PANCE ACTUAL EXAM 2026/2027 TEST | WITH COMPREHENSIVE
QUESTIONS AND VERIFIED ANSWERS | GRADED A+
At what age should you order DEXA scans for male? Female? - ANSWER 70 for males
65 for females
Give DEXA score for osteopenia? Osteoporosis? - ANSWER Osteopenia = 1 to 2.4 standard deviations,
osteoporosis = 2.5 standard deviations or greater.
What fracture is #1 cause of compartment syndrome? - ANSWER Tibial shaft fracture
A patient's lab work shows positive smith Ab and positive double strand DNA ab. Most likely
diagnosis is? - ANSWER Lupus
Where are Bouchard's nodes found? - ANSWER PIP
[B = Before]
What will XRAY show in acute osteomyelitis? - ANSWER Nothing: bone destruction in chronic
osteomyelitis
Best imaging to dx osteomyelitis? - ANSWER Bone scan or MRI will provide diagnosis
A 22 year old male patient presents with what is
clearly a septic knee. You also notice lesions on his
hands and feet. What is the most likely pathogen? - ANSWER Neisseria gonorrhoeae
What would you expect the WBC count to be in the
joint fluid of an infected knee? - ANSWER >50,000 at a minimum and probably
much higher.
A patient presents with a painless mass in her right
wrist. What is the most likely diagnosis? - ANSWER Ganglion cyst
,What is the age range for osteosarcoma? Where
are they most typically found in the body? - ANSWER Osteosarcoma (cancerous) usually occur in
15-25 year old males and are most
commonly found around the knee.
You think a patient may have an osteoid osteoma
due to his complaints of severe night pain. You
set him up for an x-ray, but in the meantime what
medication do you start him on? - ANSWER If it is truly an osteoid osteoma (benign)
ibuprofen will resolve his pain.
Clicking or locking of the knee indicates what
diagnosis? - ANSWER Meniscal tear
A 65 year old presents complaining of severe pain
in his great toe that began when he woke up this
morning. It is swollen, red and very tender. What is
the most likely diagnosis? - ANSWER 1. Gout
2. Infection
What uric acid level helps to confirm dx of gout? - ANSWER >7.5
(Normal = 3ish to 7ish?)
What is the medical treatment for gout? - ANSWER Allopurinol, colchicine
Pathology shows positive birefringent crystals. Most likely dx? - ANSWER Pseudogout
Patient with hx of HBV presents with bilateral knee pain, fever, weight loss. Most likely diagnosis? -
ANSWER Polyarteritis nodosa
,You suspect a pt has polyarteritis nodosa. What is the test for a definitive diagnosis and what is
treatment? - ANSWER Biopsy, high dose steroids
On physical exam you notice ulnar deviations and swan neck deformities. What is the most likely
diagnosis? - ANSWER Rheumatoid arthritis
Positive Neer's test indicate what diagnosis? - ANSWER Rotator cuff impingement
List three meds that may cause lupus - ANSWER Procainamide, isoniazid, quinidine
What test do you do for Sjogren's syndrome? - ANSWER Schirmer test
[Sjogren's syndrome] = dry mouth, dry eyes, autoimmune)
A patient with rheumatoid arthritis is heading to OR for ORIF of ankle. What x-rays should you get? -
ANSWER Ankle films
C-spine
Anesthesia will want them d/t concerns about instability of C1+C2
What carpal bone has high rate of nonunion and occult fracture? - ANSWER Scaphoid
[Occult = hidden]
What med is used for patient with lupus? - ANSWER Systemic steroids
Scleroderma limited version has five main characteristics (CREST) - ANSWER Calcinosis
Raynaud's
Esophageal mobility
Sclerodactyly
Telangiectasia
There is a sunbusrt appearance on XRAY. What is most likely diagnosis? - ANSWER osteosarcoma
Anatomically where are 80% of clavicle fractures located? - ANSWER Middle third
, A pathology report comes back with negative birefringent crystals. What is most likely diagnosis? -
ANSWER Gout
Four muscles of rotator cuff? - ANSWER SITS
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
Describe characteristics of lytic lesion on xray - ANSWER Spiculated, elevated periosteum, bone
destruction (think bad, very bad)
What ligament is most commonly injured in ankle sprain? - ANSWER Anterior talofibular ligament
(ATF)
Vasculitis with HBV history should make you think of what diagnosis? - ANSWER Polyarteritis nodosa
What is most common fracture in children? - ANSWER Clavicle
Fat pad sign on lateral xray of elbow has what significance? - ANSWER Blood in joint indicating
fracture even if fracture line can't be seen
Patient presents with progressive neck and muscle weakness. On physical exam you see reddish
purple maculopapular rash. Her lab work shows an anti Jo 1 antibody. What is most likely diagnosis? -
ANSWER Polymyositis
Which way does a Colles fracture angulate: dorsal or volar? - ANSWER DORSAL
Which way does a Smith fracture angulate: dorsal or volar? - ANSWER VOLAR
Tenderness over anatomical snuffbox indicates what fracture? - ANSWER Scaphoid
QUESTIONS AND VERIFIED ANSWERS | GRADED A+
At what age should you order DEXA scans for male? Female? - ANSWER 70 for males
65 for females
Give DEXA score for osteopenia? Osteoporosis? - ANSWER Osteopenia = 1 to 2.4 standard deviations,
osteoporosis = 2.5 standard deviations or greater.
