PANCE PANCE Analysis 3

Question 1

A 40-year-old woman with rheumatoid arthritis presents with fatigue, pallor, and a hemoglobin of 9.5 g/dL. Iron studies show low serum iron, low TIBC, and elevated ferritin. What is the most likely cause of her anemia?

Accepted Answer

Anemia of chronic disease

Answer

Anemia of chronic disease shows low serum iron and TIBC with elevated ferritin, reflecting sequestration of iron by inflammatory cytokines.

Question 2

A 62-year-old man presents with progressive dysphagia to solids more than liquids and a 20-lb weight loss over 3 months. He has a 40-pack-year smoking history. What is the most likely diagnosis?

Accepted Answer

Esophageal carcinoma

Answer

Progressive dysphagia to solids worse than liquids with significant weight loss in an older smoker is classic for esophageal carcinoma.

Question 3

A neonate born at 28 weeks gestation develops respiratory distress within 2 hours of birth. CXR shows bilateral ground-glass opacities and air bronchograms. What is the underlying pathophysiology?

Accepted Answer

Surfactant deficiency

Answer

Respiratory distress syndrome in premature infants results from surfactant deficiency, leading to alveolar collapse and the characteristic ground-glass appearance.

Question 4

A 55-year-old man with a history of alcohol use disorder presents with painless jaundice, clay-colored stools, and dark urine. Ultrasound shows dilation of the common bile duct. What is the most likely cause?

Accepted Answer

Pancreatic head carcinoma

Answer

Painless obstructive jaundice with dilated CBD in an older patient is the classic presentation of pancreatic head carcinoma compressing the bile duct.

Question 5

A 30-year-old woman presents with a butterfly rash, joint pain, oral ulcers, and a positive ANA with anti-dsDNA antibodies. Which complication is most likely to determine her long-term prognosis?

Accepted Answer

Lupus nephritis

Answer

Lupus nephritis is the most serious complication of SLE and the leading cause of morbidity and mortality, requiring close monitoring of renal function.

PANCE Test Practice Test

PANCE Test Practice Test

PANCE PANCE Analysis 3