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PANCE Flashcards

7 cards from real PANCE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 45-year-old male is found to have a BP of 155/95 mmHg on three separate occasions. He also has diabetes and proteinuria. What is the most appropriate antihypertensive?

    Answer: Lisinopril

    ACE inhibitors like lisinopril are first-line in diabetic patients with hypertension and proteinuria due to their renoprotective effects.

  2. A 70-year-old woman presents with sudden painless vision loss in one eye described as 'a curtain coming down.' Fundoscopy shows a pale retina with a cherry-red spot at the macula. What is the diagnosis?

    Answer: Central retinal artery occlusion

    Central retinal artery occlusion presents with sudden painless vision loss, pale ischemic retina, and cherry-red spot at the fovea.

  3. A 35-year-old male presents with recurrent episodes of severe unilateral periorbital pain lasting 45-90 minutes, associated with ipsilateral lacrimation and nasal congestion. What is the most likely diagnosis?

    Answer: Cluster headache

    Cluster headaches are severe unilateral periorbital headaches with autonomic features (lacrimation, rhinorrhea) lasting 15-180 minutes.

  4. A neonate born at 32 weeks develops respiratory distress immediately after birth with grunting, flaring, and retractions. CXR shows diffuse ground-glass opacities. What is the pathophysiology?

    Answer: Surfactant deficiency

    Respiratory distress syndrome (RDS) in premature neonates results from surfactant deficiency, causing diffuse atelectasis and ground-glass appearance on CXR.

  5. A 50-year-old male presents with fatigue, weight loss, and splenomegaly. CBC shows WBC 120,000/µL with left shift. Philadelphia chromosome (t[9;22]) is identified. What is the diagnosis?

    Answer: Chronic myelogenous leukemia

    Chronic myelogenous leukemia (CML) is characterized by the Philadelphia chromosome (BCR-ABL fusion) and markedly elevated WBC with left shift.

  6. A 22-year-old female presents with joint pain, a butterfly rash, and oral ulcers. Labs show positive ANA, anti-dsDNA, and low complement levels. What is the most likely diagnosis?

    Answer: Systemic lupus erythematosus

    SLE is confirmed by anti-dsDNA antibodies, low complement, malar rash, arthritis, and oral ulcers meeting ACR criteria.

  7. A patient presents with confusion, asterixis, and jaundice. Labs show elevated ammonia, PT, and bilirubin. What is the primary mechanism of the encephalopathy?

    Answer: Accumulation of ammonia causing cerebral edema

    Hepatic encephalopathy results primarily from elevated ammonia, which crosses the blood-brain barrier and causes astrocyte swelling and cerebral dysfunction.