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PANCE Board Practice Exam

Browse all practice questions for the PANCE Board Practice Exam. Search by topic, open any question and review its full explanation, then test yourself in the practice quiz.

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