PANCE Orthopedics Practice EXAM QUESTIONS
AND VERIFIED CORRECT ANSWERS LATEST 2026-
2027 NEW VERSION
A 33-year-old woman presents to her primary care PA due to persistent right wrist
pain. The patient has been experiencing pain on the thumb-side of the wrist every
time she holds or grips an object. She recently delivered a healthy, full-term baby
four weeks ago. Her past medical history is unremarkable, and she does not take any
medications. Vitals are within normal limits. On physical examination, swelling and
tenderness to palpation are noted at the radial aspect of the right wrist. Repetitive
tapping over the volar part of the wrist does not reproduce the pain. While the
patient is grasping the right thumb with the right four digits, the PA places the wrist
in ulnar deviation. This maneuver reproduces the pain. Which of the following best
describes the pathogenesis of this patient's disease process?
A. Entrapment and compression of the median nerve
B. Occult fracture of the distal radius
C. Myxoid degeneration o - answer>>>C. Myxoid degeneration of the abductor
pollicis longus and the extensor pollicis brevis
This patient presents in the postpartum period with pain over the radial aspect of
the wrist and a positive Finkelstein test. These findings are consistent with De
Quervain tenosynovitis, characterized by myxoid degeneration of the abductor
pollicis longus and extensor pollicis brevis.
A 45-year-old woman presents to her primary care PA to evaluate a nodule on the
wrist. The nodule appeared on the right wrist one month ago and has slightly
increased in size since then. She has not experienced any pain or limitations in her
daily activities but is worried it "might be cancerous." Past medical history is notable
for hypothyroidism, for which she takes levothyroxine. She does not smoke,
consume alcohol, or use illicit substances. Vital signs are within normal limits. The
patient also has no systemic symptoms, the nodule is painless and on the dorsum of
, -
her hand. Which of the following is the most appropriate management for this
patient's clinical condition?
A. Reassurance and observation
B. Screw and plate fixation
C. Topical nifedipine
D. Needle aspiration
E. Surgical excision - answer>>>A. Reassurance and observation
This patient presents with an asymptomatic nodule on the volar aspect of the wrist.
This presentation is most consistent with a ganglion cyst based on the above image.
In the absence of significant pain or limitations in functional mobility, she should be
treated with close observation and surveillance.
Difference between Bennett and Rolando Fractures and How to treat them? -
answer>>>Bennett fracture is an intraarticular fracture through the base of the 1st
metacarpal (thumb) with large distal fragment dislocated radially and dorsally
because of an axial blow to a partially flexed MCP.
Rolando fracture: comminuted Bennett's fracture
Treatment: ORIF
A 70-year-old woman presents to the emergency department to evaluate left wrist
pain. The patient was cleaning the bathroom when she slipped, fell, and landed on
an outstretched left arm. She was subsequently unable to move her left wrist due to
pain. Past medical history is notable for hypertension, and she takes amlodipine
daily. She does not smoke or consume alcohol. Vital signs are within normal limits.
Physical examination demonstrates swelling and deformity of the left wrist. Plain
films of the left wrist show dorsal angulation of the distal radius fracture fragment.
Which of the following is the most likely diagnosis?
,A. Galeazzi fracture
B. Smith fracture
C. Bennett fracture
D. Colles fracture
E. Monteggia fracture - answer>>>D. Colles fracture
The wrist's two common fracture patterns are the Colles fracture and Smith fracture.
A Colles fracture will demonstrate dorsal angulation of the distal radius fracture
fragment, while a Smith fracture will demonstrate volar angulation.
A 2-month-old infant boy is evaluated for the first time since delivery. The patient
was born at 40 weeks gestation via vaginal delivery and had a normal prenatal and
postnatal birth history. He feeds 2-3 oz of breastmilk and formula every 2-3 hours.
