureus or Moraxella catarrhalis. First line therapies
for bacterial sinusitis include amoxicillin, Bactrim, or doxycycline. Second line therapy
includes Augmentin, Moxifloxacin, or Telithromy)
Which of the following complications of Crohn's disease most frequently requires
surgery? - Answers - intra-abdominal abcess
A 60 year-old male complains of progressive fatigue and dyspnea. On examination his
lungs are clear to auscultation bilaterally, heart exam reveals regular rate and rhythm
without S3, S4 or murmur, and extremities show 1+ edema bilaterally. Chest x-ray
reveals cardiomegaly. electrocardiogram shows low voltage, and echocardiogram
shows an ejection fraction of 55% with a small, thickened left ventricle that has rapid
early filling with diastolic dysfunction. Which of the following is the most likely underlying
etiology of this patient's cardiomyopathy? - Answers - Amyloidosis
, (Amyloidosis is the most common cause of restrictive cardiomyopathy and is associated
with a small thickened left ventricle that has rapid early filling with diastolic dysfunction.)
An O2 saturation of 90% corresponds to what PO2 value? - Answers - 60mmHg
(O2 sat values above 90% correspond with a PO2 >70 mmHg and values less than
94% represent hypoxemia. Less than 90% O2 sat warrants measurement of arterial
blood gasses.)
A 3 year-old child playing in an abandoned shed is bitten by a black widow spider. The
mother rushes the child to the emergency department within 20 minutes of the incident.
Which of the following if the best initial intervention? - Answers - Hospital admission for
symptomatic care
The most accurate way to determine the exact degree of spinal curvature in a child with
scoliosis is by which of the following? - Answers - Cobb angle calculation
Which of the following is the portion of the nephron responsible for the absorption of
90% of the ultrafiltrate? - Answers - proximal convoluted tubule
A 55 year-old male with history of hypertension and diabetes mellitus presents to the
emergency department. The patient's wife states that the patient developed progressive
irritability and confusion today after complaining of a headache. Physical examination
reveals a BP of 230/130 mmHg and papilledema. Which of the following is the most
accurate diagnosis in this patient? - Answers - malignant HTN
(Malignant hypertension is significantly elevated BP with progressive retinopathy,
including papilledema, encephalopathy, and headache.)
Your patient has just delivered her baby vaginally without difficulty. The patient has a
laceration of the vaginal mucosa including the perineal body. You repair it without
difficulty. On the chart you document this as what type of tear? - Answers - 2*- A second
degree tear involves the underlying subcutaneous tissues, but not the rectal sphincter or
rectal mucosa.
(A third degree tear extends through the rectal sphincter, but not into the rectal
mucosa.)
A 9 year-old patient presents with conjunctivitis after swimming at the local pool. On
examination, there is visible lid edema with redness of the palpebral conjunctiva,
copious watery discharge, and scanty exudate. The sanitation system of the public pool
is through the use of a salt water system; therefore, the possibility of a chemical induced
conjunctivitis is almost non-existent. Which of the following should be instituted to
prevent the sequalae of the condition? - Answers - Sulfacetamide opthalmic
A 40 year-old female presents with a Pap smear abnormality revealing atypical
glandular cells (AGUS). What is the most appropriate intervention? - Answers -
Colposcopy and endometrial sampling
(Colposcopy and endometrial sampling are important to perform in patients with AGUS
Pap results because glandular cells are associated with squamous and glandular
precursor lesions and carcinoma.)
