PANCE Board Practice Exam

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• Best test for Chlamydia in a patient with vaginal irritation and partner positive?
• Which is the most important RF for thoracic & abdominal aortic aneurysms?
• What is the most common type of colon polyp?
• Leukocoria (white pupillary reflex) in a child is a red flag for which diagnosis?
• Cor pulmonale in COPD is primarily due to which pathophysiology?
• What is the daily recommended calcium and vitamin D intake for a postmenopausal woman?
• What is the most common symptom reported in multiple sclerosis?
• Bilateral vestibular schwannomas are most strongly associated with which genetic disorder?
• In recurrent aphthous ulcers, which medication can be prescribed?
• Isolated systolic hypertension: which medication class is considered first-line therapy?
• A 6-year-old child presents with a painful limp and radiographs show slipped capital femoral epiphysis with posterior slip. What is the most appropriate next step in management?
• What is an early sign of preeclampsia?
• Which medication should be avoided in a patient with GERD?
• Which autoantibody is most characteristic of polymyositis rather than dermatomyositis?
• What is the most common indication for cesarean delivery?
• Which medication would INCREASE the risk of an Achilles tendon rupture?
• A patient presents with a single painful penile ulcer and regional lymphadenopathy; what is the preferred treatment for likely chancroid?
• Which statement about Neurofibromatosis type 2 (NF2) is true?
• In acute coronary syndrome, what is the preferred reperfusion therapy when feasible?
• In patients with anorexia or bulimia, which test is used to assess bone mineral density?
• What is the earliest time post-conception that a serum pregnancy test can be positive?
• Which chemotherapy agent is most commonly associated with pericarditis and cardiomyopathy?
• Which histology is the most common form of lung cancer in both non-smokers and smokers?
• A woman with secondary amenorrhea, negative pregnancy test, progesterone withdrawal bleed, normal FSH, and low LH most likely has which condition?
• In Juvenile Idiopathic Arthritis, what health maintenance is suggested?
• What is the number one risk factor for pancreatic cancer?
• In placenta previa evaluation, which examination is contraindicated?
• Which diagnostic test is most useful to detect a patent foramen ovale in adults with embolic events?
• What is the first-line treatment for urinary tract infections during pregnancy?
• Which medications are contraindicated in patients with Hypertrophic Cardiomyopathy?
• Disseminated gonorrhea may present with septic arthritis and which additional finding?
• In a child with an absent red reflex, which imaging modality is often preferred to evaluate for retinoblastoma while minimizing radiation exposure?
• In children with RSV, BEST predictor of disease severity?
• What percentage of Zollinger-Ellison tumors are malignant?
• In evaluating a postmenopausal ovarian cyst, which biomarker is used to assess risk of malignancy?
• In cystic fibrosis patients with pneumonia, which organism is most likely?
• Which condition is associated with an increased risk of malignancy?
• Which statement about oral leukoplakia is true?
• In RSV management, after initial ribavirin therapy, which medication is commonly continued?
• Which tumor marker is elevated in adenocarcinoma but not elevated in mesothelioma?
• Among the presentations of chronic osteomyelitis, which finding is most common?
• Which hematologic disorder is most commonly associated with DVT and/or PE?
• Gold standard diagnostic test for trichomoniasis?
• Which valvular lesion carries a higher risk of nitroglycerin-induced syncope due to preload sensitivity?
• Which pneumonia is often confused with a URI and may present with low-grade fever and wheezing?
• In an ACL tear, which other injuries are commonly found?
• Which test is most specific for rheumatoid arthritis?
• Hairy leukoplakia is typically non-cancerous and commonly associated with which infection?
• Which laboratory finding best differentiates polymyositis from dermatomyositis?
• Regarding herpes infections, a person is contagious:
• After a normal head CT, which is the next step to diagnose meningitis?
• Turner syndrome is associated with which of the following?
• Hyaline Membrane Disease in neonates is caused by deficiency of which substance?
• A diabetic patient with suspected pulmonary embolism must have which medication stopped before ordering a spiral CT with IV contrast?
• What is the role of HDL cholesterol in lipid transport?
• In lactose intolerance, which mechanism best explains the symptoms?
• Chest tube insertion for pneumothorax is best inserted at which location?
• Which type of laxative is most appropriate for IBS patients?
• NSAIDs during pregnancy can cause which fetal complication?
• An alkaline phosphatase rise with a normal GGT most strongly suggests which pathology?
• A suspicious breast mass is found in a pregnant patient. What is the imaging modality of choice to avoid fetal radiation exposure?
• Which condition presents with cor pulmonale, severe hypoxemia, and edema in the legs?
• In scleroderma, which antibody is associated with the diffuse form and worse prognosis?
• Which is an early finding of a small-bowel obstruction?
• Which EKG change is most consistent with COPD?
• What is the LDL goal in a patient with metabolic syndrome?
• What is the earliest time post-conception that a urine pregnancy test can be positive?
