Daily PANCE and PANRE

A patient is being treated for Tuberculosis. She is experiencing central scotomata, a loss of green-red color perception and decreased visual acuity. Which agent is most likely responsible? A. rifampin B. isoniazid C. streptomycin D. ethambutol E. para-aminosalicylic acid Answer, D Ethambutol is the TB drug that causes “E”ye symptoms. I remember it because it […]

A polarized light microscopic study of joint fluid demonstrates negative birefringent crystals. What is the diagnosis? A. rheumatoid arthritis B. septic arthritis C. pseudogout gout D. aseptic arthritis E. gout Answer: E, gout Uric acid (gout) is “Needle-shaped crystals with Negative birefringence) Calcium Pyrophosphate (pseudogout) is Prism-shaped crystals with Positive birefringence)   Help Support The Physician […]

A patient that must be on a beta-blocking agent has reactive airway disease and commonly experiences central nervous system side effects from medications. Which of the following beta-blockers would most likely be tolerated by this patient? A. atenolol B. metoprolol C. nadfilol D. propranolol E. pindolol Answer: B, metoprolol This is a picky Q for the […]

A 12 year-old male presents complaining of no appetite for 24 hours and pain near his navel. During the night, the pain moved to the right lower abdomen. He is now nauseated and vomiting and has a low-grade fever. In the operating room, a normal appendix is discovered. What is the most likely diagnosis? A. […]

Which of the following is NOT a risk factor for the development of osteoporosis? A. low testosterone levels in men B. low levels of physical activity C. inadequate dietary protein D. cigarette smoking E. chronic corticosteroid use Answer: C, inadequate dietary protein Low dietary Calcium, not protein, is a risk factor for osteoporosis. All of the […]

A 58 year-old male presents complaining of weakness of his grip. Your examination reveals that the problem is bilateral. During the next few office visits, you note the development of hyperactivity of his DTRs, extensor plantar reflexes and dysarthria. The patient’s sensory system remains normal and he denies any urinary symptomatology. Which of the following […]

Your 27 year-old sister is visiting and requests you to provide refills of dexamethasone and homotropine ophthalmic drops for her. What condition is most likely being treated? A. conjunctivitis B. glaucoma C. iritis D. Herpes keratitis E. blepharitis Answer: C, iritis Iritis is treated with steroid drops (dexamethasone) and miotic drops *homotropine, like atropine (to constrict […]

A 2 month-old febrile male is brought to your facility to be evaluated for loss of appetite, irritability, and an acute petechial rash. Rectal temperature is 102.8F. Which of the following diagnostic studies is the most important in this child’s evaluation? A. white blood count and differentia B. urinalysis C. CSF analysis D. serum glucose […]

A 24 year-old male presents complaining of chest pain. He states that it is worse with swallowing and taking a deep breath. It is improved sitting up and leaning forward. He denies trauma, a cough and shortness of breath. Which of the following test would be most compatible with your suspected diagnosis? A. a hiatal […]

Secondary to a traumatic even, a child complains of pain in the index finger. An x-ray of the digit demonstrates a fracture line through the metaphysic of the proximal aspect of the middle phalanx, ending at the epiphyseal plate. What type of fracture does this child have? A. Salter Harris Type I B. Salter Harris […]

A patient is being treated for Tuberculosis. She is experiencing central scotomata, a loss of green-red color perception and decreased visual acuity. Which agent is most likely responsible? A. rifampin B. isoniazid C. streptomycin D. ethambutol E. para-aminosalicylic acid Answer, D Ethambutol is the TB drug that causes “E”ye symptoms. I remember it because it […]

A 38 year-old chronic smoker presents with shortness of breath and wheezing. He has had several similar episodes in the past. He states that each previous episode began after developing a “cold that moved into his chest.” Usually, after treatment with albuterol (VENTOLIN) and several days, the wheezing stops. He adds that he has a […]

Fluid from a thoracentesis is grossly purulent. The effusion from which this fluid was aspirated is best described as a(n): A. loculated effusion B. chylothorax. C. empyema. D. hydrothorax. E. hemothorax.  Answer: C, empyema. A grossly purulent tap would suggest staph (empyema). Loculated effusion does not describe either a trans or exudative effusion. Chylo and hydro […]

Which of the following is the earliest manifestation of diabetic nephropathy? A. proteinuria B. a progressive decline in the creatinine clearance C. an elevated serum haptoglobin D. renal insufficiency E. microalbuminuria  Answer: E, microalbuminuria Tiny amounts of albumin (microalbumin) show up first – but need a special test ordered to detect it. Intervention at this point […]