PANCE Flashcards

Which of the following statements about end-of-life concerns for cystic fibrosis patients is accurate?

Answer: Palliative care should be discussed

Cystic fibrosis is a progressive, life-limiting disease that significantly impacts quality of life as it advances. Palliative care focuses on providing relief from symptoms, pain, and stress of a serious illness, aiming to improve quality of life for both the patient and their family. Discussing palliative care early is crucial for CF patients to ensure their values and preferences are honored throughout their disease trajectory, even alongside curative treatments like lung transplantation.

Which of the following drugs would not be recommended for a glaucoma patient to take?

Answer: Amitriptyline

Amitriptyline, a tricyclic antidepressant, has anticholinergic properties that can cause pupillary dilation (mydriasis). This dilation can narrow the anterior chamber angle in susceptible individuals, potentially precipitating or worsening angle-closure glaucoma. Therefore, anticholinergic medications like amitriptyline are generally contraindicated or used with extreme caution in patients with glaucoma.

When examining a patient who has known benign prostatic hyperplasia, what would you anticipate finding?

Answer: Rubbery prostate with digital rectal exam

Benign prostatic hyperplasia (BPH) involves a non-cancerous enlargement of the prostate gland. During a digital rectal exam (DRE), a prostate affected by BPH typically feels symmetrically enlarged, smooth, and rubbery. A hard, nodular prostate would be a more concerning finding, suggestive of prostate cancer.

What constitutes a risk factor for endometriosis development?

Answer: Delayed childbearing

Delayed childbearing is a significant risk factor for endometriosis because it increases the number of menstrual cycles a woman experiences throughout her reproductive life. Each menstrual cycle provides an opportunity for endometrial tissue to reflux and implant outside the uterus, contributing to the development and progression of endometriosis. Other factors like early menarche and short, heavy periods also increase exposure to menstrual flow.

You come across a patient who has a history of optic neuritis. What test should be ordered in order to rule out any more severe comorbid conditions?

Answer: Magnetic resonance imaging (MRI)

Optic neuritis, especially in a young adult, is a common initial manifestation of multiple sclerosis (MS), a severe demyelinating condition affecting the central nervous system. Magnetic resonance imaging (MRI) of the brain and orbits is the most appropriate test to identify characteristic demyelinating lesions, which are crucial for diagnosing or ruling out MS and guiding further management.

Which type of construction sees the highest rate of ectopic pregnancies?

Answer: Fallopian tube

The vast majority of ectopic pregnancies, over 95%, occur in the fallopian tube, most commonly in the ampulla. The fallopian tubes are narrow and can be damaged or obstructed, preventing the fertilized egg from reaching the uterus and leading to implantation outside the uterine cavity.

A 28-year-old white male in generally good health has had dull testicular pain for the past two weeks. He denies penile discharge, and the scrotum is non-erythematous, he is negative for sexually transmitted infections. Which do you believe?

Answer: Testicular cancer

In a young male, persistent dull testicular pain without signs of infection (no discharge, non-erythematous scrotum, negative STIs) should raise suspicion for testicular cancer. While other conditions can cause testicular pain, testicular cancer often presents with a painless mass or a dull ache/heaviness, making it a crucial diagnosis to rule out promptly in this demographic.