Free PANCE Evaluation Test Question and Answers — Questions and Answers
Question 1: What is an endoscopic retrograde cholangiopancreatography's (ERCP) most common complication?
- Pancreatitis (Correct answer)
- Cholangitis
- Aspiration
- Perforation
Correct answer: Pancreatitis
Post-ERCP pancreatitis is the most common and often the most serious complication of endoscopic retrograde cholangiopancreatography. It occurs due to irritation or injury to the pancreatic duct during the procedure, leading to inflammation of the pancreas. While other complications like cholangitis, aspiration, and perforation can occur, pancreatitis is statistically the most frequent.
Question 2: How does donepezil function when used to treat Alzheimer's disease?
- Acetylcholinesterase inhibitor (Correct answer)
- Cholinesterase and nicotinic receptor stimulation modulator
- Glutamate antagonist
- Acetyl/butyryl cholinesterase inhibitor
Correct answer: Acetylcholinesterase inhibitor
Donepezil is an acetylcholinesterase inhibitor. It works by preventing the breakdown of acetylcholine, a neurotransmitter crucial for memory and learning, in the brain. By increasing the availability of acetylcholine, donepezil helps to improve cholinergic function and alleviate some cognitive symptoms associated with Alzheimer's disease.
Question 3: On his fingertips, a 26-year-old male has 3 to 4 cm depigmented irregular patches that have been there for the past two months and appear to be becoming bigger. What is probably taking place with this patient?
- Too much sun exposure
- Chronic fungal infection with underlying disease
- Loss of skin melanocytes with unclear cause (Correct answer)
- Acute infection with a virus
Correct answer: Loss of skin melanocytes with unclear cause
The description of 3-4 cm depigmented, irregular, and growing patches on the fingertips is characteristic of vitiligo. Vitiligo is an autoimmune condition where the body's immune system attacks and destroys melanocytes, the cells responsible for producing skin pigment. This leads to the appearance of white patches on the skin, and its cause is often unclear but involves autoimmune mechanisms.
Question 4: A 47-year-old man has been pushing his lawn mower for the past three weeks while experiencing chest pain. He states he has never been treated for similar symptoms and has no problems presently. He smoked one pack each day for twenty years until giving it up seven years ago. Physical examination results are typical. Electrocardiograms don't reveal any anomalies. Which of the following first diagnostic tests is most appropriate?
- Echocardiography
- 24-Hour ambulatory cardiac monitoring
- Coronary arteriography
- Exercise stress test (Correct answer)
Correct answer: Exercise stress test
The patient's exertional chest pain, occurring while pushing a lawn mower, is highly suggestive of stable angina, even with a normal resting EKG. An exercise stress test is the most appropriate initial diagnostic test to evaluate for exercise-induced myocardial ischemia. It helps determine if the heart receives enough blood flow during physical activity, which might not be evident at rest.
Question 5: A 35-year-old woman has had a rash on her legs for the previous three weeks. No known infectious contacts exist. Her bladder infection was treated with trimethoprim-sulfamethoxazole a month ago. A generalized rash is visible on the shins, left medial ankle, and right medial calf during physical examination. Tender, diffuse, and returning to the same spots, the rash is. A couple of the lesions show bruise-like characteristics. Which of the subsequent diagnoses is most likely?
- Nummular eczema
- Erythema multiforme
- Erythema nodosum (Correct answer)
- Lichen planus
Correct answer: Erythema nodosum
The combination of red, tender nodules on the anterior lower legs (erythema nodosum), bilateral hilar adenopathy on chest X-ray, iritis, and systemic symptoms like malaise, dyspnea, and low-grade fever is highly characteristic of sarcoidosis. Erythema nodosum is a common cutaneous manifestation of sarcoidosis, a multisystem granulomatous disease.
Question 6: A 45-year-old guy is being checked because he feels weak and weary and has experienced indications of sexual dysfunction. The reading is 100/60 mmHg for him. Physical examination reveals thinning pubic, axillary, and facial hair. Laboratory tests reveal lower levels of testosterone, thyroxine, and the luteinizing and follicle-stimulating hormones; the thyroid-stimulating hormone level is within acceptable ranges. Which of the subsequent diagnoses is most likely?
- Diabetes mellitus
- Hyperprolactinemia
- Hypopituitarism (Correct answer)
- Hypothyroidism
Correct answer: Hypopituitarism
The p-value is a statistical measure that helps determine whether the observed results in a clinical trial are statistically significant. It represents the probability of obtaining results as extreme as, or more extreme than, the observed results, assuming the null hypothesis (no effect or difference) is true. A low p-value (typically <0.05) indicates that the results are unlikely to be due to chance, suggesting statistical significance.
Question 7: A previously healthy 15-month-old kid develops anxiety, starts sobbing uncontrollably, and drools a lot. He had been calmly playing with his toys just moments ago. Pulse rate is 84/min, temperature is 36.7°C (98.1°F), and respirations are 18/min. The posterior pharynx is faintly injected but otherwise clear upon physical examination. Auscultation and percussion reveal no obstruction in the lungs. Chest X-ray study results are normal. He becomes quieter after an hour, but he still drools a lot. Which of the following is the ideal course of action?
- Insertion of a nasogastric tube
- Administration of syrup of ipecac
- Esophagogastroduodenoscopy (Correct answer)
- Barium swallow x-ray study
Correct answer: Esophagogastroduodenoscopy
The sudden onset of anxiety, uncontrollable crying, and profuse drooling in a previously healthy child, especially with normal respiratory findings, strongly suggests an esophageal foreign body. The persistent drooling indicates an obstruction or irritation preventing normal swallowing. An esophagogastroduodenoscopy (EGD) is the definitive procedure to both diagnose and remove an esophageal foreign body.
Free PANCE Evaluation Test Question and Answers
What is an endoscopic retrograde cholangiopancreatography's (ERCP) most common complication?