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PANCE Flashcards: Blueprint-Aligned Diagnoses, Tests & Next Steps

Study diagnoses, tests, next steps and management with a source-linked PANCE deck organized by the January 2025 NCCPA blueprint.

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Про цю колоду

Reviewed for 2026, this 600-card English deck follows the January 2025 NCCPA PANCE blueprint. Its two public tag axes let you switch between medical-content systems and exam-task retrievals: discriminating history and examination cues, diagnosis, diagnostic-study choice, prevention, next-step intervention, pharmacotherapy, and selected foundations. Every answer links to a current first-party clinical guideline or authoritative public-health or professional body and records the 2026-08-26 review date. Official PANCE eligibility and certification requirements remain with NCCPA. No recalled or leaked exam questions, exam items, mark schemes, curriculum prose, commercial deck wording, logos, figures, or trade dress were copied. Educational review only. This deck isn't medical advice and isn't a substitute for current clinical guidance, supervision, local protocols, or patient-specific judgment. This independently written resource is unofficial and is not affiliated with or endorsed by NCCPA.

Картки в цій колоді

  2. Картка 2

    Питання

    When an adult patient with decision-making capacity refuses a recommended treatment, what is the clinician’s next step?

    Відповідь

    Confirm that the choice is informed and voluntary, explain material risks and alternatives, document the discussion, and respect the refusal.

    Informed Consent · reviewed 2026-08-26

  3. Картка 3

    Питання

    In a child or adolescent, what core mechanism explains asthma?

    Відповідь

    Airway inflammation and hyperresponsiveness create variable, usually reversible airflow obstruction.

    2026 GINA Strategy Report · reviewed 2026-08-26

  8. Картка 8

    Питання

    What core mechanism explains ectopic pregnancy?

    Відповідь

    Implantation outside the endometrial cavity, usually in the tube, can erode vessels and rupture.

    Ectopic Pregnancy · reviewed 2026-08-26

  10. Картка 10

    Питання

    What core mechanism explains type 2 diabetes mellitus?

    Відповідь

    Insulin resistance plus progressive beta-cell dysfunction produces chronic hyperglycemia.

    Standards of Care in Diabetes—2026 · reviewed 2026-08-26

  11. Картка 11

    Питання

    What core mechanism explains acute angle-closure glaucoma?

    Відповідь

    Closure of the anterior-chamber angle blocks aqueous outflow and abruptly raises intraocular pressure.

    Management of Angle-Closure Glaucoma · reviewed 2026-08-26

  13. Картка 13

    Питання

    What core mechanism explains chronic kidney disease?

    Відповідь

    Progressive nephron loss causes hyperfiltration in remaining nephrons, fibrosis, and multisystem toxin accumulation.

    2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26

  16. Картка 16

    Питання

    In a child or adolescent, what core mechanism explains atopic dermatitis?

    Відповідь

    Skin-barrier dysfunction and type 2 inflammation increase transepidermal water loss and itch.

    Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26

  17. Картка 17

    Питання

    What clinical clue should raise suspicion for acute pancreatitis?

    Відповідь

    Severe persistent epigastric pain radiating to the back with nausea and vomiting is typical.

    ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26

  18. Картка 18

    Питання

    What core mechanism explains uncomplicated cystitis?

    Відповідь

    Ascending periurethral bacteria inflame the bladder mucosa without renal-parenchymal involvement.

    EAU Guidelines on Urological Infections · reviewed 2026-08-26

  19. Картка 19

    Питання

    Which diagnosis causes symmetric synovitis of the MCP, PIP, or wrist joints with prolonged morning stiffness?

    Відповідь

    Rheumatoid arthritis. Symmetric inflammatory pain and prolonged morning stiffness in MCP, PIP, or wrist joints with synovitis suggest rheumatoid arthritis.

    Rheumatoid Arthritis · reviewed 2026-08-26

  20. Картка 20

    Питання

    What abilities are assessed when determining decision-making capacity for a specific choice?

    Відповідь

    The patient must communicate a choice, understand relevant information, appreciate how it applies personally, and reason about the options.

    Informed Consent · reviewed 2026-08-26

  21. Картка 21

    Питання

    Which diagnosis causes fluctuating, fatigable ptosis, diplopia, dysarthria, dysphagia, or proximal weakness that worsens with use?

    Відповідь

    Myasthenia gravis. Fluctuating fatigable ptosis, diplopia, dysarthria, dysphagia, or proximal weakness that worsens with use suggests myasthenia.

    International Consensus Guidance for Management of Myasthenia Gravis: 2020 Update · reviewed 2026-08-26

  22. Картка 22

    Питання

    Which diagnosis best fits new clinically significant diarrhea after antibiotics or healthcare exposure, especially with abdominal pain or leukocytosis?

    Відповідь

    Clostridioides difficile infection. New clinically significant diarrhea after antibiotics or healthcare exposure, with abdominal pain or leukocytosis, suggests C. difficile.

    2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults · reviewed 2026-08-26

  23. Картка 23

    Питання

    For surgical decision-making, after delivery of the head, retraction against the perineum and failure of the shoulders to deliver indicate which obstetric emergency?

    Відповідь

    Shoulder dystocia. After delivery of the head, retraction against the perineum and failure of the shoulders to deliver indicates dystocia.

    Shoulder Dystocia · reviewed 2026-08-26

  24. Картка 24

    Питання

    In a child or adolescent, which diagnosis causes persistent developmentally inappropriate inattention and/or hyperactivity-impulsivity in more than one setting with impairment?

    Відповідь

    Attention-deficit/hyperactivity disorder. Persistent developmentally inappropriate inattention and/or hyperactivity-impulsivity in more than one setting with impairment suggests ADHD.

    ADHD in Children and Youth: Part 1—Etiology, Diagnosis, and Comorbidity · reviewed 2026-08-26

  25. Картка 25

    Питання

    Which diagnosis best fits sharp pleuritic chest pain that improves when sitting forward, a friction rub, and diffuse ST elevation?

    Відповідь

    Acute pericarditis. Sharp pleuritic chest pain that improves when sitting forward, a friction rub, and diffuse ST elevation support pericarditis.

    2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26

  27. Картка 27

    Питання

    For surgical decision-making, identify the condition from this pattern: Proximal weakness, easy bruising, facial plethora, wide violaceous striae, osteoporosis, or difficult diabetes and hypertension are discriminating clues.

    Відповідь

    Cushing syndrome. Proximal weakness, easy bruising, facial plethora, wide violaceous striae, osteoporosis, or difficult diabetes and hypertension are discriminating clues.

    Diagnosis of Cushing Syndrome: An Endocrine Society Clinical Practice Guideline · reviewed 2026-08-26

  28. Картка 28

    Питання

    For surgical decision-making, identify the condition from this pattern: Severe unilateral sore throat, muffled voice, drooling, trismus, and uvular deviation suggest a peritonsillar collection.

    Відповідь

    Peritonsillar abscess. Severe unilateral sore throat, muffled voice, drooling, trismus, and uvular deviation suggest a peritonsillar collection.

    Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26

  30. Картка 30

    Питання

    Which diagnosis may be silent until edema, pruritus, anemia, hypertension, or abnormal urine testing appears?

    Відповідь

    Chronic kidney disease. CKD may be silent; edema, pruritus, anemia, hypertension, or abnormal urine testing often appears later.

    2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26

  34. Картка 34

    Питання

    Which diagnosis best fits chronic diarrhea, abdominal pain, weight loss, perianal disease, and skip lesions?

    Відповідь

    Crohn disease. Chronic diarrhea, abdominal pain, weight loss, perianal disease, and skip lesions support Crohn disease.

    Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26

  35. Картка 35

    Питання

    What clinical clue should raise suspicion for pulmonary tuberculosis?

    Відповідь

    Chronic cough, fever, night sweats, weight loss, hemoptysis, or epidemiologic exposure raises concern.

    Clinical Overview of Tuberculosis Disease · reviewed 2026-08-26

  36. Картка 36

    Питання

    Which diagnosis causes well-demarcated erythematous plaques with silvery scale on extensor surfaces and nail pitting?

    Відповідь

    Plaque psoriasis. Well-demarcated erythematous plaques with silvery scale on extensor surfaces and nail pitting support psoriasis.

    Psoriasis Clinical Guidelines · reviewed 2026-08-26

  37. Картка 37

    Питання

    What clinical clue should raise suspicion for endometriosis?

    Відповідь

    Cyclic pelvic pain, dysmenorrhea, deep dyspareunia, painful defecation, or infertility suggests endometriosis.

    Endometriosis · reviewed 2026-08-26

  38. Картка 38

    Питання

    Identify the condition from this pattern: Fever, flank pain, costovertebral-angle tenderness, nausea, and urinary symptoms suggest renal infection.

    Відповідь

    Acute pyelonephritis. Fever, flank pain, costovertebral-angle tenderness, nausea, and urinary symptoms suggest renal infection.

    EAU Guidelines on Urological Infections · reviewed 2026-08-26

  39. Картка 39

    Питання

    What clinical clue should raise suspicion for panic disorder?

    Відповідь

    Recurrent unexpected panic attacks plus persistent worry or maladaptive avoidance for at least a month suggests panic disorder.

    Panic Disorder: What You Need to Know · reviewed 2026-08-26

  41. Картка 41

    Питання

    What clinical clue should raise suspicion for tension pneumothorax?

    Відповідь

    Severe dyspnea, unilateral absent breath sounds, hypotension, distended neck veins, and obstructive shock suggest tension physiology.

    Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26

  42. Картка 42

    Питання

    In a child or adolescent, which next action matters most in diabetic ketoacidosis?

    Відповідь

    Begin isotonic fluids, replace potassium according to the measured level, and start IV insulin once potassium is safe.

    Standards of Care in Diabetes—2026 · reviewed 2026-08-26

  43. Картка 43

    Питання

    Who makes decisions when an adult patient lacks capacity and has no applicable advance directive?

    Відповідь

    Use the legally authorized surrogate and guide decisions by the patient’s known wishes or, if unknown, best interests.

    Decisions for Adult Patients Who Lack Capacity · reviewed 2026-08-26

  44. Картка 44

    Питання

    For surgical decision-making, which next action matters most in retinal detachment?

    Відповідь

    Send the patient to an eye doctor or emergency department immediately for retinal evaluation and treatment. Early treatment helps prevent permanent vision loss.

    Retinal Detachment · reviewed 2026-08-26

  45. Картка 45

    Питання

    What clinical clue should raise suspicion for acute deep-vein thrombosis?

    Відповідь

    Unilateral leg swelling, pain, warmth, and risk from immobility, surgery, cancer, estrogen, or prior VTE raise suspicion.

    ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26

  46. Картка 46

    Питання

    Which next action matters most in Crohn disease?

    Відповідь

    Drain abscesses and involve surgery for obstruction, fistula complications, perforation, or refractory disease.

    Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26

  48. Картка 48

    Питання

    What antimicrobial approach is appropriate for suspected or confirmed pleural infection?

    Відповідь

    Start empiric antibiotics before culture results, covering likely organisms including anaerobes, then narrow therapy to microbiology and clinical context.

    British Thoracic Society Guideline for Pleural Disease · reviewed 2026-08-26

  51. Картка 51

    Питання

    Which next action matters most in multiple sclerosis relapse?

    Відповідь

    Exclude infection or pseudo-relapse, then treat functionally significant relapse and reassess disease-modifying therapy.

    Multiple Sclerosis in Adults: Management · reviewed 2026-08-26

  52. Картка 52

    Питання

    Which next action matters most in HIV infection?

    Відповідь

    Link a newly diagnosed patient rapidly to HIV care and begin antiretroviral therapy as soon as feasible.

    Initiation of Antiretroviral Therapy · reviewed 2026-08-26

  53. Картка 53

    Питання

    For surgical decision-making, which next action matters most in postpartum hemorrhage?

    Відповідь

    Call the hemorrhage team, massage an atonic uterus, give uterotonics, replace blood products, and control the cause procedurally if needed.

    Postpartum Hemorrhage · reviewed 2026-08-26

  54. Картка 54

    Питання

    Which next action matters most in delirium?

    Відповідь

    Treat the cause, protect the patient, and use nonpharmacologic measures first.

    Delirium: Prevention, Diagnosis and Management · reviewed 2026-08-26

  55. Картка 55

    Питання

    After successful endoscopic hemostasis of a high-risk bleeding peptic ulcer, what medication strategy is recommended?

    Відповідь

    Give high-dose proton-pump inhibitor therapy continuously or intermittently for 3 days.

    ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26

  58. Картка 58

    Питання

    What clinical clue should raise suspicion for acute bacterial rhinosinusitis?

    Відповідь

    Persistent symptoms beyond 10 days, severe fever with purulent drainage, or worsening after initial improvement are patterns that support bacterial disease.

    Clinical Practice Guideline: Adult Sinusitis Update · reviewed 2026-08-26

  59. Картка 59

    Питання

    How should a clinician respond when a patient asks not to hear serious diagnostic information?

    Відповідь

    Explore the request and preferences, confirm it is voluntary, and identify whether the patient wants information shared with a chosen surrogate.

    Withholding Information from Patients · reviewed 2026-08-26

  61. Картка 61

    Питання

    In a child or adolescent, which next action matters most in atopic dermatitis?

    Відповідь

    Treat active inflammation and address infection, sleep disruption, and trigger exposure.

    Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26

  65. Картка 65

    Питання

    In a child or adolescent, which initial medication regimen is indicated for a convulsive seizure lasting at least five minutes or recurring without recovery?

    Відповідь

    A benzodiazepine is first-line for convulsive status epilepticus, followed by an appropriate longer-acting antiseizure medicine.

    Treatment of Prolonged Seizures in Children and Adults · reviewed 2026-08-26

  67. Картка 67

    Питання

    What drug class or regimen fits sepsis?

    Відповідь

    Use broad therapy matched to source, host, and local resistance, then de-escalate from cultures and response.

    2026 Surviving Sepsis Campaign Adult Guidelines · reviewed 2026-08-26

  70. Картка 70

    Питання

    Which prevention or risk-reduction step is important for acute pancreatitis?

    Відповідь

    Treat gallstones, avoid alcohol excess, and control severe hypertriglyceridemia to reduce recurrence.

    ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26

  71. Картка 71

    Питання

    What drug class or regimen fits schizophrenia?

    Відповідь

    Use an antipsychotic through shared decision-making; clozapine is indicated for treatment resistance or persistent suicide risk under monitoring.

    Management of First-Episode Psychosis and Schizophrenia · reviewed 2026-08-26

  73. Картка 73

    Питання

    What is the key first diagnostic step for primary hypothyroidism?

    Відповідь

    Measure TSH first in most patients and free T4 to characterize overt disease.

    Guidelines for the Treatment of Hypothyroidism · reviewed 2026-08-26

  74. Картка 74

    Питання

    In an acutely ill hospitalized medical patient, what VTE prevention strategy is appropriate?

    Відповідь

    Assess VTE and bleeding risk, then use pharmacologic prophylaxis when indicated or mechanical prophylaxis when anticoagulation is unsuitable.

    ASH VTE Guidelines: Prophylaxis for Medical Patients · reviewed 2026-08-26

  76. Картка 76

    Питання

    What makes informed consent more than a signed form?

    Відповідь

    It is a communication process covering the nature, expected benefits, material risks, alternatives, and the option to decline, followed by a voluntary decision.

    Informed Consent · reviewed 2026-08-26

  77. Картка 77

    Питання

    What condition should be suspected from this finding: Severely elevated pressure with acute neurologic, cardiac, renal, retinal, or aortic injury defines an emergency.

    Відповідь

    Hypertensive emergency. Severely elevated pressure with acute neurologic, cardiac, renal, retinal, or aortic injury defines an emergency.

    2025 High Blood Pressure Guideline · reviewed 2026-08-26

  79. Картка 79

    Питання

    What is the key first diagnostic step for upper gastrointestinal bleeding?

    Відповідь

    Check hemodynamics, CBC, metabolic and coagulation studies, type and screen, then perform timely upper endoscopy after stabilization.

    ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26

  80. Картка 80

    Питання

    Which prevention or risk-reduction step is important for early syphilis?

    Відповідь

    Condom use, partner services, repeat testing for ongoing risk, and prenatal screening reduce transmission and congenital disease.

    Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26

  81. Картка 81

    Питання

    In a child or adolescent, what is the key first diagnostic step for septic arthritis?

