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Physician Assistant National Recertifying exam Practice Test

PANRE exam Format | Course Contents | Course Outline | exam Syllabus | exam Objectives

Exam Code: PANRE
Exam Name: NCCPA PANRE Physician Assistant National Recertifying Exam
Total Number of Questions: 240 multiple-choice questions
Exam Structure: Divided into four blocks of 60 questions each.
Time Allotted: 4 hours total (60 minutes per block)
Passing Score: The NCCPA uses a scaled score (ranging from 200 to 800) based on standard setting by PAs. The minimum passing scaled score is typically 379.

1. Cardiovascular System 13%

- Hypertension (essential, secondary, hypertensive emergency)
- Coronary artery disease / Acute coronary syndromes (STEMI, NSTEMI, unstable angina)
- Heart failure (systolic, diastolic, right-sided, acute decompensated)
- Valvular disorders (mitral stenosis/regurgitation, aortic stenosis/regurgitation, tricuspid regurgitation, pulmonic stenosis)
- Cardiomyopathies (dilated, hypertrophic, restrictive, peripartum)
- Pericardial diseases (pericarditis, pericardial effusion, tamponade)
- Arrhythmias (atrial fibrillation/flutter, SVT, ventricular tachycardia/fibrillation, bradycardias, heart block)
- Conduction disorders (1st, 2nd, 3rd degree AV block, bundle branch blocks)
- Congenital heart disease (ASD, VSD, PDA, tetralogy of Fallot, coarctation – adult presentation)
- Peripheral vascular disease (PAD, venous thrombosis, varicose veins, chronic venous insufficiency)
- Aortic disease (aneurysm, dissection)
- Shock (cardiogenic, hypovolemic, distributive)
- Syncope
- Dyslipidemia

2. Pulmonary System 10%

- Asthma (including occupational and exercise-induced)
- Chronic obstructive pulmonary disease (chronic bronchitis, emphysema)
- Acute/chronic bronchitis and bronchiolitis
- Pneumonia (community-acquired, healthcare-associated, aspiration, viral, fungal)
- Pulmonary embolism and deep vein thrombosis
- Lung cancer (small cell, non-small cell, solitary pulmonary nodule)
- Pleural diseases (pleural effusion, pneumothorax, hemothorax)
- Pulmonary hypertension
- Interstitial lung disease / Pulmonary fibrosis
- Obstructive sleep apnea
- Acute respiratory distress syndrome (ARDS)
- Sarcoidosis
- Occupational lung diseases (asbestosis, silicosis, coal worker’s pneumoconiosis)
- Cystic fibrosis (adult presentation)

3. Gastrointestinal System / Nutrition 9%

- Esophageal disorders (GERD, esophagitis, Barrett esophagus, motility disorders, strictures)
- Gastric disorders (peptic ulcer disease, gastritis, H. pylori, Zollinger-Ellison)
- Gallbladder and biliary disease (cholecystitis, cholelithiasis, cholangitis, biliary dyskinesia)
- Liver diseases (acute/chronic hepatitis, cirrhosis, alcoholic liver disease, NAFLD/NASH, portal hypertension, esophageal varices)
- Pancreatic disorders (acute and chronic pancreatitis, pancreatic insufficiency)
- Small intestine (malabsorption syndromes, celiac disease, Crohn’s disease, small bowel obstruction)
- Large intestine (ulcerative colitis, diverticulitis, appendicitis, ischemic colitis, C. difficile colitis)
- Colorectal cancer and screening
- Constipation and diarrhea (acute/chronic)
- GI bleeding (upper and lower)
- Hernias (inguinal, umbilical, incisional)
- Anorectal disorders (hemorrhoids, anal fissure, abscess, fistula)
- Nutrition (malnutrition, obesity, vitamin/mineral deficiencies)

4. Musculoskeletal System 8%

- Osteoarthritis and degenerative joint disease
- Rheumatoid arthritis
- Crystal-induced arthropathies (gout, pseudogout)
- Seronegative spondyloarthropathies (ankylosing spondylitis, psoriatic arthritis, reactive arthritis)
- Systemic lupus erythematosus and connective tissue diseases
- Osteoporosis and osteopenia
- Fractures and dislocations (common sites: hip, wrist, ankle, stress fractures)
- Sprains, strains, and overuse syndromes (rotator cuff, lateral/medial epicondylitis, plantar fasciitis)
- Low back pain (disc herniation, spinal stenosis, sciatica, cauda equina)
- Pediatric orthopedics (scoliosis, Osgood-Schlatter, slipped capital femoral epiphysis)
- Compartment syndrome
- Septic arthritis and osteomyelitis

5. EENT (Eyes, Ears, Nose, Throat) 7%

- Conjunctivitis, keratitis, corneal abrasion/ulcer
- Glaucoma (open-angle, acute angle-closure)
- Cataract, macular degeneration, diabetic retinopathy
- Retinal detachment, retinal vascular occlusion
- Otitis media, otitis externa, cerumen impaction
- Hearing loss (conductive vs sensorineural)
- Sinusitis (acute/chronic), allergic rhinitis
- Epistaxis
- Pharyngitis/tonsillitis, peritonsillar abscess
- Oral leukoplakia, oral cancer, salivary gland disorders
- Vertigo (BPPV, vestibular neuritis, Ménière disease)

