Last Min PANCE Review Questions and
Answers A+ Guide
What test is helpful in ruling OUT the diagnosis of systemic lupus
erythematosus? - correct answers✅✅*ANA*
ruling OUT = most SENSITIVE
ANA is 95-100% sensitive in SLE = most sensitive = best at ruling OUT. So if
you get a NEGATIVE result, you are good.
Which population is alpha-thalassemia primarily seen in? - correct
answers✅✅Southeast Asia and China
Which opioid agonist analgesic can actually cause mydriasis in OD? -
correct answers✅✅Meperidine
At therapeutic doses, meperidine causes miosis (pinpoint pupils). However,
unlike most other opioids, meperidine can cause mydriasis (dilated pupils) in
cases of toxicity. Increased muscle tone, twitching, and tremors may also be
seen with meperidine overdose. Meperidine is metabolized by the P450
system in the liver to the metabolite normeperidine, which can cause CNS
toxicity at therapeutic meperidine doses. The half-life of normeperidine is up
to 48 hours and subsequent hallucinations, seizures and psychosis may
result. Therefore, meperidine is not routinely used for the management of
acute pain in the Emergency Department. Meperidine can also potentially
interact with monoamine oxidase inhibitors and cause serotonin syndrome.
Name the SIRS criteria - correct answers✅✅Temp, Tachy, Tachy, Twelve
A patient presents with ankle pain after twisting it while walking. Which of
the following clinical findings necessitates an ankle X-ray? - correct
answers✅✅Tenderness to the POSTERIOR edge of the lateral malleolus
,Last Min PANCE Review Questions and
Answers A+ Guide
Which of the following viral infections is a known precipitant of aplastic crisis
in patients with sickle cell disease? - correct answers✅✅Parvovirus B-19
drug of choice for eclamptic seizures - correct answers✅✅Magnesium
sulfate
Most cases of eclampsia occur in the 3rd trimester, with approximately 80%
occurring during delivery or within the first 48 hours after delivery, though
seizures may occur as late as several weeks postpartum. Seizures are most
commonly tonic-clonic and last 60 to 90 seconds.
How can purpura be differentiated from rashes? - correct
answers✅✅Purpura do not blanch under pressure
Kid has Henoch-Schönlein Purpura (HSP), what test should you get? -
correct answers✅✅urinalysis to evaluate for glomerulonephritis
A complete blood count to evaluate for thrombocytopenia (C) is not
necessary in a patient with HSP. While purpura may be caused by
thrombocytopenic conditions such as Immune Thrombocytopenic Purpura,
this patients constellation of acute onset of purpura, abdominal pain, and
arthritis is more consistent with HSP.
Which of the following statements is true regarding the rapid dispersing
formulation (wafer) of olanzapine? - correct answers✅✅It is considered to
be bioequivalent to olanzapine tablet
Overdose leads to tachycardia, rather than bradycardia (A) due mainly to
muscarinic blockade.
,Last Min PANCE Review Questions and
Answers A+ Guide
Olanzapine is associated with a lower incidence of extrapyramidal effects (D)
than haloperidol.
Olanzapine is often associated with orthostatic hypotension (C) due to the
adrenergic (alpha) receptor blockade.
Which of the following is associated with an organic cause of psychosis? -
correct answers✅✅Disorientation
Patients with functional or psychiatric etiologies of psychosis are more likely
to have auditory hallucinations (A) instead of visual ones, slow onset of
symptoms (B) and normal vital signs (D).
What is another name for "organic" psychosis? - correct
answers✅✅*Medical Psychosis*
Patients with organic causes of psychosis tend to have recent memory
deficits, psychomotor retardation, *visual hallucinations*, emotional lability,
*disorientation* and occasional periods of lucidity. Additionally, those with
organic psychosis are more likely to have a *sudden onset* of symptoms,
*abnormal vital signs or physical examination findings* and social
immodesty. In patients over 40 years of age without a prior psychiatric
history, an organic cause of psychosis should always be assumed.
Which of the following is consistent with a diagnosis of infectious
mononucleosis? - correct answers✅✅*Maculopapular rash following
treatment with amoxicillin*
, Last Min PANCE Review Questions and
Answers A+ Guide
The lymphadenopathy of mononucleosis typically involves the posterior
cervical chain, as opposed to streptococcal pharyngitis which presents with
anterior cervical lymphadenopathy (A).
What is Sheehan's syndrome - correct answers✅✅a RARE cause of
amenorrhea in the complicated postpartum setting, in which severe
hemorrhage and/or hypotension results in pituitary gland necrosis.
Which of the following conditions should prompt administration of the
meningococcal vaccine prior to the standard 11 years of age? - correct
answers✅✅Sickle cell anemia
Cystic fibrosis (A), diabetes mellitus (B) and hypoplastic left heart (C) are not
indications for early meningococcal vaccination, however early 23-valent
pneumococcal vaccines are indicated in these patients.
Which of the following is the treatment of choice for mature cataracts? -
correct answers✅✅Phacoemulsification followed by artificial lens implant
Name the Ranson Criteria - correct answers✅✅
patient presents with hereditary angioedema. What should you use to treat?
- correct answers✅✅FFP
fresh frozen plasma (FFP) has been used with successful results. FFP replaces
C1 esterase inhibitor and contains kininase II, which breaks down bradykinin.
when angioedema presents in the absence of hives, it suggests involvement
of bradykinin as opposed to mast cell degranulation. Hereditary angioedema
(HAE) is due to a deficiency of C1 esterase inhibitor.