    Відповідь

    Perform urgent arthrocentesis for cell count, crystals, Gram stain, and culture; obtain blood cultures.

    Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26

  82. Картка 82

    Питання

    Which prevention or risk-reduction step is important for abnormal uterine bleeding from anovulation?

    Відповідь

    Address reversible causes of ovulatory dysfunction, review medicines that worsen bleeding, and monitor for anemia.

    Abnormal Uterine Bleeding · reviewed 2026-08-26

  83. Картка 83

    Питання

    In a young child, which diagnosis best fits a barking cough, hoarseness, and inspiratory stridor after a viral prodrome?

    Відповідь

    Croup. Barking cough, hoarseness, and inspiratory stridor after a viral prodrome in a young child suggests croup.

    Acute Management of Croup in the Emergency Department · reviewed 2026-08-26

  84. Картка 84

    Питання

    Which intervention is recommended to reduce later PTSD in an adult diagnosed with acute stress disorder?

    Відповідь

    Offer individual trauma-focused cognitive behavioral psychotherapy with exposure and/or cognitive restructuring.

    Management of Posttraumatic Stress Disorder and Acute Stress Disorder · reviewed 2026-08-26

  88. Картка 88

    Питання

    What drug class or regimen fits chronic kidney disease?

    Відповідь

    Use an ACE inhibitor or ARB for appropriate albuminuric CKD and an SGLT2 inhibitor for eligible patients.

    2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26

  89. Картка 89

    Питання

    Which microbiologic test is essential when gonococcal conjunctivitis is suspected?

    Відповідь

    Obtain a conjunctival specimen for culture; add a locally validated nucleic-acid amplification test when available, and perform susceptibility testing on cultured isolates when indicated.

    Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26

  91. Картка 91

    Питання

    When may treatment proceed without prior consent in an emergency?

    Відповідь

    When urgent treatment is needed, the patient cannot participate, no surrogate is available, and delay threatens life or serious health; document the circumstances.

    Informed Consent · reviewed 2026-08-26

  92. Картка 92

    Питання

    What drug class or regimen fits primary adrenal insufficiency?

    Відповідь

    Replace glucocorticoid and usually mineralocorticoid in chronic primary disease.

    Primary Adrenal Insufficiency Guideline Resources · reviewed 2026-08-26

  93. Картка 93

    Питання

    What is the key first diagnostic step for subarachnoid hemorrhage?

    Відповідь

    Use immediate noncontrast CT; if negative but suspicion remains, follow the time-appropriate pathway with lumbar puncture or vascular imaging.

    2023 Guideline for Aneurysmal Subarachnoid Hemorrhage · reviewed 2026-08-26

  95. Картка 95

    Питання

    In a child or adolescent, what is the key first diagnostic step for bacterial meningitis?

    Відповідь

    Obtain blood cultures and lumbar puncture when safe; perform head imaging first only for defined risk features.

    WHO Guidelines on Meningitis Diagnosis, Treatment and Care · reviewed 2026-08-26

  96. Картка 96

    Питання

    In a postmenopausal woman or man aged 50 or older, which diagnosis is established by a hip or vertebral fragility fracture?

    Відповідь

    Osteoporosis. A hip or vertebral fracture from low trauma establishes osteoporosis regardless of T-score.

    The clinician’s guide to prevention and treatment of osteoporosis · reviewed 2026-08-26

  97. Картка 97

    Питання

    What is the key first diagnostic step for preeclampsia with severe features?

    Відповідь

    Confirm pressure correctly and assess urine protein, CBC, creatinine, liver tests, fetal status, and symptoms.

    Gestational Hypertension and Preeclampsia · reviewed 2026-08-26

  99. Картка 99

    Питання

    What is the key first diagnostic step for bipolar I mania?

    Відповідь

    Diagnosis is clinical; assess substances, thyroid disease, medicines, psychosis, and safety.

    Management of Bipolar Disorder in Adults · reviewed 2026-08-26

  100. Картка 100

    Питання

    How should medication be used in hypertensive emergency?

    Відповідь

    Choose a titratable IV agent suited to the clinical syndrome; do not rapidly normalize pressure in most presentations.

    2025 High Blood Pressure Guideline · reviewed 2026-08-26

  102. Картка 102

    Питання

    What counseling point helps reduce harm from heart failure with reduced ejection fraction?

    Відповідь

    Control blood pressure and coronary risk, and avoid medicines that worsen fluid retention.

    2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26

  103. Картка 103

    Питання

    What condition should be suspected from this finding: Increasing abdominal girth, shifting dullness, edema, jaundice, or stigmata of portal hypertension suggest decompensation.

    Відповідь

    Cirrhosis with ascites. Increasing abdominal girth, shifting dullness, edema, jaundice, or stigmata of portal hypertension suggest decompensation.

    Diagnosis, Evaluation, and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome · reviewed 2026-08-26

  105. Картка 105

    Питання

    In a patient with prior demyelinating events, which diagnosis fits a new focal neurologic deficit evolving over hours to days and lasting more than 24 hours?

    Відповідь

    Multiple sclerosis relapse. A focal neurologic deficit evolving over hours to days and lasting over 24 hours, separated in time and space from prior events, suggests relapse.

    Multiple Sclerosis in Adults: Management · reviewed 2026-08-26

  107. Картка 107

    Питання

    What condition should be suspected from this finding: Acute retroviral illness can cause fever, rash, pharyngitis, lymphadenopathy, or no symptoms; chronic infection may remain silent.

    Відповідь

    HIV infection. Acute retroviral illness can cause fever, rash, pharyngitis, lymphadenopathy, or no symptoms; chronic infection may remain silent.

    About HIV · reviewed 2026-08-26

  108. Картка 108

    Питання

    Which prevention or risk-reduction step is important for sudden sensorineural hearing loss?

    Відповідь

    Counsel patients to seek same-day care for sudden hearing change rather than waiting for spontaneous recovery.

    Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26

  109. Картка 109

    Питання

    For surgical decision-making, what condition should be suspected from this finding: Heavy postpartum bleeding with uterine atony, retained tissue, trauma, or coagulopathy can rapidly cause shock.

    Відповідь

    Postpartum hemorrhage. Heavy postpartum bleeding with uterine atony, retained tissue, trauma, or coagulopathy can rapidly cause shock.

    Postpartum Hemorrhage · reviewed 2026-08-26

  110. Картка 110

    Питання

    What is the clinician’s duty after recognizing a significant medical error that harmed a patient?

    Відповідь

    Disclose the known facts honestly, explain the clinical impact and next care steps, express appropriate concern, and follow reporting processes.

    Promoting Patient Safety · reviewed 2026-08-26

  111. Картка 111

    Питання

    Which diagnosis causes an acute, fluctuating disturbance of attention and awareness with disorganized thinking?

    Відповідь

    Delirium. An acute fluctuating disturbance of attention and awareness with disorganized thinking suggests delirium.

    Delirium: Prevention, Diagnosis and Management · reviewed 2026-08-26

  113. Картка 113

    Питання

    Which next action matters most in uncomplicated cystitis?

    Відповідь

    Assess for pyelonephritis, pregnancy, obstruction, or sepsis before treating as uncomplicated disease.

    EAU Guidelines on Urological Infections · reviewed 2026-08-26

  114. Картка 114

    Питання

    What is the key first diagnostic step for acute deep-vein thrombosis?

    Відповідь

    Use pretest probability with D-dimer or compression ultrasonography rather than symptoms alone.

    ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26

  116. Картка 116

    Питання

    What diagnostic approach is most appropriate when stable chronic hypertension is suspected?

    Відповідь

    Confirm persistent elevation with standardized office technique and out-of-office monitoring when appropriate.

    2025 High Blood Pressure Guideline · reviewed 2026-08-26

  118. Картка 118

    Питання

    What is the key first diagnostic step for herpes zoster?

    Відповідь

    Clinical diagnosis is typical; PCR from a lesion is most useful when confirmation matters.

    Clinical Overview of Shingles (Herpes Zoster) · reviewed 2026-08-26

  119. Картка 119

    Питання

    How should a clinician initially manage osteoporosis in a postmenopausal woman at high fracture risk?

    Відповідь

    Offer pharmacologic therapy after shared decision-making, then reassess adherence and fracture risk.

    Pharmacological Management of Osteoporosis in Postmenopausal Women · reviewed 2026-08-26

  120. Картка 120

    Питання

    Which bedside pattern best points to migraine with aura?

    Відповідь

    Recurrent unilateral pulsating headache with nausea or sensory sensitivity, preceded by gradually spreading reversible visual or sensory symptoms, suggests migraine with aura.

    ICHD-3: Migraine with Aura · reviewed 2026-08-26

  121. Картка 121

    Питання

    What condition should be suspected from this finding: Polyuria, polydipsia, blurred vision, recurrent infections, or an asymptomatic high-risk patient may reveal hyperglycemia.

    Відповідь

    Type 2 diabetes mellitus. Polyuria, polydipsia, blurred vision, recurrent infections, or an asymptomatic high-risk patient may reveal hyperglycemia.

    Standards of Care in Diabetes—2026 · reviewed 2026-08-26

  122. Картка 122

    Питання

    Which bedside pattern best points to early syphilis?

    Відповідь

    A painless chancre or a diffuse rash involving palms and soles with generalized lymphadenopathy suggests syphilis by stage.

    Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26

  123. Картка 123

    Питання

    For surgical decision-making, what condition should be suspected from this finding: Sudden painful red eye, blurred vision with halos, headache, nausea, a fixed mid-dilated pupil, and a firm globe are classic.

    Відповідь

    Acute angle-closure glaucoma. Sudden painful red eye, blurred vision with halos, headache, nausea, a fixed mid-dilated pupil, and a firm globe are classic.

    Management of Angle-Closure Glaucoma · reviewed 2026-08-26

  124. Картка 124

    Питання

    Which bedside pattern best points to abnormal uterine bleeding from anovulation?

    Відповідь

    Irregular unpredictable bleeding without cyclic ovulation is common at reproductive extremes or with endocrine disruption.

    Abnormal Uterine Bleeding · reviewed 2026-08-26

  125. Картка 125

    Питання

    How should a clinician manage a boundary-crossing gift from a patient?

    Відповідь

    Assess its meaning, value, timing, and effect on care; decline gifts that exploit, obligate, or distort the professional relationship.

    Gifts from Patients · reviewed 2026-08-26

  128. Картка 128

    Питання

    In a child aged 6–11 years or an adolescent, what diagnostic approach is most appropriate when asthma is suspected?

    Відповідь

    Demonstrate variable expiratory airflow limitation with spirometry and bronchodilator response or an accepted alternative.

    2026 GINA Strategy Report · reviewed 2026-08-26

  129. Картка 129

    Питання

    Which prevention or risk-reduction step is important for chronic kidney disease?

    Відповідь

    Control blood pressure, diabetes, tobacco use, and nephrotoxin exposure; vaccinate and reduce cardiovascular risk.

    2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26

  130. Картка 130

    Питання

    In a child or adolescent, how should medication be used in acute appendicitis?

    Відповідь

    Preoperative antibiotics should cover enteric gram-negative organisms and anaerobes.

    Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26

  132. Картка 132

    Питання

    Which drug class is preferred before oral therapy for knee osteoarthritis pain when topical treatment is feasible?

    Відповідь

    Use a topical NSAID first; it provides local pain relief with less systemic exposure than an oral NSAID.

    2019 ACR/Arthritis Foundation Guideline for Osteoarthritis · reviewed 2026-08-26

  133. Картка 133

    Питання

    A patient has this pattern: Exertional calf discomfort relieved by rest, diminished pulses, and nonhealing foot wounds suggest lower-extremity arterial disease. What is the most likely diagnosis?

    Відповідь

    Peripheral artery disease. Exertional calf discomfort relieved by rest, diminished pulses, and nonhealing foot wounds suggest lower-extremity arterial disease.

    2024 ACC/AHA Guideline for Lower Extremity Peripheral Artery Disease: Key Points · reviewed 2026-08-26

  135. Картка 135

    Питання

    Which prevention or risk-reduction step is important for melanoma?

    Відповідь

    Use sun protection and teach patients to report changing lesions rather than relying on routine self-treatment.

    Melanoma Clinical Guidelines · reviewed 2026-08-26

  136. Картка 136

    Питання

    How should a clinician initially manage community-acquired pneumonia?

    Відповідь

    Stabilize oxygenation and sepsis, then choose outpatient or inpatient care using clinical judgment and a validated severity tool.

    Diagnosis and Treatment of Adults with Community-acquired Pneumonia · reviewed 2026-08-26

  137. Картка 137

    Питання

    Which prevention or risk-reduction step is important for ureteral stone?

    Відповідь

    High fluid intake and stone-specific dietary changes based on metabolic evaluation reduce recurrence.

    EAU Guidelines on Urolithiasis · reviewed 2026-08-26

  138. Картка 138

    Питання

    For surgical decision-making, how should a clinician initially manage ectopic pregnancy?

    Відповідь

    Hemodynamic instability or suspected rupture requires emergency surgery; stable management depends on imaging, hCG, size, and follow-up reliability.

    Ectopic Pregnancy · reviewed 2026-08-26

  139. Картка 139

    Питання

    What counseling point helps reduce harm from tension pneumothorax?

    Відповідь

    After chest trauma or an invasive thoracic procedure, urgently reassess new dyspnea, hypotension, or unilateral breath-sound loss so tension physiology is decompressed without delay.

    Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26

  141. Картка 141

    Питання

    What should happen when a clinician’s personal belief conflicts with a requested legal service?

    Відповідь

    Disclose the limitation without judgment, protect urgent care, provide timely information or referral, and avoid abandoning the patient.

    Physician Exercise of Conscience · reviewed 2026-08-26

  144. Картка 144

    Питання

    How should a clinician initially manage primary hypothyroidism?

    Відповідь

    Start replacement when indicated and recheck TSH after dose changes rather than adjusting from symptoms alone.

    Guidelines for the Treatment of Hypothyroidism · reviewed 2026-08-26

  145. Картка 145

    Питання

    Which activity counseling can reduce carpal tunnel symptoms or slow progression?

    Відповідь

    Modify job or recreational activities that aggravate symptoms, especially prolonged wrist flexion or extension.

    Carpal Tunnel Syndrome · reviewed 2026-08-26

  146. Картка 146

    Питання

    How should a clinician initially manage bacterial conjunctivitis?

    Відповідь

    Remove contact lenses and urgently assess pain, photophobia, vision loss, corneal opacity, or hyperacute discharge.

    Clinical Overview of Pink Eye (Conjunctivitis) · reviewed 2026-08-26

  147. Картка 147

    Питання

    Which diagnosis is marked by a rising creatinine or falling urine output after illness, volume loss, nephrotoxin exposure, obstruction, or sepsis?

    Відповідь

    Acute kidney injury. A rising creatinine or falling urine output after illness, volume loss, nephrotoxin exposure, obstruction, or sepsis indicates AKI.

    KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26

  149. Картка 149

    Питання

    In a child or adolescent, what condition should be suspected from this finding: Isolated petechiae, bruising, or mucosal bleeding with thrombocytopenia and otherwise preserved cell lines suggests ITP.

    Відповідь

    Immune thrombocytopenia. Isolated petechiae, bruising, or mucosal bleeding with thrombocytopenia and otherwise preserved cell lines suggests ITP.

    American Society of Hematology 2019 Guidelines for Immune Thrombocytopenia · reviewed 2026-08-26

  151. Картка 151

    Питання

    A patient has this pattern: Dyspnea with reduced breath sounds, dullness to percussion, and decreased tactile fremitus suggests pleural fluid. What is the most likely diagnosis?

    Відповідь

    Pleural effusion. Dyspnea with reduced breath sounds, dullness to percussion, and decreased tactile fremitus suggests pleural fluid.

    British Thoracic Society Guideline for Pleural Disease · reviewed 2026-08-26

  152. Картка 152

    Питання

    How should medication be used in pulmonary tuberculosis?

    Відповідь

    Treat drug-susceptible disease with a multidrug regimen and adherence support; tailor to susceptibility and patient factors.

    Treatment for Drug-Susceptible Tuberculosis Disease · reviewed 2026-08-26

  153. Картка 153

    Питання

    How should medication be used in endometriosis?

    Відповідь

    Combined hormonal contraceptives or progestins are common first-line suppressive therapies when pregnancy is not desired.

