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PANCE Analysis Flashcards

7 cards from real PANCE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 PANCE Analysis flashcards as text

  1. A 58-year-old man presents with crushing chest pain radiating to the left arm. ECG shows ST elevations in leads II, III, and aVF. Which coronary artery is most likely occluded?

    Answer: Right coronary artery

    ST elevations in leads II, III, and aVF indicate an inferior MI, which is most commonly caused by occlusion of the right coronary artery.

  2. A patient with type 2 diabetes and CKD stage 3 requires glucose-lowering therapy. Which agent is contraindicated due to risk of lactic acidosis?

    Answer: Metformin

    Metformin is contraindicated when eGFR is below 30 mL/min due to risk of lactic acidosis from impaired renal clearance.

  3. A 35-year-old woman presents with episodic hypertension, headache, diaphoresis, and palpitations. Plasma free metanephrines are markedly elevated. What is the most appropriate next step?

    Answer: CT scan of the abdomen and pelvis

    Once biochemical confirmation of pheochromocytoma is established, CT of the abdomen and pelvis is performed to localize the tumor before surgical resection.

  4. A 22-year-old college student presents with fever, severe headache, photophobia, and a non-blanching petechial rash. What is the most immediate treatment?

    Answer: Administer IV ceftriaxone immediately without delay

    In suspected bacterial meningitis with a petechial rash (suggesting meningococcemia), IV antibiotics must be given immediately without waiting for lumbar puncture to prevent death.

  5. A 70-year-old man on warfarin for atrial fibrillation presents with an INR of 8.5 and active GI bleeding. What is the most appropriate reversal strategy?

    Answer: 4-factor prothrombin complex concentrate plus vitamin K IV

    For life-threatening bleeding on warfarin, 4-factor PCC provides rapid reversal combined with IV vitamin K for sustained effect.

  6. A 28-year-old woman at 32 weeks gestation develops blood pressure of 156/104 mmHg, 3+ proteinuria, and a severe headache. Which medication is the first-line treatment for seizure prophylaxis?

    Answer: Magnesium sulfate

    Magnesium sulfate is the drug of choice for prevention and treatment of eclamptic seizures in women with severe preeclampsia.

  7. A 45-year-old man with HIV (CD4 count 80 cells/µL) presents with dyspnea, dry cough, and bilateral interstitial infiltrates on CXR. LDH is elevated. What is the most likely diagnosis?

    Answer: Pneumocystis jirovecii pneumonia

    PCP is the most common opportunistic pulmonary infection in HIV patients with CD4 <200, presenting with bilateral interstitial infiltrates and elevated LDH.