SMARTY PANCE QUESTIONS AND ANSWERS LATEST
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Which of the following is essential to make a diagnosis of cystic fibrosis?
A. Positive family history
B. Elevated sweat chloride
C. Recurrent respiratory infections
D. Elevated trypsinogen levels - CORRECT ANSWERS B. Elevated sweat chloride
A 23 year-old female with history of asthma for the past 5 years presents with complaints of
increasing shortness of breath for 2 days. Her asthma has been well controlled until 2 days ago
and since yesterday she has been using her albuterol inhaler every 4-6 hours. She is normally
very active, however yesterday she did not complete her 30 minutes exercise routine due to
increasing dyspnea. She denies any cough, fever, recent surgeries or use of oral contraceptives.
On examination, you note the presence of prolonged expiration and diffuse wheezing. The
remainder of the exam is unremarkable. Which of the following is the most appropriate initial
diagnostic evaluation prior to initiation of treatment?
A. chest x-ray
B. sputum gram stain
C. peak flow
D. ventilation - perfusion scan - CORRECT ANSWERS C. peak flow
A patient presents with a history of progressive worsening of dyspnea over the past several
years. He gives a history of having worked as a ship builder for over 50 years. He denies any
alcohol or tobacco use. On examination you note clubbing and inspiratory crackles. Which of
the following chest x-ray findings support your suspected diagnosis?
A. hyperinflation and flat diaphragms
B. interstitial fibrosis and pleural thickening
C. cavitary lesions involving the upper lobes
,SMARTY PANCE QUESTIONS AND ANSWERS LATEST
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D. "eggshell" calcification of hilar lymph nodes - CORRECT ANSWERS B. interstitial
fibrosis and pleural thickening (Asbestosis)
You are called to the nursery to see a male infant, born by uncomplicated vaginal delivery. He
weighs 2,600 grams and has one deep crease on the anterior third of each foot. Respirations
are 88 breaths/minute with expiratory grunting and intercostals retractions. He is cyanotic on
room air and becomes pink when placed in 60% oxygen. Chest x-ray shows atelectasis with air
bronchograms. Which of the following is the most likely diagnosis?
A. neonatal pneumonia
B. congenital heart disease
C. hyaline membrane disease
D. chronic lung disease of prematurity - CORRECT ANSWERS C. hyaline membrane
disease
A 32 year-old African American female presents with complaints of a gradual worsening of
exertional dyspnea associated with a mild dry cough. She has tried various cough preparations
on her own without any significant relief. Her examination is essentially unremarkable. A chest
x-ray reveals the presence of bilateral hilar adenopathy. Which of the following is the most
likely diagnosis?
A. silicosis
B. sarcoidosis
C. tuberculosis
D. mycoplasma pneumonia - CORRECT ANSWERS B. sarcoidosis
A 53 year-old female status post abdominal hysterectomy 3 days ago suddenly develops
pleuritic chest pain and dyspnea. On exam she is tachycardic and tachypneic with rales in the
left lower lobe. A chest x-ray is unremarkable and an EKG reveals tachycardia. Which of the
following is the most likely diagnosis?
,SMARTY PANCE QUESTIONS AND ANSWERS LATEST
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A. atelectasis
B. pneumothorax
C. pulmonary embolism
D. myocardial infarction - CORRECT ANSWERS C. pulmonary embolism
A 17 year-old male who is trying out for the track team notes excessive coughing with chest
tightness when running. Which of the following is the most appropriate preventive agent for
this patient?
A. Albuterol inhaler (Proventil)
B. Inhaled corticosteroids
C. Aminophylline (Theo-Dur)
D. Ipratropium (Atrovent) - CORRECT ANSWERS A. Albuterol inhaler (Proventil)
A 62 year-old female is admitted to a nursing home during an outbreak of influenza. In review
of her records, you note that she did not receive the flu vaccine this year. Which of the
following is the most appropriate drug of choice for influenza prophylaxis in this patient?
