MSK cram the PANCE question review
Questions and Answers A+ Guide
A 42-yr-old female presents to the office complaining of a burning pain in the
ball of her foot radiating to the 3rd and 4th toe. She states the burning
sensation is worse after a long day of standing on her feet, especially if she
wears high heels. Physical exam shows tenderness in the plantar aspect of
the distal foot over the 3rd intermetatarsal space. What is the likely
diagnosis? - correct answers✅✅Morton neuroma
compressive neuropathy - numbness and burning in the 3rd intermetatarsal
space most commonly affected, more common in women, heels = risk factor
A 63-yr-old female presents to the office to review the results of her bone
density test. She has a history of vertebral fractures and her recent bone
density test reveals a T-score of -2.8. The treating physician decides to start
the patient on Raloxifene. What is likely positive in this patient's past medical
history that would influence the decision to start her on Raloxifene rather
than an alternative osteoporosis medication? - correct answers✅✅Breast
cancer history
Raloxifene is a selective estrogen receptor modulator so it is often used in
patients with risk for breast cancer
A 42-yr-old female presents to the office complaining of heartburn, small
white lumps on her fingers, as well as a tight feeling in her hands that makes
it difficult to make a fist. On exam you note telangiectasias on the palms and
face. Labs are positive for antinuclear antibodies and anti-centromere
antibodies. What is the likely diagnosis for this patient? - correct
answers✅✅CREST syndrome
Calcinosis cutis
Raynaud
Esophageal dysmotility
,MSK cram the PANCE question review
Questions and Answers A+ Guide
Sclerodactyly
Telangiectasia
A 63 F presents to her doctor's office complaining of pain and stiffness in her
shoulders, hip, and neck. She states the SX are very severe in the morning,
sometimes limiting her activity, and as the day goes on there is some
improvement. Physical exam shows normal muscle strength, slightly reduced
range of motion. Labs show elevated ESR and CRP. Rheumatoid factor and
creatine kinase are normal. The patient is diagnosed with polymyalgia
rheumatica and started on steroids. A clinical assessment for what other
condition should be considered? - correct answers✅✅Giant cell arteritis
A 62 M presents to the ER after being involved in a MVA. He is complaining of
severe pain in his right hip. On physical exam you not the right leg is
internally rotated and adducted. X-ray shows a dislocation of the right hip.
What type of dislocation did this patient likely suffer? - correct
answers✅✅Posterior dislocation
most common type of hip dislocation, especially after a car accident MOI
A 46 M presents to the office complaining of severe lower back pain radiating
into both legs, as well as numbness in his inner thighs and buttocks that
started after moving some furniture. Physical exam shows lower extremity
weakness, saddle paresthesia, and loss of rectal tone. What is the diagnostic
test of choice for the likely diagnosis in this patient? - correct
answers✅✅MRI
MRI is the preferred diagnostic test in Cauda Equina syndrome, generally
with contrast
, MSK cram the PANCE question review
Questions and Answers A+ Guide
Anterior displacement of one vertebral body with respect to the one beneath
it is called what? - correct answers✅✅Spondylolisthesis
"list the thesis on a piece of paper and pass it forward" = Spondylo-list-thesis
is forward slipping
A 32 F presents to the office complaining of fatigue, weakness, fever, and a
rash for the past 2 months. On exam you note erythema over the cheeks and
nose sparing the nasolabial folds. You suspect Lupus and order an ANA test
which comes back positive. Which additional lab tests listed below would be
most appropriate to order next to assist in making the diagnosis?