• Which medication class is most important for reducing mortality in congestive heart failure?
• Which antibiotic is the drug of choice for classic pneumococcal pneumonia presenting with lobar consolidation?
• A patient presents with thick, non-scrapable white lesions in the mouth. What is the most appropriate next step?
• What is the 2nd MCC of gastritis/PUD?
• What is the frontline treatment for Trigger Finger?
• In COPD with pulmonary hypertension, what is the SINGLE most important therapy to reduce morbidity?
• Which medication is used to slow progression of wet macular degeneration?
• Which imaging modality is preferred to locate placenta previa?
• What is the recommended action regarding metformin when IV contrast is to be used?
• Which of the following is NOT routinely checked at the time of a spontaneous abortion?
• Which measurement BEST predicts disease severity in RSV infection?
• What is the safest sequence when meningitis is suspected and LP is being considered?
• Giving antibiotics in suspected GABHS pharyngitis reduces risk of all of the following EXCEPT:
• Which statement best describes the latency sites for HSV-1 and HSV-2?
• A patient presents with severe pharyngitis, muffled voice, drooling and uvula deviation. Which test is most appropriate to order?
• Turner syndrome is commonly associated with which renal abnormality?
• Which finding is most suggestive of viral conjunctivitis?
• For otitis externa where the tympanic membrane cannot be visualized due to cerumen, what is the most appropriate antibiotic ear drop regimen?
• Which nutritional component should be added to the diet of a patient with COPD?
• Niacin therapy is associated with reduction in which outcome?
• Maternal hyperglycemia during pregnancy is associated with delayed fetal lung maturity due to decreased surfactant production.
• A painless white oral lesion that cannot be scraped off and appears thick with folds or projections is most consistent with which finding?
• In an acute presentation suggestive of Crohn disease, which imaging test is most appropriate to start?
• What is the inheritance pattern of Huntington disease?
• What is the most common risk factor for PCOS?
• A young patient presents with new onset mitral stenosis; which test should be ordered first to evaluate prior streptococcal exposure?
• Which intervention has been shown to reduce fibroid-related symptoms?
• In patients with a history of anorexia or bulimia, which health maintenance test is considered most critical to order?
• What is the most likely etiology of acute low back pain in a patient without red flags?
• Which side effect is most commonly associated with alendronate use?
• In a patient with BV, but allergic to metronidazole, what alternative may be used?
• Oral lichen planus has a strong association with which infection?
• Which of the following is the most consistent clinical feature of Turner syndrome?
• In a patient with syphilis who has a documented penicillin allergy, which antibiotic is preferred for treatment?
• Which cardiac abnormality is most likely in a patient who used Phentermine/Fenfluramine (Phen-Fen)?
• What test is essential to diagnose COPD by demonstrating obstructive airway limitation?
• After stopping GP IIb/IIIa inhibitor infusion, platelet function typically returns to normal in approximately how many hours?
• In the setting of viral myocarditis, which virus is the most common etiologic agent?
• What is the treatment of choice for gestational diabetes?
• Hypercalcemia in lung cancer is most commonly due to production of PTHrP by which histology?
• Which food item should be avoided or limited in a patient taking warfarin?
• Bitemporal vision loss is most likely due to a lesion at the optic chiasm caused by which condition?
• Which thoracic malignancy is strongly linked to asbestos exposure?
• Inferior wall MI is most commonly caused by occlusion of which artery?
• Which finding is most important to assess in a child with a supracondylar fracture?
• Which congenital lesion is classically associated with a continuous murmur best heard at the left infraclavicular area?
• Which of the following is considered a risk factor for endometriosis?
• Which agent is a direct thrombin inhibitor among the direct oral anticoagulants?
• Which gynecologic cancer has the highest mortality?
• What is the most common site for a pulmonary embolism to originate from?
• Which medication has the greatest impact on SLOWING the progression of thoracic and/or abdominal aortic aneurysm?
• Which organism is involved in the acute exacerbation of chronic bronchitis?
• In a presumed orbital fracture, which imaging test is most appropriate?
• In an 85-year-old man with HTN and CAD who develops syncope after nitroglycerin for chest pain, what is the most appropriate next step in evaluation?
• What is the most common site of metastasis for colon cancer?
• In a patient started on an ACE inhibitor who develops generalized weakness, which diagnostic test is most appropriate to evaluate suspected renal artery stenosis?
• Which finding is considered a latent sign of pulmonary embolism?
• A patient with suspected meningitis presents with signs suggesting increased intracranial pressure (eg, papilledema). What is the most appropriate action before LP?
• Which organism commonly causes pneumonia that can mimic a viral upper respiratory infection due to wheezing?
• Which ethnic group has the highest prevalence of metabolic syndrome?
• If placenta previa or placental abruption is suspected, which initial investigation is indicated?
• A child presenting with absent red reflex requires what action?
• With knee dislocations, which injury is the most common associated injury?
