PANCE Practice Exam 2 Questions and
Answers Graded A+
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
...
PANCE Practice Exam 2 Questions and
Answers Graded A+
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 nondrinker. 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 olive-sized mass can be felt in the right upper quadrant with
deep palpation after the child has vomited. Vomitus is t
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