Ace the PANCE Exam Using Rosh Review Practice Questions
psychoterapy
Trial of a beta-blocker
why: Patients with autonomic dys-
function and mvp are trialed on
beta-blockers, counseled on catteine,
alcohol and tobacco abstinence and
given a 24-hour cardiac monitor. In
patients with neurologic findings and
1. Which of the following is first-line therapy for
a patient with factitious disorder?
2. A 26-year-old woman presents with anxiety
and palpitations. She denies dyspnea, exer-
cise intolerance, orthopnea, or paroxysmal
nocturnal dyspnea. Neurologic review of sys-
tems is negative. She has a family history of
mitral valve prolapse. Examination reveals a
thin body habitus, normal peripheral pulses,
clear breath sounds, absent chest wall thrills
and no peripheral edema. A full neuromuscu-
MVP, the clinician must first rule-out
lar examination reveals no gross abnormali- atrial fibrillation and left atrial throm-
ties. While auscultating over the cardiac apex,
bus. Once accomplished, daily aspirin
you hear a mid-systolic click, but do not appre-
ciate any other murmur. A chest radiograph is given, and the use of warfarin (A)
and ECG are normal.
, Ace the PANCE Exam Using Rosh Review Practice Questions
Which of the following is the most is considered. Consider low dose dai-
appropriate intervention at this time? ly antibiotic prophylaxis (B) in pa-
tients with any mid-systolic click and
late-systolic murmur is incorrect. This
is not one of the groups considered
at high risk for infective endocardi-
tis. Patients with progression into MR,
or who have MVP and new atrial fib-
rillation or pulmonary hypertension,
should be referred as soon as possible
for surgical repair (C).
3. List some physical abnormalities which are as- Pectus excavatum, low BMI, scoliosis,
sociated with mitral valve prolapse? kyphosis, straight-back, long-narrow
chest and joint hypermobility.
4.
, Ace the PANCE Exam Using Rosh Review Practice Questions
A 4-year-old boy who has not received routine Measles
childhood vaccinations presents with fever,
cough, coryza, and conjunctivitis for three
days. Today his mother noted an erythema-
tous macular rash over his face, trunk, and Why: Clinically, measles is associated
extremities. Which of the following is the most with fever, conjunctivitis, coryza, and
likely diagnosis? cough (the 3 Cs). The rash is a discrete
red maculopapular rash that first ap-
pears on the forehead, becoming co-
alescent as it spreads down the trunk
to the feet. The rash fades in the same
head-to-feet pattern as it appeared.
Measles is also associated with Koplik
spots. These are 1-3 mm bluish-white
spots on a bright red surface that ap-
pear first on the buccal mucosa op-
posite the lower molars. They are a
pathognomonic enanthem of measles
and appear approximately within 48
hours after the onset of symptoms.
5. When are patients contagious with measles? 5 days before rash to 4 days after
6. A 25-year-old man presents to the clinic re- Pneumo - chest tube thoracostomy
porting sudden shortness of breath and pain
with breathing. He reports no preexisting
medical conditions or current medication use
Why: small pneumothorax should be
but is a current smoker. Vital signs include HR
treated by observation for 4 to 6 hours
143 bpm, RR 27 breaths per minute, BP 102/71
with or without supplemental oxygen.
mm Hg, T 98.1°F, and SpO2 87% on room thin man with
air. Physical examination demonstrates a tall, diminished breath
, Ace the PANCE Exam Using Rosh Review Practice Questions
sounds and A large pneumothorax in this patient
population requires drainage with as-
psychoterapy
Trial of a beta-blocker
why: Patients with autonomic dys-
function and mvp are trialed on
beta-blockers, counseled on catteine,
alcohol and tobacco abstinence and
given a 24-hour cardiac monitor. In
patients with neurologic findings and
1. Which of the following is first-line therapy for
a patient with factitious disorder?
2. A 26-year-old woman presents with anxiety
and palpitations. She denies dyspnea, exer-
cise intolerance, orthopnea, or paroxysmal
nocturnal dyspnea. Neurologic review of sys-
tems is negative. She has a family history of
mitral valve prolapse. Examination reveals a
thin body habitus, normal peripheral pulses,
clear breath sounds, absent chest wall thrills
and no peripheral edema. A full neuromuscu-
MVP, the clinician must first rule-out
lar examination reveals no gross abnormali- atrial fibrillation and left atrial throm-
ties. While auscultating over the cardiac apex,
bus. Once accomplished, daily aspirin
you hear a mid-systolic click, but do not appre-
ciate any other murmur. A chest radiograph is given, and the use of warfarin (A)
and ECG are normal.
, Ace the PANCE Exam Using Rosh Review Practice Questions
Which of the following is the most is considered. Consider low dose dai-
appropriate intervention at this time? ly antibiotic prophylaxis (B) in pa-
tients with any mid-systolic click and
late-systolic murmur is incorrect. This
is not one of the groups considered
at high risk for infective endocardi-
tis. Patients with progression into MR,
or who have MVP and new atrial fib-
rillation or pulmonary hypertension,
should be referred as soon as possible
for surgical repair (C).
3. List some physical abnormalities which are as- Pectus excavatum, low BMI, scoliosis,
sociated with mitral valve prolapse? kyphosis, straight-back, long-narrow
chest and joint hypermobility.
4.
, Ace the PANCE Exam Using Rosh Review Practice Questions
A 4-year-old boy who has not received routine Measles
childhood vaccinations presents with fever,
cough, coryza, and conjunctivitis for three
days. Today his mother noted an erythema-
tous macular rash over his face, trunk, and Why: Clinically, measles is associated
extremities. Which of the following is the most with fever, conjunctivitis, coryza, and
likely diagnosis? cough (the 3 Cs). The rash is a discrete
red maculopapular rash that first ap-
pears on the forehead, becoming co-
alescent as it spreads down the trunk
to the feet. The rash fades in the same
head-to-feet pattern as it appeared.
Measles is also associated with Koplik
spots. These are 1-3 mm bluish-white
spots on a bright red surface that ap-
pear first on the buccal mucosa op-
posite the lower molars. They are a
pathognomonic enanthem of measles
and appear approximately within 48
hours after the onset of symptoms.
5. When are patients contagious with measles? 5 days before rash to 4 days after
6. A 25-year-old man presents to the clinic re- Pneumo - chest tube thoracostomy
porting sudden shortness of breath and pain
with breathing. He reports no preexisting
medical conditions or current medication use
Why: small pneumothorax should be
but is a current smoker. Vital signs include HR
treated by observation for 4 to 6 hours
143 bpm, RR 27 breaths per minute, BP 102/71
with or without supplemental oxygen.
mm Hg, T 98.1°F, and SpO2 87% on room thin man with
air. Physical examination demonstrates a tall, diminished breath
, Ace the PANCE Exam Using Rosh Review Practice Questions
sounds and A large pneumothorax in this patient
population requires drainage with as-
