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PANRE Flashcards

7 cards from real PANRE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 70-year-old man with BPH is started on tamsulosin. He develops dizziness after standing. Which mechanism explains this side effect?

    Answer: Alpha-1 receptor blockade causing venous pooling

    Tamsulosin is an alpha-1 adrenergic blocker; blockade of vascular alpha-1 receptors causes vasodilation and orthostatic hypotension.

  2. A 40-year-old woman presents with progressive proximal muscle weakness and a heliotrope rash around her eyes. CK is markedly elevated. What is the most likely diagnosis?

    Answer: Dermatomyositis

    Dermatomyositis presents with proximal muscle weakness, elevated CK, and pathognomonic skin findings including heliotrope rash and Gottron papules.

  3. A 55-year-old man with a 30-pack-year smoking history presents with hemoptysis and a coin lesion on chest X-ray. PET scan shows no uptake. What is the next best step?

    Answer: CT-guided needle biopsy

    A solitary pulmonary nodule in a high-risk smoker with no PET activity requires tissue diagnosis; CT-guided needle biopsy is the most direct approach.

  4. A 28-year-old man presents with sudden severe 'thunderclap' headache reaching maximum intensity within seconds. CT head is negative. What is the next step?

    Answer: Perform lumbar puncture

    A thunderclap headache with negative CT requires lumbar puncture to rule out subarachnoid hemorrhage, as CT misses 2-5% of SAH.

  5. A 50-year-old woman is found to have a fasting glucose of 112 mg/dL on two separate occasions. BMI is 31. Which intervention is most effective at preventing progression to type 2 diabetes?

    Answer: Lifestyle modification with weight loss and exercise

    The Diabetes Prevention Program showed intensive lifestyle modification reduces diabetes risk by 58%, more effective than metformin (31%) in prediabetes.

  6. A 62-year-old woman with osteoporosis on alendronate for 5 years develops sudden mid-shaft femur pain while walking. X-ray shows a transverse fracture with cortical thickening. What is the cause?

    Answer: Atypical femur fracture from bisphosphonate use

    Long-term bisphosphonate use is associated with atypical subtrochanteric and femoral shaft fractures with characteristic transverse pattern and cortical beaking.

  7. A patient with schizophrenia on haloperidol develops fever (103°F), muscle rigidity, altered consciousness, and elevated CK. What is the most likely diagnosis?

    Answer: Neuroleptic malignant syndrome

    Neuroleptic malignant syndrome (NMS) is a life-threatening reaction to antipsychotics presenting with hyperthermia, lead-pipe rigidity, altered consciousness, and elevated CK.