    Endometriosis · reviewed 2026-08-26

  154. Картка 154

    Питання

    How should medication be used in panic disorder?

    Відповідь

    SSRIs or SNRIs are preferred long-term medicines; benzodiazepines carry dependence and safety risks.

    Panic Disorder: What You Need to Know · reviewed 2026-08-26

  156. Картка 156

    Питання

    In a patient younger than 16, which diagnosis fits persistent joint swelling, limited motion, or morning stiffness after other causes are excluded?

    Відповідь

    Juvenile idiopathic arthritis. Persistent joint swelling, limited motion, or morning stiffness beginning before age 16, after excluding other causes, suggests JIA.

    2026 Juvenile Idiopathic Arthritis Guidelines · reviewed 2026-08-26

  157. Картка 157

    Питання

    Which bedside pattern best points to primary adrenal insufficiency?

    Відповідь

    Weight loss, fatigue, hypotension, salt craving, hyperpigmentation, hyponatremia, and hyperkalemia suggest primary adrenal failure.

    Primary Adrenal Insufficiency Guideline Resources · reviewed 2026-08-26

  158. Картка 158

    Питання

    When can confidential information be shared with another treating clinician without a separate HIPAA authorization?

    Відповідь

    HIPAA generally permits disclosure for treatment, using reasonable safeguards and only information relevant to care.

    Uses and Disclosures for Treatment, Payment, and Health Care Operations · reviewed 2026-08-26

  160. Картка 160

    Питання

    Which pathophysiologic process drives heart failure with reduced ejection fraction?

    Відповідь

    Reduced contractility activates sympathetic and renin-angiotensin-aldosterone pathways that drive maladaptive remodeling.

    2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26

  161. Картка 161

    Питання

    In a child, typically 6 months to 3 years, what immediate plan is appropriate for croup?

    Відповідь

    Keep the child calm, give dexamethasone, and add nebulized epinephrine for moderate or severe stridor.

    Acute Management of Croup in the Emergency Department · reviewed 2026-08-26

  163. Картка 163

    Питання

    What is the key first diagnostic step for testicular torsion?

    Відповідь

    Make a clinical diagnosis and obtain urgent urologic assessment; use Doppler ultrasound only if the diagnosis is uncertain and imaging will not delay exploration.

    Testicular Torsion · reviewed 2026-08-26

  164. Картка 164

    Питання

    What counseling point helps reduce harm from Parkinson disease?

    Відповідь

    Exercise, fall-risk reduction, medication review, and driving and swallowing assessment reduce complications.

    Parkinson’s Disease in Adults · reviewed 2026-08-26

  166. Картка 166

    Питання

    What counseling point helps reduce harm from gonococcal urethritis or cervicitis?

    Відповідь

    Condom use, routine screening by risk, and partner treatment reduce reinfection and complications.

    Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26

  168. Картка 168

    Питання

    What counseling point helps reduce harm from menopause vasomotor symptoms?

    Відповідь

    Cooling strategies and avoiding individual triggers can reduce symptom burden; assess bone and cardiovascular risk separately.

    The Menopause Years · reviewed 2026-08-26

  169. Картка 169

    Питання

    A patient has this pattern: Most chronic infections are asymptomatic; abnormal aminotransferases or risk-based screening may reveal disease. What is the most likely diagnosis?

    Відповідь

    Chronic hepatitis C. Most chronic infections are asymptomatic; abnormal aminotransferases or risk-based screening may reveal disease.

    Viral Hepatitis Clinical Care · reviewed 2026-08-26

  172. Картка 172

    Питання

    In a child or adolescent with sickle cell disease, which pain pattern supports an acute vaso-occlusive episode?

    Відповідь

    Acute severe extremity, back, or bone pain that matches the patient’s typical vaso-occlusive pattern and has no alternative cause supports an acute vaso-occlusive pain episode.

    ASH 2020 Guidelines for Sickle Cell Disease: Management of Acute and Chronic Pain · reviewed 2026-08-26

  175. Картка 175

    Питання

    How should medication be used in sudden sensorineural hearing loss?

    Відповідь

    Offer corticosteroids within the treatment window when appropriate; intratympanic therapy is an option in selected cases.

    Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26

  176. Картка 176

    Питання

    What is the HIPAA minimum-necessary rule?

    Відповідь

    For many uses and disclosures, limit protected information to what is reasonably needed for the purpose; the rule does not apply in the same way to disclosures for treatment.

    Minimum Necessary Requirement · reviewed 2026-08-26

  177. Картка 177

    Питання

    For surgical decision-making, hypotension, elevated jugular venous pressure, tachycardia, muffled heart sounds, and pulsus paradoxus indicate which diagnosis?

    Відповідь

    Cardiac tamponade. Hypotension, elevated jugular venous pressure, tachycardia, muffled heart sounds, and pulsus paradoxus suggest tamponade physiology.

    2025 Concise Clinical Guidance: Diagnosis and Management of Pericarditis · reviewed 2026-08-26

  178. Картка 178

    Питання

    In a child or adolescent, what diagnostic approach is most appropriate when acute appendicitis is suspected?

    Відповідь

    Use ultrasound as the initial imaging study in many children; use CT or MRI when ultrasound is nondiagnostic and suspicion persists, according to local expertise.

    Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26

  179. Картка 179

    Питання

    For surgical decision-making, sudden focal weakness, facial droop, speech change, gaze deviation, neglect, or ataxia indicate which time-critical diagnosis?

    Відповідь

    Acute ischemic stroke. Sudden focal weakness, facial droop, speech change, gaze deviation, neglect, or ataxia is stroke until proved otherwise.

    2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke · reviewed 2026-08-26

  180. Картка 180

    Питання

    A clinician is considering gout flare. Which finding adds the most support?

    Відповідь

    Abrupt severe monoarthritis with erythema, often at the first metatarsophalangeal joint, suggests gout.

    Gout · reviewed 2026-08-26

  181. Картка 181

    Питання

    Which diagnosis best fits new cough, fever, dyspnea, pleuritic pain, and focal crackles when an infiltrate is confirmed?

    Відповідь

    Community-acquired pneumonia. New cough, fever, dyspnea, pleuritic pain, and focal crackles suggest pneumonia, but clinical findings alone are imperfect.

    Diagnosis and Treatment of Adults with Community-acquired Pneumonia · reviewed 2026-08-26

  182. Картка 182

    Питання

    In a child aged 6–11 years or an adolescent, what medication strategy is appropriate for asthma?

    Відповідь

    For children 6–11 years and adolescents, use an age-appropriate inhaled corticosteroid-containing strategy rather than short-acting beta agonist-only treatment.

    2026 GINA Strategy Report · reviewed 2026-08-26

  183. Картка 183

    Питання

    For surgical decision-making, a patient has this pattern: Unilateral pelvic pain or bleeding in early pregnancy, especially with syncope or shoulder pain, raises concern for ectopic implantation. What is the most likely diagnosis?

    Відповідь

    Ectopic pregnancy. Unilateral pelvic pain or bleeding in early pregnancy, especially with syncope or shoulder pain, raises concern for ectopic implantation.

    Ectopic Pregnancy · reviewed 2026-08-26

  184. Картка 184

    Питання

    In a child or adolescent, which diagnosis requires at least two weeks of depressed mood or loss of interest with functional change and associated neurovegetative or cognitive symptoms?

    Відповідь

    Major depressive disorder. At least two weeks of depressed mood or loss of interest with functional change and associated neurovegetative or cognitive symptoms suggests major depression.

    Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Major and Persistent Depressive Disorders · reviewed 2026-08-26

  186. Картка 186

    Питання

    For surgical decision-making, what condition should be suspected from this finding: An evolving asymmetric pigmented lesion with border irregularity, color variation, or a concerning outlier pattern requires evaluation.

    Відповідь

    Melanoma. An evolving asymmetric pigmented lesion with border irregularity, color variation, or a concerning outlier pattern requires evaluation.

    Melanoma Clinical Guidelines · reviewed 2026-08-26

  188. Картка 188

    Питання

    For surgical decision-making, what condition should be suspected from this finding: Sudden colicky flank pain radiating to the groin with hematuria and restlessness is typical.

    Відповідь

    Ureteral stone. Sudden colicky flank pain radiating to the groin with hematuria and restlessness is typical.

    EAU Guidelines on Urolithiasis · reviewed 2026-08-26

  191. Картка 191

    Питання

    What diagnostic approach is most appropriate when acute bacterial rhinosinusitis is suspected?

    Відповідь

    Diagnosis is clinical; routine imaging is not needed unless a complication or alternative diagnosis is suspected.

    Clinical Practice Guideline: Adult Sinusitis Update · reviewed 2026-08-26

  192. Картка 192

    Питання

    What should a clinician do before discussing a patient in a public or semipublic area?

    Відповідь

    Move to a private setting when practical and use reasonable safeguards so others do not overhear identifiable information.

    Incidental Uses and Disclosures · reviewed 2026-08-26

  193. Картка 193

    Питання

    A clinician is considering Parkinson disease. Which finding adds the most support?

    Відповідь

    Bradykinesia plus rest tremor or rigidity, with reduced arm swing and shuffling gait, supports parkinsonism.

    Parkinson’s Disease in Adults · reviewed 2026-08-26

  194. Картка 194

    Питання

    What immediate plan is appropriate for chronic hepatitis C?

    Відповідь

    Stage liver disease, review interactions, test for coinfections, and link every patient with active infection to curative treatment.

    Viral Hepatitis Clinical Care · reviewed 2026-08-26

  195. Картка 195

    Питання

    A clinician is considering gonococcal urethritis or cervicitis. Which finding adds the most support?

    Відповідь

    Purulent urethral discharge, dysuria, cervicitis, pelvic pain, or exposure may indicate gonorrhea, but infection can be asymptomatic.

    Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26

  196. Картка 196

    Питання

    In a child or adolescent, what immediate plan is appropriate for juvenile idiopathic arthritis?

    Відповідь

    Refer to pediatric rheumatology early and treat to control inflammation and preserve function.

    2026 Juvenile Idiopathic Arthritis Guidelines · reviewed 2026-08-26

  197. Картка 197

    Питання

    A clinician is considering menopause vasomotor symptoms. Which finding adds the most support?

    Відповідь

    Hot flashes, night sweats, sleep disruption, and menstrual transition at the expected age usually identify menopausal vasomotor symptoms.

    The Menopause Years · reviewed 2026-08-26

  198. Картка 198

    Питання

    Which diagnosis best fits this presentation: Progressive exertional dyspnea, dry cough, bibasilar fine crackles, and clubbing in an older adult suggest fibrotic interstitial disease.

    Відповідь

    Idiopathic pulmonary fibrosis. Progressive exertional dyspnea, dry cough, bibasilar fine crackles, and clubbing in an older adult suggest fibrotic interstitial disease.

    Idiopathic Pulmonary Fibrosis: An Update and Progressive Pulmonary Fibrosis in Adults · reviewed 2026-08-26

  199. Картка 199

    Питання

    A clinician is considering alcohol withdrawal. Which finding adds the most support?

    Відповідь

    Tremor, autonomic hyperactivity, insomnia, nausea, anxiety, hallucinations, or seizures after reducing heavy alcohol use suggests withdrawal.

    The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management · reviewed 2026-08-26

  202. Картка 202

    Питання

    For surgical decision-making, what is the priority management step for pleural effusion?

    Відповідь

    Drain a large symptomatic effusion or complicated parapneumonic collection and treat the underlying disease.

    British Thoracic Society Guideline for Pleural Disease · reviewed 2026-08-26

  203. Картка 203

    Питання

    In acute decompensated heart failure with fluid overload, which drug class is used first to relieve congestion?

    Відповідь

    Give an intravenous loop diuretic and adjust it to urine output, symptoms, renal function, and electrolytes.

    2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26

  204. Картка 204

    Питання

    For surgical decision-making, what immediate plan is appropriate for subarachnoid hemorrhage?

    Відповідь

    Stabilize, control pressure carefully, give nimodipine, and obtain urgent neurovascular treatment of the aneurysm.

    2023 Guideline for Aneurysmal Subarachnoid Hemorrhage · reviewed 2026-08-26

  206. Картка 206

    Питання

    In a child or adolescent, what immediate plan is appropriate for bacterial meningitis?

    Відповідь

    Give empiric antibiotics immediately; do not delay for imaging or lumbar puncture when delay is likely.

    WHO Guidelines on Meningitis Diagnosis, Treatment and Care · reviewed 2026-08-26

  207. Картка 207

    Питання

    In a child or adolescent, which diagnosis fits hyperglycemia with dehydration, abdominal pain, vomiting, Kussmaul respirations, or altered mental status?

    Відповідь

    Diabetic ketoacidosis. Hyperglycemia with dehydration, abdominal pain, vomiting, Kussmaul respirations, or altered mental status suggests ketoacidosis.

    Standards of Care in Diabetes—2026 · reviewed 2026-08-26

  208. Картка 208

    Питання

    For surgical decision-making, what immediate plan is appropriate for preeclampsia with severe features?

    Відповідь

    Stabilize the mother, prevent seizure, control persistent severe pressure, and plan delivery by gestational age and status.

    Gestational Hypertension and Preeclampsia · reviewed 2026-08-26

  209. Картка 209

    Питання

    For surgical decision-making, new flashes, floaters, and a curtain or shadow across the visual field indicate which diagnosis?

    Відповідь

    Retinal detachment. New flashes, floaters, and a curtain or shadow across the visual field suggest detachment.

    Retinal Detachment · reviewed 2026-08-26

  210. Картка 210

    Питання

    What immediate plan is appropriate for bipolar I mania?

    Відповідь

    Hospitalize when danger, grave disability, or severe psychosis requires containment; stop antidepressant monotherapy.

    Management of Bipolar Disorder in Adults · reviewed 2026-08-26

  211. Картка 211

    Питання

    May a clinician leave appointment information in a voicemail?

    Відповідь

    Yes, with reasonable safeguards: keep the message limited and follow any confidential communication request the patient has made.

    Incidental Uses and Disclosures · reviewed 2026-08-26

  212. Картка 212

    Питання

    When is a loop diuretic appropriate in acute kidney injury?

    Відповідь

    Use a loop diuretic only to manage volume overload; it does not reverse intrinsic kidney injury or improve renal recovery.

    KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26

  213. Картка 213

    Питання

    How should a clinician initially manage plaque psoriasis?

    Відповідь

    Assess body-surface area, special-site involvement, symptoms, and joint disease before selecting therapy.

    Psoriasis Clinical Guidelines · reviewed 2026-08-26

  216. Картка 216

    Питання

    Which drug class is first-line for erectile dysfunction when no contraindication such as nitrate use exists?

    Відповідь

    Use a phosphodiesterase-5 inhibitor after reviewing cardiovascular fitness, interactions, and correct use; never combine it with nitrates.

    Erectile Dysfunction Guideline · reviewed 2026-08-26

  217. Картка 217

    Питання

    Which pathophysiologic process drives COPD?

    Відповідь

    Small-airway disease and emphysematous parenchymal destruction cause persistent expiratory flow limitation.

    2026 GOLD Report and Pocket Guide · reviewed 2026-08-26

  218. Картка 218

    Питання

    Which history or examination finding most strongly supports Crohn disease?

    Відповідь

    Chronic diarrhea, abdominal pain, weight loss, perianal disease, and skip lesions support Crohn disease.

    Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26

  221. Картка 221

    Питання

    What clinical clue should raise suspicion for hypertensive emergency?

    Відповідь

    Severely elevated pressure with acute neurologic, cardiac, renal, retinal, or aortic injury defines an emergency.

    2025 High Blood Pressure Guideline · reviewed 2026-08-26

  222. Картка 222

    Питання

    What medication strategy is appropriate for early syphilis?

    Відповідь

    Benzathine penicillin G is preferred for early syphilis; penicillin is required in pregnancy.

    Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26

  225. Картка 225

    Питання

    What counseling point helps reduce harm from peritonsillar abscess?

    Відповідь

    Seek prompt care for worsening unilateral throat pain, drooling, muffled voice, trismus, or breathing difficulty so an abscess and airway risk are not missed.

    Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26

  227. Картка 227

    Питання

    When may protected health information be disclosed to prevent a serious threat?

    Відповідь

    HIPAA permits a good-faith disclosure consistent with law and ethical standards to someone reasonably able to prevent or lessen a serious and imminent threat.

