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Central retinal vein occlusion (CRVO) presents with sudden painless vision loss and classic fundoscopic findings: “blood and thunder” (diffuse retinal hemorrhages, cotton wool spots, venous engorgement). CRAO shows a pale retina with cherry-red fovea. Retinal detachment presents with floaters/flashes and curtain-like vision loss. Macular degeneration causes gradual central vision loss. PANCE emphasizes ophthalmic emergencies and their classic fundus findings.

Glaucoma causes increased intraocular pressure, optic disc cupping, and progressive peripheral vision loss. Macular degeneration causes central vision loss. Retinal detachment causes acute flashes, floaters, and curtain vision. Optic neuritis causes painful monocular vision loss with afferent pupillary defect. PANCE emphasizes ocular disease presentations and fundoscopy findings.

Iron deficiency anemia is microcytic, hypochromic, with low ferritin and high TIBC. Anemia of chronic disease has low iron but normal/high ferritin. Thalassemia shows microcytosis with normal iron studies. Sideroblastic anemia shows ring sideroblasts on marrow. Recognizing iron studies is a key hematology skill for PANCE.

This presentation suggests subarachnoid hemorrhage (SAH). If CT is negative but suspicion is high, lumbar puncture should be performed to look for xanthochromia. MRI is not the next step in acute SAH. Heparin would worsen bleeding. EEG evaluates seizures, not SAH. PANCE neurology highlights correct diagnostic sequencing for suspected SAH.

Zenker’s diverticulum is a pharyngoesophageal pouch causing dysphagia, regurgitation of undigested food, halitosis, and aspiration risk. Achalasia causes bird-beak narrowing at LES. Schatzki ring causes intermittent dysphagia to solids. Esophageal carcinoma presents with progressive dysphagia and weight loss without pouch formation. PANCE GI emphasizes classic imaging findings.