PANCE, Medical exams, 7%

Infectious Diseases

This cross-cutting content area tests organism recognition, empiric and targeted therapy, and prevention across bacterial, viral, fungal, and parasitic disease. Vaccination schedules and reportable-disease awareness also appear here.

Position: 5 of 15 content areas
Published weighting: 7% in the official framework
Topics covered: 6 topics in this guide

What is covered

Topics inside this content area.

These topics describe the scope students most often review for this part of PANCE. Treat them as a study checklist rather than an exhaustive list of what a single exam form can sample.

Bacterial infections: High-yield gram-positive and gram-negative syndromes with first-line antimicrobial choices.
Viral infections: HIV staging and prophylaxis, herpesviruses, influenza, and hepatitis-virus distinctions.
Fungal and parasitic infections: Endemic mycoses by geography plus the common protozoal and helminthic presentations.
Sexually transmitted infections: Diagnostic testing, current first-line regimens, and partner-treatment principles.
Sepsis and systemic infection: Recognition criteria, early management priorities, and source-control logic.
Immunization and prevention: Routine schedules, special-population vaccines, and post-exposure prophylaxis rules.

Study tips

How to practice Infectious disease.

Section-specific guidance that follows from how this material is usually tested.

Organize antimicrobials by bug-and-drug pairs rather than drug classes alone.
Review geographic and exposure clues; stems often hide the organism in a travel or hobby detail.
Rehearse vaccine timing rules with spaced repetition since they decay quickly.

Where this fits

Infectious Diseases is 5 of 15 content areas in the PANCE guide, and it carries a published weighting of 7% in the official framework. Use the full guide to balance it against everything else you have to review.

Back to the PANCE guide Official exam information

Sample Infectious disease questions

Practice questions, not yet expert-reviewed

Original practice questions written to the published framework for this section. No expert has reviewed them, and they are not taken from any official exam. Try each one before you open the answer.

Question 1Foundational
Which organism is the most common bacterial cause of community-acquired pneumonia in adults?
1. AStreptococcus pneumoniae
2. BMycoplasma pneumoniae
3. CHaemophilus influenzae
4. DStaphylococcus aureus
Show answer
Answer: A. Streptococcus pneumoniae
Streptococcus pneumoniae remains the single most frequently identified bacterial cause of community-acquired pneumonia and classically produces an abrupt febrile illness with rusty sputum and lobar consolidation. Mycoplasma pneumoniae is the tempting distractor because it is common in young adults, but it causes a milder walking pneumonia with diffuse interstitial findings.
Key insight: Empiric coverage for community-acquired pneumonia is built around the pneumococcus for a reason.
Question 2Foundational
A hiker in the northeastern United States develops a slowly expanding erythematous rash with central clearing at the site of a tick bite. Which organism causes this lesion?
1. ARickettsia rickettsii
2. BBorrelia burgdorferi
3. CEhrlichia chaffeensis
4. DBabesia microti
Show answer
Answer: B. Borrelia burgdorferi
Erythema migrans, the expanding annular rash with central clearing, is the hallmark of early localized Lyme disease caused by the spirochete Borrelia burgdorferi. Rickettsia rickettsii is the tempting distractor because it is also tick borne, but Rocky Mountain spotted fever produces a petechial rash that begins on the wrists and ankles and spreads centrally.
Key insight: Erythema migrans is clinically diagnostic for Lyme disease, so treatment does not wait for serology.
Question 3Intermediate
Below which CD4 T-lymphocyte count does a person with HIV meet the immunologic criterion for a diagnosis of AIDS?
1. A500 cells/mm3
2. B350 cells/mm3
3. C200 cells/mm3
4. D50 cells/mm3
Show answer
Answer: C. 200 cells/mm3
A CD4 count below 200 cells per cubic millimeter defines AIDS regardless of symptoms, and it is also the threshold at which Pneumocystis prophylaxis is started. A count near 50 cells per cubic millimeter is the tempting distractor because it is the threshold for disseminated Mycobacterium avium complex prophylaxis, not for the AIDS definition itself.
Key insight: 200 is the number that defines AIDS and starts Pneumocystis prophylaxis.
Question 4Intermediate
True or false: live attenuated vaccines such as the measles, mumps, and rubella vaccine are contraindicated during pregnancy.
1. ATrue
2. BFalse
Show answer
Answer: A. True
Live attenuated vaccines are withheld during pregnancy because of a theoretical risk of fetal infection from the replicating vaccine strain, and they are given after delivery instead. Inactivated vaccines such as influenza and tetanus-diphtheria-acellular pertussis are the opposite case and are actively recommended during pregnancy.
Key insight: Pregnancy rules out live vaccines and specifically recommends the inactivated ones.
Question 5Advanced
A previously unvaccinated adult is bitten by a bat that escapes and cannot be tested. Which rabies post-exposure prophylaxis regimen is indicated?
1. ARabies vaccine series alone
2. BRabies immune globulin alone
3. CRabies immune globulin plus the rabies vaccine series
4. DObservation for ten days with no immediate prophylaxis
Show answer
Answer: C. Rabies immune globulin plus the rabies vaccine series
A person who has never been vaccinated needs both passive immunity from rabies immune globulin infiltrated around the wound and active immunity from the vaccine series, because antibodies from the vaccine take days to appear. Vaccine alone is the tempting distractor, but that regimen is correct only for someone with documented prior rabies vaccination.
Key insight: Never vaccinated means immune globulin plus vaccine; previously vaccinated means vaccine boosters only.

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Infectious Diseases