    HIPAA Disclosure to Prevent or Lessen a Serious and Imminent Threat · reviewed 2026-08-26

  230. Картка 230

    Питання

    Which bedside pattern best points to herpes zoster?

    Відповідь

    A painful unilateral grouped-vesicle eruption in a dermatomal distribution is characteristic.

    Clinical Overview of Shingles (Herpes Zoster) · reviewed 2026-08-26

  231. Картка 231

    Питання

    A patient has this pattern: Thrombocytopenia plus microangiopathic hemolytic anemia, often with neurologic, renal, or fever findings, is an emergency. What is the most likely diagnosis?

    Відповідь

    Thrombotic thrombocytopenic purpura. Thrombocytopenia plus microangiopathic hemolytic anemia, often with neurologic, renal, or fever findings, is an emergency.

    ISTH Guidelines for the Diagnosis and Treatment of Thrombotic Thrombocytopenic Purpura · reviewed 2026-08-26

  232. Картка 232

    Питання

    Which bedside pattern best points to testicular torsion?

    Відповідь

    Sudden severe unilateral testicular pain with nausea or vomiting, a high-riding transverse testis, and loss of the cremasteric reflex strongly suggests torsion.

    Testicular Torsion · reviewed 2026-08-26

  233. Картка 233

    Питання

    For surgical decision-making, which diagnosis best fits hematemesis, coffee-ground emesis, or melena with orthostasis?

    Відповідь

    Upper gastrointestinal bleeding. Hematemesis, coffee-ground emesis, or melena with orthostasis indicates an upper gastrointestinal source until shown otherwise.

    ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26

  234. Картка 234

    Питання

    In a child or adolescent, what diagnostic approach is most appropriate when generalized tonic-clonic seizure is suspected?

    Відповідь

    Check glucose and reversible causes; use EEG and brain imaging based on whether this is a first unprovoked event or known epilepsy.

    Epilepsies in Children, Young People and Adults · reviewed 2026-08-26

  235. Картка 235

    Питання

    Identify the condition from this pattern: Repeated properly measured elevated readings, usually without symptoms, establish the clinical pattern.

    Відповідь

    Stable chronic hypertension. Repeated properly measured elevated readings, usually without symptoms, establish the clinical pattern.

    2025 High Blood Pressure Guideline · reviewed 2026-08-26

  236. Картка 236

    Питання

    What diagnostic approach is most appropriate when sepsis is suspected?

    Відповідь

    Measure lactate, obtain cultures before antibiotics when this causes no meaningful delay, and evaluate the source.

    2026 Surviving Sepsis Campaign Adult Guidelines · reviewed 2026-08-26

  237. Картка 237

    Питання

    For surgical decision-making, in a child with acute severe monoarticular pain, restricted passive motion, fever, or bacteremia risk, which diagnosis must be excluded urgently?

    Відповідь

    Septic arthritis. Acute severe monoarticular pain, restricted passive motion, fever, or bacteremia risk is septic arthritis until excluded.

    Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26

  238. Картка 238

    Питання

    What diagnostic approach is most appropriate when pelvic inflammatory disease is suspected?

    Відповідь

    Test for gonorrhea, chlamydia, HIV, and syphilis; use ultrasound when abscess or another diagnosis is possible.

    Pelvic Inflammatory Disease: STI Treatment Guidelines · reviewed 2026-08-26

  239. Картка 239

    Питання

    Which pharmacologic approach is preferred for COPD?

    Відповідь

    Long-acting bronchodilators are maintenance therapy; add inhaled corticosteroid for selected exacerbation-prone patients based on phenotype and eosinophils.

    2026 GOLD Report and Pocket Guide · reviewed 2026-08-26

  240. Картка 240

    Питання

    What diagnostic approach is most appropriate when schizophrenia is suspected?

    Відповідь

    Diagnosis is clinical with medical, neurologic, and substance evaluation for first-episode psychosis.

    Management of First-Episode Psychosis and Schizophrenia · reviewed 2026-08-26

  241. Картка 241

    Питання

    Which next action matters most in hypertensive emergency?

    Відповідь

    Lower pressure with monitored IV therapy at a controlled rate tailored to the injured organ.

    2025 High Blood Pressure Guideline · reviewed 2026-08-26

  242. Картка 242

    Питання

    How should an interpreter be used for a patient with limited English proficiency?

    Відповідь

    Use a qualified medical interpreter, speak to the patient directly, pause in short segments, and avoid relying on children or untrained family for consequential decisions.

    Limited English Proficiency Guidance · reviewed 2026-08-26

  245. Картка 245

    Питання

    What immediate plan is appropriate for acute bacterial rhinosinusitis?

    Відповідь

    Assess orbital or intracranial red flags and arrange urgent evaluation when present.

    Clinical Practice Guideline: Adult Sinusitis Update · reviewed 2026-08-26

  246. Картка 246

    Питання

    Which preventive measure belongs in care for gout flare?

    Відповідь

    Weight management, limiting excess alcohol, reviewing urate-raising medicines, and long-term urate control reduce flares.

    Gout · reviewed 2026-08-26

  249. Картка 249

    Питання

    Which test or testing sequence best evaluates suspected COPD?

    Відповідь

    Post-bronchodilator spirometry confirms persistent airflow obstruction.

    2026 GOLD Report and Pocket Guide · reviewed 2026-08-26

  251. Картка 251

    Питання

    Which pathophysiologic process drives subarachnoid hemorrhage?

    Відповідь

    Arterial blood entering the subarachnoid space raises intracranial pressure and can trigger vasospasm.

    2023 Guideline for Aneurysmal Subarachnoid Hemorrhage · reviewed 2026-08-26

  252. Картка 252

    Питання

    In a child or adolescent, which pathophysiologic process drives bacterial meningitis?

    Відповідь

    Bacterial invasion of the subarachnoid space triggers intense inflammation, edema, and raised intracranial pressure.

    WHO Guidelines on Meningitis Diagnosis, Treatment and Care · reviewed 2026-08-26

  253. Картка 253

    Питання

    Which pathophysiologic process drives preeclampsia with severe features?

    Відповідь

    Abnormal placentation and systemic endothelial dysfunction produce vasoconstriction and multisystem injury.

    Gestational Hypertension and Preeclampsia · reviewed 2026-08-26

  254. Картка 254

    Питання

    Which clinical feature defines bipolar I disorder?

    Відповідь

    At least one manic episode defines bipolar I disorder; a major depressive episode is common but is not required for the diagnosis.

    Management of Bipolar Disorder in Adults · reviewed 2026-08-26

  255. Картка 255

    Питання

    For surgical decision-making, what is the priority management step for upper gastrointestinal bleeding?

    Відповідь

    Establish IV access, resuscitate, use a restrictive transfusion strategy for most patients, and arrange endoscopic hemostasis.

    ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26

  256. Картка 256

    Питання

    Which history or examination finding most strongly supports rheumatoid arthritis?

    Відповідь

    Symmetric inflammatory pain and prolonged morning stiffness in MCP, PIP, or wrist joints with synovitis suggest rheumatoid arthritis.

    Rheumatoid Arthritis · reviewed 2026-08-26

  257. Картка 257

    Питання

    What is teach-back?

    Відповідь

    Ask the patient to explain the plan in their own words so the clinician can find and correct communication gaps without testing or blaming the patient.

    Use the Teach-Back Method · reviewed 2026-08-26

  260. Картка 260

    Питання

    A clinician is considering sudden sensorineural hearing loss. Which finding adds the most support?

    Відповідь

    A rapid unilateral hearing decrease, often noticed on waking and sometimes with tinnitus, is an otologic emergency.

    Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26

  261. Картка 261

    Питання

    Which preventive measure belongs in care for obstructive sleep apnea?

    Відповідь

    Weight management, alcohol and sedative avoidance near bedtime, and treatment of nasal obstruction reduce severity.

    Sleep Apnea Treatment · reviewed 2026-08-26

  262. Картка 262

    Питання

    In a child or adolescent, what diagnostic approach is most appropriate when atopic dermatitis is suspected?

    Відповідь

    Diagnosis is clinical; testing is reserved for an alternative diagnosis or a specific suspected trigger.

    Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26

  263. Картка 263

    Питання

    How should a clinician initially manage acute pyelonephritis?

    Відповідь

    Give fluids and antibiotics, and admit patients with sepsis, inability to take oral therapy, pregnancy concerns, or obstruction.

    EAU Guidelines on Urological Infections · reviewed 2026-08-26

  264. Картка 264

    Питання

    For surgical decision-making, which diagnosis best fits this presentation: A sudden maximal-at-onset thunderclap headache, neck stiffness, vomiting, or brief loss of consciousness is concerning.

    Відповідь

    Subarachnoid hemorrhage. A sudden maximal-at-onset thunderclap headache, neck stiffness, vomiting, or brief loss of consciousness is concerning.

    2023 Guideline for Aneurysmal Subarachnoid Hemorrhage · reviewed 2026-08-26

  266. Картка 266

    Питання

    In a child or adolescent, which diagnosis best fits this presentation: Fever, headache, neck stiffness, altered mental status, or a nonblanching rash should trigger urgent evaluation.

    Відповідь

    Bacterial meningitis. Fever, headache, neck stiffness, altered mental status, or a nonblanching rash should trigger urgent evaluation.

    WHO Guidelines on Meningitis Diagnosis, Treatment and Care · reviewed 2026-08-26

  267. Картка 267

    Питання

    What drug class or regimen fits stable chronic hypertension?

    Відповідь

    First-line classes include thiazide-type diuretics, ACE inhibitors or ARBs, and long-acting dihydropyridine calcium-channel blockers.

    2025 High Blood Pressure Guideline · reviewed 2026-08-26

  268. Картка 268

    Питання

    For surgical decision-making, which diagnosis best fits this presentation: New hypertension after 20 weeks with end-organ findings such as severe pressure, thrombocytopenia, liver injury, kidney injury, pulmonary edema, or neurologic symptoms suggests severe disease.

    Відповідь

    Preeclampsia with severe features. New hypertension after 20 weeks with end-organ findings such as severe pressure, thrombocytopenia, liver injury, kidney injury, pulmonary edema, or neurologic symptoms suggests severe disease.

    Gestational Hypertension and Preeclampsia · reviewed 2026-08-26

  269. Картка 269

    Питання

    Which pharmacologic approach is preferred for acute pancreatitis?

    Відповідь

    Routine prophylactic antibiotics do not treat sterile pancreatitis; reserve antimicrobials for proven or strongly suspected infection.

    ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26

  270. Картка 270

    Питання

    Which diagnosis best fits this presentation: At least one week of elevated or irritable mood with increased energy, decreased sleep, pressured speech, grandiosity, and risky behavior suggests mania.

    Відповідь

    Bipolar I mania. At least one week of elevated or irritable mood with increased energy, decreased sleep, pressured speech, grandiosity, and risky behavior suggests mania.

    Management of Bipolar Disorder in Adults · reviewed 2026-08-26

  271. Картка 271

    Питання

    For surgical decision-making, in a child or adolescent, what is the priority management step for septic arthritis?

    Відповідь

    Drain the joint promptly and start empiric antibiotics after cultures unless the patient is unstable.

    Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26

  273. Картка 273

    Питання

    In a child or adolescent, which diagnosis causes variable wheeze, cough, chest tightness, or dyspnea that changes over time and with triggers?

    Відповідь

    Asthma. Variable wheeze, cough, chest tightness, or dyspnea that changes over time and with triggers suggests asthma.

    2026 GINA Strategy Report · reviewed 2026-08-26

  274. Картка 274

    Питання

    In a child or adolescent, which pathophysiologic process drives diabetic ketoacidosis?

    Відповідь

    Absolute or marked insulin deficiency drives lipolysis, ketogenesis, osmotic diuresis, and total-body potassium loss.

    Standards of Care in Diabetes—2026 · reviewed 2026-08-26

  275. Картка 275

    Питання

    How should a clinician respond to a patient requesting an unnecessary antibiotic?

    Відповідь

    Acknowledge the concern, explain why the antibiotic will not help and may harm, offer a clear alternative plan, and define return precautions.

    Core Elements of Outpatient Antibiotic Stewardship · reviewed 2026-08-26

  276. Картка 276

    Питання

    Which pathophysiologic process drives retinal detachment?

    Відповідь

    Fluid passing through a retinal break separates neurosensory retina from the pigment epithelium.

    Retinal Detachment · reviewed 2026-08-26

  279. Картка 279

    Питання

    In a child or adolescent, which pathophysiologic process drives acute appendicitis?

    Відповідь

    Luminal obstruction causes distention, ischemia, bacterial overgrowth, and eventual perforation.

    Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26

  280. Картка 280

    Питання

    Which preventive measure belongs in care for Clostridioides difficile infection?

    Відповідь

    Isolate suspected or confirmed CDI with contact precautions, use C. difficile sporicidal agents for daily and terminal cleaning, and engage antibiotic stewardship.

    Clinical Guidance for C. diff Infection Prevention in Acute Care Facilities · reviewed 2026-08-26

  281. Картка 281

    Питання

    After an acute ACL tear, which nonprescription medicines may be used for symptom relief when safe?

    Відповідь

    Ibuprofen or naproxen can reduce pain and swelling; acetaminophen can reduce pain. Check comorbidities and contraindications before NSAID use.

    Anterior cruciate ligament (ACL) injury - aftercare · reviewed 2026-08-26

  282. Картка 282

    Питання

    Which preventive measure belongs in care for shoulder dystocia?

    Відповідь

    Team drills, clear communication, and avoiding fundal pressure reduce preventable harm.

    Shoulder Dystocia · reviewed 2026-08-26

  284. Картка 284

    Питання

    In a child or adolescent, which preventive measure belongs in care for attention-deficit/hyperactivity disorder?

    Відповідь

    Use an individualized multimodal plan with psychoeducation, parent and school interventions, and clear functional goals.

    ADHD in Children and Youth: Part 2—Treatment · reviewed 2026-08-26

  286. Картка 286

    Питання

    A clinician is considering hyponatremia due to SIADH. Which finding adds the most support?

    Відповідь

    Nausea, confusion, gait change, seizure, or subtle cognitive symptoms with hypotonic euvolemic hyponatremia may reflect SIADH.

    Clinical Practice Guideline on Diagnosis and Treatment of Hyponatraemia · reviewed 2026-08-26

  287. Картка 287

    Питання

    During a pulseless arrest, the monitor shows chaotic ventricular activity without organized QRS complexes. Which arrest rhythm is present?

    Відповідь

    Ventricular fibrillation cardiac arrest. Sudden unresponsiveness with absent normal breathing and no pulse is cardiac arrest; the monitor may show chaotic ventricular activity.

    2025 American Heart Association Guidelines for CPR and ECC: Adult Advanced Life Support · reviewed 2026-08-26

  289. Картка 289

    Питання

    A patient has this pattern: Progressive weak stream, hesitancy, incomplete emptying, nocturia, and frequency suggest bladder-outlet symptoms. What is the most likely diagnosis?

    Відповідь

    Benign prostatic hyperplasia. Progressive weak stream, hesitancy, incomplete emptying, nocturia, and frequency suggest bladder-outlet symptoms.

    EAU Guidelines on the Management of Non-neurogenic Male Lower Urinary Tract Symptoms · reviewed 2026-08-26

  290. Картка 290

    Питання

    Which test or testing sequence best evaluates suspected primary adrenal insufficiency?

    Відповідь

    Measure morning cortisol and ACTH, then confirm with cosyntropin testing when the patient is stable.

    Primary Adrenal Insufficiency Guideline Resources · reviewed 2026-08-26

  291. Картка 291

    Питання

    What medication strategy is appropriate for peritonsillar abscess?

    Відповідь

    Use antibiotics covering group A streptococci and oral anaerobes after drainage.

    Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26

  292. Картка 292

    Питання

    What belongs in a safe handoff?

    Відповідь

    State illness severity, active problems, recent changes, pending results, contingency plans, and who owns each next action, then allow questions.

    TeamSTEPPS Communication Module · reviewed 2026-08-26

  294. Картка 294

    Питання

    For surgical decision-making, identify the condition from this pattern: Pain out of proportion, pain with passive stretch, tense swelling, and progressive neurologic deficits after injury are warning signs.

    Відповідь

    Acute compartment syndrome. Pain out of proportion, pain with passive stretch, tense swelling, and progressive neurologic deficits after injury are warning signs.

