PANCE PRECISION 4.0 Q’BANK | COMPREHENSIVE QUESTIONS AND DETAILED VERIFIED SOLUTIONS|GRADED A+|NEWEST 2026/2027 UPDATE!!!!

DETAILED VERIFIED SOLUTIONS|GRADED A+|NEWEST 2026/2027



Abdominal aortic aneurysm-

Health Maintenance - ANSWER Avoiding heavy lifting and vigorous physical activity



Abdominal Aortic Aneurysm-

Using Diagnostic and Laboratory Studies - ANSWER Initial imaging study of choice in
suspected AAA to determine presence, size, & extent; Also used to monitor progression in
size (expansion) = Abdominal US and if unstable. Gold Standard = CT with contrast



Abdominal Aortic Aneurysm-

Formulating the Most Likely Diagnosis - ANSWER White men > 65 YO with a smoking
history

Asx until expanding/ruptures; rupture = sudden, severe, constant back/flank/
abdominal/groin pain and/or in shock

Palpable pulsatile abdominal mass on PE



Acute MI-

Pharmaceutical Therapeutics - ANSWER Acute medications: MONAAnticoagulants =
LMWH/unfractionated heparin (usually with + troponin) Clot busters only for
STEMISubacute medications - Beta blockers - ACE inhibitors - Statins



Acute MI-

Using Diagnostic and LaboratoryStudies - ANSWER 12-lead EKG within 10 minutes of
arrival to EDSTEMI = ST elevation in two anatomically contiguous leads w/reciprocal
changesTroponin is positive in STEMI & NSTEMI



Acute MI, Anterior-

1

,Formulating the Most LikelyDiagnosis - ANSWER ST elevations in V1-V4 on 12-lead EKG
with resiprocal changes



Adverse Drug Effect: Antiarrhythmics-

Pharmaceutical Therapeutics - ANSWER Amiodarone SE's = optic neuritis/thyroid
disease/hepatitis/pulmonary fibrosisBeta blockers = bradycardia/bronchospasm Na+
channel blockers OD = wide complex QRS Na+ channel blockers OD = wide complex QRS



Aneurysm, Thoracoabdominal-

Pharmaceutical Therapeutics - ANSWER SABA (statin/antiplatelet/BB/ACEI)



Angina-

Pharmaceutical Therapeutics - ANSWER Stable = Nitro/BB/CCBUnstable = "MONA"
(morphine, O2, nitro, ASA)



Angina Pectoris-

History Taking and PerformingPhysical Exam - ANSWER Chest
discomfort/pressure/squeezing/burning/fullness +/- radiation to
neck/arm/jaw/shoulder/back; usually precipitated by exertion, eating, exposureto cold, or
emotional stress that is relieved by rest or NTG; ask patient about
frequency/severity/number of NTG pills to subside pain



Angina Pectoris-

Pharmaceutical Therapeutics - ANSWER MONA for acute. For chronic: NTG, BB and CCB



Aortic Aneurysm-

Clinical Intervention - ANSWER Surgical revascularization with > 5.5 cm



Aortic Insufficiency-



2

,Formulating the Most LikelyDiagnosis - ANSWER Diastolic blowing decrescendo murmur
best heard in LUSB that increases when pt sits and leans forward, squats, or lays supine and
raises leg; decreases with valsalva maneuvers and standing; wide pulse pressure; bounding
pulses; definitive diagnosis made on cardiac catheterization



Aortic Insufficiency/ Regurgitation-

History Taking and PerformingPhysical Exam - ANSWER Holo-diastolic blowing murmur.
No radiation.



Aortic Insufficiency/ Regurgitation-

Using Diagnostic and LaboratoryStudies - ANSWER Echocardiogram. Definitive diagnosis
= cardiac catheterization



Aortic Valve Stenosis-

Clinical Intervention - ANSWER Aortic valve replacement only effective treatment



Arrhythmia atrioventricular block, second degree (mobitz type II)-

Clinical Intervention - ANSWER Initial: Transcutaneous pacing; Definitive: Permanent
pacemaker



Arrhythmia, Atrial Fibrillation-

Clinical Intervention - ANSWER Unstable (shock) = cardioversion



Arrhythmia, atrial fibrillation-

History Taking and Physical Examination - ANSWER Always with an irregularly irregular
rhythm



Arrhythmia, Atrial Fibrillation-




3

, Pharmaceutical Therapeutics - ANSWER Anticoagulation usually with NOACs (dabigatran
(Pradaxa), rivaroxaban(Xarelto), apixaban (Eliquis).Rate control: BBs/non-dihydropyridine
CCBs (arely digoxin)



Arrhythmia, Atrial Fibrillation-

Using Diagnostic and LaboratoryStudies - ANSWER EKG: irregularly irregular rhythm, no
discrete P waves.



Arrhythmia, Atrial Fibrillation-

Formulating the Most LikelyDiagnosis - ANSWER EKG: irregularly irregular rhythm, no P
waves, usually narrow complex QRS Presents as either an arrhythmia or an embolic event
(CVA, limb ischemia,mesentery ischemia, renal infarct)



Arrhythmia, atrial flutter-

Using Laboratory and DiagnosticStudies - ANSWER EKG: "Sawtooth" pattern



Arrhythmia, atrioventricular block, third degree-

Using Laboratory and DiagnosticStudies - ANSWER Slow heart rate and no coordination
between atria and ventricles



Arrhythmia, Bradycardia-

Formulating the Most LikelyDiagnosis - ANSWER HR < 60bpm. If responsive to atropoine,
usually benign. If not responding to atrpoine, probably needs a pacemaker



Arrhythmia, Complete HeartBlock-

Clinical Intervention - ANSWER Acute/symptomatic: temporary pacing (aka trans-
cutaneous pacemaker) Definitive tx: permanent pacemaker



Arrhythmia, JunctionalRhythm-



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