The Final Step PANCE Review
At what age should you order DEXA scans for male? Female?
70 for males
65 for females
Give DEXA score for osteopenia? Osteoporosis?
Osteopenia = 1 to 2.4 standard deviations, osteoporosis = 2.5 standard
deviations or greater.
What fracture is #1 cause of compartment syndrome?
Tibial shaft fracture
A patient's lab work shows positive smith Ab and positive double strand
DNA ab. Most likely diagnosis is?
Lupus
Where are Bouchard's nodes found?
,PIP
[B = Before]
What will XRAY show in acute osteomyelitis?
Nothing: bone destruction in chronic osteomyelitis
Best imaging to dx osteomyelitis?
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?
Neisseria gonorrhoeae
What would you expect the WBC count to be in the
joint fluid of an infected knee?
>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?
Ganglion cyst
,What is the age range for osteosarcoma? Where
are they most typically found in the body?
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?
If it is truly an osteoid osteoma (benign)
ibuprofen will resolve his pain.
Clicking or locking of the knee indicates what
diagnosis?
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?
1. Gout
2. Infection
What uric acid level helps to confirm dx of gout?
>7.5
(Normal = 3ish to 7ish?)
What is the medical treatment for gout?
Allopurinol, colchicine
Pathology shows positive birefringent crystals. Most likely dx?
Pseudogout
Patient with hx of HBV presents with bilateral knee pain, fever, weight
loss. Most likely diagnosis?
At what age should you order DEXA scans for male? Female?
70 for males
65 for females
Give DEXA score for osteopenia? Osteoporosis?
Osteopenia = 1 to 2.4 standard deviations, osteoporosis = 2.5 standard
deviations or greater.
What fracture is #1 cause of compartment syndrome?
Tibial shaft fracture
A patient's lab work shows positive smith Ab and positive double strand
DNA ab. Most likely diagnosis is?
Lupus
Where are Bouchard's nodes found?
,PIP
[B = Before]
What will XRAY show in acute osteomyelitis?
Nothing: bone destruction in chronic osteomyelitis
Best imaging to dx osteomyelitis?
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?
Neisseria gonorrhoeae
What would you expect the WBC count to be in the
joint fluid of an infected knee?
>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?
Ganglion cyst
,What is the age range for osteosarcoma? Where
are they most typically found in the body?
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?
If it is truly an osteoid osteoma (benign)
ibuprofen will resolve his pain.
Clicking or locking of the knee indicates what
diagnosis?
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?
1. Gout
2. Infection
What uric acid level helps to confirm dx of gout?
>7.5
(Normal = 3ish to 7ish?)
What is the medical treatment for gout?
Allopurinol, colchicine
Pathology shows positive birefringent crystals. Most likely dx?
Pseudogout
Patient with hx of HBV presents with bilateral knee pain, fever, weight
loss. Most likely diagnosis?
