PANCE Practice Test Questions and Answers 2024, Exams of Medicine

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PANCE practice test Questions and

Answers 2024

What do pirmented granular "muddy" casts indicate in the setting of oliguria? Correct Answer is Acute tubular necrosis How can hyperphosphatemia be treated? Correct Answer is aluminum hydroxide What is the genetic basis for a patient with disproportionately small legs and arms, frontal bossing and mindfacial hypoplasia? Correct Answer is autosomal recessive Besides extreme growth what other symptoms can a patient with acromegaly have? Correct Answer is headaches, visual field defects, weakness, soft doughy hands, and amenorrhea **kids have giganticism What is the cause of acromegaly? Correct Answer is Excess growth hormone How should X-rays be done to diagnosis SCFE (slipped femoral epiphysis)? Correct Answer is Frog leg position What are the personality characterisitics of schizoid personality disorder? Correct Answer is restricted range of emotion, being a loner, chosing solitary activities What drugs are used to help treat the bradykinesia of Parkinson's? Correct Answer is amantadine, levodopa, selective MOAis How do anticholinergics help treat Parkinson's? Correct Answer is they help treat the tremor and rigidity What are the findings associated with intussusception? Correct Answer is presents 6-18 months of age drawing up of the knees currant jelly stool sausage-shaped mass in upper abdomen Wha tis the most common cause of subacute endocarditis Correct Answer is Strep. viridans In adults without significant risk factors how often should fasting lipid profiles be obtained?

Correct Answer is every 5 years How is Raynaud's disease treated? Correct Answer is CCBs What are Janeway's lesions? Correct Answer is small hemorrhagic lesions on the skin seen in endocarditis What are Osler's nodes? Correct Answer is painful red, raised lesion seen in endocardititis What are Roth's spots? Correct Answer is exudative retinal lesions seen in endocarditis A pancytopenia with circulating blasts is characteristic of______________ Correct Answer is acute leukemia How is acute myeloid leukemia differentiated from lymphoblastic leukemia? Correct Answer is Auer's rods or myeloid enzymes like peroxidase are seen in AML What geene is associated with chronic myeloid leukemia? Correct Answer is bcr/abl gene and phildelphia chromosome What are the treatments of acute-closure glaucoma? Correct Answer is IV acetazolamide, possibly mannitol if very severe, later topical pilocarpine can be used to reverse underlying angle closure and later surgery iridotomy/iridectomy How does IgA nephropathy present? Correct Answer is usually after URI and presents with hematuria and proteinuria Dorsal angulation of the wrist is commonly seen in___________ Correct Answer is Colle's fracture What drugs should be avoided in patients with G6PD deficiency? Correct Answer is sufa-containing drugs like Bactrim, nirtorfurantoin, because they can cause hemolytic crisis What infection is associated with Guillan Barre? Correct Answer is Campylobacter What causes molluscum contagiosum? Correct Answer is poxvirus Posterior cerebral artery occlusion can cause what neurological manifestation? Correct Answer is Alexia- inability to understand written words

Middle cerebral artery occlusion can cause what neurological manifestation? Correct Answer is homonymous hemianopia Horner's syndrome is associated with what cerebral artery occlusion? Correct Answer is Posterior inferior artery occlusion What is a physical exam test used to help diagnosis thoracic outlet syndrome? Correct Answer is Elevated stress test: arm exteneded and externally rotated with the patient opening and closing hands for 3 min When is transphenoidal surgery indicated for a prolactinoma? Correct Answer is When the adenoma is >3cm, otherwise Bromocriptine a dopamine agonist is the treatment of choice What disease does cryptococcus neoformans cause? Correct Answer is meningoencephalitis and pneumonia usually in an immunocompromised pt, has a capsule and budding yeast with India Ink dye What is heistoplasmosis? Correct Answer is fungal infection of lungs or retina often seen in HIV patients What are some manifestations of Vitamin A deficiency? What is it typically caused by in the U.S.? Correct Answer is night blindness, xerosis of junctiva, Bitot's spots (white patches on conjunctiva)

• typically caused by fat malabsorption or mineral oil laxative abuse What is the triad associated with niacin deficiency? Correct Answer is pellagra with diarrhea, dematitis and dementia What is asbestos exposure linked to? Correct Answer is mesothelioma and peuritic plaques HOw does acute glaucoma present? PE findings? Correct Answer is visual acutiy is decreased corena is steamy/cloudy pupil is dilated and fixed redness may be diffuse or a reddish violet flush around the limbus green rimming to the iris is associated with ___________? Correct Answer is Keyser-Fleischer rings- Wilson's disease What causes an S3? Correct Answer is It is highly suggestive of heart failure It is due to increased resistance to ventricular filling during passive atrial emptying

