THE FINAL STEP PANCE EVALUATION EXAM
QUESTIONS AND ANSWERS SURE A+
✔✔A new mother presents with pain over the radial
wrist. She has a positive Finkelstein's test. What is
the most likely diagnosis? - ✔✔de Quervain's tenosynovitis
✔✔A positive McMurry indicates what? - ✔✔Meniscal tear
✔✔What is first line treatment for carpal tunnel? - ✔✔Night splint
✔✔Most common cause of C-spine fracture? - ✔✔MVA
✔✔Podagra = - ✔✔gout (of the foot)
✔✔A patient presents to the ER with saddle anesthesia and loss of bowel and bladder
function. Dx? - ✔✔Cauda equina
✔✔A patient with HIV presents with severe groin pain. What is most likely diagnosis? -
✔✔Avascular necrosis of the femoral head. Antiretroviral meds put patients at risk for
AVN.
,✔✔95 yo F presents to ER after fall in her home. Her left leg is shortened and externally
rotated. What is most likely diagnosis? - ✔✔Hip fracture
✔✔You recommend bisphosphonates for patient with osteoporosis. What instruction do
you give her for immediately after taking medication? - ✔✔Remain upright for 30 min
✔✔What is most common cause of a hip dislocation? Is it usually anterior or posterior? -
✔✔MVA, posterior
✔✔Which of the four rotator cuff muscles is most commonly injured? -
✔✔Supraspinatus
✔✔What is the medical term for tennis elbow? - ✔✔Lateral epicondylitis
✔✔What is a first line treatment for rheumatoid arthritis? - ✔✔Methotrexate
✔✔A patient presents to the ER after taking a baseball bat to the knee. He is unable to
actively extend his knee. What is the most likely diagnosis? - ✔✔Patella fracture
✔✔Are most shoulder dislocations anterior or posterior? - ✔✔Anterior
✔✔What is the most useful physical exam test for diagnosing an ACL tear? -
✔✔Lachman's, followed by anterior drawer
✔✔What is the most common knee injury? - ✔✔Medial meniscal tear
✔✔Where are Heberden's nodes found? - ✔✔Distal interphalangeal joint (DIP)
✔✔A patient presents with knee pain following a soccer game two days ago. He has
joint line tenderness medially and feels a locking in the knee from time to time. What
two physical exam tests should you do? - ✔✔Medial meniscal tear
1. McMurray
2. Apley
✔✔A patient presents with conjunctivitis, urethritis, arthritis, and oral lesions. Most likely
diagnosis? Other labs? - ✔✔Reactive arthritis
HLA B-27
✔✔A 46 yo male comes into ER limping a little on the right side. He states that it felt as
though he
was kicked in the back of the leg during a soccer
game, but clearly no one was behind him. What is
the most likely diagnosis? - ✔✔Achilles tendon rupture
,✔✔Anti jo antibodies should make you think of what
diagnosis? - ✔✔Polymyositis
✔✔A positive cross over test indicates what diagnosis? - ✔✔Acromioclavicular joint
injury
✔✔A positive Hawkin's test indicates what diagnosis? - ✔✔Rotator cuff injury
✔✔A positive Finkelstein's test indicates what diagnosis? - ✔✔de Quervian's
tenosynovitis
✔✔A positive Phalen and Tinel's sign indicates what
diagnosis? - ✔✔Carpal tunnel
✔✔A bamboo spine indicates - ✔✔anklyosing spondylitis
✔✔A positive straight leg test indicates what
diagnosis? - ✔✔Herniated disc
✔✔An African American female presents with malar
rash and a positive double stranded DNA antibody.
What is the most likely diagnosis? - ✔✔Lupus
✔✔Carpal tunnel affects what nerve and what parts of the hand? - ✔✔Median nerve:
thumb, pointer, ring fingers.