What fracture is #1 cause of compartment syndrome? - ANSWER Tibial shaft fracture
A patient's lab work shows positive smith Ab and positive double strand DNA ab. Most likely
diagnosis is? - ANSWER Lupus
Where are Bouchard's nodes found? - ANSWER PIP
[B = Before]
What will XRAY show in acute osteomyelitis? - ANSWER Nothing: bone destruction in chronic
osteomyelitis
Best imaging to dx osteomyelitis? - ANSWER Bone scan or MRI will provide diagnosis
A 22 year old male patient presents with what is
clearly a septic knee. You also notice lesions on his
hands and feet. What is the most likely pathogen? - ANSWER Neisseria gonorrhoeae
What would you expect the WBC count to be in the
joint fluid of an infected knee? - ANSWER >50,000 at a minimum and probably
much higher.
A patient presents with a painless mass in her right
wrist. What is the most likely diagnosis? - ANSWER Ganglion cyst
,What is the age range for osteosarcoma? Where
are they most typically found in the body? - ANSWER Osteosarcoma (cancerous) usually occur in
15-25 year old males and are most
commonly found around the knee.
You think a patient may have an osteoid osteoma
due to his complaints of severe night pain. You
set him up for an x-ray, but in the meantime what
medication do you start him on? - ANSWER If it is truly an osteoid osteoma (benign)
ibuprofen will resolve his pain.
Clicking or locking of the knee indicates what
diagnosis? - ANSWER Meniscal tear
A 65 year old presents complaining of severe pain
in his great toe that began when he woke up this
morning. It is swollen, red and very tender. What is
the most likely diagnosis? - ANSWER 1. Gout
2. Infection
What uric acid level helps to confirm dx of gout? - ANSWER >7.5
(Normal = 3ish to 7ish?)
What is the medical treatment for gout? - ANSWER Allopurinol, colchicine
Pathology shows positive birefringent crystals. Most likely dx? - ANSWER Pseudogout
Patient with hx of HBV presents with bilateral knee pain, fever, weight loss. Most likely diagnosis? -
ANSWER Polyarteritis nodosa
,You suspect a pt has polyarteritis nodosa. What is the test for a definitive diagnosis and what is
treatment? - ANSWER Biopsy, high dose steroids
On physical exam you notice ulnar deviations and swan neck deformities. What is the most likely
diagnosis? - ANSWER Rheumatoid arthritis
Positive Neer's test indicate what diagnosis? - ANSWER Rotator cuff impingement
List three meds that may cause lupus - ANSWER Procainamide, isoniazid, quinidine
What test do you do for Sjogren's syndrome? - ANSWER Schirmer test
[Sjogren's syndrome] = dry mouth, dry eyes, autoimmune)
A patient with rheumatoid arthritis is heading to OR for ORIF of ankle. What x-rays should you get? -
ANSWER Ankle films
C-spine
Anesthesia will want them d/t concerns about instability of C1+C2
What carpal bone has high rate of nonunion and occult fracture? - ANSWER Scaphoid
[Occult = hidden]
What med is used for patient with lupus? - ANSWER Systemic steroids
Scleroderma limited version has five main characteristics (CREST) - ANSWER Calcinosis
Raynaud's
Esophageal mobility
Sclerodactyly
Telangiectasia
There is a sunbusrt appearance on XRAY. What is most likely diagnosis? - ANSWER osteosarcoma
Anatomically where are 80% of clavicle fractures located? - ANSWER Middle third
, A pathology report comes back with negative birefringent crystals. What is most likely diagnosis? -
ANSWER Gout
Four muscles of rotator cuff? - ANSWER SITS
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
Describe characteristics of lytic lesion on xray - ANSWER Spiculated, elevated periosteum, bone
destruction (think bad, very bad)
What ligament is most commonly injured in ankle sprain? - ANSWER Anterior talofibular ligament
(ATF)
Vasculitis with HBV history should make you think of what diagnosis? - ANSWER Polyarteritis nodosa
What is most common fracture in children? - ANSWER Clavicle
Fat pad sign on lateral xray of elbow has what significance? - ANSWER Blood in joint indicating
fracture even if fracture line can't be seen
Patient presents with progressive neck and muscle weakness. On physical exam you see reddish
purple maculopapular rash. Her lab work shows an anti Jo 1 antibody. What is most likely diagnosis? -
ANSWER Polymyositis
Which way does a Colles fracture angulate: dorsal or volar? - ANSWER DORSAL
Which way does a Smith fracture angulate: dorsal or volar? - ANSWER VOLAR
Tenderness over anatomical snuffbox indicates what fracture? - ANSWER Scaphoid
