PANCE PANCE Analysis 5

Question 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?

Accepted Answer

Imatinib (Gleevec)

Answer

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

Question 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?

Accepted Answer

Urethral catheterization

Answer

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

Question 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?

Accepted Answer

Nephrotic syndrome

Answer

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

Question 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?

Accepted Answer

Sumatriptan 50 mg orally

Answer

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.

Question 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?

Accepted Answer

Spironolactone

Answer

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

PANCE Test Practice Test

PANCE Test Practice Test

PANCE PANCE Analysis 5