[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-389914-105":59,"doc-detail-389914-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","sample-pance-questions-initial-diagnostic-study-and-differential-diagnosis","Sample PANCE Questions - Initial Diagnostic Study and Differential Diagnosis","","A set of sample PANCE-style clinical questions emphasizes selecting the most appropriate initial diagnostic study and forming differential diagnoses from symptom patterns, triggers, and test findings. Case 1 focuses on possible coronary artery disease presenting with exertional chest heaviness, guiding the choice among imaging and functional tests. Case 2 targets a sulfa-associated tender recurrent rash suggesting erythema nodosum. Case 3 uses a multi-system syndrome with laboratory abnormalities to determine hyperparathyroidism.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":20,"@type":76,"position":81},"https://docshare.wps.com/document/exam/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/sample-pance-questions-initial-diagnostic-study-and-differential-diagnosis/389914/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/sample-pance-questions-initial-diagnostic-study-and-differential-diagnosis/389914.png","ImageObject",300,407,{"name":92,"@type":93},"Lucas Martin","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-25",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is the exercise stress test the most appropriate initial study in Question 1?","Question",{"text":113,"@type":114},"It is noninvasive, inexpensive, convenient, and sensitive for evaluating possible coronary artery disease in a patient presenting with recent chest pain characteristics.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What most likely explains the rash in Question 2 and what diagnosis fits best?",{"text":118,"@type":114},"The rash occurs after treatment with trimethoprim-sulfamethoxazole and appears on the lower extremities below the knees with bruising-like lesions; this pattern most strongly supports erythema nodosum.",{"name":120,"@type":111,"acceptedAnswer":121},"Which diagnosis best matches the symptoms and laboratory pattern in Question 3?",{"text":122,"@type":114},"Hyperparathyroidism fits best because the clinical syndrome includes classic multi-system features and the labs show hypercalcemia with hypophosphatemia.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},389914,1791439185,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":19,"category_name":20,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},8796095360427,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Sample PANCE Questions  \nQuestion 1  \nFor the past three weeks, a 47-year-old man has had the feeling of heaviness in his chest while pushing his lawn mower. He says he has never been treated for similar symptoms and has no symptoms now. He smoked one pack of cigarettes daily for 20 years but quit smoking seven years ago. Findings on physical examination are normal. Electrocardiography shows no abnormalities. Which of the following is the most appropriate initial diagnostic study?  \nA. Coronary arteriography  \nB. Echocardiography  \nC. Exercise stress test  \nD. 24-Hour ambulatory cardiac monitoring  \nE. Myocardial perfusion scan  \nMedical Content Category: Cardiovascular System  \nCritique:  \nThis question tests the examinee’s ability to identify the most appropriate initial diagnostic study in a patient with possible coronary artery disease.  \nOption (C), exercise stress test, is correct because it is the most appropriate initial step in the workup of a patient with recent chest pain because the test is noninvasive, inexpensive, convenient, and sensitive in this type of patient.  \nThe most definitive diagnostic test for a patient with coronary artery disease is Option (A), coronary arteriography, but this test is not the most appropriate initial test in an asymptomatic patient with no abnormal findings on electrocardiography. Option (B), echocardiography, is a valuable tool for examining valvular structures, cardiac size, ejection fraction, as well as other anatomic features. However, echocardiography is not routinely indicated for evaluating ischemia resulting from coronary artery disease and is, therefore, incorrect. Option (D), 24-hour ambulatory cardiac monitoring, is also incorrect. Twenty-four-hour ambulatory cardiac monitoring is used primarily for evaluating disturbances of rate and rhythm and it is able to detect ST-segment depression, but it is less effective than exercise stress testing in confirming a diagnosis of coronary artery disease in the initial workup of a patient. This patient’s electrocardiogram shows no abnormalities, and therefore, Option (E), myocardial perfusion scan, is incorrect. This option would only be correct if the results of resting electrocardiography were abnormal, making it difficult to interpret an exercise stress test.  \nQuestion 2  \nA 32-year-old woman has had a rash on her legs for the past three weeks. There are no known infectious contacts. One month ago, she had a bladder infection and was treated with trimethoprim-sulfamethoxazole. Physical examination shows a diffuse rash on the shins, the left medial ankle, and the right medial calf. The rash is tender, diffuse, and recurs in the same areas. A few of the lesions have the appearance of bruising. Which of the following is the most likely diagnosis?  \nA. Erythema multiforme  \nB. Erythema nodosum  \nC. Lichen planus  \nD. Lichen simplex  \nE. Nummular eczema  \nMedical Content Category: Dermatologic System  \nCritique:  \nThis question tests the examinee’s ability to diagnose a rash based on the patient’s history and the description of the rash. The examinee must first consider that the rash could be an allergic reaction to the sulfa antibiotic.  \nThe correct answer is Option (B), erythema nodosum, because this type of rash may be antibiotic-related, occurs on the lower extremities below the knees, and has the appearance of bruising. All of these symptoms are present in this clinical scenario.  \nOptions (A), erythema multiforme, and (C), lichen planus, can also result from an allergic reaction to a sulfa antibiotic, but the presentation of this patient’s rash is not consistent with either of these conditions. Options (D), lichen simplex, and (E), nummular eczema, are chronic conditions that result in scaling. Therefore, given the time frame and the presentation of this patient’s rash, these two options are incorrect.  \nQuestion 3  \nA 41-year-old woman has a nine-month history of nausea, constipation, dyspepsia, general fatigue, arthralgia, a","cbCaisPOiZf8f1N0","https://ap.wps.com/l/cbCaisPOiZf8f1N0","pdf",158830,13,"English","# Question 1\n## Coronary artery disease initial diagnostic study\n# Question 2\n## Most likely diagnosis for recurrent tender rash\n# Question 3\n## Most likely diagnosis based on labs","[{\"question\":\"Why is the exercise stress test the most appropriate initial study in Question 1?\",\"answer\":\"It is noninvasive, inexpensive, convenient, and sensitive for evaluating possible coronary artery disease in a patient presenting with recent chest pain characteristics.\"},{\"question\":\"What most likely explains the rash in Question 2 and what diagnosis fits best?\",\"answer\":\"The rash occurs after treatment with trimethoprim-sulfamethoxazole and appears on the lower extremities below the knees with bruising-like lesions; this pattern most strongly supports erythema nodosum.\"},{\"question\":\"Which diagnosis best matches the symptoms and laboratory pattern in Question 3?\",\"answer\":\"Hyperparathyroidism fits best because the clinical syndrome includes classic multi-system features and the labs show hypercalcemia with hypophosphatemia.\"}]","Sample PANCE Questions - Initial Diagnostic Study and Differential Diagnosis | PDF",1790328396,33]