Acute Abdomen PANCE Questions PDF

1. A 25-year-old male presents with periumbilical pain that has shifted to the RLQ, accompanied by nausea and low-grade fever. On exam, there is tenderness at McBurney’s point. What is the most likely diagnosis? A. Diverticulitis B. Acute Appendicitis C. Crohn’s Disease D. Acute Pancreat...

1. A 25-year-old male presents with periumbilical pain that has shifted to the RLQ, accompanied by nausea and low-grade fever. On exam, there is tenderness at McBurney’s point. What is the most likely diagnosis? A. Diverticulitis B. Acute Appendicitis C. Crohn’s Disease D. Acute Pancreatitis Correct Answer: B 2. A 45-year-old female presents with RUQ pain that radiates to the right shoulder and worsens after meals. Murphy’s sign is positive. What is the most appropriate next step in the management of this patient? A. CT abdomen B. RUQ ultrasound C. Endoscopy D. Plain abdominal X-ray Correct Answer: B 3. A 70-year-old male with a history of atrial fibrillation presents with sudden severe abdominal pain that is out of proportion to physical findings. What is the most likely diagnosis? A. Acute appendicitis B. Acute pancreatitis C. Ischemic bowel D. Perforated ulcer Correct Answer: C 4. Which of the following imaging studies is most sensitive for diagnosing acute appendicitis in a pediatric patient? A. CT abdomen B. MRI abdomen C. Ultrasound D. Plain X-ray Correct Answer: C 5. A 56-year-old male presents with sudden onset severe epigastric pain radiating to the back after a large meal. Serum lipase is elevated. What is the most likely diagnosis? A. Acute pancreatitis B. Perforated peptic ulcer C. Cholecystitis D. Mesenteric ischemia Correct Answer: A 6. A patient with a history of Crohn’s disease presents with fever, LLQ pain, and change in bowel habits. What is the most likely diagnosis? A. Diverticulitis B. Small bowel obstruction C. Toxic megacolon D. Hernia Correct Answer: A 7. What is the most common cause of small bowel obstruction in the United States? A. Hernias B. Adhesions C. Tumors D. Volvulus Correct Answer: B 8. Which of the following symptoms is most suggestive of a perforated peptic ulcer? A. Gradual onset of crampy abdominal pain B. Sudden severe epigastric pain radiating to the back C. Steady LLQ pain with fever D. Diffuse cramping and nausea Correct Answer: B 9. A patient with a history of heavy alcohol use presents with epigastric pain and vomiting. Lipase levels are elevated. Which of the following is the best initial management? A. Antibiotics B. IV fluids and pain control C. Immediate surgery D. Endoscopic retrograde cholangiopancreatography (ERCP) Correct Answer: B 10. A 65-year-old male with a pulsatile abdominal mass and hypotension is most likely suffering from: A. Cholangitis B. Ischemic bowel C. Ruptured abdominal aortic aneurysm (AAA) D. Acute appendicitis Correct Answer: C... (remaining 30 questions follow a similar format)...