• What is the earliest finding in Legionnaires disease?
• Which test is used to monitor warfarin therapy?
• A 10-year-old girl with suspected acute appendicitis; the BEST test to order is?
• In atrial fibrillation, which agent is commonly used to reduce stroke risk?
• Best Initial screening test for suspected Zollinger-Ellison Syndrome?
• A buckle fracture of the distal radius is also known as which type of fracture?
• Which test is considered the gold standard for diagnosing pulmonary embolism?
• A patient receiving doxorubicin develops sudden substernal chest pain that improves with sitting up and leaning forward; which drug is the likely culprit?
• Which symptom is classic for acute pericarditis?
• A patient suspected of hepatocellular carcinoma; which diagnostic test is best?
• IV contrast used in spiral CT is primarily excreted by which organ?
• At approximately what gestational age is the fundal height at the level of the umbilicus?
• What is considered the BEST test for diagnosing HSV1/HSV2?
• Which of the following medications should be taken with folic acid to reduce risk of neural tube defects?
• In ACS, if PCI is feasible, which intervention is most likely to improve survival?
• Which hepatitis type has the highest risk of liver failure?
• Felty's Syndrome includes RA with splenomegaly and what complication?
• In dietary management of high triglycerides, which statement best describes OM3 and OM6?
• Which statement about triglycerides and cardiovascular risk is most accurate?
• For a boxer fracture, how should the wrist be positioned in splinting?
• What is the most common congenital heart defect in children?
• Which antibiotic has been shown to contribute to drug-resistant pneumococcal infections in smokers when used as first-line therapy?
• In a newly diagnosed Ulcerative Colitis patient, what is the current colonoscopy screening recommendation?
• What is considered frontline therapy for Thromboangiitis Obliterans?
• Which test can you order to see if rivaroxaban is working?
• Which therapy has been proven to reduce mortality in COPD patients?
• Which of the following is a contraindication to methotrexate usage in ectopic pregnancy?
• Which disease is diagnosed by exclusion, requiring exclusion of temporal arteritis to establish the diagnosis?
• In systemic lupus erythematosus, antiphospholipid antibodies increase the risk of which complication?
• HSV-1 commonly becomes latent in which structure?
• A 47-year-old man with diabetes and congestive heart failure presents with hyperpigmented skin and elevated AST. What is the most likely diagnosis?
• Which finding is most characteristic of Neurofibromatosis type 1 (NF1)?
• Which laboratory test is most specific for diagnosing SLE?
• Which is the most important risk factor for gastric cancer?
• Untreated chlamydia increases risk for all of the following EXCEPT:
• In knee dislocation, which noninvasive test is best for initial vascular screening?
• For rheumatoid arthritis, which test is most sensitive and often used as an initial screen?
• In a shoulder injury, which injury requires checking the deltoid sensation to assess axillary nerve function?
• Which statement best distinguishes restrictive from obstructive airway disease?
• Which test is BEST used to determine pneumothorax?
• What is the leading cause of blindness in adults?
• Which of the following is the best INITIAL test for Rheumatoid Arthritis?
• In COPD, which radiographic finding is commonly seen besides hyperinflation?
• A 49-year-old woman with abdominal pain, ascites, hepatomegaly, and elevated LFTs is scheduled for ultrasound. Which diagnosis is being evaluated with the ultrasound in this scenario?
• Which medication is contraindicated during pregnancy due to risk of premature ductus arteriosus closure?
• In mononucleosis with splenomegaly, how long should patients avoid contact sports?
• What is the most common site of osteosarcoma?
• Which test is used to evaluate tear production in suspected Sjogren's syndrome?
• The natural tendency of AFIB is to become chronic.
• Intraductal papilloma is benign but may harbor a precancerous finding. What is the recommended management to mitigate risk?
• If head imaging reveals a space-occupying lesion, what should be done before LP?
• Which statement about glyburide in gestational diabetes is true?
• If orbital cellulitis is suspected, what is the most appropriate next step?
• What is the definitive diagnostic test for inflammatory bowel disease in stable, non-acute patients?
• In postmenopausal bleeding, an endometrial thickness of less than 4 mm on transvaginal ultrasound most likely indicates what endometrial condition?
• Which condition increases risk for postpartum endometritis?
• Which autoantibody is commonly present in Sjogren's syndrome?
• In an adult with one week of lower back pain after lifting a heavy object, with no red flags, what is the most appropriate next step in management?
• Right ventricular failure due to chronic lung disease is called what?
• Which disorder has a high association with Hepatitis B and aneurysms?
• Which serologic marker indicates immunity to Hepatitis B (from vaccination or recovery)?
• Which test is commonly used as a screening test for syphilis?
• Which medication is the MOST important to give a patient with AFIB?
• A patient has a Cobb angle of 30 degrees. What is the appropriate management?
• The combination inhaler ipratropium bromide and albuterol (Combivent) is considered the best option for managing which condition?
