Sample Questions

PANCE Sample Questions

6 practice questions with complete answer explanations.

Sample Questions

Question 1cardiology

A 65-year-old man presents with crushing substernal chest pain radiating to the jaw. ECG shows ST elevation in leads V1–V4. What is the most likely diagnosis?

A.Inferior wall MI

B.Anterior wall MI✓ Correct

C.Lateral wall MI

D.Posterior wall MI

Explanation

ST elevation in V1–V4 localizes to the anterior wall (LAD territory).

Question 2infectious-disease

A 22-year-old woman presents with a sore throat, fever, and fatigue for 1 week. Exam shows tonsillar exudates, cervical lymphadenopathy, and splenomegaly. Monospot is positive. The most likely diagnosis is:

A.Streptococcal pharyngitis

B.Infectious mononucleosis✓ Correct

C.Diphtheria

D.Cytomegalovirus

Explanation

Mono: EBV causing splenomegaly, lymphadenopathy, positive monospot. Avoid amoxicillin (rash) and contact sports (splenic rupture risk).

Question 3pharmacology

Which antihypertensive is MOST contraindicated in a pregnant patient?

A.Methyldopa

B.Labetalol

C.Lisinopril✓ Correct

D.Nifedipine

Explanation

ACE inhibitors (and ARBs) are teratogenic — they cause renal dysgenesis and oligohydramnios. Methyldopa and labetalol are first-line in pregnancy.

Question 4endocrine

A 40-year-old woman has a fasting glucose of 128 and HbA1c of 7.1%. What is the diagnosis?

A.Impaired fasting glucose

B.Pre-diabetes

C.Type 2 diabetes✓ Correct

D.Normal

Explanation

Diabetes criteria: fasting ≥126, A1c ≥6.5%, random ≥200 with symptoms, OGTT 2h ≥200. She meets both fasting and A1c thresholds.

Question 5emergency

What is the FIRST-line treatment for anaphylaxis?

A.IV diphenhydramine

B.IM epinephrine 0.3 mg✓ Correct

C.IV methylprednisolone

D.Nebulized albuterol

Explanation

IM epinephrine in the lateral thigh is first-line, every 5–15 min as needed. Antihistamines and steroids are adjuncts, not primary.

Question 6pediatrics

A 7-year-old boy presents with a 'barking cough', stridor, and low-grade fever. X-ray shows steeple sign. Diagnosis?

A.Epiglottitis

B.Croup (laryngotracheobronchitis)✓ Correct

C.Bacterial tracheitis

D.Foreign body aspiration

Explanation

Classic croup: barking cough, stridor, steeple sign on neck X-ray. Treat with dexamethasone and racemic epinephrine if severe.

Test-Taking Tips

1.Start Qbank questions early in the 2nd year of PA school.
2.Focus on cardiology and pulmonology — together they're ~23% of the exam.
3.Review ECG interpretation systematically.
4.Use spaced repetition (Anki) for pharm and microbio.
5.Take full-length NCCPA practice exams 2–4 weeks before testing.
6.Don't neglect OB/GYN and peds — they're commonly missed areas.

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