Answers A+ Guide
What test is helpful in ruling OUT the diagnosis of systemic lupus
erythematosus? - correct answers✅✅*ANA*
ruling OUT = most SENSITIVE
ANA is 95-100% sensitive in SLE = most sensitive = best at ruling OUT. So if
you get a NEGATIVE result, you are good.
Which population is alpha-thalassemia primarily seen in? - correct
answers✅✅Southeast Asia and China
Which opioid agonist analgesic can actually cause mydriasis in OD? -
correct answers✅✅Meperidine
At therapeutic doses, meperidine causes miosis (pinpoint pupils). However,
unlike most other opioids, meperidine can cause mydriasis (dilated pupils) in
cases of toxicity. Increased muscle tone, twitching, and tremors may also be
seen with meperidine overdose. Meperidine is metabolized by the P450
system in the liver to the metabolite normeperidine, which can cause CNS
toxicity at therapeutic meperidine doses. The half-life of normeperidine is up
to 48 hours and subsequent hallucinations, seizures and psychosis may
result. Therefore, meperidine is not routinely used for the management of
acute pain in the Emergency Department. Meperidine can also potentially
interact with monoamine oxidase inhibitors and cause serotonin syndrome.
Name the SIRS criteria - correct answers✅✅Temp, Tachy, Tachy, Twelve
A patient presents with ankle pain after twisting it while walking. Which of
the following clinical findings necessitates an ankle X-ray? - correct
answers✅✅Tenderness to the POSTERIOR edge of the lateral malleolus
,Last Min PANCE Review Questions and
Answers A+ Guide
Which of the following viral infections is a known precipitant of aplastic crisis
in patients with sickle cell disease? - correct answers✅✅Parvovirus B-19
drug of choice for eclamptic seizures - correct answers✅✅Magnesium
sulfate
Most cases of eclampsia occur in the 3rd trimester, with approximately 80%
occurring during delivery or within the first 48 hours after delivery, though
seizures may occur as late as several weeks postpartum. Seizures are most
commonly tonic-clonic and last 60 to 90 seconds.
How can purpura be differentiated from rashes? - correct
answers✅✅Purpura do not blanch under pressure
Kid has Henoch-Schönlein Purpura (HSP), what test should you get? -
correct answers✅✅urinalysis to evaluate for glomerulonephritis
A complete blood count to evaluate for thrombocytopenia (C) is not
necessary in a patient with HSP. While purpura may be caused by
thrombocytopenic conditions such as Immune Thrombocytopenic Purpura,
this patients constellation of acute onset of purpura, abdominal pain, and
arthritis is more consistent with HSP.
Which of the following statements is true regarding the rapid dispersing
formulation (wafer) of olanzapine? - correct answers✅✅It is considered to
be bioequivalent to olanzapine tablet
Overdose leads to tachycardia, rather than bradycardia (A) due mainly to
muscarinic blockade.
,Last Min PANCE Review Questions and
Answers A+ Guide
Olanzapine is associated with a lower incidence of extrapyramidal effects (D)
than haloperidol.
Olanzapine is often associated with orthostatic hypotension (C) due to the
adrenergic (alpha) receptor blockade.
Which of the following is associated with an organic cause of psychosis? -
correct answers✅✅Disorientation
Patients with functional or psychiatric etiologies of psychosis are more likely
to have auditory hallucinations (A) instead of visual ones, slow onset of
symptoms (B) and normal vital signs (D).
What is another name for "organic" psychosis? - correct
answers✅✅*Medical Psychosis*
Patients with organic causes of psychosis tend to have recent memory
deficits, psychomotor retardation, *visual hallucinations*, emotional lability,
*disorientation* and occasional periods of lucidity. Additionally, those with
organic psychosis are more likely to have a *sudden onset* of symptoms,
*abnormal vital signs or physical examination findings* and social
immodesty. In patients over 40 years of age without a prior psychiatric
history, an organic cause of psychosis should always be assumed.
Which of the following is consistent with a diagnosis of infectious
mononucleosis? - correct answers✅✅*Maculopapular rash following
treatment with amoxicillin*
, Last Min PANCE Review Questions and
Answers A+ Guide
The lymphadenopathy of mononucleosis typically involves the posterior
cervical chain, as opposed to streptococcal pharyngitis which presents with
anterior cervical lymphadenopathy (A).
What is Sheehan's syndrome - correct answers✅✅a RARE cause of
amenorrhea in the complicated postpartum setting, in which severe
hemorrhage and/or hypotension results in pituitary gland necrosis.
Which of the following conditions should prompt administration of the
meningococcal vaccine prior to the standard 11 years of age? - correct
answers✅✅Sickle cell anemia
Cystic fibrosis (A), diabetes mellitus (B) and hypoplastic left heart (C) are not
indications for early meningococcal vaccination, however early 23-valent
pneumococcal vaccines are indicated in these patients.
Which of the following is the treatment of choice for mature cataracts? -
correct answers✅✅Phacoemulsification followed by artificial lens implant
Name the Ranson Criteria - correct answers✅✅
patient presents with hereditary angioedema. What should you use to treat?
- correct answers✅✅FFP
fresh frozen plasma (FFP) has been used with successful results. FFP replaces
C1 esterase inhibitor and contains kininase II, which breaks down bradykinin.
when angioedema presents in the absence of hives, it suggests involvement
of bradykinin as opposed to mast cell degranulation. Hereditary angioedema
(HAE) is due to a deficiency of C1 esterase inhibitor.