A. Ciprofloxin (Cipro)
B. Zanamivir (Relenza)
C. Clarithromycin (Biaxin)
D. Alpha-2b interferon (Avonex) - CORRECT ANSWERS B. Zanamivir (Relenza)
Which of the following is an independent risk factor for development of a mesothelioma?
A. Cigarette smoking
B. Asbestos exposure
C. Radon gas exposure
, SMARTY PANCE QUESTIONS AND ANSWERS LATEST
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PASS
D. Chronic obstructive lung disease - CORRECT ANSWERS B. Asbestos exposure
Which of the following is a major contraindication to curative surgical resection of a lung
tumor?
A. Liver metastases
B. Vagus nerve involvement
C. Non-malignant pleural effusion
D. Chest wall invasion of the tumor - CORRECT ANSWERS A. Liver metastases
A 36 year-old male developed a sore throat and was treated with IM penicillin. Within 20
minutes, he felt faint, became dyspneic, and had diarrhea. Upon entry to the emergency
department, he was pale and apprehensive. He had a thready pulse, and systolic blood pressure
was 40 mmHg. Which of the following is the most appropriate initial agent to use?
A. Dopamine
B. Epinephrine
C. Hyrocortisone
D. Diphenhydramine - CORRECT ANSWERS B. Epinephrine
A 22 year-old female with a history of asthma presents with complaints of increasing "asthma"
attacks. The patient states she has been well controlled on albuterol inhaler until one month
ago. Since that time she notices that she has had to use her inhaler 3-4 times a week and also
has had increasing nighttime use averaging about three episodes in the past month. Spirometry
reveals > 85% predicted value. Which of the following is the most appropriate intervention at
this time?
A. Oral prednisone
B. Oral theophylline
C. Salmeterol inhaler
DOWNLOADED 2025/2026 A COMPLETE EXAM SOLUTION
WITH 100% CORRECT DETAILED ANSWERS BEST RATED A+ FOR
PASS
Which of the following is essential to make a diagnosis of cystic fibrosis?
A. Positive family history
B. Elevated sweat chloride
C. Recurrent respiratory infections
D. Elevated trypsinogen levels - CORRECT ANSWERS B. Elevated sweat chloride
A 23 year-old female with history of asthma for the past 5 years presents with complaints of
increasing shortness of breath for 2 days. Her asthma has been well controlled until 2 days ago
and since yesterday she has been using her albuterol inhaler every 4-6 hours. She is normally
very active, however yesterday she did not complete her 30 minutes exercise routine due to
increasing dyspnea. She denies any cough, fever, recent surgeries or use of oral contraceptives.
On examination, you note the presence of prolonged expiration and diffuse wheezing. The
remainder of the exam is unremarkable. Which of the following is the most appropriate initial
diagnostic evaluation prior to initiation of treatment?
A. chest x-ray
B. sputum gram stain
C. peak flow
D. ventilation - perfusion scan - CORRECT ANSWERS C. peak flow
A patient presents with a history of progressive worsening of dyspnea over the past several
years. He gives a history of having worked as a ship builder for over 50 years. He denies any
alcohol or tobacco use. On examination you note clubbing and inspiratory crackles. Which of
the following chest x-ray findings support your suspected diagnosis?
A. hyperinflation and flat diaphragms
B. interstitial fibrosis and pleural thickening
C. cavitary lesions involving the upper lobes
,SMARTY PANCE QUESTIONS AND ANSWERS LATEST
DOWNLOADED 2025/2026 A COMPLETE EXAM SOLUTION
WITH 100% CORRECT DETAILED ANSWERS BEST RATED A+ FOR
PASS
D. "eggshell" calcification of hilar lymph nodes - CORRECT ANSWERS B. interstitial
fibrosis and pleural thickening (Asbestosis)
You are called to the nursery to see a male infant, born by uncomplicated vaginal delivery. He
weighs 2,600 grams and has one deep crease on the anterior third of each foot. Respirations
are 88 breaths/minute with expiratory grunting and intercostals retractions. He is cyanotic on
room air and becomes pink when placed in 60% oxygen. Chest x-ray shows atelectasis with air
bronchograms. Which of the following is the most likely diagnosis?