A) Anti-centromere antibody
B) Anti-tissue transglutaminase antibody
C) Anti-smith antibody
D) Anti-CCP antibody - correct answers✅✅C) Anti-smith antibody
Anti-smith and anti-DS-DNA are most sensitive for Lupus
LUPUS = Lou Piss
Lou is taking a piss on his smith and wesson double barrel shotgun
Anti-double-stranded DNA
Anti-Smith antibodies
Anti-centromere = CREST
Anti-transglutaminase antibody = celiac disease
Anti-CCP = rheumatoid arthritis
A 3 M presents to the office accompanied by his mother with reports of acute
R elbow pain and limited use of the RUE. The mother states this all started
Questions and Answers A+ Guide
A 42-yr-old female presents to the office complaining of a burning pain in the
ball of her foot radiating to the 3rd and 4th toe. She states the burning
sensation is worse after a long day of standing on her feet, especially if she
wears high heels. Physical exam shows tenderness in the plantar aspect of
the distal foot over the 3rd intermetatarsal space. What is the likely
diagnosis? - correct answers✅✅Morton neuroma
compressive neuropathy - numbness and burning in the 3rd intermetatarsal
space most commonly affected, more common in women, heels = risk factor
A 63-yr-old female presents to the office to review the results of her bone
density test. She has a history of vertebral fractures and her recent bone
density test reveals a T-score of -2.8. The treating physician decides to start
the patient on Raloxifene. What is likely positive in this patient's past medical
history that would influence the decision to start her on Raloxifene rather
than an alternative osteoporosis medication? - correct answers✅✅Breast
cancer history
Raloxifene is a selective estrogen receptor modulator so it is often used in
patients with risk for breast cancer
A 42-yr-old female presents to the office complaining of heartburn, small
white lumps on her fingers, as well as a tight feeling in her hands that makes
it difficult to make a fist. On exam you note telangiectasias on the palms and
face. Labs are positive for antinuclear antibodies and anti-centromere
antibodies. What is the likely diagnosis for this patient? - correct
answers✅✅CREST syndrome
Calcinosis cutis
Raynaud
Esophageal dysmotility
,MSK cram the PANCE question review
Questions and Answers A+ Guide
Sclerodactyly
Telangiectasia
A 63 F presents to her doctor's office complaining of pain and stiffness in her
shoulders, hip, and neck. She states the SX are very severe in the morning,
sometimes limiting her activity, and as the day goes on there is some
improvement. Physical exam shows normal muscle strength, slightly reduced
range of motion. Labs show elevated ESR and CRP. Rheumatoid factor and
creatine kinase are normal. The patient is diagnosed with polymyalgia
rheumatica and started on steroids. A clinical assessment for what other
condition should be considered? - correct answers✅✅Giant cell arteritis
A 62 M presents to the ER after being involved in a MVA. He is complaining of
severe pain in his right hip. On physical exam you not the right leg is
internally rotated and adducted. X-ray shows a dislocation of the right hip.
What type of dislocation did this patient likely suffer? - correct
answers✅✅Posterior dislocation
most common type of hip dislocation, especially after a car accident MOI
A 46 M presents to the office complaining of severe lower back pain radiating
into both legs, as well as numbness in his inner thighs and buttocks that
started after moving some furniture. Physical exam shows lower extremity
weakness, saddle paresthesia, and loss of rectal tone. What is the diagnostic
test of choice for the likely diagnosis in this patient? - correct
answers✅✅MRI
MRI is the preferred diagnostic test in Cauda Equina syndrome, generally
with contrast
, MSK cram the PANCE question review
Questions and Answers A+ Guide
Anterior displacement of one vertebral body with respect to the one beneath
it is called what? - correct answers✅✅Spondylolisthesis
"list the thesis on a piece of paper and pass it forward" = Spondylo-list-thesis
is forward slipping
A 32 F presents to the office complaining of fatigue, weakness, fever, and a
rash for the past 2 months. On exam you note erythema over the cheeks and
nose sparing the nasolabial folds. You suspect Lupus and order an ANA test
which comes back positive. Which additional lab tests listed below would be
most appropriate to order next to assist in making the diagnosis?
A) Anti-centromere antibody
B) Anti-tissue transglutaminase antibody
C) Anti-smith antibody
D) Anti-CCP antibody - correct answers✅✅C) Anti-smith antibody
Anti-smith and anti-DS-DNA are most sensitive for Lupus
LUPUS = Lou Piss
Lou is taking a piss on his smith and wesson double barrel shotgun
Anti-double-stranded DNA
Anti-Smith antibodies
Anti-centromere = CREST
Anti-transglutaminase antibody = celiac disease
Anti-CCP = rheumatoid arthritis
A 3 M presents to the office accompanied by his mother with reports of acute
R elbow pain and limited use of the RUE. The mother states this all started
