PANCE PANCE 5

Question 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?

Accepted Answer

Legg-Calvé-Perthes disease

Answer

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

Question 2

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

Accepted Answer

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

Answer

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.

Question 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?

Accepted Answer

HELLP syndrome

Answer

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

Question 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?

Accepted Answer

Amphotericin B plus flucytosine

Answer

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

Question 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?

Accepted Answer

Hodgkin lymphoma

Answer

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

PANCE Test Practice Test

PANCE Test Practice Test

PANCE PANCE 5