• Which statement best summarizes boards’ preferred reperfusion approach for ACS when feasible?
• Hypocalcemia predisposes to QT interval prolongation and potential ventricular arrhythmias. Which electrolyte abnormality fits this description?
• In children, prior RSV infections increase the risk of developing which condition later?
• A patient with SLE who had a prior DVT asks which test is most important to order to evaluate for antiphospholipid syndrome.
• Which symptom is most characteristic of Sjogren's syndrome?
• What is the typical time range for an adenomatous colon polyp to progress to colorectal cancer?
• In suspected trichomoniasis, what is the initial diagnostic test?
• In celiac disease, which gluten-containing grain must be avoided?
• Which form of lung cancer presents with a pleural effusion?
• Which lab is most-specific for Rheumatoid Arthritis?
• In a postmenopausal patient with two months of intermittent vaginal spotting, what is the most appropriate next step?
• Which medication should a gout patient avoid due to potential uric acid elevation?
• In the treatment of diarrhea, what is considered the mainstay of treatment?
• In myocarditis, which infection is MOST LIKELY in the recent history?
• Which statement about rapid antigen detection tests for GABHS pharyngitis is true?
• In sinusitis, what is the most common history finding?
• What is the most common symptom reported in systemic lupus erythematosus (SLE)?
• Osteosarcoma has a known association with which other cancer, requiring consideration and screening for the concurrent condition?
• Which anthropometric measure is the most consistent predictor of diabetes, coronary disease, and mortality?
• What is the definitive treatment for slipped capital femoral epiphysis?
• Patients with Down syndrome are at higher risk for which of the following?
• Which autoantibody is associated with dermatomyositis?
• Which condition is a well-established risk factor for immunocompromise?
• What is the most appropriate initial imaging test to evaluate a patient with atrial fibrillation?
• Which fracture is classically seen in postmenopausal women after a fall on an outstretched hand?
• Which physical exam maneuver best distinguishes mitral valve prolapse from hypertrophic cardiomyopathy?
• Which is the earliest finding associated with pulmonary embolism?
• Which MI territory is usually associated with new-onset mitral regurgitation?
• In a patient with posterior epistaxis, what is the most common effective treatment?
• Which statement about fibromyalgia is TRUE?
• An osteoporotic postmenopausal woman is most likely to experience which type of pathologic fracture?
• Esophagitis due to CMV most commonly presents with which endoscopic finding?
• Which imaging modality is best for evaluating suspected acoustic neuromas?
• In a newborn with a positive Galeazzi sign, what is the most appropriate treatment?
• A 25-year-old male with sickle cell disease status post splenectomy. Which vaccine is most important to give?
• Bevacizumab is used to treat wet AMD because it decreases what?
• In a newly diagnosed myocarditis patient, which infection is MOST LIKELY in their recent history?
• A 10-year-old with scoliosis and axillary freckling is evaluated. What is the most appropriate management at this time?
• Which medication class is most effective at slowing progression of thoracic/abdominal aortic aneurysm?
• What percentage of lung cancer is attributable to cigarette smoking?
• In atrial fibrillation, dabigatran is primarily indicated for which type?
• In a patient with hypertension and coronary artery disease who has had recurrent TIAs, which test is most appropriate to evaluate for a patent foramen ovale?
• What is the most common presenting symptom of vulvar cancer?
• Intraductal papilloma management: what is the recommended treatment given DCIS risk?
• Which finding would most strongly indicate the need for head imaging before LP?
• Which is a known risk factor for premature menopause?
• Improving oxygenation in COPD reduces progression to pulmonary hypertension and cor pulmonale. Which intervention best achieves this?
• The prevalence of AFIB increases dramatically with?
• In a patient with recurrent yeast infections, which test is NOT indicated to assess immunocompromise?
• LP can be safely performed without prior imaging in which patient scenario?
• Caplan Syndrome implies RA with which condition?
• During an acute angina episode in the ER, after administration of nitroglycerin, the patient collapses. What is the most likely etiology of the syncope?
• Which analgesic is considered safe and commonly used during pregnancy?
• Which general statement about pregnancy and medications is true?
• A continuous 'machine-like' murmur on examination suggests patent ductus arteriosus; what is the first-line medical therapy to close PDA?
• Bevacizumab used in ocular disease exerts its therapeutic effect by inhibiting what?
• Which test is used to determine whether the newborn's red blood cells have been coated by maternal antibodies after birth?
• Which imaging modality is first-line for evaluating Budd-Chiari syndrome?
• In a patient with SLE, which test is most likely to be positive due to antiphospholipid antibodies?
• Infants of mothers with uncontrolled gestational diabetes are at higher risk for which neonatal condition?
• Which test is most important to confirm diagnosis of Polymyalgia Rheumatica?
• What test is considered gold standard for Zollinger-Ellison Syndrome?
• HSV-2 commonly becomes latent in which structure?
