PANRE Ultimate PANRE 4

Question 1

A 5-year-old boy presents with fever, drooling, and severe odynophagia. He is sitting in a 'tripod' position and appears toxic. X-ray shows a 'thumbprint sign.' What is the most concerning diagnosis?

Accepted Answer

Epiglottitis

Answer

The thumbprint sign on lateral neck X-ray with drooling, stridor, and tripod positioning is classic for acute epiglottitis, a life-threatening airway emergency.

Question 2

A 55-year-old woman with rheumatoid arthritis on long-term methotrexate should receive which supplementation to reduce toxicity?

Accepted Answer

Folic acid

Answer

Folic acid supplementation reduces methotrexate-related side effects (mucositis, hepatotoxicity, cytopenias) without significantly reducing its anti-inflammatory efficacy.

Question 3

A 38-year-old male presents with rectal bleeding, weight loss, and change in bowel habits. Colonoscopy reveals a mass in the sigmoid colon. Which tumor marker is most useful for monitoring treatment response?

Accepted Answer

CEA

Answer

Carcinoembryonic antigen (CEA) is the primary tumor marker used to monitor treatment response and surveillance for recurrence in colorectal cancer.

Question 4

A 72-year-old woman on alendronate for osteoporosis presents with mid-thigh pain after minimal trauma. X-ray shows a transverse fracture with cortical beaking of the lateral cortex. What complication occurred?

Accepted Answer

Atypical femoral fracture from bisphosphonate use

Answer

Long-term bisphosphonate use is associated with atypical femoral fractures, characterized by transverse fracture pattern and cortical beaking on the lateral cortex.

Question 5

A 60-year-old male smoker presents with hemoptysis and a central cavitary lung mass on CT. Biopsy shows large cells with abundant cytoplasm and no glandular or squamous features. What is the most likely cell type?

Accepted Answer

Large cell carcinoma

Answer

Large cell carcinoma is an undifferentiated NSCLC that lacks features of adenocarcinoma, squamous cell, or small cell carcinoma on histology and is often centrally located.

PANRE Test Practice Test

PANRE Test Practice Test

PANRE Ultimate PANRE 4