A 75 year-old female with history of coronary artery disease and dyslipidemia presents
for routine follow-up. Physical examination reveals loss of hair on the lower extremities
bilaterally with thinning of the skin. Femoral pulses are +2/4 bilaterally, pedal pulses are
diminished bilaterally. Ankle brachial index is reduced. Which of the following signs or
symptoms is this patient most likely to have? - Answers - calf pain with walking
You are following a patient in labor at term. You evaluate the fetal monitoring tracing
and note the presence of variable, repetitive decelerations in the heart rates. The
contractions have a sharp deceleration slope. What is the recommended treatment for
these decelerations? - Answers - change maternal position
An otherwise healthy college student presents with complaints of cough, malaise, fever,
yellow-green nasal discharge and headache for the past 3 weeks. She complains of
facial pain over the cheeks and while chewing. On examination, the nasal turbinates are
erythematous and edematous nearly obstructing the nares bilaterally. She has not been
previously evaluated. What is the most appropriate antibiotic in this patient? - Answers -
Trimethoprim/sulfamethoxazole (Bactrim)
(Acute bacterial rhinosinusitis (sinusitis) is associated with S. pneumoniae, H.
Influenzae, and less commonly S. Aureus or Moraxella catarrhalis. First line therapies
for bacterial sinusitis include amoxicillin, Bactrim, or doxycycline. Second line therapy
includes Augmentin, Moxifloxacin, or Telithromy)
Which of the following complications of Crohn's disease most frequently requires
surgery? - Answers - intra-abdominal abcess
A 60 year-old male complains of progressive fatigue and dyspnea. On examination his
lungs are clear to auscultation bilaterally, heart exam reveals regular rate and rhythm
without S3, S4 or murmur, and extremities show 1+ edema bilaterally. Chest x-ray
reveals cardiomegaly. electrocardiogram shows low voltage, and echocardiogram
shows an ejection fraction of 55% with a small, thickened left ventricle that has rapid
early filling with diastolic dysfunction. Which of the following is the most likely underlying
etiology of this patient's cardiomyopathy? - Answers - Amyloidosis
, (Amyloidosis is the most common cause of restrictive cardiomyopathy and is associated
with a small thickened left ventricle that has rapid early filling with diastolic dysfunction.)
An O2 saturation of 90% corresponds to what PO2 value? - Answers - 60mmHg
(O2 sat values above 90% correspond with a PO2 >70 mmHg and values less than
94% represent hypoxemia. Less than 90% O2 sat warrants measurement of arterial
blood gasses.)
A 3 year-old child playing in an abandoned shed is bitten by a black widow spider. The
mother rushes the child to the emergency department within 20 minutes of the incident.
Which of the following if the best initial intervention? - Answers - Hospital admission for
symptomatic care
The most accurate way to determine the exact degree of spinal curvature in a child with
scoliosis is by which of the following? - Answers - Cobb angle calculation
Which of the following is the portion of the nephron responsible for the absorption of
90% of the ultrafiltrate? - Answers - proximal convoluted tubule
A 55 year-old male with history of hypertension and diabetes mellitus presents to the
emergency department. The patient's wife states that the patient developed progressive
irritability and confusion today after complaining of a headache. Physical examination
reveals a BP of 230/130 mmHg and papilledema. Which of the following is the most
accurate diagnosis in this patient? - Answers - malignant HTN
(Malignant hypertension is significantly elevated BP with progressive retinopathy,
including papilledema, encephalopathy, and headache.)
Your patient has just delivered her baby vaginally without difficulty. The patient has a
laceration of the vaginal mucosa including the perineal body. You repair it without
difficulty. On the chart you document this as what type of tear? - Answers - 2*- A second
degree tear involves the underlying subcutaneous tissues, but not the rectal sphincter or
rectal mucosa.
(A third degree tear extends through the rectal sphincter, but not into the rectal
mucosa.)
A 9 year-old patient presents with conjunctivitis after swimming at the local pool. On
examination, there is visible lid edema with redness of the palpebral conjunctiva,
copious watery discharge, and scanty exudate. The sanitation system of the public pool
is through the use of a salt water system; therefore, the possibility of a chemical induced
conjunctivitis is almost non-existent. Which of the following should be instituted to
prevent the sequalae of the condition? - Answers - Sulfacetamide opthalmic
