PANRE PANRE 2

Question 1

A 58-year-old man with type 2 diabetes presents with a painless foot ulcer. ABI is 0.6. Which is the most appropriate next step?

Accepted Answer

Refer for vascular surgery evaluation

Answer

Start oral antibiotics and wound care

Answer

Obtain plain X-ray of the foot

Answer

Prescribe compression stockings

Question 2

A 72-year-old woman on warfarin for atrial fibrillation is started on fluconazole. What is the expected effect?

Accepted Answer

Increased INR due to CYP2C9 inhibition

Answer

Decreased INR due to CYP2C9 induction

Answer

No change in INR

Answer

Decreased INR due to vitamin K competition

Question 3

A 45-year-old woman presents with episodic hypertension, headache, diaphoresis, and palpitations. Which initial test is most appropriate?

Accepted Answer

24-hour urine catecholamines and metanephrines

Answer

Plasma aldosterone-to-renin ratio

Answer

Thyroid-stimulating hormone

Answer

Urine cortisol

Question 4

A 3-year-old child is brought in with a barking cough, inspiratory stridor, and low-grade fever. Which pathogen is most likely responsible?

Accepted Answer

Parainfluenza virus

Answer

Respiratory syncytial virus

Answer

Bordetella pertussis

Answer

Haemophilus influenzae type b

Question 5

Which finding on ECG is most consistent with hyperkalemia?

Accepted Answer

Peaked T waves with widened QRS

Answer

Prolonged PR interval with delta waves

Answer

ST elevation in leads V1-V4

Answer

Shortened QT interval with U waves

Question 6

A 65-year-old man with COPD is noted to have a hematocrit of 56%. Which mechanism best explains this finding?

Accepted Answer

Secondary polycythemia from chronic hypoxemia

Answer

Decreased erythropoietin from renal artery stenosis

Answer

Polycythemia vera with JAK2 mutation

Answer

Dehydration causing hemoconcentration

Question 7

A 28-year-old woman at 10 weeks gestation presents with severe nausea, vomiting, and weight loss of 8 pounds. Urine shows ketonuria. What is the diagnosis?

Accepted Answer

Hyperemesis gravidarum

Answer

Gastroenteritis

Answer

Appendicitis

Answer

Cholecystitis