PANRE Test Review- Broad with
Complete Solutions
myeloproliferative disorder affecting older individuals; median age 60
- short duration of fever
- malaise/fatigue
- *bleeding (gums bleeding is common)*
- CBC= panyctopenia, *Auer rods are pathognomonic for AML* - ANSWER-Acute
Myelogenous Leukemia (AML) presentation and labs?
Cluster headaches - ANSWER-Intense, episodic headaches that occur more commonly
in men than women. Symptoms are unilateral, often accompanied by rhinorrhea and
lacrimation, miosis, and ptosis of the eye
This presentation is suggestive of what type of headaches?
Propranolol - ANSWER-Benign essential tremor treatment?
Transilluminating the mass - ANSWER-A 34-year-old woman presents to your clinic
with a 3-month history of a mildly tender mass on the dorsocentral aspect of her
dominant right wrist.
What examination technique would help to show that this mass is a ganglion cyst?
MRI - ANSWER-most sensitive imaging modality for the diagnosis of osteomyelitis?
Pyelonephritis
White blood cell casts in urine are pathognomonic for pyelonephritis - ANSWER-32-
year-old female presents with fever, chills, nausea, and *flank pain* for 24 hours. She
developed dysuria and urinary frequency 3 days prior and states that both have
worsened. On physical exam, you note suprapubic abdominal pain and *CVA
tenderness*. The urinalysis reveals *white blood cell casts*.
What is most likely diagnosis?
Patient is presenting with a lactational *breast abscess*.
With breast abscesses, needle aspiration under ultrasound guidance is the preferred
initial intervention (followed by a course of oral dicloxacillin) - ANSWER-A lactating
woman with a 5-month-old infant presents with increasing unilateral breast discomfort
, over the past few days. A home monitoring of her temperature revealed a reading of
100.8°F (38.2°C). She has been unable to feed her child from the affected breast for the
past 24 hours. Examination reveals a breast with a fluctuant mass.
What is the next step in management of this patient?
The patient's clinical history, hyperpigmentation, and lab abnormalities (hyperkalemia,
hyponatremia) are suggestive of *Addison's disease (primary adrenal insufficiency)*.
The cosyntropin stimulation test (ACTH test) is used to assess the function of adrenal
gland. - ANSWER-A 34-year-old woman presents with a 6-month history of progressive
fatigue. She has had to stop running due to lack of energy, and she is napping
frequently. She has a poor appetite, dry skin, and darkening of the skin over her elbows
and knees. Physical examination is significant for orthostatic hypotension and
hyperpigmentation of the elbows and knees.
Labs show Hyperkalemia (elevated potassium) and Hyponatremia (low sodium)
Based on the clinical scenario, the most likely diagnosis is *syphilis*. The *VDRL* is a
screening test for syphilis, which would be expected to be positive in this case. The
patient's body rash specifically affecting the palms and soles strongly suggests
secondary syphilis. Also, the perineal lesions suggest condylomata lata of secondary
syphilis. - ANSWER-A 28-year-old man presents for evaluation of a rash. His trunk is
covered with a pink-red papulosquamous eruption with scattered discrete coppery
papules on the palms of his hands and a few lesions on the soles of his feet. He is
afebrile and has not experienced any illness in the past month that he can recall. Skin
exam reveals soft, flat, moist papules scattered on his perineum.
What laboratory test will yield the most information about this patient's condition?
Apthous ulcers (canker sores) - ANSWER-While performing a comprehensive oral
exam on a patient, you note 3 lesions on the buccal mucosa on the right side of the oral
cavity. You document these lesions with the following description: 3 *round lesions*,
each measuring approximately 2 mm in diameter, with the presence of a *white-yellow
center surrounded by a red halo*. When questioned, the patient states that this is
"nothing new" and that they usually appear during her period.
what is most likely diagnosis?
Menieres disease - ANSWER-A 42-year-old man presents with a 24-hour history of
severe vertigo, tinnitus, hearing loss, nausea, and vomiting intermittently; episodes last
at least 30 minutes. After a thorough history and examination, the patient is diagnosed
with _______?
