PANCE Practice 404 Actual Questions and

PANCE Practice | 404 Actual Questions and Answers

mc idiopathic nephropathy WW esp Asia and south american.Presents with hematuria following and upper respiratory infection - Answer IgA nephropathy

hereditary nephritis causes hematuria, renal failure and deafness, +/- eye involvement with family h/o hematuria - Answer Alport syndrome

ass/ with alveolar hemorrhages that results in hemoptysis and a rapid decline in renal function - Answer Goodpasture syndrome

systemic disease that causes a rapid loss of renal function ass/ with sinus and lung involvement - Answer wegener granulomatosis

• barlow for bilateral subluxation of hips and dec abduction of both hips

most common in female infant - Answer developmental dysplasia of hip

detects any subluxation or postieror dislocation of the femoral head by direct pressure on the lngitudinal axis of femur while the hip is adducted - Answer Barlow test

Gently abducting and adducting the flexed hup detects any reduction or dislocation of the femoral head from the acetabulum - Answer ortolani test

presents to ED with AMS pmhx of Multiple myeloma, inc confusion over past 48 hours and became obtunded, bp-90/50 dry mucous membranes. initial management includes? - Answer beginning aggressive isotonic IV hydration followed by diuresis.dx- Hypercalemia 2ry to MM dehyrdration from solute induced diuresis

a recent immigrant from Vietnam presents to ED with headache, abd pain, myalgias and fever, CBC- HCT 21%, HBG 7.0 blood smear reveals parasites within the RBC. Which is the TOC? 1 / 4

A. PCN G

• Chloroquine
• Interferon-alpha
• Amphotericin B - Answer B.

Chloroquine is the TOC for acute malaria

Pseudohyphae on KOH Dx of? - Answer Candidiasis

A pt p/w c/o visual loss. He describes a sequence of flashing lights followed by a large number of floaters and then a shade over the vision in one eye. Which is the dx?

• retinal detachment
• central retinal artery occlusion
• Vitreous hemorrhage
• Amaurosis fugax - Answer A. Rentinal Detachment

a 21 y/o sustained trauma to back of head during volleyball game. She c/o unilateral blurred vision but not pain. Exam reveal a hanging retina. Which of the following statements is part of the recommended pt education?

• Pt should remain sitting upright
• More than 80 % of traumatic retinal detachments occur within 2 hours of acute

injury

• Prgnosis for full recovery is excellent - Answer C. A ruptured globe should

be suspected if there is a circumferential, elevated, dense subconjunctival hemorrhage

measles - Answer rubeola

• y/o undocumented child is brought to rural clinic with fever, coryza,

conjunctivitis and irritability. photophobia is present. Which of the following physical exam findings would be pathognomonic for rubeola/measles in this child?

• Koplik's spots
• Strawberry tongue
• Erythema Marginatum
• Slapped-cheek appearance - Answer A. Koplik spots are located on the

buccal mucosa alongside the molars. They appear bluish-white on a bright-red background and are pathognomonic of measles. 2 / 4

Aphthous ulcers - Answer common finding with early sx HIV

which of the following drug classes has the highest risk of ototoxicity?

• Fluoroquinolones
• Aminoglycosides
• Marolides
• Tetracycline - Answer B. Aminoglycoside can cause ototoxicity which can be

irreversible and cumulative

TOC in an Orbital blow out fracture - Answer CT scan

a child presents 3 weeks after having been treated for otitis media. At this time, the child has otalgia, fever and drainage from ear cnal. PE- reveals postauricular pain and forward displacement of pinna on the affected side. Which is the dx?

• Cellulitis
• Mastoiditis
• Otitis Externa
• Sinusitis - Answer mastoiditis is the most frquent cx of inadequately

treated otitis media. IT presents with postauricular pain, erythema and forward displacement of pinna

traumatic iritis presents as a deep achy pain, photophobia, and occasionallly, excessive tearing. Which of the following is the TOC?

• PO Steriods
• Topical anesthetic
• Topical cycloplegics
• Topical abx - Answer C. Topical short acting cycloplegics such as 1%

cyclopentolate, or 5% hoatropine should be initiated

The mother of a 16day old infant brings her baby in for 2 week checkup. She states she has noticed a moderate amount of clear to white eye d/c for several day from both eyes of the baby. Which is the cause?

• Staph aureus
• Chlamydia trachomatis
• GBBHS 3 / 4

• Neisseria gonorrhea - Answer B. Chlamydia trachomatis typically present

aroounf 14days of life with thin clear to white d/c.

A 54 y/o man present with painful, bright red, raised, edematous, indurated plaquw on his nose and left cheek. The area is sharply marginated from the surrounding normal skin and has advancing raised borders. There is no evidence of skin trauma. Which of the following pathogens is the most likely causative agent?

• Staph Epidermidis
• Haemophilus influenzae
• Pseudomonas aerugionsa
• Groups A beta-hemolytic Strep - Answer D. Groups A beta-hemolytic Strep-

classic presentation of erysipelas which usually caused by group a streptococci. Pt often have chills and fever as well

A 20 y/o pt who has been trying to tan c/o appearance of a rash. Exam shows groups of irregular shaped, confluent hypopigmented macules on shoulders and back. A wood lamp reveals a faint yellowish fluorescence and a fine border of scale surrounding the lesion. What is the most appropriate dx procedure for confirming the suspected dx?

• Tzanck smear of skin shaving
• Serum for VDRL test
• Skin scraping of the scales examined with KOH - Answer C. Skin scraping of

the scales examined with KOH- Microscopic examination of skin scrapings using 10-20% KOH would likely reveal typical spaghetti and meatball appearance of pityrosporum ovale seen in tinea versicolor

A pt present with discrete purple papules, each lesion has white dots or lines in fine reticular patterns on the surface. This condition is associated with which oral dz?

• Apthous ulcer
• Candidiasis
• Lichen planus
• Bullous pemphigoid - Answer C. Lichen planus- Wickham's striae are white

dots and lines in a fine reticular pattern on the surface of the primary lesion of lichen planus papule. They may be found on the flexor surface of the wrist and penis, lips, tongue, and buccal and vaginal mucous membranes.

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