    Management of Acute Compartment Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26

  297. Картка 297

    Питання

    Which history or examination finding most strongly supports shoulder dystocia?

    Відповідь

    After delivery of the head, retraction against the perineum and failure of the shoulders to deliver indicates dystocia.

    Shoulder Dystocia · reviewed 2026-08-26

  298. Картка 298

    Питання

    In a child or adolescent, which history or examination finding most strongly supports attention-deficit/hyperactivity disorder?

    Відповідь

    Persistent developmentally inappropriate inattention and/or hyperactivity-impulsivity in more than one setting with impairment suggests ADHD.

    ADHD in Children and Youth: Part 1—Etiology, Diagnosis, and Comorbidity · reviewed 2026-08-26

  300. Картка 300

    Питання

    In a child, typically 6 months to 3 years, what clinical clue should raise suspicion for croup?

    Відповідь

    Barking cough, hoarseness, and inspiratory stridor after a viral prodrome in a young child suggests croup.

    Acute Management of Croup in the Emergency Department · reviewed 2026-08-26

    Illustrated clinical review desk with a stethoscope, ECG trace, lungs, brain, and study cards arranged around a clear central title-safe area.

    600 карток

    PANCE Flashcards: Blueprint-Aligned Diagnoses, Tests & Next Steps

    Вивчати цю колоду безкоштовно

    Відкриється Nibomo, і ви зможете почати навчання.

  303. Картка 303

    Питання

    For surgical decision-making, in a child or adolescent, identify the condition from this pattern: Periumbilical pain migrating to the right lower quadrant with anorexia, nausea, fever, and focal tenderness is typical.

    Відповідь

    Acute appendicitis. Periumbilical pain migrating to the right lower quadrant with anorexia, nausea, fever, and focal tenderness is typical.

    Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26

  305. Картка 305

    Питання

    In a child or adolescent, what is the priority management step for generalized tonic-clonic seizure?

    Відповідь

    Protect from injury, position for airway safety, time the event, and treat as status epilepticus when it persists.

    Epilepsies in Children, Young People and Adults · reviewed 2026-08-26

  306. Картка 306

    Питання

    Which diagnosis causes fatigue, cold intolerance, constipation, dry skin, bradycardia, and delayed reflex relaxation?

    Відповідь

    Primary hypothyroidism. Fatigue, cold intolerance, constipation, dry skin, bradycardia, and delayed reflex relaxation support hypothyroidism.

    Guidelines for the Treatment of Hypothyroidism · reviewed 2026-08-26

  307. Картка 307

    Питання

    What is the priority management step for sepsis?

    Відповідь

    Start rapid resuscitation, broad empiric antimicrobials, and urgent source control.

    2026 Surviving Sepsis Campaign Adult Guidelines · reviewed 2026-08-26

  308. Картка 308

    Питання

    Which diagnosis best fits diffuse conjunctival injection with mucopurulent discharge and eyelids stuck on waking?

    Відповідь

    Bacterial conjunctivitis. Diffuse conjunctival injection with mucopurulent discharge and eyelids stuck on waking supports bacterial conjunctivitis.

    Clinical Overview of Pink Eye (Conjunctivitis) · reviewed 2026-08-26

  309. Картка 309

    Питання

    What is the priority management step for pelvic inflammatory disease?

    Відповідь

    Start empiric treatment promptly; admit for pregnancy, severe illness, abscess, surgical emergency uncertainty, or failed outpatient care.

    Pelvic Inflammatory Disease: STI Treatment Guidelines · reviewed 2026-08-26

  310. Картка 310

    Питання

    What is closed-loop communication during an emergency?

    Відповідь

    The receiver repeats the instruction, the sender confirms or corrects it, and completion is announced so the team shares the same state.

    TeamSTEPPS Check-Back Tool · reviewed 2026-08-26

  311. Картка 311

    Питання

    What is the priority management step for schizophrenia?

    Відповідь

    Assess danger, catatonia, and ability to care for self, then combine antipsychotic treatment with psychosocial support.

    Management of First-Episode Psychosis and Schizophrenia · reviewed 2026-08-26

  317. Картка 317

    Питання

    Which diagnosis best fits progressive exertional dyspnea, chronic cough or sputum, and exposure to tobacco, biomass, or occupational irritants?

    Відповідь

    COPD. Progressive exertional dyspnea, chronic cough or sputum, and exposure to tobacco, biomass, or occupational irritants suggest COPD.

    2026 GOLD Report and Pocket Guide · reviewed 2026-08-26

  318. Картка 318

    Питання

    Which test or testing sequence best evaluates suspected acute cholecystitis?

    Відповідь

    Right-upper-quadrant ultrasound is first-line; a gallbladder nuclear-medicine scan (HIDA) is an appropriate next study when ultrasound is negative or equivocal and suspicion remains high.

    ACR Appropriateness Criteria® Right Upper Quadrant Pain · reviewed 2026-08-26

  319. Картка 319

    Питання

    In a postmenopausal woman or man aged 50 or older, what clinical clue should raise suspicion for osteoporosis?

    Відповідь

    A fragility fracture, height loss, or kyphosis should prompt assessment for osteoporosis and vertebral fracture.

    The clinician’s guide to prevention and treatment of osteoporosis · reviewed 2026-08-26

  320. Картка 320

    Питання

    Which pharmacologic approach is preferred for Parkinson disease?

    Відповідь

    Levodopa provides the strongest motor benefit for many patients; dopamine agonists carry impulse-control and sleep risks.

    Parkinson’s Disease in Adults · reviewed 2026-08-26

  321. Картка 321

    Питання

    A patient has this pattern: Pressure-like substernal pain with diaphoresis, nausea, or radiation to the arm or jaw is a classic ischemic pattern. What is the most likely diagnosis?

    Відповідь

    Acute coronary syndrome. Pressure-like substernal pain with diaphoresis, nausea, or radiation to the arm or jaw is a classic ischemic pattern.

    2025 ACC/AHA Guideline for the Management of Patients With Acute Coronary Syndromes · reviewed 2026-08-26

  322. Картка 322

    Питання

    Which pharmacologic approach is preferred for gonococcal urethritis or cervicitis?

    Відповідь

    Ceftriaxone is first-line for uncomplicated infection; add chlamydia treatment if it has not been excluded.

    Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26

  323. Картка 323

    Питання

    In a child aged 6 months or older, which examination best evaluates suspected acute otitis media?

    Відповідь

    Use pneumatic otoscopy to confirm middle-ear effusion and assess for a bulging tympanic membrane; tympanometry is less reliable in young infants.

    Management of Acute Otitis Media in Children Six Months of Age and Older · reviewed 2026-08-26

  324. Картка 324

    Питання

    Which pharmacologic approach is preferred for menopause vasomotor symptoms?

    Відповідь

    Systemic menopausal hormone therapy is most effective for eligible patients; nonhormonal options include selected SSRIs, SNRIs, gabapentin, or fezolinetant.

    Hormone Therapy for Menopause · reviewed 2026-08-26

  325. Картка 325

    Питання

    How should a clinician handle an ambiguous verbal medication order?

    Відповідь

    Stop and clarify the drug, dose, route, timing, and patient; read it back and do not guess.

    TeamSTEPPS Communication Module · reviewed 2026-08-26

  327. Картка 327

    Питання

    In a child or adolescent, how should a clinician initially manage asthma?

    Відповідь

    Assess severity during exacerbation, give repeated bronchodilator, systemic corticosteroid when indicated, oxygen, and escalate for fatigue or silent chest.

    2026 GINA Strategy Report · reviewed 2026-08-26

  329. Картка 329

    Питання

    What counseling point helps reduce harm from acute kidney injury?

    Відповідь

    Avoid unnecessary nephrotoxins, adjust medicine doses, maintain perfusion, and monitor high-risk patients.

    KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26

  331. Картка 331

    Питання

    For surgical decision-making, in a child or adolescent, which next action matters most in acute appendicitis?

    Відповідь

    Give fluids, analgesia, antibiotics, and obtain prompt surgical consultation.

    Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26

  334. Картка 334

    Питання

    In a child or adolescent, which diagnosis fits sudden loss of consciousness with bilateral tonic then clonic movements followed by confusion?

    Відповідь

    Generalized tonic-clonic seizure. Sudden loss of consciousness with bilateral tonic then clonic movements followed by confusion supports a generalized convulsion.

    Epilepsies in Children, Young People and Adults · reviewed 2026-08-26

  335. Картка 335

    Питання

    How should medication be used in herpes zoster?

    Відповідь

    Start an oral antiviral early for eligible patients, especially with severe pain, older age, or high-risk sites.

    Clinical Overview of Shingles (Herpes Zoster) · reviewed 2026-08-26

  336. Картка 336

    Питання

    Which diagnosis is defined by suspected infection with acute organ dysfunction and may include altered mentation, hypotension, tachypnea, or poor perfusion?

    Відповідь

    Sepsis. Suspected infection with acute organ dysfunction, altered mentation, hypotension, tachypnea, or poor perfusion suggests sepsis.

    2026 Surviving Sepsis Campaign Adult Guidelines · reviewed 2026-08-26

  337. Картка 337

    Питання

    What medication strategy is appropriate for uncomplicated cystitis?

    Відповідь

    Nitrofurantoin, trimethoprim-sulfamethoxazole where appropriate, or fosfomycin are common first-line options guided by patient factors and resistance.

    EAU Guidelines on Urological Infections · reviewed 2026-08-26

  338. Картка 338

    Питання

    Which diagnosis warrants empiric treatment when lower abdominal pain occurs with cervical-motion, uterine, or adnexal tenderness in a patient at STI risk?

    Відповідь

    Pelvic inflammatory disease. Lower abdominal pain with cervical motion, uterine, or adnexal tenderness in a patient at STI risk supports empiric PID treatment.

    Pelvic Inflammatory Disease: STI Treatment Guidelines · reviewed 2026-08-26

  339. Картка 339

    Питання

    How should a clinician confirm or characterize pulmonary embolism?

    Відповідь

    Use pretest probability with PERC or D-dimer when appropriate and CT pulmonary angiography for indicated stable patients.

    ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26

  340. Картка 340

    Питання

    Which diagnosis requires at least six months of illness with psychosis and functional decline, including at least one month of active symptoms, after exclusions?

    Відповідь

    Schizophrenia. At least six months of illness with psychosis and functional decline, including at least one month of active symptoms, supports schizophrenia after exclusions.

    Management of First-Episode Psychosis and Schizophrenia · reviewed 2026-08-26

  342. Картка 342

    Питання

    What is the priority management step for primary adrenal insufficiency?

    Відповідь

    Suspected adrenal crisis requires immediate glucocorticoid and isotonic fluid treatment before confirmatory results.

    Primary Adrenal Insufficiency Guideline Resources · reviewed 2026-08-26

  344. Картка 344

    Питання

    In a child aged 6 months or older, what is the priority management step for acute otitis media?

    Відповідь

    Provide analgesia; treat severe illness promptly with antibiotics and use 24–48 hours of watchful waiting only for selected mildly ill children with reliable follow-up.

    Management of Acute Otitis Media in Children Six Months of Age and Older · reviewed 2026-08-26

  345. Картка 345

    Питання

    When antibiotic susceptibility is unknown, which empiric regimen is preferred for most treatment-naive Helicobacter pylori infection?

    Відповідь

    Use 14-day optimized bismuth quadruple therapy: a proton-pump inhibitor, bismuth, tetracycline, and metronidazole.

    ACG Clinical Guideline: Treatment of Helicobacter pylori Infection · reviewed 2026-08-26

  346. Картка 346

    Питання

    In a child or adolescent, which diagnosis best fits this presentation: Hematuria with dysmorphic red cells or casts, hypertension, edema, and reduced kidney function suggests glomerular inflammation.

    Відповідь

    Nephritic syndrome. Hematuria with dysmorphic red cells or casts, hypertension, edema, and reduced kidney function suggests glomerular inflammation.

    KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases with 2024 Chapter Updates · reviewed 2026-08-26

  352. Картка 352

    Питання

    Which test or testing sequence best evaluates suspected pulmonary tuberculosis?

    Відповідь

    Obtain chest imaging and multiple respiratory specimens for nucleic-acid testing, smear, and culture with susceptibility testing.

    Clinical and Laboratory Diagnosis for Tuberculosis · reviewed 2026-08-26

  353. Картка 353

    Питання

    Which test or testing sequence best evaluates suspected endometriosis?

    Відповідь

    Diagnosis can be clinical with imaging for endometrioma or deep disease; laparoscopy is not mandatory before initial treatment.

    Endometriosis · reviewed 2026-08-26

  354. Картка 354

    Питання

    Which test or testing sequence best evaluates suspected panic disorder?

    Відповідь

    Diagnosis is clinical after considering cardiac, pulmonary, endocrine, neurologic, medication, and substance causes.

    Panic Disorder: What You Need to Know · reviewed 2026-08-26

  355. Картка 355

    Питання

    How can a clinician reduce avoidable harm related to Crohn disease?

    Відповідь

    Support smoking cessation and use effective maintenance therapy with objective monitoring to reduce relapse and complications.

    Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26

  358. Картка 358

    Питання

    Which history or examination finding most strongly supports peritonsillar abscess?

    Відповідь

    Severe unilateral sore throat, muffled voice, drooling, trismus, and uvular deviation suggest a peritonsillar collection.

    Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26

  359. Картка 359

    Питання

    When should a safety event or near miss be reported?

    Відповідь

    Report it through the local safety system promptly, including near misses, so hazards can be corrected without waiting for patient harm.

    Reporting Patient Safety Events · reviewed 2026-08-26

  361. Картка 361

    Питання

    Which bedside pattern best points to pleural effusion?

    Відповідь

    Dyspnea with reduced breath sounds, dullness to percussion, and decreased tactile fremitus suggests pleural fluid.

    British Thoracic Society Guideline for Pleural Disease · reviewed 2026-08-26

  362. Картка 362

    Питання

    For surgical decision-making, what immediate plan is appropriate for melanoma?

    Відповідь

    Prompt complete diagnostic excision and staging guide definitive surgical management.

    Melanoma Clinical Guidelines · reviewed 2026-08-26

  363. Картка 363

    Питання

    A clinician is considering uncomplicated cystitis. Which finding adds the most support?

    Відповідь

    Dysuria and frequency without vaginal symptoms strongly support lower urinary infection in an appropriate patient.

    EAU Guidelines on Urological Infections · reviewed 2026-08-26

  364. Картка 364

    Питання

    In a child or adolescent, which clinical sequence defines a generalized tonic-clonic seizure?

    Відповідь

    Loss of consciousness with bilateral tonic stiffening followed by clonic jerking and a postictal period defines the typical sequence.

    Epilepsies in Children, Young People and Adults · reviewed 2026-08-26

  365. Картка 365

    Питання

    What is the priority management step for chronic kidney disease?

    Відповідь

    Identify cause, quantify progression risk, treat complications, and refer for high-risk features or advanced disease.

    2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26

  366. Картка 366

    Питання

    Why does sepsis produce its defining clinical pattern?

    Відповідь

    A dysregulated host response causes endothelial injury, vasodilation, capillary leak, and organ dysfunction.

    2026 Surviving Sepsis Campaign Adult Guidelines · reviewed 2026-08-26

  367. Картка 367

    Питання

    Which history or examination finding most strongly supports stable chronic hypertension?

    Відповідь

    Repeated properly measured elevated readings, usually without symptoms, establish the clinical pattern.

    2025 High Blood Pressure Guideline · reviewed 2026-08-26

  368. Картка 368

    Питання

    Why does pelvic inflammatory disease produce its defining clinical pattern?

    Відповідь

    Ascending polymicrobial infection inflames endometrium and tubes, causing scarring and future ectopic or infertility risk.

    Pelvic Inflammatory Disease: STI Treatment Guidelines · reviewed 2026-08-26

  369. Картка 369

    Питання

    Which bedside pattern best points to chronic hepatitis C?

    Відповідь

    Most chronic infections are asymptomatic; abnormal aminotransferases or risk-based screening may reveal disease.

    Viral Hepatitis Clinical Care · reviewed 2026-08-26

  370. Картка 370

    Питання

    Which symptom domains should a clinician assess in schizophrenia?

    Відповідь

    Assess positive, negative, cognitive, and mood symptoms together with substance use, functioning, and safety.