Charcot's triad
Complete Solutions
myeloproliferative disorder affecting older individuals; median age 60
- short duration of fever
- malaise/fatigue
- *bleeding (gums bleeding is common)*
- CBC= panyctopenia, *Auer rods are pathognomonic for AML* - ANSWER-Acute
Myelogenous Leukemia (AML) presentation and labs?
Cluster headaches - ANSWER-Intense, episodic headaches that occur more commonly
in men than women. Symptoms are unilateral, often accompanied by rhinorrhea and
lacrimation, miosis, and ptosis of the eye
This presentation is suggestive of what type of headaches?
Propranolol - ANSWER-Benign essential tremor treatment?
Transilluminating the mass - ANSWER-A 34-year-old woman presents to your clinic
with a 3-month history of a mildly tender mass on the dorsocentral aspect of her
dominant right wrist.
What examination technique would help to show that this mass is a ganglion cyst?
MRI - ANSWER-most sensitive imaging modality for the diagnosis of osteomyelitis?
Pyelonephritis
White blood cell casts in urine are pathognomonic for pyelonephritis - ANSWER-32-
year-old female presents with fever, chills, nausea, and *flank pain* for 24 hours. She
developed dysuria and urinary frequency 3 days prior and states that both have
worsened. On physical exam, you note suprapubic abdominal pain and *CVA
tenderness*. The urinalysis reveals *white blood cell casts*.
What is most likely diagnosis?
Patient is presenting with a lactational *breast abscess*.
With breast abscesses, needle aspiration under ultrasound guidance is the preferred
initial intervention (followed by a course of oral dicloxacillin) - ANSWER-A lactating
woman with a 5-month-old infant presents with increasing unilateral breast discomfort
, over the past few days. A home monitoring of her temperature revealed a reading of
100.8°F (38.2°C). She has been unable to feed her child from the affected breast for the
past 24 hours. Examination reveals a breast with a fluctuant mass.
What is the next step in management of this patient?
The patient's clinical history, hyperpigmentation, and lab abnormalities (hyperkalemia,
hyponatremia) are suggestive of *Addison's disease (primary adrenal insufficiency)*.
The cosyntropin stimulation test (ACTH test) is used to assess the function of adrenal
gland. - ANSWER-A 34-year-old woman presents with a 6-month history of progressive
fatigue. She has had to stop running due to lack of energy, and she is napping
frequently. She has a poor appetite, dry skin, and darkening of the skin over her elbows
and knees. Physical examination is significant for orthostatic hypotension and
hyperpigmentation of the elbows and knees.
Labs show Hyperkalemia (elevated potassium) and Hyponatremia (low sodium)
Based on the clinical scenario, the most likely diagnosis is *syphilis*. The *VDRL* is a
screening test for syphilis, which would be expected to be positive in this case. The
patient's body rash specifically affecting the palms and soles strongly suggests
secondary syphilis. Also, the perineal lesions suggest condylomata lata of secondary
syphilis. - ANSWER-A 28-year-old man presents for evaluation of a rash. His trunk is
covered with a pink-red papulosquamous eruption with scattered discrete coppery
papules on the palms of his hands and a few lesions on the soles of his feet. He is
afebrile and has not experienced any illness in the past month that he can recall. Skin
exam reveals soft, flat, moist papules scattered on his perineum.
What laboratory test will yield the most information about this patient's condition?
Apthous ulcers (canker sores) - ANSWER-While performing a comprehensive oral
exam on a patient, you note 3 lesions on the buccal mucosa on the right side of the oral
cavity. You document these lesions with the following description: 3 *round lesions*,
each measuring approximately 2 mm in diameter, with the presence of a *white-yellow
center surrounded by a red halo*. When questioned, the patient states that this is
"nothing new" and that they usually appear during her period.
what is most likely diagnosis?
Menieres disease - ANSWER-A 42-year-old man presents with a 24-hour history of
severe vertigo, tinnitus, hearing loss, nausea, and vomiting intermittently; episodes last
at least 30 minutes. After a thorough history and examination, the patient is diagnosed
with _______?
Charcot's triad