• Which is the most common cause of bacterial enteritis in the United States?
• In non-valvular atrial fibrillation, which anticoagulant is commonly used?
• In a young patient with parkinsonian features, which evaluation helps to rule out Wilson disease?
• Which is the main distinguishing factor between Ehler's Danlos and Marfan syndromes?
• A patient presents with Horner syndrome signs (ptosis, miosis, anhidrosis) and suspected brachial plexus injury. What is the most appropriate next step in care?
• What is the preferred method of hydration in diarrhea when oral intake is tolerated?
• Which pneumonia typically peaks in late summer and presents with high fever, toxic appearance, bradycardia, and diarrhea?
• In a newly diagnosed osteosarcoma patient, what must you order?
• Resection of an osteochondroma is recommended when located in which anatomical site?
• Methotrexate in RA management is classified as what type of drug?
• Which is the recommended daily folic acid intake for someone who has had a prior fetal loss due to neural tube defect?
• In suspected Boerhaave syndrome, which contrast esophagram is preferred for evaluation?
• A 52-year-old patient with diabetes and stage 4 renal failure presents with sudden shortness of breath; which initial diagnostic test is best to rule out pulmonary embolism?
• Which scenario best indicates CT before LP due to potential raised ICP?
• In fibrocystic breast disease, which medication should be avoided because it contains estrogen and can worsen symptoms?
• For recurrent Bartholin cysts, which management option is appropriate?
• In a patient with torsades de pointes and associated QT prolongation, what medication should be added in addition to magnesium sulfate?
• What is the single most important component in the management of COPD?
• Which of the following is a common cause of bowel obstruction in children?
• Which statement about PE testing is supported by the material?
• What is the most common MI symptom besides chest pain?
• In the management of RSV in hospitalized patients, which therapy is most important to administer first?
• In patients hospitalized for DVT started on unfractionated heparin, when should warfarin be started?
• What is the most sensitive predictor of coronary artery disease?
• Untreated group A streptococcal pharyngitis can lead to which major complication?
• Which statement about Zollinger-Ellison syndrome is NOT true?
• Which XRAY finding is common in Pseudogout?
• Which antibiotic class is ineffective against Mycoplasma pneumoniae due to lack of a cell wall?
• Which fracture is characteristically seen in children and involves lifting of the periosteum (a buckle injury)?
• Which medication may interact with dabigatran?
• Which is the most likely complaint from a patient with Polymyalgia Rheumatica?
• Which is the BEST option for someone with CHRONIC gout?
• In a child with refractory strabismus, what test should be obtained?
• Which is the MOST COMMON cause of secondary pulmonary hypertension?
• Drug of choice for pneumonia in patients with COPD is which antibiotic?
• The most common MI responsible for chordae rupture is MI of which coronary artery?
• What is the most common cause of fever in the postpartum period after 24 hours?
• Which lab is MOST appropriate to order in suspected fibromyalgia?
• Chronic hypoxemia in COPD leads to increased erythropoietin production. Which statement best describes this effect?
• Which GI disorder is most associated with macrocytic (megaloblastic) anemia due to vitamin B12 deficiency?
• In adults with suspected meningitis, which imaging study is commonly used first to rule out mass lesion before LP?
• In chronic sinusitis imaging, which condition must be ruled out because it can underlie persistent symptoms?
• Which organism is the primary cause of group A beta-hemolytic streptococcal pharyngitis?
• Which finding is the most specific for acute pericarditis?
• What is the most common clinical feature of lung cancer?
• In a patient with new onset murmur, which test should be ordered initially?
• In a patient with newly diagnosed atrial fibrillation, which test is most important to order to evaluate an underlying reversible cause?
• In advanced COPD, which findings are commonly observed?
• Which condition is most commonly associated with development of optic neuritis?
• What is the most common local symptom of lung cancer?
• In a patient diagnosed with Huntington disease, what important consideration should be discussed with the patient?
• Which is the frontline treatment for chronic osteomyelitis with a non-healing ulcer?
• In Zollinger-Ellison syndrome, diarrhea occurs in approximately what percentage of cases?
• In new-onset atrial fibrillation, the presence of a diastolic opening snap and an accentuated first heart sound most strongly suggests which valve lesion?
• Which diagnostic procedure should be avoided in an acute flare of ulcerative colitis due to risk of complications?
• In a newly diagnosed Celiac patient, which foods should be avoided?
• What is the approximate risk that a mother with gestational diabetes will develop type 2 diabetes later?
• In a patient with a history of an eating disorder, which cardiac abnormality are you most worried about?
• Combivent is most appropriate for management of which condition?
• Which test is the gold standard to confirm a diagnosis of syphilis?
• Which statement is true about small cell lung cancer?
• In a Weber C ankle fracture, which injury should you rule out?
• Which of the following are risk factors for acute cholecystitis in a female patient presenting to the ER?
• Which medication has FDA approval to help fibrocystic breast disease?