    Management of First-Episode Psychosis and Schizophrenia · reviewed 2026-08-26

  371. Картка 371

    Питання

    For surgical decision-making, an older adult after a fall has groin pain, cannot bear weight, and holds a shortened, externally rotated leg. Which diagnosis is most likely?

    Відповідь

    Hip fracture. An older adult after a fall with groin pain, inability to bear weight, and a shortened externally rotated leg likely has a hip fracture.

    Management of Hip Fractures in Older Adults: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26

  372. Картка 372

    Питання

    In pulmonary embolism with hemodynamic compromise and no prohibitive bleeding risk, which drug class should be considered for reperfusion?

    Відповідь

    Use systemic thrombolytic therapy followed by anticoagulation; weigh the immediate bleeding risk and activate an advanced-reperfusion pathway.

    ASH 2020 Guidelines for Treatment of Deep Vein Thrombosis and Pulmonary Embolism · reviewed 2026-08-26

  373. Картка 373

    Питання

    Which diagnosis best fits this presentation: Unilateral leg swelling, pain, warmth, and risk from immobility, surgery, cancer, estrogen, or prior VTE raise suspicion.

    Відповідь

    Acute deep-vein thrombosis. Unilateral leg swelling, pain, warmth, and risk from immobility, surgery, cancer, estrogen, or prior VTE raise suspicion.

    ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26

  374. Картка 374

    Питання

    Which preventive measure belongs in care for type 2 diabetes mellitus?

    Відповідь

    Weight-supportive nutrition, physical activity, tobacco avoidance, and cardiometabolic risk control prevent complications.

    Standards of Care in Diabetes—2026 · reviewed 2026-08-26

  376. Картка 376

    Питання

    Which preventive measure belongs in care for acute angle-closure glaucoma?

    Відповідь

    Definitive treatment of the fellow narrow-angle eye helps prevent a second attack.

    Management of Angle-Closure Glaucoma · reviewed 2026-08-26

  377. Картка 377

    Питання

    Exertional dyspnea, orthopnea, edema, elevated jugular venous pressure, an S3, and an echocardiographic LVEF of 35% indicate which heart-failure phenotype?

    Відповідь

    Heart failure with reduced ejection fraction (HFrEF). The congestion findings establish heart failure, and an LVEF of 40% or less identifies the reduced-EF phenotype.

    2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26

  378. Картка 378

    Питання

    What clinical clue should raise suspicion for multiple sclerosis relapse?

    Відповідь

    A focal neurologic deficit evolving over hours to days and lasting over 24 hours, separated in time and space from prior events, suggests relapse.

    Multiple Sclerosis in Adults: Management · reviewed 2026-08-26

  380. Картка 380

    Питання

    What clinical clue should raise suspicion for HIV infection?

    Відповідь

    Acute retroviral illness can cause fever, rash, pharyngitis, lymphadenopathy, or no symptoms; chronic infection may remain silent.

    About HIV · reviewed 2026-08-26

  382. Картка 382

    Питання

    What clinical clue should raise suspicion for postpartum hemorrhage?

    Відповідь

    Heavy postpartum bleeding with uterine atony, retained tissue, trauma, or coagulopathy can rapidly cause shock.

    Postpartum Hemorrhage · reviewed 2026-08-26

  384. Картка 384

    Питання

    What clinical clue should raise suspicion for delirium?

    Відповідь

    An acute fluctuating disturbance of attention and awareness with disorganized thinking suggests delirium.

    Delirium: Prevention, Diagnosis and Management · reviewed 2026-08-26

  385. Картка 385

    Питання

    For surgical decision-making, what immediate plan is appropriate for ureteral stone?

    Відповідь

    Provide analgesia, check for infection and kidney injury, and decompress urgently when obstruction is infected.

    EAU Guidelines on Urolithiasis · reviewed 2026-08-26

  387. Картка 387

    Питання

    In a child or adolescent, a clinician is considering atopic dermatitis. Which finding adds the most support?

    Відповідь

    Chronic pruritic eczematous patches with age-dependent flexural or facial distribution and a relapsing course are typical.

    Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26

  389. Картка 389

    Питання

    Which history or examination finding most strongly supports chronic kidney disease?

    Відповідь

    CKD may be silent; edema, pruritus, anemia, hypertension, or abnormal urine testing often appears later.

    2024 CKD Evaluation and Management Guideline · reviewed 2026-08-26

  390. Картка 390

    Питання

    Identify the condition from this pattern: Persistent symptoms beyond 10 days, severe fever with purulent drainage, or worsening after initial improvement are patterns that support bacterial disease.

    Відповідь

    Acute bacterial rhinosinusitis. Persistent symptoms beyond 10 days, severe fever with purulent drainage, or worsening after initial improvement are patterns that support bacterial disease.

    Clinical Practice Guideline: Adult Sinusitis Update · reviewed 2026-08-26

  392. Картка 392

    Питання

    How should a clinician respond to a patient’s prejudiced request or discriminatory behavior?

    Відповідь

    Address the behavior directly, explore its reasons, set limits that protect staff and other patients, and do not accommodate invidious discrimination; urgent care still takes priority.

    Discrimination and Disruptive Behavior by Patients · reviewed 2026-08-26

  394. Картка 394

    Питання

    How should a clinician confirm or characterize acute pancreatitis?

    Відповідь

    Diagnosis requires two of three: characteristic pain, lipase or amylase at least three times normal, or compatible imaging.

    ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26

  395. Картка 395

    Питання

    Which next action matters most in pulmonary tuberculosis?

    Відповідь

    Isolate suspected contagious disease and coordinate promptly with public health.

    Tuberculosis Infection Control · reviewed 2026-08-26

  397. Картка 397

    Питання

    For surgical decision-making, which next action matters most in endometriosis?

    Відповідь

    Offer empiric symptom treatment or surgery based on severity, fertility goals, masses, and response.

    Endometriosis · reviewed 2026-08-26

  398. Картка 398

    Питання

    A patient has this pattern: Sudden dyspnea, pleuritic pain, tachycardia, hypoxemia, hemoptysis, or syncope with VTE risk raises suspicion. What is the most likely diagnosis?

    Відповідь

    Pulmonary embolism. Sudden dyspnea, pleuritic pain, tachycardia, hypoxemia, hemoptysis, or syncope with VTE risk raises suspicion.

    ASH VTE Guidelines: Diagnosis of Venous Thromboembolism · reviewed 2026-08-26

  399. Картка 399

    Питання

    Which next action matters most in panic disorder?

    Відповідь

    During an attack, ensure safety and exclude an emergency; for ongoing disorder, offer cognitive behavioral therapy and/or medication.

    Panic Disorder: What You Need to Know · reviewed 2026-08-26

  401. Картка 401

    Питання

    What immediate plan is appropriate for COPD?

    Відповідь

    For an exacerbation, increase short-acting bronchodilation, use systemic steroids, add antibiotics when indicated, and support ventilation.

    2026 GOLD Report and Pocket Guide · reviewed 2026-08-26

  402. Картка 402

    Питання

    In a child or adolescent, which bedside pattern best points to juvenile idiopathic arthritis?

    Відповідь

    Persistent joint swelling, limited motion, or morning stiffness beginning before age 16, after excluding other causes, suggests JIA.

    2026 Juvenile Idiopathic Arthritis Guidelines · reviewed 2026-08-26

  403. Картка 403

    Питання

    What is the priority management step for stable chronic hypertension?

    Відповідь

    Estimate cardiovascular risk, assess target-organ damage, and set an individualized treatment plan.

    2025 High Blood Pressure Guideline · reviewed 2026-08-26

  408. Картка 408

    Питання

    Which medication prevents seizures in preeclampsia with severe features?

    Відповідь

    Use magnesium sulfate for seizure prophylaxis while controlling severe hypertension and planning delivery according to maternal and fetal status.

    Gestational Hypertension and Preeclampsia · reviewed 2026-08-26

  409. Картка 409

    Питання

    What is shared decision-making?

    Відповідь

    The clinician presents reasonable options and evidence, elicits the patient’s goals and tradeoffs, and reaches a choice together when more than one path is reasonable.

    The SHARE Approach · reviewed 2026-08-26

  410. Картка 410

    Питання

    In a child aged 6 years or older or an adolescent, what drug class or regimen fits attention-deficit/hyperactivity disorder?

    Відповідь

    Extended-release stimulants are first-line medication for most children and adolescents when combined with nonpharmacologic care and monitored for benefit and adverse effects.

    ADHD in Children and Youth: Part 2—Treatment · reviewed 2026-08-26

  412. Картка 412

    Питання

    Which pharmacologic approach is preferred for acute angle-closure glaucoma?

    Відповідь

    Use pressure-lowering topical agents plus systemic acetazolamide when appropriate; pilocarpine is added after pressure begins to fall.

    Management of Angle-Closure Glaucoma · reviewed 2026-08-26

  413. Картка 413

    Питання

    Which diagnosis best fits this presentation: A painful unilateral grouped-vesicle eruption in a dermatomal distribution is characteristic.

    Відповідь

    Herpes zoster. A painful unilateral grouped-vesicle eruption in a dermatomal distribution is characteristic.

    Clinical Overview of Shingles (Herpes Zoster) · reviewed 2026-08-26

  415. Картка 415

    Питання

    What counseling point helps reduce harm from symptomatic aortic stenosis?

    Відповідь

    Teach patients to report exertional dyspnea, angina, presyncope, or syncope promptly; new symptoms require timely reassessment, and severe symptomatic AS warrants valve-team evaluation rather than surveillance alone.

    2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26

  416. Картка 416

    Питання

    For surgical decision-making, which diagnosis best fits this presentation: Abrupt severe unilateral scrotal pain, a high-riding transverse testis, nausea, and an absent cremasteric reflex are concerning.

    Відповідь

    Testicular torsion. Sudden severe unilateral pain with nausea or vomiting, a high-riding transverse testis, and loss of the cremasteric reflex is the classic pattern.

    Testicular Torsion · reviewed 2026-08-26

  420. Картка 420

    Питання

    For surgical decision-making, what condition should be suspected from this finding: Headache, fever, focal deficit, seizure, or signs of raised intracranial pressure after sinus, ear, dental, or bloodstream infection raise suspicion.

    Відповідь

    Bacterial brain abscess. Headache, fever, focal deficit, seizure, or signs of raised intracranial pressure after sinus, ear, dental, or bloodstream infection raise suspicion.

    ESCMID Guideline on Diagnosis and Treatment of Brain Abscess in Children and Adults · reviewed 2026-08-26

  422. Картка 422

    Питання

    What condition should be suspected from this finding: Chronic cough, fever, night sweats, weight loss, hemoptysis, or epidemiologic exposure raises concern.

    Відповідь

    Pulmonary tuberculosis. Chronic cough, fever, night sweats, weight loss, hemoptysis, or epidemiologic exposure raises concern.

    Clinical Overview of Tuberculosis Disease · reviewed 2026-08-26

  423. Картка 423

    Питання

    Which pharmacologic approach is preferred for type 2 diabetes mellitus?

    Відповідь

    Choose glucose-lowering therapy around comorbid ASCVD, heart failure, CKD, weight goals, hypoglycemia risk, and patient priorities; metformin remains appropriate for many.

    Standards of Care in Diabetes—2026 · reviewed 2026-08-26

  424. Картка 424

    Питання

    For surgical decision-making, which diagnosis best fits cyclic pelvic pain, dysmenorrhea, deep dyspareunia, painful defecation, or infertility?

    Відповідь

    Endometriosis. Cyclic pelvic pain, dysmenorrhea, deep dyspareunia, painful defecation, or infertility suggests endometriosis.

    Endometriosis · reviewed 2026-08-26

  425. Картка 425

    Питання

    How should a clinician confirm or characterize sudden sensorineural hearing loss?

    Відповідь

    Differentiate sensorineural from conductive loss with bedside testing and urgent audiometry.

    Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26

  426. Картка 426

    Питання

    Which diagnosis requires recurrent unexpected panic attacks plus persistent worry or maladaptive avoidance for at least one month?

    Відповідь

    Panic disorder. Recurrent unexpected panic attacks plus persistent worry or maladaptive avoidance for at least a month suggests panic disorder.

    Panic Disorder: What You Need to Know · reviewed 2026-08-26

  427. Картка 427

    Питання

    How should uncertainty be communicated?

    Відповідь

    Name what is known and unknown, explain the leading possibilities and why, state the plan to reduce uncertainty, and give specific follow-up or return precautions.

    Why Does Clinical Uncertainty Matter? · reviewed 2026-08-26

  428. Картка 428

    Питання

    Which medication is FDA-approved for moderate-to-severe obstructive sleep apnea in adults with obesity?

    Відповідь

    Tirzepatide is approved for adults with obesity and moderate-to-severe obstructive sleep apnea, used with a reduced-calorie diet and increased physical activity.

    FDA Approves First Medication for Obstructive Sleep Apnea · reviewed 2026-08-26

  431. Картка 431

    Питання

    A clinician is considering upper gastrointestinal bleeding. Which finding adds the most support?

    Відповідь

    Hematemesis, coffee-ground emesis, or melena with orthostasis indicates an upper gastrointestinal source until shown otherwise.

    ACG Clinical Guideline: Upper Gastrointestinal and Ulcer Bleeding · reviewed 2026-08-26

  434. Картка 434

    Питання

    Which treatment should not be offered solely to treat multiple sclerosis?

    Відповідь

    Do not offer vitamin D solely to treat multiple sclerosis.

    Multiple Sclerosis in Adults: Management · reviewed 2026-08-26

  435. Картка 435

    Питання

    Which pathophysiologic process drives plaque psoriasis?

    Відповідь

    IL-23 and Th17 pathway activation drives accelerated keratinocyte turnover.

    Psoriasis Clinical Guidelines · reviewed 2026-08-26

  436. Картка 436

    Питання

    How can a clinician reduce avoidable harm related to HIV infection?

    Відповідь

    PrEP, condoms, sterile injection equipment, perinatal treatment, and sustained viral suppression prevent transmission.

    Preventing HIV · reviewed 2026-08-26

  437. Картка 437

    Питання

    Which pathophysiologic process drives acute pyelonephritis?

    Відповідь

    Ascending infection reaches the renal pelvis and parenchyma, producing systemic illness.

    EAU Guidelines on Urological Infections · reviewed 2026-08-26

  438. Картка 438

    Питання

    How can a clinician reduce avoidable harm related to postpartum hemorrhage?

    Відповідь

    Antenatal anemia treatment, active management of the third stage, and hemorrhage protocols reduce morbidity.

    Postpartum Hemorrhage · reviewed 2026-08-26

  439. Картка 439

    Питання

    What is the key first diagnostic step for tension pneumothorax?

    Відповідь

    Diagnosis is clinical in an unstable patient; bedside ultrasound can support it but imaging must not delay decompression.

    Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26

  440. Картка 440

    Питання

    How can a clinician reduce avoidable harm related to delirium?

    Відповідь

    Orientation, mobility, sleep protection, hearing and vision aids, hydration, and medication review reduce hospital delirium.

    Delirium: Prevention, Diagnosis and Management · reviewed 2026-08-26

  445. Картка 445

    Питання

    A patient has this pattern: Severe persistent epigastric pain radiating to the back with nausea and vomiting is typical. What is the most likely diagnosis?

    Відповідь

    Acute pancreatitis. Severe persistent epigastric pain radiating to the back with nausea and vomiting is typical.

    ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26

  446. Картка 446

    Питання

    For surgical decision-making, a noncontact pivot causes an audible pop, immediate swelling, instability, and a positive Lachman test. What is the most likely diagnosis?

    Відповідь

    Anterior cruciate ligament tear. A noncontact pivot, audible pop, immediate swelling, and instability with a positive Lachman test suggest an ACL tear.

    Management of Anterior Cruciate Ligament Injuries: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26

  448. Картка 448

    Питання

    Which electrolyte disorder may cause weakness, paresthesias, bradycardia, or ECG changes but can be dangerous even without symptoms?

    Відповідь

    Hyperkalemia. Weakness, paresthesias, bradycardia, or ECG changes can occur, but dangerous hyperkalemia may be asymptomatic.

    Clinical Practice Guideline: Treatment of Acute Hyperkalaemia in Adults · reviewed 2026-08-26

  450. Картка 450

    Питання

    Which pharmacologic approach is preferred for heart failure with reduced ejection fraction?

