PANRE PANRE 3

Question 1

A 50-year-old man with a history of alcohol use disorder presents with confusion, ataxia, and ophthalmoplegia. Which treatment should be given immediately?

Accepted Answer

Thiamine 100 mg IV

Answer

The classic triad of confusion, ataxia, and ophthalmoplegia is Wernicke encephalopathy; thiamine must be given before glucose to prevent worsening.

Question 2

A 40-year-old woman presents with fatigue, constipation, weight gain, and cold intolerance. TSH is 12 mIU/L and free T4 is low. Which treatment is indicated?

Accepted Answer

Levothyroxine

Answer

Primary hypothyroidism (elevated TSH, low free T4) is treated with levothyroxine replacement therapy.

Question 3

A 66-year-old woman presents with sudden painless vision loss in one eye described as a 'curtain coming down.' Fundoscopy shows a pale retina with a cherry-red spot at the macula. What is the diagnosis?

Accepted Answer

Central retinal artery occlusion

Answer

Central retinal artery occlusion presents with sudden painless vision loss, pale ischemic retina, and a cherry-red spot at the fovea due to preserved choroidal circulation.

Question 4

A 55-year-old man with rheumatoid arthritis on methotrexate develops a macrocytic anemia. Which supplementation is most appropriate?

Accepted Answer

Folate

Answer

Methotrexate inhibits dihydrofolate reductase, causing folate deficiency; supplemental folic acid is given to mitigate this side effect.

Question 5

A 32-year-old woman presents with recurrent unprovoked DVTs. Labs show a prolonged aPTT that does not correct on mixing study. Which condition is most likely?

Accepted Answer

Antiphospholipid syndrome

Answer

A prolonged aPTT that fails to correct on mixing study suggests an inhibitor (antibody), most consistent with lupus anticoagulant in antiphospholipid syndrome.

PANRE Test Practice Test

PANRE Test Practice Test

PANRE PANRE 3