• Which of the following is an appropriate indication for preoperative pulmonary embolism prophylaxis?
• At what age should annual low-dose CT screening begin for high-risk adults with a 30+ pack-year history?
• In an Rh-negative mother, which test best determines whether there are maternal antibodies that could affect an Rh-positive fetus?
• What is considered the gold standard study in someone with knee dislocation to evaluate vascular injury?
• In treatment of deep venous thrombosis, when should warfarin be started relative to heparin?
• Which sign is Hamman’s sign associated with?
• Which statement about Zollinger-Ellison tumors is UNTRUE?
• Which statement about Trichomonas testing is correct?
• What is the recommended prophylaxis for anyone potentially exposed to Hepatitis A?
• Which laboratory test is used to monitor warfarin therapy?
• When evaluating a markedly elevated alkaline phosphatase, which enzyme helps distinguish hepatobiliary disease from bone pathology?
• Which neonatal condition is commonly associated with infants of mothers with uncontrolled gestational diabetes?
• In a postmenopausal patient with an ovarian cyst, which test helps assess risk of malignancy?
• In a patient with chronic vertigo, what is the best imaging test to order?
• Which is the current guideline for lung cancer screening in high-risk individuals?
• Which congenital heart defect is associated with elevated renin levels and systemic hypertension?
• Why is glyburide not considered the treatment of choice for gestational diabetes?
• A patient presents with fever and sudden left lower quadrant pain. The best initial diagnostic study is which?
• What is the #1 cause of infant death in the neonate period?
• In a child with recurrent otitis media, which test should be ordered?
• In a patient with cystic fibrosis, which vitamin supplementation is most important?
• HRT is contraindicated in which of the following patients?
• Which eyelid condition generally requires antibiotics due to infectious etiology?
• Which pneumonia is classically associated with late summer and presents with high fever and bradycardia?
• The typical chest X-ray finding in COPD is which of the following?
• Dabigatran (Pradaxa) is best used for which of the following patient scenarios?
• Which imaging test is described as the most reliable for diagnosing a pulmonary embolism?
• A newborn becomes blue and sweaty with feeding. Which congenital heart defect is most likely?
• A middle-aged smoker with two weeks of flu-like symptoms develops high fever, cough, diarrhea, and bradycardia. Which organism is most likely?
• Which of the following is a typical presenting feature of small cell lung cancer?
• In suspected Paget's disease, which laboratory test is most informative?
• Which infection requires treating a patient's sexual partners?
• Scoliosis with axillary freckling is a clue for which systemic condition?
• 65-year-old with chest pain and SOB; initial EKG and enzymes negative; next step?
• Hemothorax presents with which clinical finding on percussion?
• Which of the following has the biggest impact in limiting RA progression?
• A patient on omeprazole develops peripheral neuropathy. What is the most likely cause?
• What is the earliest indicator of compartment syndrome?
• Which management is most appropriate for Mallet finger?
• The most common type of pneumonia in a 60-year-old patient is which?
• Recurrent otitis media in children has been linked to which nutritional deficiency?
• Which autoantibody is commonly associated with both polymyositis and dermatomyositis?
• In a patient with metastatic colon cancer, which finding is most likely?
• Among elderly patients with MI, which symptom is most commonly reported?
• Which medication is contraindicated in a patient with CAD?
• In a woman s/p cesarean with a history of gestational diabetes, what is the recommended DM screening postpartum?
• Which statement about radiographs in early rheumatoid arthritis is true?
• A patient with copious purulent eye discharge who wears contact lenses should be treated with which therapy?
• Which medication is contraindicated in patients with a first-degree atrioventricular block?
• Horner syndrome can be a sign of a Pancoast tumor; which malignancy is commonly associated?
• In a patient with newly diagnosed myasthenia gravis, which diagnostic test should be obtained to evaluate for thymoma?
• A 16-year-old with otitis externa and diabetes mellitus should be treated with which regimen?
• A patient presents with progressive dysphagia to both solids & liquids. What is the GOLD STANDARD diagnostic test for this condition?
• In a neonate with bacterial conjunctivitis, the most appropriate treatment is?
• In atrial fibrillation with rapid ventricular response due to hyperthyroidism, which rate-controlling agent is most appropriate?
• A patient with a history of infectious mononucleosis due to EBV is at higher risk for which lymphoma?
• Which finding would most strongly prompt pre-LP imaging?
• Dysfunctional uterine bleeding is most commonly seen in which of the following groups?
• Which drug class is commonly cited as significantly increasing the levels of other medications by inhibiting drug metabolism?
• What single factor differentiates preseptal cellulitis from orbital cellulitis?
• According to Centor criteria for streptococcal pharyngitis, which score range suggests antibiotic therapy?
• In atrial fibrillation, what is the most important medication to reduce thromboembolic risk?
• Which of the following is the ONLY viable pregnancy among spontaneous abortion categories?