A. neonatal pneumonia
B. congenital heart disease
C. hyaline membrane disease
D. chronic lung disease of prematurity - CORRECT ANSWERS C. hyaline membrane
disease
A 32 year-old African American female presents with complaints of a gradual worsening of
exertional dyspnea associated with a mild dry cough. She has tried various cough preparations
on her own without any significant relief. Her examination is essentially unremarkable. A chest
x-ray reveals the presence of bilateral hilar adenopathy. Which of the following is the most
likely diagnosis?
A. silicosis
B. sarcoidosis
C. tuberculosis
D. mycoplasma pneumonia - CORRECT ANSWERS B. sarcoidosis
A 53 year-old female status post abdominal hysterectomy 3 days ago suddenly develops
pleuritic chest pain and dyspnea. On exam she is tachycardic and tachypneic with rales in the
left lower lobe. A chest x-ray is unremarkable and an EKG reveals tachycardia. Which of the
following is the most likely diagnosis?
,SMARTY PANCE QUESTIONS AND ANSWERS LATEST
DOWNLOADED 2025/2026 A COMPLETE EXAM SOLUTION
WITH 100% CORRECT DETAILED ANSWERS BEST RATED A+ FOR
PASS
A. atelectasis
B. pneumothorax
C. pulmonary embolism
D. myocardial infarction - CORRECT ANSWERS C. pulmonary embolism
A 17 year-old male who is trying out for the track team notes excessive coughing with chest
tightness when running. Which of the following is the most appropriate preventive agent for
this patient?
A. Albuterol inhaler (Proventil)
B. Inhaled corticosteroids
C. Aminophylline (Theo-Dur)
D. Ipratropium (Atrovent) - CORRECT ANSWERS A. Albuterol inhaler (Proventil)
A 62 year-old female is admitted to a nursing home during an outbreak of influenza. In review
of her records, you note that she did not receive the flu vaccine this year. Which of the
following is the most appropriate drug of choice for influenza prophylaxis in this patient?
A. Ciprofloxin (Cipro)
B. Zanamivir (Relenza)
C. Clarithromycin (Biaxin)
D. Alpha-2b interferon (Avonex) - CORRECT ANSWERS B. Zanamivir (Relenza)
Which of the following is an independent risk factor for development of a mesothelioma?
A. Cigarette smoking
B. Asbestos exposure
C. Radon gas exposure
, SMARTY PANCE QUESTIONS AND ANSWERS LATEST
DOWNLOADED 2025/2026 A COMPLETE EXAM SOLUTION
WITH 100% CORRECT DETAILED ANSWERS BEST RATED A+ FOR
PASS
D. Chronic obstructive lung disease - CORRECT ANSWERS B. Asbestos exposure
Which of the following is a major contraindication to curative surgical resection of a lung
tumor?
A. Liver metastases
B. Vagus nerve involvement
C. Non-malignant pleural effusion
D. Chest wall invasion of the tumor - CORRECT ANSWERS A. Liver metastases
A 36 year-old male developed a sore throat and was treated with IM penicillin. Within 20
minutes, he felt faint, became dyspneic, and had diarrhea. Upon entry to the emergency
department, he was pale and apprehensive. He had a thready pulse, and systolic blood pressure
was 40 mmHg. Which of the following is the most appropriate initial agent to use?
A. Dopamine
B. Epinephrine
C. Hyrocortisone
D. Diphenhydramine - CORRECT ANSWERS B. Epinephrine
A 22 year-old female with a history of asthma presents with complaints of increasing "asthma"
attacks. The patient states she has been well controlled on albuterol inhaler until one month
ago. Since that time she notices that she has had to use her inhaler 3-4 times a week and also
has had increasing nighttime use averaging about three episodes in the past month. Spirometry
reveals > 85% predicted value. Which of the following is the most appropriate intervention at
this time?
A. Oral prednisone
B. Oral theophylline
C. Salmeterol inhaler
