PANCE Practice Exam with Complete Solution

PANCE Practice Exam with Complete Solution which type of hypersentitivy rxn is the most severe? requiring emergency tx? - ✔✔type 1 Type IV< III< II < I in an alcoholic pt with global confusion, ataxia (gait imbalance ...

PANCE Practice Exam with Complete Solution which type of hypersentitivy rxn is the most severe? requiring emergency tx? - ✔✔type 1 Type IV< III< II < I in an alcoholic pt with global confusion, ataxia (gait imbalance), nystagmus + ocular msl paralysis - ✔✔wernicke's encephalopathy Tx: IV thiamine which type of hypersensitivity rxn is characterized by antigen -antibody rxns mediated by IgE -- that results in hypotension, shock, urticaria, or angioedema? - ✔✔type I best diagnostic test for carpal tunnel syndrome ? - ✔✔electromyogram males with early onset of poor gait that is progressively worsening. Plus pseudohypertrophy of the calves and + Gowers sign (need to lift oneself "climb up" up when getting up) and a positive fam history a Muscle bx to confirm this dx would show: - ✔✔duchenne muscular dystrophy which tests differentiate between nerve and muscular problems? - ✔✔electromyogram and nerve conduction studies Cushing's syndrome pt should immediately stop which meds? - ✔✔steroids. Lambert-Eaton myasthenic syndrome - ✔✔immune mediated disorder where ACH is not properly released - this causes weakness in scapular and pelvic girdle muscles. and difficulty climbing stairs or impotence. deep tendon reflexes are decreased or absent. overdose cholinesterase inhibitors such as pyridostigmine or neostigmine can cause what ? (usually prescribed for MG) - ✔✔cholinergic crisis. excessive salivation, lacrimation, emesis, urinary incontinence, gynecomastia, sparse body hair, small soft testes - ✔✔klinefelters' syndrome (XXY) retinal a. emboli can cause brief episodes of monocular blindness known as - ✔✔amaruosis fugax inhibition of protein C due to use of warfarin causes what? - ✔✔skin necrosis in wilson's dz which are the only type of contraceptives recommended? - ✔✔progestin only pill or levoestregel releasing IUD how do u differentiate between amphetamine or cocaine high? - ✔✔time; amphetamine = 4-6 hrs cocaine = 2 hrs. cushings syndrome pts that are not surgical candidates can use what? - ✔✔oral ketoconazole distended neck veins with prominent A or V waves - ✔✔cor pulmonale IgA vasculitis that erupts over skin post URI, manifesting as paplaple lesions and pts also present with hematuria, arthalgia, and abdominal pain and bloody stools. dx: best dx tool: tx: - ✔✔henoch schonlein purpura coag studies: should be NEGATIVE! kidney bx: IgA deposits tx: supportive as dz is self limiting (NSAIDs, bed rest, hydration) which restrictive lung dz has increased serum ACE (angiotensin converting enzyme)? - ✔✔sarcoidosis in pts with orthostatic hypotension, how can you differentiate between autonomic insufficiency or hypovolemia? - ✔✔in autonomic insufficiency there is no compensatory increase in HR which two conditions are associated with: 1. menstrual irregularity 2. androgen exces - hirsutism 3. mood changes 4. insulin resistance - hyperglycemia 5. obesity how can u differentiate the two? - ✔✔PCOS and hypercortisolism ***hypercortisolism has obesity in truncal distribution and is assoc with HTN and inc urinary cortisol. what are the two most common causes of ACUTE renal failure? - ✔✔1. acute tubular necrosis (due to ischemia, shock, sepsis or cardiac arrest or nephrotoxins) 2. prerenal dz (HF or hypovolemia) what is the BUN/Cr ratio like in acute tubular necrosis? - ✔✔normal BUN/Cr ratio only higher in dz with reduced urine outflow = pre/post renal azotemia BUN/Cr ratio is only lower in severe liver dz. beriberi, av fistulas, hyperthyroidism, Paget's dz of bone can all cause what kind of HF? - ✔✔high cardiac output HF. how can you differentiate between inflammatory and non-inflammatory diarrhea? - ✔✔inflammatory diarrhea can be bloody shigella, entameoba, capmhylobacter, salmonella, yersinia are all organisms that are more likely to cause what kind of diarrhea? - ✔✔inflammatory norovirus, rotavirus, e.coli, staph aureus, giardia, crytosproridium are all organisms that cause wht kind of diarrhea? - ✔✔non-inflammatory. in a pt with guillan barre, PMH is significant for recent travel and severe diarrhea (enterocolitis) - what organism can you assume caused this? - ✔✔camphylobacter. which organisms are most likely to cause traveler's diarrhea? - ✔✔e.coli, shigella, camphylobacter which organisms are responsible for causing diarrhea from drinking contaminated water? - ✔✔giardia, cryptosproridium stool immunoassay and micro studies to confirm dx. tx: metronidazole. extraintestinal manifestations of uveitis, erythema nodosum or pyoderma gangrenosum , large joint arthritis, and cholangitis can be seen with wha