• Carcinoid syndrome commonly presents with which triad of symptoms?
• In a patient with sickle cell disease who develops acute osteomyelitis, which organism is most likely?
• Which factor may compromise the accuracy of the Urea breath test or fecal antigen test for H. pylori?
• Which test localizes a gastrinoma after biochemical confirmation?
• Patients on warfarin should have their INR checked every how many weeks?
• Maternal hyperglycemia in pregnancy and fetal surfactant: true statement?
• Which XRAY finding is most consistent with osteoarthritis?
• Routine surveillance for Hepatitis C includes regular AFP and ultrasound. Which option best represents this?
• Which factor provides protective benefit for both endometrial and ovarian cancer?
• Which serologic marker indicates acute Hepatitis B infection?
• In atrial fibrillation with heart failure, which agent is preferred for rate control?
• What is a common complication of hypertriglyceridemia?
• What is the best overall diagnostic test to confirm osteomyelitis?
• A patient presents with sudden onset of severe retrosternal chest pain and a crunching sound on auscultation. What test is considered gold standard for diagnosing this condition?
• In suspected osteomyelitis, which test is best to obtain first?
• Metronidazole with alcohol can cause a disulfiram-like reaction; which symptom is most commonly reported?
• What is the best initial imaging test when evaluating suspected endometriosis?
• Which antibiotic is considered frontline for COPD exacerbations with pseudomonal coverage?
• In Juvenile Idiopathic Arthritis, what is the most common complication?
• In non-smoking women, which type of lung cancer is commonly seen?
• This organism is commonly seen in smokers who get pneumonia.
• Which deficiencies may contribute to recurrent canker sores?
• Dysfunctional uterine bleeding is due to which hormonal pattern in young and perimenopausal women?
• Which two histologies are commonly classified as peripheral lung cancers?
• Drug of choice for pneumonia caused by Mycoplasma is which antibiotic?
• Which is considered the PRIMARY etiology among individuals with COPD?
• What is the recommended pre-LP step to ensure safety in suspected meningitis?
• A 65-year-old man with AFIB secondary to severe aortic stenosis; which anticoagulation regimen is most appropriate?
• Which is the most common site for bursitis to occur?
• Which type of pneumonia presents in a lobar pattern and is classically treated with Penicillin G?
• In atrial fibrillation with valvular disease, which anticoagulant is typically recommended?
• Primary Sclerosing Cholangitis is most strongly associated with which condition?
• What is the MCC of gastritis/PUD?
• SCFE occurs primarily in which age group?
• What is the most common paraneoplastic finding in lung cancer?
• In a patient with acute ulcerative colitis flare presenting with fever and LLQ pain, what is the BEST diagnostic test to order?
• Which of the following is a risk factor for endometriosis?
• In irritable bowel syndrome, the physical examination is typically characterized as which of the following?
• Osteosarcoma has a known association with retinoblastoma. Which of the following statements best reflects this relationship?
• Why is it so important to treat tension pneumothorax immediately?
• What is the leading theory for gestational hypertension?
• What is the gold standard test for diagnosing wet macular degeneration?
• Which agent is considered frontline therapy for COPD?
• Which organism is the etiologic agent for trichomoniasis?
• What is the most common mediastinal tumor?
• Which medication should be avoided in someone with a history of seizures due to lowering the seizure threshold?
• A young patient presents with trigeminal neuralgia. Which test should be ordered to evaluate for another possible condition, such as multiple sclerosis?
• In a patient with hyphema, what is the first step in management?
• In pregnancy, which imaging modality is avoided due to radiation exposure when evaluating a breast lesion?
• Which of the following is considered a risk factor for epiglottitis in adults?
• Which condition often accompanies a hemothorax?
• In a newly diagnosed RA patient, which finding would be most suggestive of Felty's Syndrome?
• ABG findings suggestive of pulmonary embolism include all of the following except which?
• Pneumonia-like symptoms in a chicken farmer; most likely etiology?
• The diagnosis of COPD is supported when there is a decrease in:
• Which lung cancer subtype is associated with SIADH?
• Which description best characterizes the murmur produced by spontaneous rupture of the chordae tendineae?
• In a patient with familial adenomatous polyposis, what is the most appropriate management?
• In pneumonia with poultry exposure, which organism is most likely?
• Chest tube insertion for pneumothorax is best performed at which location?
• Which dietary adjustment is recommended for hypertriglyceridemia?
• Which type of hepatitis has the highest risk for cirrhosis and hepatocellular carcinoma?
• Which antibiotic is contraindicated for urinary tract infections during pregnancy?
• What is the common initial serologic screen for suspected SLE?
• In which condition is antibiotic therapy not routinely used?
• In a patient with Graves disease and atrial fibrillation with rapid ventricular response, which agent is preferred for rate control?
• Which biomarker is elevated in myocardial injury and used in diagnosis?
• For a preadolescent with a scoliosis Cobb angle of 30 degrees, which management is recommended?