    Відповідь

    Foundational chronic therapy includes an ARNI or ACE inhibitor/ARB, an evidence-based beta-blocker, an MRA, and an SGLT2 inhibitor when tolerated.

    2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26

  451. Картка 451

    Питання

    For surgical decision-making, severe dyspnea, unilateral absent breath sounds, hypotension, distended neck veins, and obstructive shock indicate which diagnosis?

    Відповідь

    Tension pneumothorax. Severe dyspnea, unilateral absent breath sounds, hypotension, distended neck veins, and obstructive shock suggest tension physiology.

    Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26

  452. Картка 452

    Питання

    Which bedside pattern best points to ectopic pregnancy?

    Відповідь

    Unilateral pelvic pain or bleeding in early pregnancy, especially with syncope or shoulder pain, raises concern for ectopic implantation.

    Ectopic Pregnancy · reviewed 2026-08-26

  456. Картка 456

    Питання

    What clinical clue should raise suspicion for type 2 diabetes mellitus?

    Відповідь

    Polyuria, polydipsia, blurred vision, recurrent infections, or an asymptomatic high-risk patient may reveal hyperglycemia.

    Standards of Care in Diabetes—2026 · reviewed 2026-08-26

  457. Картка 457

    Питання

    In a postmenopausal woman or man aged 50 or older, which steps support bone health and reduce fracture risk?

    Відповідь

    Adequate calcium and vitamin D, weight-bearing and muscle-strengthening exercise, fall-risk reduction, tobacco cessation, and avoiding excess alcohol support bone health.

    The clinician’s guide to prevention and treatment of osteoporosis · reviewed 2026-08-26

  458. Картка 458

    Питання

    What clinical clue should raise suspicion for acute angle-closure glaucoma?

    Відповідь

    Sudden painful red eye, blurred vision with halos, headache, nausea, a fixed mid-dilated pupil, and a firm globe are classic.

    Management of Angle-Closure Glaucoma · reviewed 2026-08-26

  461. Картка 461

    Питання

    Which test or testing sequence best evaluates suspected plaque psoriasis?

    Відповідь

    Diagnosis is usually clinical; biopsy is reserved for uncertain morphology.

    Psoriasis Clinical Guidelines · reviewed 2026-08-26

  463. Картка 463

    Питання

    What diagnostic approach is most appropriate when uncomplicated cystitis is suspected?

    Відповідь

    Urinalysis supports the diagnosis; culture is important for complicated, recurrent, resistant, pregnant, or atypical cases.

    EAU Guidelines on Urological Infections · reviewed 2026-08-26

  466. Картка 466

    Питання

    How should a clinician initially manage early syphilis?

    Відповідь

    Treat the patient and ensure partner evaluation; urgent specialist evaluation is needed for ocular, otic, or neurologic disease.

    Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26

  469. Картка 469

    Питання

    Why does acute cholecystitis produce its defining clinical pattern?

    Відповідь

    A gallstone can block bile flow, causing gallbladder pain and swelling (inflammation).

    Cholecystectomy · reviewed 2026-08-26

  471. Картка 471

    Питання

    In a child or adolescent, a clinician is considering septic arthritis. Which finding adds the most support?

    Відповідь

    Acute severe monoarticular pain, restricted passive motion, fever, or bacteremia risk is septic arthritis until excluded.

    Guideline for Management of Septic Arthritis in Native Joints · reviewed 2026-08-26

  473. Картка 473

    Питання

    For an eligible infant or selected high-risk child aged 8–19 months, which immunization strategy reduces severe RSV disease?

    Відповідь

    Use either maternal RSV vaccination or a recommended long-acting RSV antibody to protect infants; give nirsevimab to eligible high-risk children aged 8–19 months entering a second RSV season.

    RSV Immunization Guidance for Infants and Young Children · reviewed 2026-08-26

  474. Картка 474

    Питання

    Which diagnosis causes weight loss, fatigue, hypotension, salt craving, hyperpigmentation, hyponatremia, and hyperkalemia?

    Відповідь

    Primary adrenal insufficiency. Weight loss, fatigue, hypotension, salt craving, hyperpigmentation, hyponatremia, and hyperkalemia suggest primary adrenal failure.

    Primary Adrenal Insufficiency Guideline Resources · reviewed 2026-08-26

  475. Картка 475

    Питання

    What is the ethical approach to a learner performing a procedure?

    Відповідь

    Tell the patient who will participate, describe supervision, obtain voluntary agreement, and ensure refusal does not compromise care.

    Residents and Fellows: Patient Involvement in Self-Education · reviewed 2026-08-26

  476. Картка 476

    Питання

    In a child aged 6 months or older, what condition should be suspected from a bulging tympanic membrane with acute ear pain or new otorrhea?

    Відповідь

    Acute otitis media. A bulging tympanic membrane with acute ear pain or new otorrhea is more specific than redness alone.

    Management of Acute Otitis Media in Children Six Months of Age and Older · reviewed 2026-08-26

  478. Картка 478

    Питання

    How should medication be used in multiple sclerosis relapse?

    Відповідь

    High-dose corticosteroids shorten a disabling relapse; they do not alter long-term progression by themselves.

    Multiple Sclerosis in Adults: Management · reviewed 2026-08-26

  479. Картка 479

    Питання

    What immediate plan is appropriate for acute pancreatitis?

    Відповідь

    Use early isotonic fluids guided by response, analgesia, and early oral feeding as tolerated; address the cause.

    ACG Clinical Guideline: Management of Acute Pancreatitis · reviewed 2026-08-26

  480. Картка 480

    Питання

    How should medication be used in HIV infection?

    Відповідь

    Use a recommended combination antiretroviral regimen selected for resistance, interactions, comorbidity, pregnancy potential, and patient preference.

    What to Start: Initial Combination Antiretroviral Regimens · reviewed 2026-08-26

  482. Картка 482

    Питання

    How should medication be used in postpartum hemorrhage?

    Відповідь

    Oxytocin is first-line for uterine atony; add other uterotonics according to contraindications and give tranexamic acid early when indicated.

    Postpartum Hemorrhage · reviewed 2026-08-26

  483. Картка 483

    Питання

    In a child or adolescent, which history or examination finding most strongly supports asthma?

    Відповідь

    Variable wheeze, cough, chest tightness, or dyspnea that changes over time and with triggers suggests asthma.

    2026 GINA Strategy Report · reviewed 2026-08-26

  484. Картка 484

    Питання

    How should medication be used in delirium?

    Відповідь

    Reserve short-term antipsychotic use for severe dangerous agitation after reversible causes and contraindications are addressed.

    Delirium: Prevention, Diagnosis and Management · reviewed 2026-08-26

  485. Картка 485

    Питання

    Which preventive measure belongs in care for herpes zoster?

    Відповідь

    Age-appropriate recombinant zoster vaccination lowers zoster and postherpetic-neuralgia risk.

    Clinical Overview of Shingles (Herpes Zoster) · reviewed 2026-08-26

  486. Картка 486

    Питання

    For surgical decision-making, what condition should be suspected from this finding: Abrupt severe chest or back pain, pulse or blood-pressure asymmetry, and a new aortic regurgitation murmur are high-risk clues.

    Відповідь

    Aortic dissection. Abrupt severe chest or back pain, pulse or blood-pressure asymmetry, and a new aortic regurgitation murmur are high-risk clues.

    2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease · reviewed 2026-08-26

  487. Картка 487

    Питання

    Which preventive step is required during surgery for viable testicular torsion?

    Відповідь

    Perform bilateral orchiopexy, fixing the affected and contralateral testes to reduce future torsion risk.

    Testicular Torsion · reviewed 2026-08-26

  488. Картка 488

    Питання

    Which test or testing sequence best evaluates suspected hyponatremia due to SIADH?

    Відповідь

    Confirm low serum osmolality with inappropriately concentrated urine and urine sodium after excluding thyroid, adrenal, renal, and diuretic causes.

    Clinical Practice Guideline on Diagnosis and Treatment of Hyponatraemia · reviewed 2026-08-26

  489. Картка 489

    Питання

    Why does primary hypothyroidism produce its defining clinical pattern?

    Відповідь

    Low thyroid hormone removes feedback inhibition, so TSH rises in primary gland failure.

    Guidelines for the Treatment of Hypothyroidism · reviewed 2026-08-26

  491. Картка 491

    Питання

    Why does bacterial conjunctivitis produce its defining clinical pattern?

    Відповідь

    Bacterial infection of the conjunctiva commonly produces red eye with purulent discharge that mats the eyelids.

    Clinical Overview of Pink Eye (Conjunctivitis) · reviewed 2026-08-26

  492. Картка 492

    Питання

    When is a chaperone appropriate for an intimate examination?

    Відповідь

    Offer a trained chaperone, respect patient preferences when safety permits, explain the examination, obtain consent, and document who was present.

    Use of Chaperones · reviewed 2026-08-26

  493. Картка 493

    Питання

    Which diagnosis causes recurrent unilateral pulsating headache with nausea or sensory sensitivity, preceded by gradually spreading reversible visual or sensory symptoms?

    Відповідь

    Migraine with aura. Recurrent unilateral pulsating headache with nausea or sensory sensitivity, preceded by gradually spreading reversible visual or sensory symptoms, suggests migraine with aura.

    ICHD-3: Migraine with Aura · reviewed 2026-08-26

  494. Картка 494

    Питання

    What medication strategy is appropriate for Crohn disease?

    Відповідь

    Corticosteroids can induce remission but are not maintenance therapy; immunomodulator or biologic selection depends on risk and phenotype.

    Updated 2025 ACG Guidelines for Crohn’s Disease · reviewed 2026-08-26

  495. Картка 495

    Питання

    Which diagnosis best fits a painless chancre or a diffuse rash involving the palms and soles with generalized lymphadenopathy?

    Відповідь

    Early syphilis. A painless chancre or a diffuse rash involving palms and soles with generalized lymphadenopathy suggests syphilis by stage.

    Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26

  497. Картка 497

    Питання

    Which diagnosis best fits irregular, unpredictable uterine bleeding at reproductive extremes or with endocrine disruption?

    Відповідь

    Abnormal uterine bleeding from anovulation. Irregular unpredictable bleeding without cyclic ovulation is common at reproductive extremes or with endocrine disruption.

    Abnormal Uterine Bleeding · reviewed 2026-08-26

  499. Картка 499

    Питання

    Which diagnosis requires intrusion, avoidance, negative mood or cognition, and hyperarousal lasting more than one month after trauma?

    Відповідь

    Post-traumatic stress disorder. Intrusion, avoidance, negative mood or cognition, and hyperarousal lasting over a month after trauma suggest PTSD.

    Management of Posttraumatic Stress Disorder and Acute Stress Disorder · reviewed 2026-08-26

  501. Картка 501

    Питання

    Which diagnosis best fits loud snoring, witnessed apneas, gasping, daytime sleepiness, morning headache, or resistant hypertension?

    Відповідь

    Obstructive sleep apnea. Loud snoring, witnessed apneas, gasping, daytime sleepiness, morning headache, or resistant hypertension suggests OSA.

    Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea · reviewed 2026-08-26

  502. Картка 502

    Питання

    What drug class or regimen fits atrial fibrillation?

    Відповідь

    Choose anticoagulation from validated thromboembolic-risk assessment; direct oral anticoagulants are preferred for most eligible patients without mechanical valves or moderate-to-severe rheumatic mitral stenosis.

    2023 ACC/AHA/ACCP/HRS Guideline for Atrial Fibrillation: Key Perspectives · reviewed 2026-08-26

  503. Картка 503

    Питання

    In a child or adolescent, which history or examination finding most strongly supports acute appendicitis?

    Відповідь

    Periumbilical pain migrating to the right lower quadrant with anorexia, nausea, fever, and focal tenderness is typical.

    Guideline for the Diagnosis and Treatment of Appendicitis · reviewed 2026-08-26

  504. Картка 504

    Питання

    Which diagnosis best fits this presentation: Nocturnal numbness or tingling in the thumb, index, and middle fingers with thenar weakness suggests median-nerve compression.

    Відповідь

    Carpal tunnel syndrome. Nocturnal numbness or tingling in the thumb, index, and middle fingers with thenar weakness suggests median-nerve compression.

    Management of Carpal Tunnel Syndrome: Evidence-Based Clinical Practice Guideline · reviewed 2026-08-26

  506. Картка 506

    Питання

    In a child or adolescent, how can a clinician reduce avoidable harm related to diabetic ketoacidosis?

    Відповідь

    Sick-day planning, continued basal insulin, ketone checks, and early contact for illness reduce recurrence.

    Standards of Care in Diabetes—2026 · reviewed 2026-08-26

  507. Картка 507

    Питання

    How should a clinician confirm or characterize early syphilis?

    Відповідь

    Use a nontreponemal test with a treponemal confirmatory test, or the reverse sequence; evaluate neurologic or ocular symptoms separately.

    Primary and Secondary Syphilis: STI Treatment Guidelines · reviewed 2026-08-26

  508. Картка 508

    Питання

    How can a clinician reduce avoidable harm related to retinal detachment?

    Відповідь

    Assess sudden new floaters, flashes, or a curtain immediately; early treatment can prevent permanent vision loss. Dilated examination can find a small tear or detachment before vision is affected.

    Retinal Detachment · reviewed 2026-08-26

  510. Картка 510

    Питання

    How should social media be handled when a clinical story seems de-identified?

    Відповідь

    Do not post patient material without proper authorization; combinations of details can identify a person even when names are removed.

    Professionalism in the Use of Social Media · reviewed 2026-08-26

  513. Картка 513

    Питання

    In a child or adolescent, what medication strategy is appropriate for atopic dermatitis?

    Відповідь

    Topical corticosteroids are first-line for most flares; steroid-sparing topical agents help at sensitive sites or with maintenance.

    Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26

  516. Картка 516

    Питання

    Which history or examination finding most strongly supports acute pyelonephritis?

    Відповідь

    Fever, flank pain, costovertebral-angle tenderness, nausea, and urinary symptoms suggest renal infection.

    EAU Guidelines on Urological Infections · reviewed 2026-08-26

  517. Картка 517

    Питання

    For surgical decision-making, which next action matters most in tension pneumothorax?

    Відповідь

    Perform immediate decompression followed by tube thoracostomy.

    Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26

  518. Картка 518

    Питання

    Which diagnosis best fits this presentation: Chronic diarrhea, bloating, weight loss, iron deficiency, dermatitis herpetiformis, or unexplained osteoporosis can be the clue.

    Відповідь

    Celiac disease. Chronic diarrhea, bloating, weight loss, iron deficiency, dermatitis herpetiformis, or unexplained osteoporosis can be the clue.

    ACG Clinical Guidelines: Diagnosis and Management of Celiac Disease · reviewed 2026-08-26

  519. Картка 519

    Питання

    What physiologic disturbance underlies anterior cruciate ligament tear?

    Відповідь

    An ACL tear removes a primary restraint to anterior tibial translation and rotation, producing anterior and rotational instability.

    The Management of Anterior Cruciate Ligament Injuries · reviewed 2026-08-26

  520. Картка 520

    Питання

    A clinician is considering heart failure with reduced ejection fraction. Which finding adds the most support?

    Відповідь

    Exertional dyspnea, orthopnea, edema, elevated jugular venous pressure, and an S3 support volume-overloaded heart failure.

    2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26

  523. Картка 523

    Питання

    What physiologic disturbance underlies pulmonary tuberculosis?

    Відповідь

    Mycobacteria survive in macrophages and drive granulomatous inflammation with latent or active disease.

    Clinical Overview of Tuberculosis Disease · reviewed 2026-08-26

  524. Картка 524

    Питання

    Which antibiotic is required for gonococcal conjunctivitis in an adult?

    Відповідь

    Give systemic ceftriaxone; consider one-time saline lavage and evaluate for chlamydial coinfection when it has not been excluded.

    Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26

  525. Картка 525

    Питання

    What physiologic disturbance underlies endometriosis?

    Відповідь

    Estrogen-responsive ectopic endometrial-like tissue drives inflammation, fibrosis, and pain.

    Endometriosis · reviewed 2026-08-26

  526. Картка 526

    Питання

    What should a clinician do after sending protected information to the wrong recipient?

    Відповідь

    Act immediately to limit further disclosure, notify the organization’s privacy or security process, document facts, and follow breach assessment requirements.

