PANCE Cheat Sheet 2026

The 30 highest-yield PANCE facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which of the following is the recommended screening interval for colonoscopy in an average-risk patient with no findings on initial screening at age 50? → 10 years
2. A 55-year-old woman is found to have a diastolic murmur at the left sternal border that increases with inspiration. What is the most likely diagnosis? → Pulmonary regurgitation
3. In PANCE practice, what is the best approach to quality improvement in gastrointestinal? → Use data-driven methods with measurable outcomes
4. Which physical exam finding is pathognomonic for constrictive pericarditis? → Kussmaul sign
5. A patient with a humeral shaft fracture develops wrist drop and inability to extend the fingers. Which nerve is most likely injured? → Radial nerve
6. A 34-year-old woman presents with a 2-week history of fatigue, weight gain, cold intolerance, and constipation. Which lab finding would you expect? → High TSH, low free T4
7. A 40-year-old woman presents with right upper quadrant pain after fatty meals, fever of 38.8°C, and jaundice. What is the most likely diagnosis? → Ascending cholangitis
8. A 68-year-old male presents with inability to urinate and a distended, palpable bladder. What is the most common cause in this population? → Benign prostatic hyperplasia
9. Which documentation is essential when working with endocrine system in PANCE? → Detailed technical specifications and as-built diagrams
10. A patient with CKD has normocytic anemia and a reticulocyte count of 0.5%. What is the most likely pathophysiologic cause? → Decreased erythropoietin production
11. A 38-year-old woman at 20 weeks gestation undergoes amniocentesis. Which complication should be discussed as the most significant risk? → Pregnancy loss (~0.1-0.3%)
12. Which approach is recommended for troubleshooting cardiovascular system issues? → Use systematic isolation and testing methods
13. Which electrolyte abnormality is most characteristic of primary hyperaldosteronism (Conn syndrome)? → Hypokalemia and hypertension
14. A patient with a seizure disorder is started on valproic acid. Which laboratory value must be monitored due to a serious adverse effect? → Liver function tests
15. Graves disease is caused by which mechanism? → Stimulating antibodies against the TSH receptor
16. A 25-year-old male presents after a fall on an outstretched hand with anatomical snuffbox tenderness. X-ray is negative. What is the next best step? → MRI or CT scan of the wrist
17. A 22-year-old college student presents with fever, severe headache, photophobia, and a non-blanching petechial rash. What is the most immediate treatment? → Administer IV ceftriaxone immediately without delay
18. Which documentation is essential when working with cardiovascular system in PANCE? → Detailed technical specifications and as-built diagrams
19. A 45-year-old with silicosis develops a new cavitary upper lobe lesion. Which organism is most likely responsible? → Mycobacterium tuberculosis
20. Which medication class is first-line for reducing proteinuria and slowing CKD progression in a patient with diabetic nephropathy? → ACE inhibitors
21. A patient on mechanical ventilation has high peak airway pressures but normal plateau pressures. Which condition best explains this finding? → Kinked endotracheal tube
22. A 40-year-old diver presents with right ear pain and conductive hearing loss after a dive to 30 meters. Otoscopy shows a hemotympanum. What is the diagnosis? → Barotrauma (ear squeeze)
23. A 52-year-old man has a serum calcium of 11.8 mg/dL, PTH of 95 pg/mL, and is asymptomatic. What is the most likely diagnosis? → Primary hyperparathyroidism
24. A 60-year-old woman with atrial fibrillation has a CHA₂DS₂-VASc score of 4. She has no contraindications. Which anticoagulation is preferred? → Direct oral anticoagulant (DOAC)
25. A newborn has ambiguous genitalia, hyponatremia, hyperkalemia, and low cortisol. 17-hydroxyprogesterone is markedly elevated. What is the most likely diagnosis? → Congenital adrenal hyperplasia due to 21-hydroxylase deficiency
26. A 50-year-old man with dilated cardiomyopathy and EF of 25% is on optimal medical therapy. Which device therapy reduces mortality most significantly? → Implantable cardioverter-defibrillator (ICD)
27. A 45-year-old man has prolonged QT on EKG (QTc 510 ms) and is prescribed an antibiotic. Which is SAFEST to use? → Amoxicillin
28. Which professional attribute is most valued in eent within the PANCE field? → Accountability and commitment to standards
29. In PANCE certification, what does redundancy in system design primarily provide? → Fault tolerance and high availability
30. Which lab pattern is most consistent with prerenal azotemia? → BUN:Cr ratio >20:1 with urine sodium <20 mEq/L