• Elevation of cardiac biomarkers comes from injury to:
• In a positive herpes mother, what is the current recommendation for delivery?
• For atrial fibrillation due to valvular heart disease, which anticoagulant is preferred?
• First initial intervention in treatment of tension pneumothorax?
• Which organism is a common cause of pneumonia specifically in smokers?
• Frontline therapy for Chlamydia pneumoniae (pneumonia) is which antibiotic?
• Which statement is true regarding anticoagulation in atrial fibrillation?
• Which antibiotic is considered frontline in COPD exacerbations with pseudomonal coverage?
• Which imaging study should be obtained prior to LP when there is concern for a mass lesion?
• What is the most common symptom associated with Hypertrophic Cardiomyopathy?
• Which malignancy has been associated with Sjogren's syndrome?
• In a patient with mononucleosis and splenomegaly, what is the recommended duration to avoid contact sports?
• Which lipid parameter has the greatest impact on morbidity and mortality?
• In HIV infection, which organism most commonly causes infectious esophagitis?
• In suspected hepatocellular carcinoma, why are biopsies generally avoided?
• Which test is most reliable for confirming eradication of H. pylori after therapy?
• Inferior MI due to RCA occlusion typically presents with which symptom besides chest pain?
• Spontaneous chordae tendineae rupture usually causes which murmur?
• Which statement most accurately describes LP timing in suspected meningitis?
• Which test is most important to order before initiating methotrexate therapy?
• Which medication should be avoided in a patient with sialolithiasis?
• Which medication has been shown to increase incidence of pyloric stenosis?
• Before performing a lumbar puncture to evaluate suspected meningitis, which test must be ordered to rule out a space-occupying brain lesion?
• Which vaccine is indicated for a patient with severe burns?
• Which finding is most suggestive of a pelvic fracture?
• Which medication class is most important for reducing mortality in coronary artery disease?
• In someone with refractory GERD, what is the most appropriate INITIAL diagnostic study?
• What percentage of MIs are unrecognized by clinicians?
• A patient presents with wheezing, severe diarrhea, and bright red facial flushing. Which initial test should be ordered?
• In carcinoid tumors, which urinary metabolite is elevated?
• Which lipid abnormality is most characteristic of metabolic syndrome?
• Which mechanism accounts for more than 90% of gout cases?
• What is the gold standard diagnostic test for gastrin-secreting tumors (gastrinomas)?
• Adeno-in-situ is another term for bronchoalveolar adenocarcinoma, a variant of which main lung cancer category?
• Which antibiotic class is generally effective against Mycoplasma pneumoniae due to the absence of a cell wall?
• In chronic sinusitis lasting more than eight weeks, what is the best imaging study to evaluate for complications or underlying disease?
• Which test is considered the gold standard for diagnosing H. pylori?
• In pneumonia treated in COPD patients, which antibiotic is preferred due to underlying lung disease?
• Which neurocutaneous syndrome is characterized by cafe-au-lait spots and multiple neurofibromas?
• When endometrial thickness is greater than 4 mm on ultrasound in a postmenopausal patient with bleeding, what is the next best step?
• Which symptom is most common in MI among elderly patients?
• Which imaging modality is preferred to evaluate suspected valvular disease such as aortic stenosis?
• Inferior wall myocardial infarction is typically due to occlusion of which coronary artery?
• Horseshoe kidney is associated with which syndrome?
• In the management of ascites, which diuretic should always be added?
• What is the test of choice to diagnose lactose intolerance?
• Before LP, which pre-procedure test is most essential to perform to identify bacteremia?
• Which enzymes are typically elevated in polymyositis and dermatomyositis?
• Pepto-Bismol use in children after a viral illness increases risk of which syndrome?
• What is the first sign of elevated conjugated (direct) bilirubin?
• Which cancer most commonly presents with painless jaundice?
• A patient presents with white lacy leukoplakia in the oral cavity. What condition must be ruled out?
• Which finding is most suggestive of raised intracranial pressure and warrants pre-LP imaging?
• Which is the BEST predictor of cardiovascular mortality?
• In evaluating GERD, which test is considered the GOLD STANDARD?
• Which physical examination finding is most specific for deep vein thrombosis?
• A newborn presents with a lower bowel obstruction. The most likely cause is which condition?
• Klinefelter syndrome is associated with which condition?
• Which parameter is the best indicator of COPD severity?
• Which is the most COMMON gynecologic cancer?
• Cor pulmonale is best described as failure of which heart chamber due to chronic respiratory disease?
• Which lung cancer subtype has the highest risk of metastasis?
• To help rule out drug-induced lupus, which antibody is most appropriate to test for?
• Which congenital cardiac anomaly is Turner syndrome commonly associated with?
• Which marker indicates a person with Hepatitis B is infectious?
• In a young patient with abnormal PFTs and no history of smoking, which test is most appropriate to order?