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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 5-year-old presents with a limp and hip pain. X-ray shows flattening and fragmentation of the femoral head. Labs are normal. What is the most likely diagnosis?

    Answer: Legg-Calvé-Perthes disease

    Legg-Calvé-Perthes disease is avascular necrosis of the femoral head in children, presenting with limp and X-ray showing femoral head fragmentation.

  2. A 72-year-old woman with osteoporosis is started on alendronate. What is the most important counseling instruction regarding administration?

    Answer: Take with a full glass of water and remain upright for 30 minutes

    Bisphosphonates must be taken with a full glass of water and the patient must remain upright for at least 30 minutes to prevent esophageal irritation.

  3. A 32-year-old woman at 38 weeks gestation develops severe headache, BP 165/110, and RUQ pain. Labs show thrombocytopenia, elevated LFTs, and low haptoglobin. What is the diagnosis?

    Answer: HELLP syndrome

    HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) is a severe variant of preeclampsia requiring urgent delivery.

  4. A 45-year-old male with HIV (CD4 count 80) presents with headache, fever, and meningismus. CSF India ink preparation shows encapsulated yeast. What is the most appropriate treatment?

    Answer: Amphotericin B plus flucytosine

    Cryptococcal meningitis in immunocompromised patients is treated with induction using amphotericin B plus flucytosine, followed by consolidation with fluconazole.

  5. A 19-year-old male presents with fever, night sweats, and weight loss. Exam reveals painless cervical lymphadenopathy. Biopsy shows Reed-Sternberg cells. What is the diagnosis?

    Answer: Hodgkin lymphoma

    Reed-Sternberg cells ('owl eye' nuclei) are pathognomonic for Hodgkin lymphoma, which presents with painless lymphadenopathy and B symptoms.

  6. A 65-year-old male with BPH and urinary retention is catheterized and drains 1,200 mL of urine. Two hours later he develops gross hematuria and hypotension. What has occurred?

    Answer: Post-obstructive diuresis with hemorrhagic cystitis

    Rapid decompression of a chronically distended bladder can cause hemorrhagic cystitis from mucosal tears and post-obstructive diuresis leading to hemodynamic instability.

  7. A 50-year-old presents with symmetric ascending weakness starting in the legs 2 weeks after a GI illness. Deep tendon reflexes are absent. CSF shows elevated protein with normal cell count (albuminocytologic dissociation). What is the diagnosis?

    Answer: Guillain-Barré syndrome

    Guillain-Barré syndrome is an autoimmune demyelinating polyneuropathy characterized by ascending weakness, areflexia, and albuminocytologic dissociation in CSF.