PANCE — Practice Questions, Part 2 flashcards
6 of 75 questions free to study here · 8 topics · the whole deck is built into Willys
Multiple-choice practice questions, one best answer each, on skin, EENT, scrotal, musculoskeletal, neurologic and psychiatric disease, pregnancy, gynecology and pediatrics.
Practice deck · part of PANCE (Physician Assistant boards) · written against: NCCPA PANCE content blueprint, effective January 2025 (organ systems); no dosing. Updated 2026-10-10.
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A 20-year-old man notices pale, finely scaling macules across his upper back and chest that stood out after a beach vacation. A KOH preparation of the scale shows short hyphae mixed with round yeast forms. What is the most likely diagnosis?
A) Pityriasis rosea
B) Pityriasis alba
C) Vitiligo
D) Tinea versicolorD) Tinea versicolorDermatologic › Inflammatory and Infectious Skin Disease
Malassezia yeast and short hyphae (the spaghetti-and-meatballs pattern) cause the scaly, hypopigmented patches of tinea versicolor. Vitiligo is complete depigmentation without scale, and its KOH prep is negative. -
A 66-year-old woman develops a severe headache, a painful red right eye, halos around lights and vomiting shortly after leaving a dark movie theater. The right pupil is mid-dilated and fixed, and the cornea is hazy. What is the most likely diagnosis?
A) Acute angle-closure glaucoma
B) Acute anterior uveitis
C) Bacterial keratitis
D) Migraine with a prolonged visual auraA) Acute angle-closure glaucomaEENT › Eye
Pupil dilation in the dark can close a narrow angle, sharply raising intraocular pressure and causing a fixed mid-dilated pupil, corneal haze and halos. It is an emergency, and dilating drops must be avoided. -
A 23-year-old fell on an outstretched hand while skateboarding. He has tenderness in the anatomic snuffbox, but wrist X-rays including scaphoid views are normal. What is the best next step?
A) Open reduction and internal fixation
B) Elastic wrap and return to full activity as tolerated
C) Thumb spica splint and repeat X-rays in 1–2 weeks
D) Volar wrist splint for comfort onlyC) Thumb spica splint and repeat X-rays in 1–2 weeksMusculoskeletal › Upper Extremity and Spine
Snuffbox tenderness means an occult scaphoid fracture until proven otherwise, so the wrist is immobilized in a thumb spica and reimaged (or MRI is done). Missing it risks nonunion and avascular necrosis of the proximal pole. -
A 67-year-old man has sudden weakness of the right face and arm and difficulty speaking that began 40 minutes ago. What is the best next step?
A) Carotid duplex ultrasound
B) Noncontrast CT of the head
C) Lumbar puncture
D) Immediate IV thrombolytic therapyB) Noncontrast CT of the headNeurologic › Cerebrovascular Disease
A noncontrast head CT must first exclude hemorrhage before any thrombolytic is given. Early ischemic strokes often look normal on CT, which is expected and does not delay treatment. -
At 17 weeks, a 38-year-old's second-trimester quad screen shows low AFP, low estriol, high hCG and high inhibin A. What is the most appropriate next step?
A) Repeat the quad screen in four weeks
B) Offer amniocentesis for fetal karyotype
C) Order an oral glucose tolerance test
D) Reassure her that the screen result is normalB) Offer amniocentesis for fetal karyotypeReproductive › Prenatal Care
This pattern suggests trisomy 21, and because a screen is never diagnostic on its own, diagnostic testing such as amniocentesis is offered. Repeating the screen would not give a diagnosis. -
A 5-week-old firstborn boy has projectile, nonbilious vomiting after every feed and seems hungry again right afterward. Which laboratory pattern is expected?
A) Respiratory alkalosis with hypercalcemia
B) Hyperchloremic, hyperkalemic metabolic acidosis
C) Hypochloremic, hypokalemic metabolic alkalosis
D) Anion gap metabolic acidosisC) Hypochloremic, hypokalemic metabolic alkalosisPediatrics › Congenital and Neonatal Conditions
Repeated vomiting of gastric acid in pyloric stenosis causes a hypochloremic, hypokalemic metabolic alkalosis. Abdominal ultrasound confirms the thickened pylorus.
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About these cards
Review status: Second-reader reviewed, with corrections applied.
Checked against:
- NCCPA PANCE content blueprint, effective January 2025 (topic outline only; no text copied)
- Checked against standard internal-medicine references (reference only; no text copied)
- Checked against the 2016 American Epilepsy Society convulsive status epilepticus guideline, the 2020 ASAM alcohol withdrawal guideline, the 2023 ACP osteoporosis guideline, the 2014 AAP bronchiolitis guideline, the CDC 2021 STI Treatment Guidelines, the 2026 AHA/ASA acute ischemic stroke guideline and the ACOG April 2026 Clinical Practice Update on postmenopausal bleeding (reference only; no text copied)
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