What causes an S4? Correct Answer is Hypertensive heart disease, CAD, aortic stenosis and cardiomyopathy. It can present in diastolic failure. It is caused by increased resistance to ventricular filling during atrial contraction What is one way to tell an anemia of chronic disease as opposed to iron deficiency anemia? Correct Answer is Reticulocytes- will be increased in anemia of chronic disease and decreased in iron deficiency Patchy diffuse lung infiltrates can be found with what type of pneumonia? Correct Answer is viral or mycoplasma S1 with an opening snap following S2, heard best at the left sternal border and apex, best describes? Correct Answer is Mitral Stenosis Pt with R. heart failure that has a diastolic rumbling murmur heard best at the LLSB and xiphoid, increased with inspiration, best describes? Correct Answer is tricuspid stenosis low pitched, blowing decrescendo diastolic murmur best heard at the L. 3rd intercostal space? Correct Answer is aortic regurgitation- often following rheumatic fever systolic ejection murmur that peaks at mid-systole hear best at the 2nd intercostal are radiating to the neck and apex? Correct Answer is aortic stenosis- can present with dyspnea, fatigue and syncope At what age should patients have routine audiologic screening every few years? Correct Answer is age 65 HOw do glipizide and other sulfonylureas work? Correct Answer is increase insulin secretion How is a patient exposed to rabies supposed to be treated? Correct Answer is human rabies Ig is administered (half into wound, half IV) and also human diploid cell vaccine given IM: at 1, 3, 7, 14, 28 days How long can a women with endometriosis be put on Lupron? Correct Answer is Only 6 months, because of risk for bone demineralization What is the most common cause of tinea corporis? Correct Answer is trichophyton rubrum

lesions of pink to purple polygonal pruritis papules describe? Correct Answer is lichen planus U waves on EKG are associated with Correct Answer is hypokalemia What results will you find in sensorineural hearing loss? Correct Answer is air conduction will exceed bone conduction only in the "good" ear Bilateral hilar adenopathy is class for ________? Correct Answer is Stage 1 aarcoidosis- most common in AA females pain with resisted wrist extension is seen with _______? Correct Answer is lateral epicondylitis Pain with wrist felxion is seen in ________? Correct Answer is medial epiconydlitis What is the classic triad for Reactive arthritis (Reiter's syndrome)? Correct Answer is Can't see, can't pee, can't climb a tree: conjunctivitis, urethritis, and aseptic arthritis and mucocutaneous lesions *Camplyobacter associated What is the ABX used for prophylaxis against Mycobaterium Avium in a pt with HIV? Correct Answer is Used if CD4 is less than 50, Azithromycin What is the ABX used for prophylaxis against Cryptoccus infection in a pt with HIV? Correct Answer is Used if CD4 less than 200, Fluconzaole What is the ABX used for prophylaxis against CMV in a pt with HIV? Correct Answer is Used if CD4 less than 100, Ganciclovir Fundoscopic exam showing cotton wool patches, copper wiring, flame-shaped hemorrhages AV nicking, indicates? Correct Answer is hypertensive retinopathy gradual central visual loss and metamorphopsia (distored images), drusen spots (yellowish round spots at posterior poll, indicate? Correct Answer is macular degeneration What is one situation to give children asthma? Correct Answer is Rheumatic fever, aspirin is indicated How is herpetic keratitis treated? Correct Answer is topical idoxuridine

Elevated ST segments in all leads Correct Answer is pericarditis How is C. diff most often treated? Correct Answer is metronidazole, vancomycin Ring- enhancing cerebral lesions are characterisitc of__________ Correct Answer is toxoplamosis- most common in patients with AIDs progressive proxim al weakness is seen in________? Correct Answer is polymositis Loss of normal skin folds can be found in _________ Correct Answer is scleroderma (systemic sclerosis) What antibiotics should be avoided in patients with long QT syndrome? Correct Answer is macrolides and some fluoroquinolones firm, nontender swelling of the eyelid with redness and swelling of the nearby conjunctiva Correct Answer is chalazion= granulamatous inflammation of the meibomian gland