PANCE PANCE 3

Question 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?

Accepted Answer

Lisinopril

Answer

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

Question 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?

Accepted Answer

Central retinal artery occlusion

Answer

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

Question 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?

Accepted Answer

Cluster headache

Answer

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

Question 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?

Accepted Answer

Surfactant deficiency

Answer

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

Question 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?

Accepted Answer

Chronic myelogenous leukemia

Answer

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

PANCE Test Practice Test

PANCE Test Practice Test

PANCE PANCE 3