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PANCE Practice Exam – With COMPLETE SOLUTION 300 Questions with 100% Correct Answers

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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 - ✔✔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 (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 - ✔✔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 [Show More]

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