He is in the 75th percentile for height, 75th percentile for weight, and 50th
percentile for head circumference. On physical examination, there is prominent
head posturing. The head is tilted to the right side, and the chin is rotated to the left
shoulder. A mass is palpable in the inferior portion of the neck on the right side. The
mass is firm and does not transilluminate with a penlight. The rest of the physical
examination, including the reflexes and muscular tone of the extremities, is normal.
Which of the following is the most likely cause of this patient's condition?
A. Clavicle fracture
B. Congenital muscular torticollis
C. Lymphangioma
D. Vertebral anomaly
E. C - answer>>>B. Congenital muscular torticollis
A 35-year-old man comes to the clinic due to back pain. Upon entering the clinic, the
patient is observed to be limping and appears in pain. He discloses back pain for the
past few months that has been progressively worsening. Two days ago, he felt
severe pain while lifting a box at home. The patient now describes the pain as dull,
, -
7/10 in severity, which worsens with movement and radiates to the left thigh. He
has noticed numbness in the perianal region while using the toilet. Vitals are within
normal limits. On physical examination, focal tenderness is noticed over the lumbar
and paraspinal area. There is a loss of sensation around the perianal area but a
normal anal sphincter tone. Knee jerk reflex is normal but the ankle reflex is absent
on the left. Strength is 5/5 on the right and 4/5 in the left gluteus maximus and
hamstring muscles. Which of the following features will prompt the need for
emergent imaging?
A - answer>>>E. The patient's loss of sensation
Could be cauda equina syndrome
A 45-year-old man comes to the office due to an acute onset of back pain. Two hours
ago, he felt a sharp, middle-back pain while lifting a heavy box. The patient describes
the pain as "shooting" and burning, 7/10 in severity, and radiating from the back to
the right foot. He does not have any bowel or bladder symptoms. Vitals are within
normal limits. On physical examination, knee jerk and Achilles reflexes are 2+
bilaterally. Straight leg raise is positive on the right side. Motor strength for
dorsiflexion is 5/5 on the left compared to 3/5 on the right lower extremity. Which
of the following nerve roots is most likely affected by this patient's condition?
A. L1
B. L4
C. L5
D. S1
E. S2 - answer>>>C. L5
AND VERIFIED CORRECT ANSWERS LATEST 2026-
2027 NEW VERSION
A 33-year-old woman presents to her primary care PA due to persistent right wrist
pain. The patient has been experiencing pain on the thumb-side of the wrist every
time she holds or grips an object. She recently delivered a healthy, full-term baby
four weeks ago. Her past medical history is unremarkable, and she does not take any
medications. Vitals are within normal limits. On physical examination, swelling and
tenderness to palpation are noted at the radial aspect of the right wrist. Repetitive
tapping over the volar part of the wrist does not reproduce the pain. While the
patient is grasping the right thumb with the right four digits, the PA places the wrist
in ulnar deviation. This maneuver reproduces the pain. Which of the following best
describes the pathogenesis of this patient's disease process?
A. Entrapment and compression of the median nerve
B. Occult fracture of the distal radius
C. Myxoid degeneration o - answer>>>C. Myxoid degeneration of the abductor
pollicis longus and the extensor pollicis brevis
This patient presents in the postpartum period with pain over the radial aspect of
the wrist and a positive Finkelstein test. These findings are consistent with De
Quervain tenosynovitis, characterized by myxoid degeneration of the abductor
pollicis longus and extensor pollicis brevis.
A 45-year-old woman presents to her primary care PA to evaluate a nodule on the
wrist. The nodule appeared on the right wrist one month ago and has slightly
increased in size since then. She has not experienced any pain or limitations in her
daily activities but is worried it "might be cancerous." Past medical history is notable
for hypothyroidism, for which she takes levothyroxine. She does not smoke,
consume alcohol, or use illicit substances. Vital signs are within normal limits. The
patient also has no systemic symptoms, the nodule is painless and on the dorsum of
, -
her hand. Which of the following is the most appropriate management for this
patient's clinical condition?
A. Reassurance and observation
B. Screw and plate fixation
C. Topical nifedipine
D. Needle aspiration
E. Surgical excision - answer>>>A. Reassurance and observation
This patient presents with an asymptomatic nodule on the volar aspect of the wrist.