Thenar wasting is sign of advanced disease
✔✔Silver fork deformity on xray - ✔✔Colles fracture
✔✔A positive Apley indicates what diagnosis? - ✔✔Meniscal tear
✔✔List six medications that can be used for migraine
prophylaxis? - ✔✔Beta blockers, tricyclics, calcium
channel blockers, NSAIDs and
valproic acid
✔✔A patient presents with what appears to be an
inability to understand speech. Which aphasia
should be at the top of your differential? - ✔✔Wernicke's aphasia
✔✔A patient presents with signs of a stroke to the ED. Most important test? - ✔✔Non-
contrast CT
, ✔✔A patient is brought in following a seizure in which she did not lose consciousness.
Most likely diagnosis? - ✔✔Simple partial seizure
✔✔What is the medical treatment for a stroke in which
the CT has shown no evidence of a hemorrhage? - ✔✔Heparin/coumadin,
thrombolytics,
steroids, hyperosmotics
✔✔A patient presents with a painful ipsilateral third
nerve palsy. What is the most likely diagnosis? - ✔✔Posterior communicating artery
aneurysm (PCOM)
✔✔What seizure medication may cause overgrowth of
the gums? - ✔✔Phenytoin
✔✔A sudden thunderclap headache should make you
think of what diagnosis? - ✔✔Subarachnoid hemorrhage
✔✔Describe Kernig's sign - ✔✔The patient lies supine, flex hip while
keeping knee straight. Back pain is
positive.
✔✔If CT is negative and you still believe there is a
stroke what is the next best test to order? - ✔✔Lumbar Puncture
✔✔A patient presents with lateralized throbbing
headache. He is also complaining of nausea,
vomiting and photophobia. What type of headache
is most likely? - ✔✔Migraine
✔✔A middle age male presents with unilateral
periorbital headaches occurring daily for several
weeks. These headaches are extremely painful.
Which type of headache is the most likely cause? - ✔✔Cluster headache
✔✔List three drugs that treat cluster headaches. - ✔✔1) Oxygen
2) Sumatriptan
3) Butoprophal
✔✔A 34 year old presents symptoms which are
relapsing and remitting over the past few weeks.
These include visual problems and weakness in her
QUESTIONS AND ANSWERS SURE A+
✔✔A new mother presents with pain over the radial
wrist. She has a positive Finkelstein's test. What is
the most likely diagnosis? - ✔✔de Quervain's tenosynovitis
✔✔A positive McMurry indicates what? - ✔✔Meniscal tear
✔✔What is first line treatment for carpal tunnel? - ✔✔Night splint
✔✔Most common cause of C-spine fracture? - ✔✔MVA
✔✔Podagra = - ✔✔gout (of the foot)
✔✔A patient presents to the ER with saddle anesthesia and loss of bowel and bladder
function. Dx? - ✔✔Cauda equina
✔✔A patient with HIV presents with severe groin pain. What is most likely diagnosis? -
✔✔Avascular necrosis of the femoral head. Antiretroviral meds put patients at risk for
AVN.
