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PANCE Analysis 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.

Read the first 7 PANCE Analysis flashcards as text

  1. A 45-year-old man presents with fatigue, splenomegaly, and a WBC of 120,000/µL with a left shift. Cytogenetics reveal the Philadelphia chromosome t(9;22). What is the first-line treatment?

    Answer: Imatinib (Gleevec)

    Imatinib, a BCR-ABL tyrosine kinase inhibitor, is first-line therapy for chronic myeloid leukemia (CML) harboring the Philadelphia chromosome.

  2. A 67-year-old man with BPH presents with inability to void, suprapubic distension, and a post-void residual of 800 mL on ultrasound. What is the most immediate intervention?

    Answer: Urethral catheterization

    Acute urinary retention requires immediate relief via urethral catheterization to decompress the bladder and prevent renal injury.

  3. A 3-year-old boy presents with periorbital edema, ascites, and frothy urine. Urinalysis shows 4+ proteinuria. Serum albumin is 1.8 g/dL. What is the most likely diagnosis?

    Answer: Nephrotic syndrome

    Nephrotic syndrome is characterized by massive proteinuria (>3.5g/day), hypoalbuminemia, edema, and hyperlipidemia; in children, minimal change disease is the most common cause.

  4. A 25-year-old woman presents with recurrent episodes of severe unilateral headache with photophobia, phonophobia, and nausea lasting 8-12 hours. She has no neurological deficits. What is the best abortive therapy?

    Answer: Sumatriptan 50 mg orally

    Triptans (5-HT1B/1D agonists) are first-line abortive therapy for moderate-to-severe migraines, providing targeted relief by causing vasoconstriction and blocking pain pathways.

  5. A 60-year-old man with newly diagnosed heart failure has an ejection fraction of 30%. He is already on an ACE inhibitor and a beta-blocker. Which additional agent has been shown to reduce mortality in this patient?

    Answer: Spironolactone

    Aldosterone antagonists (spironolactone/eplerenone) reduce mortality in HFrEF when added to ACE inhibitor and beta-blocker therapy in appropriately selected patients.

  6. A 52-year-old woman presents with progressive proximal muscle weakness making it difficult to rise from a chair, a heliotrope rash on her eyelids, and Gottron papules on her knuckles. What laboratory finding is most helpful in confirming the diagnosis?

    Answer: Elevated creatine kinase

    Elevated creatine kinase reflects muscle inflammation and damage in dermatomyositis, making it the most useful confirmatory lab alongside the characteristic skin findings.

  7. A 38-year-old man presents with recurrent kidney stones. 24-hour urine shows elevated uric acid. He has a history of gout. What is the most appropriate long-term preventive measure for his kidney stones?

    Answer: Urinary alkalinization with potassium citrate and allopurinol

    Uric acid stones form in acidic urine; urinary alkalinization with potassium citrate raises urine pH to dissolve/prevent stones, and allopurinol reduces uric acid production.