    Breach Notification Rule · reviewed 2026-08-26

  527. Картка 527

    Питання

    Which clinical pattern defines a panic attack?

    Відповідь

    An abrupt surge of intense fear or discomfort with physical and cognitive symptoms that peaks within minutes defines a panic attack.

    Panic Disorder: What You Need to Know · reviewed 2026-08-26

  528. Картка 528

    Питання

    What clinical clue should raise suspicion for acute kidney injury?

    Відповідь

    A rising creatinine or falling urine output after illness, volume loss, nephrotoxin exposure, obstruction, or sepsis indicates AKI.

    KDIGO Clinical Practice Guideline for Acute Kidney Injury · reviewed 2026-08-26

  529. Картка 529

    Питання

    What physiologic disturbance underlies tension pneumothorax?

    Відповідь

    A one-way pleural air leak raises intrathoracic pressure, collapses the lung, and impairs venous return.

    Thoracic Trauma WSES-AAST Guidelines · reviewed 2026-08-26

  532. Картка 532

    Питання

    A patient has this pattern: Fever plus a new or changing murmur, embolic findings, injection-drug use, or prosthetic material raises suspicion. What is the most likely diagnosis?

    Відповідь

    Infective endocarditis. Fever plus a new or changing murmur, embolic findings, injection-drug use, or prosthetic material raises suspicion.

    2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26

  536. Картка 536

    Питання

    Which prevention or risk-reduction step is important for community-acquired pneumonia?

    Відповідь

    Keep age- and risk-appropriate pneumococcal vaccination current to reduce preventable pneumococcal pneumonia.

    Pneumococcal Vaccine Recommendations · reviewed 2026-08-26

  538. Картка 538

    Питання

    Which prevention or risk-reduction step is important for ectopic pregnancy?

    Відповідь

    Early testing after a missed period and prompt evaluation of pain or bleeding reduce rupture morbidity.

    Ectopic Pregnancy · reviewed 2026-08-26

  542. Картка 542

    Питання

    In a child or adolescent, what drug class or regimen fits diabetic ketoacidosis?

    Відповідь

    Use continuous IV regular insulin; add dextrose as glucose falls so ketone clearance can continue.

    Standards of Care in Diabetes—2026 · reviewed 2026-08-26

  543. Картка 543

    Питання

    What is the key first diagnostic step for peritonsillar abscess?

    Відповідь

    Diagnosis is usually clinical; ultrasound or CT helps when the diagnosis or deep-space extension is uncertain.

    Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26

  544. Картка 544

    Питання

    What does continuity require before ending a clinician-patient relationship?

    Відповідь

    Give reasonable notice, provide urgent coverage during the transition, offer transfer resources, and make records available as permitted.

    Terminating a Patient-Physician Relationship · reviewed 2026-08-26

  545. Картка 545

    Питання

    What counseling point helps reduce harm from chronic hepatitis C?

    Відповідь

    Avoid blood exposure, do not share injection equipment, and screen all adults and each pregnancy as recommended.

    Viral Hepatitis Clinical Care · reviewed 2026-08-26

  547. Картка 547

    Питання

    In a child or adolescent, what counseling point helps reduce harm from juvenile idiopathic arthritis?

    Відповідь

    Vaccination, eye screening, activity, and growth monitoring reduce preventable morbidity.

    2026 Juvenile Idiopathic Arthritis Guidelines · reviewed 2026-08-26

  549. Картка 549

    Питання

    A clinician is considering subarachnoid hemorrhage. Which finding adds the most support?

    Відповідь

    A sudden maximal-at-onset thunderclap headache, neck stiffness, vomiting, or brief loss of consciousness is concerning.

    2023 Guideline for Aneurysmal Subarachnoid Hemorrhage · reviewed 2026-08-26

  551. Картка 551

    Питання

    In a child, typically 6 months to 3 years, what counseling point helps reduce harm from croup?

    Відповідь

    Caregivers should seek urgent assessment for stridor at rest, marked chest retractions, cyanosis, lethargy, or poor air entry.

    Acute Management of Croup in the Emergency Department · reviewed 2026-08-26

  552. Картка 552

    Питання

    In a child or adolescent, a clinician is considering bacterial meningitis. Which finding adds the most support?

    Відповідь

    Fever, headache, neck stiffness, altered mental status, or a nonblanching rash should trigger urgent evaluation.

    WHO Guidelines on Meningitis Diagnosis, Treatment and Care · reviewed 2026-08-26

  553. Картка 553

    Питання

    A clinician is considering preeclampsia with severe features. Which finding adds the most support?

    Відповідь

    New hypertension after 20 weeks with end-organ findings such as severe pressure, thrombocytopenia, liver injury, kidney injury, pulmonary edema, or neurologic symptoms suggests severe disease.

    Gestational Hypertension and Preeclampsia · reviewed 2026-08-26

  554. Картка 554

    Питання

    A clinician is considering bipolar I mania. Which finding adds the most support?

    Відповідь

    At least one week of elevated or irritable mood with increased energy, decreased sleep, pressured speech, grandiosity, and risky behavior suggests mania.

    Management of Bipolar Disorder in Adults · reviewed 2026-08-26

  558. Картка 558

    Питання

    Which bedside pattern best points to retinal detachment?

    Відповідь

    New flashes, floaters, and a curtain or shadow across the visual field suggest detachment.

    Retinal Detachment · reviewed 2026-08-26

  559. Картка 559

    Питання

    How should a clinician respond when requested to falsify a work note or record?

    Відповідь

    Decline, document objective facts accurately, explain what can truthfully be certified, and preserve the integrity of the record.

    Management of Medical Records · reviewed 2026-08-26

  560. Картка 560

    Питання

    How can a clinician reduce avoidable harm related to hypertensive emergency?

    Відповідь

    Accurate home monitoring and sustained treatment adherence reduce progression to crisis.

    2025 High Blood Pressure Guideline · reviewed 2026-08-26

  561. Картка 561

    Питання

    What clinical clue should raise suspicion for COPD?

    Відповідь

    Progressive exertional dyspnea, chronic cough or sputum, and exposure to tobacco, biomass, or occupational irritants suggest COPD.

    2026 GOLD Report and Pocket Guide · reviewed 2026-08-26

  562. Картка 562

    Питання

    Which pharmacologic approach is preferred for acute pyelonephritis?

    Відповідь

    Select empiric therapy from local resistance and severity, then narrow to the culture.

    EAU Guidelines on Urological Infections · reviewed 2026-08-26

  563. Картка 563

    Питання

    Which history or examination finding most strongly supports plaque psoriasis?

    Відповідь

    Well-demarcated erythematous plaques with silvery scale on extensor surfaces and nail pitting support psoriasis.

    Psoriasis Clinical Guidelines · reviewed 2026-08-26

  564. Картка 564

    Питання

    What immediate plan is appropriate for Parkinson disease?

    Відповідь

    Start multidisciplinary care and choose symptomatic treatment by functional impact, age, cognition, and adverse-effect risk.

    Parkinson’s Disease in Adults · reviewed 2026-08-26

  565. Картка 565

    Питання

    Which diagnosis best fits hypotonic euvolemic hyponatremia with inappropriately concentrated urine after thyroid, adrenal, renal, and diuretic causes are excluded?

    Відповідь

    Hyponatremia due to SIADH. Nausea, confusion, gait change, seizure, or subtle cognitive symptoms with hypotonic euvolemic hyponatremia may reflect SIADH.

    Clinical Practice Guideline on Diagnosis and Treatment of Hyponatraemia · reviewed 2026-08-26

  566. Картка 566

    Питання

    What immediate plan is appropriate for gonococcal urethritis or cervicitis?

    Відповідь

    Treat promptly, test for other STIs, abstain until treatment criteria are met, and arrange partner services.

    Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26

  568. Картка 568

    Питання

    What immediate plan is appropriate for menopause vasomotor symptoms?

    Відповідь

    Match treatment to symptom burden, uterus status, contraindications, and patient preference.

    Hormone Therapy for Menopause · reviewed 2026-08-26

  571. Картка 571

    Питання

    In a child or adolescent, what drug class or regimen fits sickle cell vaso-occlusive crisis?

    Відповідь

    Use rapid individualized analgesia, with nonsteroidal anti-inflammatory drugs for selected mild pain and opioids for severe pain, followed by frequent reassessment.

    ASH 2020 Guidelines for Sickle Cell Disease: Management of Acute and Chronic Pain · reviewed 2026-08-26

  574. Картка 574

    Питання

    In a child or adolescent, which bedside pattern best points to diabetic ketoacidosis?

    Відповідь

    Hyperglycemia with dehydration, abdominal pain, vomiting, Kussmaul respirations, or altered mental status suggests ketoacidosis.

    Standards of Care in Diabetes—2026 · reviewed 2026-08-26

  575. Картка 575

    Питання

    For surgical decision-making, how should a clinician initially manage peritonsillar abscess?

    Відповідь

    Assess the airway, drain the abscess, hydrate, and treat infection.

    Tonsillitis and Peritonsillar Abscess · reviewed 2026-08-26

  576. Картка 576

    Питання

    Which factors determine a PA’s scope of practice?

    Відповідь

    A PA’s education and experience, state law, practice-setting policy and credentialing, and the care team’s arrangements together define the services the PA may provide.

    PA Scope of Practice · reviewed 2026-08-26

  577. Картка 577

    Питання

    What immediate plan is appropriate for heart failure with reduced ejection fraction?

    Відповідь

    For acute pulmonary edema, support oxygenation and relieve congestion while identifying the trigger.

    2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure · reviewed 2026-08-26

  580. Картка 580

    Питання

    What medication strategy is appropriate for community-acquired pneumonia?

    Відповідь

    Use guideline-concordant empiric antibiotics based on setting, comorbidity, and local resistance; narrow when microbiology permits.

    Diagnosis and Treatment of Adults with Community-acquired Pneumonia · reviewed 2026-08-26

  581. Картка 581

    Питання

    Which diagnosis is defined by acute hypoxemic respiratory failure with bilateral opacities not fully explained by cardiac failure after a known insult?

    Відповідь

    Acute respiratory distress syndrome. Acute hypoxemic respiratory failure with bilateral opacities not fully explained by cardiac failure after a known insult suggests ARDS.

    An Update on Management of Adult Patients with Acute Respiratory Distress Syndrome · reviewed 2026-08-26

  582. Картка 582

    Питання

    What medication strategy is appropriate for ectopic pregnancy?

    Відповідь

    Methotrexate is an option for selected stable unruptured ectopic pregnancy without contraindications.

    Ectopic Pregnancy · reviewed 2026-08-26

  584. Картка 584

    Питання

    In a child or adolescent, identify the condition from this pattern: Chronic pruritic eczematous patches with age-dependent flexural or facial distribution and a relapsing course are typical.

    Відповідь

    Atopic dermatitis. Chronic pruritic eczematous patches with age-dependent flexural or facial distribution and a relapsing course are typical.

    Atopic Dermatitis Clinical Guidelines · reviewed 2026-08-26

  585. Картка 585

    Питання

    Which pharmacologic approach is preferred for a postmenopausal woman with osteoporosis at high fracture risk?

    Відповідь

    Bisphosphonates are first-line for many postmenopausal women at high fracture risk; consider anabolic therapy for very high risk.

    Pharmacological Management of Osteoporosis in Postmenopausal Women · reviewed 2026-08-26

  587. Картка 587

    Питання

    Which diagnosis best fits dysuria and frequency without vaginal symptoms in an otherwise appropriate patient?

    Відповідь

    Uncomplicated cystitis. Dysuria and frequency without vaginal symptoms strongly support lower urinary infection in an appropriate patient.

    EAU Guidelines on Urological Infections · reviewed 2026-08-26

  589. Картка 589

    Питання

    What condition should be suspected from this finding: A single fever in a patient with severe chemotherapy-related neutropenia is an emergency even when examination is unrevealing.

    Відповідь

    Neutropenic fever. A single fever in a patient with severe chemotherapy-related neutropenia is an emergency even when examination is unrevealing.

    Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy · reviewed 2026-08-26

  590. Картка 590

    Питання

    What is the purpose of root cause analysis after a serious patient-safety event?

    Відповідь

    Identify active and latent system contributors, then design and track corrective actions that reduce recurrence rather than stopping at individual blame.

    Root Cause Analysis · reviewed 2026-08-26

  591. Картка 591

    Питання

    For surgical decision-making, a patient has this pattern: Often asymptomatic hypercalcemia, nephrolithiasis, bone loss, constipation, or neurocognitive symptoms can be the clue. What is the most likely diagnosis?

    Відповідь

    Primary hyperparathyroidism. Often asymptomatic hypercalcemia, nephrolithiasis, bone loss, constipation, or neurocognitive symptoms can be the clue.

    Evaluation and Management of Primary Hyperparathyroidism: Fifth International Workshop Guidelines · reviewed 2026-08-26

  593. Картка 593

    Питання

    A patient has this pattern: A rapid unilateral hearing decrease, often noticed on waking and sometimes with tinnitus, is an otologic emergency. What is the most likely diagnosis?

    Відповідь

    Sudden sensorineural hearing loss. A rapid unilateral hearing decrease, often noticed on waking and sometimes with tinnitus, is an otologic emergency.

    Clinical Practice Guideline: Sudden Hearing Loss (Update) · reviewed 2026-08-26

  594. Картка 594

    Питання

    Which diagnosis requires bradykinesia plus rest tremor or rigidity and often includes reduced arm swing or a shuffling gait?

    Відповідь

    Parkinson disease. Bradykinesia plus rest tremor or rigidity, with reduced arm swing and shuffling gait, supports parkinsonism.

    Parkinson’s Disease in Adults · reviewed 2026-08-26

  595. Картка 595

    Питання

    Which diagnosis best fits purulent urethral discharge, dysuria, cervicitis, pelvic pain, or a relevant sexual exposure, although infection may be asymptomatic?

    Відповідь

    Gonococcal urethritis or cervicitis. Purulent urethral discharge, dysuria, cervicitis, pelvic pain, or exposure may indicate gonorrhea, but infection can be asymptomatic.

    Gonococcal Infections Among Adolescents and Adults · reviewed 2026-08-26

  596. Картка 596

    Питання

    Which diagnosis best fits hot flashes, night sweats, sleep disruption, and menstrual transition at the expected age?

    Відповідь

    Menopause vasomotor symptoms. Hot flashes, night sweats, sleep disruption, and menstrual transition at the expected age usually identify menopausal vasomotor symptoms.

    The Menopause Years · reviewed 2026-08-26

  597. Картка 597

    Питання

    Which diagnosis causes tremor, autonomic hyperactivity, insomnia, nausea, anxiety, hallucinations, or seizures after reducing heavy alcohol use?

    Відповідь

    Alcohol withdrawal. Tremor, autonomic hyperactivity, insomnia, nausea, anxiety, hallucinations, or seizures after reducing heavy alcohol use suggests withdrawal.

    The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management · reviewed 2026-08-26

  598. Картка 598

    Питання

    Which diagnosis causes bloody diarrhea, urgency, tenesmus, and crampy abdominal pain with continuous colonic inflammation?

    Відповідь

    Ulcerative colitis. Bloody diarrhea, urgency, tenesmus, and crampy abdominal pain with continuous colonic inflammation suggest ulcerative colitis.

    Updated 2025 ACG Guidelines to Manage Adult Ulcerative Colitis Patients · reviewed 2026-08-26

  599. Картка 599

    Питання

    Which diagnosis best fits abrupt severe monoarthritis with erythema, often at the first metatarsophalangeal joint?

    Відповідь

    Gout flare. Abrupt severe monoarthritis with erythema, often at the first metatarsophalangeal joint, suggests gout.

    Gout · reviewed 2026-08-26

  600. Картка 600

    Питання

    For surgical decision-making, which diagnosis best fits this presentation: Exertional dyspnea, angina, or syncope with a harsh crescendo-decrescendo systolic murmur radiating to the carotids is typical.

    Відповідь

    Symptomatic aortic stenosis. Exertional dyspnea, angina, or syncope with a harsh crescendo-decrescendo systolic murmur radiating to the carotids is typical.

    2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease · reviewed 2026-08-26

Illustrated clinical review desk with a stethoscope, ECG trace, lungs, brain, and study cards arranged around a clear central title-safe area.

600 карток

PANCE Flashcards: Blueprint-Aligned Diagnoses, Tests & Next Steps

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