,✔✔95 yo F presents to ER after fall in her home. Her left leg is shortened and externally
rotated. What is most likely diagnosis? - ✔✔Hip fracture
✔✔You recommend bisphosphonates for patient with osteoporosis. What instruction do
you give her for immediately after taking medication? - ✔✔Remain upright for 30 min
✔✔What is most common cause of a hip dislocation? Is it usually anterior or posterior? -
✔✔MVA, posterior
✔✔Which of the four rotator cuff muscles is most commonly injured? -
✔✔Supraspinatus
✔✔What is the medical term for tennis elbow? - ✔✔Lateral epicondylitis
✔✔What is a first line treatment for rheumatoid arthritis? - ✔✔Methotrexate
✔✔A patient presents to the ER after taking a baseball bat to the knee. He is unable to
actively extend his knee. What is the most likely diagnosis? - ✔✔Patella fracture
✔✔Are most shoulder dislocations anterior or posterior? - ✔✔Anterior
✔✔What is the most useful physical exam test for diagnosing an ACL tear? -
✔✔Lachman's, followed by anterior drawer
✔✔What is the most common knee injury? - ✔✔Medial meniscal tear
✔✔Where are Heberden's nodes found? - ✔✔Distal interphalangeal joint (DIP)
✔✔A patient presents with knee pain following a soccer game two days ago. He has
joint line tenderness medially and feels a locking in the knee from time to time. What
two physical exam tests should you do? - ✔✔Medial meniscal tear
1. McMurray
2. Apley
✔✔A patient presents with conjunctivitis, urethritis, arthritis, and oral lesions. Most likely
diagnosis? Other labs? - ✔✔Reactive arthritis
HLA B-27
✔✔A 46 yo male comes into ER limping a little on the right side. He states that it felt as
though he
was kicked in the back of the leg during a soccer
game, but clearly no one was behind him. What is
the most likely diagnosis? - ✔✔Achilles tendon rupture
,✔✔Anti jo antibodies should make you think of what
diagnosis? - ✔✔Polymyositis
✔✔A positive cross over test indicates what diagnosis? - ✔✔Acromioclavicular joint
injury
✔✔A positive Hawkin's test indicates what diagnosis? - ✔✔Rotator cuff injury
✔✔A positive Finkelstein's test indicates what diagnosis? - ✔✔de Quervian's
tenosynovitis
✔✔A positive Phalen and Tinel's sign indicates what
diagnosis? - ✔✔Carpal tunnel
✔✔A bamboo spine indicates - ✔✔anklyosing spondylitis
✔✔A positive straight leg test indicates what
diagnosis? - ✔✔Herniated disc
✔✔An African American female presents with malar
rash and a positive double stranded DNA antibody.
What is the most likely diagnosis? - ✔✔Lupus
✔✔Carpal tunnel affects what nerve and what parts of the hand? - ✔✔Median nerve:
thumb, pointer, ring fingers.
Thenar wasting is sign of advanced disease
✔✔Silver fork deformity on xray - ✔✔Colles fracture
✔✔A positive Apley indicates what diagnosis? - ✔✔Meniscal tear
✔✔List six medications that can be used for migraine
prophylaxis? - ✔✔Beta blockers, tricyclics, calcium
channel blockers, NSAIDs and
valproic acid
✔✔A patient presents with what appears to be an
inability to understand speech. Which aphasia
should be at the top of your differential? - ✔✔Wernicke's aphasia
✔✔A patient presents with signs of a stroke to the ED. Most important test? - ✔✔Non-
contrast CT
, ✔✔A patient is brought in following a seizure in which she did not lose consciousness.
Most likely diagnosis? - ✔✔Simple partial seizure
✔✔What is the medical treatment for a stroke in which
the CT has shown no evidence of a hemorrhage? - ✔✔Heparin/coumadin,
thrombolytics,
steroids, hyperosmotics
✔✔A patient presents with a painful ipsilateral third
nerve palsy. What is the most likely diagnosis? - ✔✔Posterior communicating artery
aneurysm (PCOM)
✔✔What seizure medication may cause overgrowth of
the gums? - ✔✔Phenytoin
✔✔A sudden thunderclap headache should make you
think of what diagnosis? - ✔✔Subarachnoid hemorrhage
✔✔Describe Kernig's sign - ✔✔The patient lies supine, flex hip while
keeping knee straight. Back pain is
positive.
✔✔If CT is negative and you still believe there is a
stroke what is the next best test to order? - ✔✔Lumbar Puncture
✔✔A patient presents with lateralized throbbing
headache. He is also complaining of nausea,
vomiting and photophobia. What type of headache
is most likely? - ✔✔Migraine
✔✔A middle age male presents with unilateral
periorbital headaches occurring daily for several
weeks. These headaches are extremely painful.
Which type of headache is the most likely cause? - ✔✔Cluster headache
✔✔List three drugs that treat cluster headaches. - ✔✔1) Oxygen
2) Sumatriptan
3) Butoprophal
✔✔A 34 year old presents symptoms which are
relapsing and remitting over the past few weeks.
These include visual problems and weakness in her