This presentation is most consistent with a ganglion cyst based on the above image.
In the absence of significant pain or limitations in functional mobility, she should be
treated with close observation and surveillance.
Difference between Bennett and Rolando Fractures and How to treat them? -
answer>>>Bennett fracture is an intraarticular fracture through the base of the 1st
metacarpal (thumb) with large distal fragment dislocated radially and dorsally
because of an axial blow to a partially flexed MCP.
Rolando fracture: comminuted Bennett's fracture
Treatment: ORIF
A 70-year-old woman presents to the emergency department to evaluate left wrist
pain. The patient was cleaning the bathroom when she slipped, fell, and landed on
an outstretched left arm. She was subsequently unable to move her left wrist due to
pain. Past medical history is notable for hypertension, and she takes amlodipine
daily. She does not smoke or consume alcohol. Vital signs are within normal limits.
Physical examination demonstrates swelling and deformity of the left wrist. Plain
films of the left wrist show dorsal angulation of the distal radius fracture fragment.
Which of the following is the most likely diagnosis?
,A. Galeazzi fracture
B. Smith fracture
C. Bennett fracture
D. Colles fracture
E. Monteggia fracture - answer>>>D. Colles fracture
The wrist's two common fracture patterns are the Colles fracture and Smith fracture.
A Colles fracture will demonstrate dorsal angulation of the distal radius fracture
fragment, while a Smith fracture will demonstrate volar angulation.
A 2-month-old infant boy is evaluated for the first time since delivery. The patient
was born at 40 weeks gestation via vaginal delivery and had a normal prenatal and
postnatal birth history. He feeds 2-3 oz of breastmilk and formula every 2-3 hours.
He is in the 75th percentile for height, 75th percentile for weight, and 50th
percentile for head circumference. On physical examination, there is prominent
head posturing. The head is tilted to the right side, and the chin is rotated to the left
shoulder. A mass is palpable in the inferior portion of the neck on the right side. The
mass is firm and does not transilluminate with a penlight. The rest of the physical
examination, including the reflexes and muscular tone of the extremities, is normal.
Which of the following is the most likely cause of this patient's condition?
A. Clavicle fracture
B. Congenital muscular torticollis
C. Lymphangioma
D. Vertebral anomaly
E. C - answer>>>B. Congenital muscular torticollis
A 35-year-old man comes to the clinic due to back pain. Upon entering the clinic, the
patient is observed to be limping and appears in pain. He discloses back pain for the
past few months that has been progressively worsening. Two days ago, he felt
severe pain while lifting a box at home. The patient now describes the pain as dull,
, -
7/10 in severity, which worsens with movement and radiates to the left thigh. He
has noticed numbness in the perianal region while using the toilet. Vitals are within
normal limits. On physical examination, focal tenderness is noticed over the lumbar
and paraspinal area. There is a loss of sensation around the perianal area but a
normal anal sphincter tone. Knee jerk reflex is normal but the ankle reflex is absent
on the left. Strength is 5/5 on the right and 4/5 in the left gluteus maximus and
hamstring muscles. Which of the following features will prompt the need for
emergent imaging?
A - answer>>>E. The patient's loss of sensation
Could be cauda equina syndrome
A 45-year-old man comes to the office due to an acute onset of back pain. Two hours
ago, he felt a sharp, middle-back pain while lifting a heavy box. The patient describes
the pain as "shooting" and burning, 7/10 in severity, and radiating from the back to
the right foot. He does not have any bowel or bladder symptoms. Vitals are within
normal limits. On physical examination, knee jerk and Achilles reflexes are 2+
bilaterally. Straight leg raise is positive on the right side. Motor strength for
dorsiflexion is 5/5 on the left compared to 3/5 on the right lower extremity. Which
of the following nerve roots is most likely affected by this patient's condition?
A. L1
B. L4
C. L5
D. S1
E. S2 - answer>>>C. L5
