PANCE Practice Exam 2 Questions and
Answers (Latest Update 2024) Verified
Answers/ explained
A 27-year-old woman complains of years of menstrual
irregularity and increasing facial and chest hair. PMH:
significant for ovarian cyst and left cytectomy. She is a non-
smoker and non-drinker. Labs include a negative uCG,
elevated LH, and low FSH. She desires fertility and she has
not responded to three cycles of clomiphene. What would be
the next choice of medication that may return ovulation?
A. Insulin
B. Metformin
C. Dexamethasone
D. Spironalactone
E. Finasteride - Correct Answer ✅ The answer is B.
EXPLANATION: Dexamethasone, finasteride, and
spironalactone all treat symptoms of hirsutism, but do not
treat the underlying cause of PCO or improve fertility
outcomes. PCO has an underlying insulin resistance that can
be treated with oral hypoglycemics and improve sensitivity to
insulin. Adding insulin does not improve the resistance.
A 2-week-old male infant presents for a routine checkup. The
mother complains that he nurses every hour, but vomits
,PANCE Practice Exam 2 Questions and
Answers (Latest Update 2024) Verified
Answers/ explained
(nonbilious) after every time he eats. He has only had three
bowel movements since he has been home. On examination,
the infant has not gained any weight since leaving the
hospital, and the clinician notes gastric peristaltic waves.
Which of the following is the treatment of choice for this
patient?
A. pyloromyotomy
B. metoclopramide
C. laparotomy
D. omeprazole - Correct Answer ✅ The answer is A.
EXPLANATION: This infant is presenting with signs and
symptoms of pyloric stenosis. Infants typically have vomiting
(projectile at times) after every feeding and it normally starts
between the age of 2 and 4 weeks. The infant nurses
fervently and is hungry. In addition, there may be
dehydration, constipation, weight loss, and apathy. Abdomen
may be distended with gastric peristaltic waves. Occasionally,
an olive-sized mass can be felt in the right upper quadrant
with deep palpation after the child has vomited. Vomitus is
typically nonbilious. Diagnosis is confirmed by an upper
gastrointestinal series with delayed gastric emptying,
enlarged pyloric muscle, and characteristic semilunar
,PANCE Practice Exam 2 Questions and
Answers (Latest Update 2024) Verified
Answers/ explained
impressions on the gastric antrum. In addition, an ultrasound
is needed to verify the hypertrophic muscle. The treatment of
choice for these patients is pyloromyotomy, which can be
done laparoscopically. These patients make full recoveries
and have an excellent prognosis.
Upon performing a newborn examination, the clinician notes
a widened pulse pressure, paradoxical splitting of S2, and a
"machine"-like murmur heard best at the second intercostal
space, left sternal border, and inferior to the clavicle. Which
of the following is the most likely diagnosis?
A. tetralogy of Fallot
B. ventricular septal defect
C. atrial septal defect
D. patent ductus arteriosus - Correct Answer ✅ The answer
is D.
EXPLANATION: Patent ductus arteriosus (PDA) is an isolated
abnormality that occurs in infants. The ductus arteriosus is a
normal fetal vessel that joins the aorta and the pulmonary
artery and spontaneously closes after 3 to 5 days. Lack of
closure results in the audible murmur that is "machine-like"
, PANCE Practice Exam 2 Questions and
Answers (Latest Update 2024) Verified
Answers/ explained
and maximal at the second intercostal space (ICS), at the left
sternal border (LSB), and inferior to the clavicle. It is typically
a pansystolic murmur with bounding pulses and a widened
pulse pressure. There is also a paradoxical splitting of S1 and
S2. Echocardiography confirms the PDA, the direction and
degree of shunting, and the presence of lesions for which the
PDA is needed to keep. If there are no other cardiac
malformations requiring the PDA, then if the PDA is large,
surgery should be completed before 1 year of age.
Symptomatic PDAs that are relatively small may be closed
with indomethacin in preterm infants.
an ejection type, systolic murmur heard best at the LSB,
second ICS with a wide, fixed S2 and normal pulses. -
Correct Answer ✅ atrial septal defect (ASD)
a harsh, pansystolic murmur heard best at the third and
fourth ICS. With increasing size, heaves, thrills, and lifts are
present along with radiation throughout the chest. - Correct
Answer ✅ Ventricular septal defect (VSD)
Answers (Latest Update 2024) Verified
Answers/ explained
A 27-year-old woman complains of years of menstrual
irregularity and increasing facial and chest hair. PMH:
significant for ovarian cyst and left cytectomy. She is a non-
smoker and non-drinker. Labs include a negative uCG,
elevated LH, and low FSH. She desires fertility and she has
not responded to three cycles of clomiphene. What would be
the next choice of medication that may return ovulation?
