PANRE PANRE 5

Question 1

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

Accepted Answer

Alpha-1 receptor blockade causing venous pooling

Answer

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

Question 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?

Accepted Answer

Dermatomyositis

Answer

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

Question 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?

Accepted Answer

CT-guided needle biopsy

Answer

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.

Question 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?

Accepted Answer

Perform lumbar puncture

Answer

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

Question 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?

Accepted Answer

Lifestyle modification with weight loss and exercise

Answer

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

PANRE Test Practice Test

PANRE Test Practice Test

PANRE PANRE 5