The Audio PANCE and PANRE Board Review Podcast Episode 11

The Audio PANCE and PANRE is an audio board review series that includes 10 Multiple Choice PANCE and PANRE Board Review Questions in each episode. I hope you enjoy this free audio component to the examination portion of this site. The full series is available to all members of the PANCE and PANRE Academy. You can download and listen to past FREE episodes here, on iTunes or Stitcher. (sometimes it takes a few hours to show up on iTunes after publication) You can listen to the latest episode, download the transcript and take an interactive quiz of the questions below. Download a Free PDF Transcript of the Questions and AnswersFREE  PDF Transcript or view on Scribd Listen Carefully Then Take The Quiz Questions 1-10 The Audio PANCE and PANRE Episode 11 1. What is the initial treatment of choice for hyperthyroidism in a 10-week pregnant patient? A. No treatment is necessary. B. Propylthiouracil (PTU) C. Radioiodine treatment D. Subtotal thyroidectomy Click here to see the answerB. Propylthiouracil (PTU) – This is the initial treatment of choice. 2. A patient presents with eye pain and blurred vision. Snellen testing reveals vision of 20/200 in the affected eye and 20/20 in the unaffected eye. Fluorescein staining reveals the presence of a dendritic ulcer. Which of the following is the most likely diagnosis? A. Viral keratitis B. Fungal corneal ulcer C. Acanthamoeba keratitis D. Bacterial corneal ulcer Click here to see the answerA. Viral keratitis – Herpes Simplex virus is a common cause of dendritic ulceration noted on fluorescein staining. And in case you were wondering: B. Fungal corneal ulcers have an indolent course with intraocular infection being common but fluorescein staining is negative for a dendritic pattern. C. Acanthamoeba keratitis has a waxing and waning course over several months and has no fluorescein staining in a dendritic pattern. D. Bacterial corneal ulcers can progress aggressively resulting in corneal perforation. Fluorescein staining does not occur in a dendritic pattern. 3. A 63 year-old female with history of diabetes mellitus presents for blood pressure follow-up. At her last two visits her blood pressure was 150/92 and 152/96. Today in the office her blood pressure is 146/92. Recent blood work shows a Sodium 140 mEq/L, Potassium 4.2 mEq/L, BUN of 23 mg/dL, and Creatinine of 1.1 mg/dL. Which of the following is the most appropriate initial medication in this patient? A. Terazosin (Hytrin) B. Atenolol (Tenormin) C. Lisinopril (Zestril) D. Hydrochlorothiazide (HCTZ) Click here to see the answerC. Lisinopril (Zestril) – For the boards ACE inhibitors should be part of the initial treatment of hypertension in diabetics because of beneficial effects in diabetic nephropathy and is the most appropriate initial medication. In real practice, despite what we have been led to believe, it actually makes little difference which antihypertensive is used in diabetic patients just as long as we reach our blood pressure goals. 4. What is the EKG manifestation of cardiac end-organ damage due to hypertension? A. Right bundle branch block B. Left ventricular hypertrophy C. Right ventricular hypertrophy D. ST segment elevation in lateral precordial leads Click here to see the answerB. Left ventricular hypertrophy – Long-standing hypertension can lead to left ventricular hypertrophy with characteristic changes noted on EKG. 5. Annual blood pressure determinations should be obtained beginning at the age of A. 3 years. B. 5 years. C. 12 years. D. 18 years. Click here to see the answerA. 3 years – Periodic measurements of blood pressure should be part of routine preventive health assessments beginning at the age of 3 years. 6. In adults and intravenous drug abusers, which of the following bones is most commonly affected with acute osteomyelitis? A. Femur B. Humerus C. Vertebral spine D. Tibia Click here to see the answerC.