A. Insulin
B. Metformin
C. Dexamethasone
D. Spironalactone
E. Finasteride - Correct Answer ✅ The answer is B.
EXPLANATION: Dexamethasone, finasteride, and
spironalactone all treat symptoms of hirsutism, but do not
treat the underlying cause of PCO or improve fertility
outcomes. PCO has an underlying insulin resistance that can
be treated with oral hypoglycemics and improve sensitivity to
insulin. Adding insulin does not improve the resistance.
A 2-week-old male infant presents for a routine checkup. The
mother complains that he nurses every hour, but vomits
,PANCE Practice Exam 2 Questions and
Answers (Latest Update 2024) Verified
Answers/ explained
(nonbilious) after every time he eats. He has only had three
bowel movements since he has been home. On examination,
the infant has not gained any weight since leaving the
hospital, and the clinician notes gastric peristaltic waves.
Which of the following is the treatment of choice for this
patient?
A. pyloromyotomy
B. metoclopramide
C. laparotomy
D. omeprazole - Correct Answer ✅ The answer is A.
EXPLANATION: This infant is presenting with signs and
symptoms of pyloric stenosis. Infants typically have vomiting
(projectile at times) after every feeding and it normally starts
between the age of 2 and 4 weeks. The infant nurses
fervently and is hungry. In addition, there may be
dehydration, constipation, weight loss, and apathy. Abdomen
may be distended with gastric peristaltic waves. Occasionally,
an olive-sized mass can be felt in the right upper quadrant
with deep palpation after the child has vomited. Vomitus is
typically nonbilious. Diagnosis is confirmed by an upper
gastrointestinal series with delayed gastric emptying,
enlarged pyloric muscle, and characteristic semilunar
,PANCE Practice Exam 2 Questions and
Answers (Latest Update 2024) Verified
Answers/ explained
impressions on the gastric antrum. In addition, an ultrasound
is needed to verify the hypertrophic muscle. The treatment of
choice for these patients is pyloromyotomy, which can be
done laparoscopically. These patients make full recoveries
and have an excellent prognosis.
Upon performing a newborn examination, the clinician notes
a widened pulse pressure, paradoxical splitting of S2, and a
"machine"-like murmur heard best at the second intercostal
space, left sternal border, and inferior to the clavicle. Which
of the following is the most likely diagnosis?
A. tetralogy of Fallot
B. ventricular septal defect
C. atrial septal defect
D. patent ductus arteriosus - Correct Answer ✅ The answer
is D.
EXPLANATION: Patent ductus arteriosus (PDA) is an isolated
abnormality that occurs in infants. The ductus arteriosus is a
normal fetal vessel that joins the aorta and the pulmonary
artery and spontaneously closes after 3 to 5 days. Lack of
closure results in the audible murmur that is "machine-like"
, PANCE Practice Exam 2 Questions and
Answers (Latest Update 2024) Verified
Answers/ explained
and maximal at the second intercostal space (ICS), at the left
sternal border (LSB), and inferior to the clavicle. It is typically
a pansystolic murmur with bounding pulses and a widened
pulse pressure. There is also a paradoxical splitting of S1 and
S2. Echocardiography confirms the PDA, the direction and
degree of shunting, and the presence of lesions for which the
PDA is needed to keep. If there are no other cardiac
malformations requiring the PDA, then if the PDA is large,
surgery should be completed before 1 year of age.
Symptomatic PDAs that are relatively small may be closed
with indomethacin in preterm infants.
an ejection type, systolic murmur heard best at the LSB,
second ICS with a wide, fixed S2 and normal pulses. -
Correct Answer ✅ atrial septal defect (ASD)
a harsh, pansystolic murmur heard best at the third and
fourth ICS. With increasing size, heaves, thrills, and lifts are
present along with radiation throughout the chest. - Correct
Answer ✅ Ventricular septal defect (VSD)