6. Reproductive System (Female) 5% & Genitourinary System (Male and Female) 5%

- Menstrual disorders (amenorrhea, abnormal uterine bleeding, dysmenorrhea)
- Menopause and hormone replacement
- Breast diseases (fibrocystic changes, mastitis, breast cancer screening, fibroadenoma)
- Pelvic inflammatory disease, endometritis
- Cervical dysplasia and cancer screening
- Contraception and family planning
- Vaginitis (bacterial vaginosis, candida, trichomoniasis)
- Endometriosis, adenomyosis, uterine leiomyoma
- Polycystic ovarian syndrome
- Benign and malignant ovarian tumors
- Prostate disorders (BPH, prostatitis, prostate cancer)
- Erectile dysfunction
- Testicular torsion, epididymitis, orchitis
- Urinary incontinence (stress, urge, overflow)
- Urologic cancers (bladder, renal cell, testicular)

7. Endocrine System 5%

- Diabetes mellitus (Type 1, Type 2, gestational, complications: DKA, HHS)
- Thyroid disorders (hypothyroidism, hyperthyroidism, thyroiditis, nodules, cancer)
- Adrenal disorders (Addison disease, Cushing syndrome, pheochromocytoma)
- Pituitary disorders (diabetes insipidus, acromegaly, hypopituitarism)
- Parathyroid disorders (hyper/hypocalcemia, hyperparathyroidism)
- Metabolic syndrome
- Dyslipidemia (already listed under CV but tested again here)

8. Neurology 5%

- Headache (migraine, tension, cluster, secondary causes)
- Seizure disorders and epilepsy
- Stroke (ischemic, hemorrhagic, TIA)
- Dementia (Alzheimer, vascular, Lewy body)
- Parkinson disease and movement disorders
- Multiple sclerosis
- Peripheral neuropathy (diabetic, B12 deficiency, Guillain-Barré)
- Myasthenia gravis and neuromuscular junction disorders
- Meningitis and encephalitis
- Brain tumors and metastases

9. Psychiatry / Behavioral Health 5%

- Mood disorders (depression, bipolar disorder, dysthymia)
- Anxiety disorders (GAD, panic disorder, PTSD, OCD)
- Psychotic disorders (schizophrenia, schizoaffective)
- Substance use disorders (alcohol, opioid, stimulant, cannabis)
- ADHD (adult presentation)
- Eating disorders (anorexia, bulimia)
- Personality disorders
- Suicide risk assessment
- Somatoform and factitious disorders

10. Dermatology 5%

- Bacterial infections (impetigo, cellulitis, folliculitis, MRSA)
- Viral infections (herpes simplex, zoster, warts, molluscum)
- Fungal infections (tinea, candida, onychomycosis)
- Parasitic (scabies, lice)
- Acne, rosacea, hidradenitis suppurativa
- Psoriasis, lichen planus
- Eczema (atopic, contact, seborrheic)
- Urticaria and angioedema
- Drug eruptions
- Bullous diseases (pemphigus, bullous pemphigoid)
- Skin cancer (basal cell, squamous cell, melanoma, actinic keratosis)

11. Infectious Diseases 5%

- Sepsis and septic shock
- HIV/AIDS and opportunistic infections
- Tuberculosis and latent TB
- Sexually transmitted infections (gonorrhea, chlamydia, syphilis, herpes, HPV)
- Tick-borne diseases (Lyme, Rocky Mountain spotted fever, ehrlichiosis)
- Viral hepatitis (A, B, C)
- Osteomyelitis
- Endocarditis (native valve, prosthetic valve, culture-negative)
- Fever of unknown origin

12. Hematology 3%

- Anemias (iron deficiency, B12/folate deficiency, hemolytic, aplastic)
- Thrombocytopenia (ITP, TTP, HIT)
- Coagulopathies (hemophilia, von Willebrand, acquired)
- Leukemia (ALL, CLL, AML, CML)
- Lymphoma (Hodgkin, non-Hodgkin)
- Multiple myeloma and plasma cell disorders
- Transfusion reactions

13. Renal System 3%

- Acute kidney injury
- Chronic kidney disease and ESRD
- Glomerulonephritis and nephrotic syndrome
- Electrolyte disturbances (hyponatremia, hyperkalemia, etc.)
- Acid-base disorders
- Nephrolithiasis
- Pyelonephritis and urinary tract infections

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PANRE
Physician Assistant National Recertifying Exam
https://killexams.com/pass4sure/exam-detail/PANRE
Question: 60
A patient comes to the office presenting with paroxysmal or sustained
hypertension, severe headaches, palpitations, flushing, heat intolerance, and
hyperglycemia. Further laboratory results reveal that the patient�s levels of
epinephrine and norepinephrine are excessive. Based on these findings, the patient
is most likely diagnosed with:
A. Hypothyroidism
B. Hyperthyroidism
C. Pheochromocytoma
D. Addison�s disease
Answer: C
Pheochromocytoma is a catecholamine-producing hormone, which is manifested
by the increased levels of epinephrine and norepinephrine in the system. Without
appropriate treatment, pheochromocytoma can cause hypertensive retinopathy,
nephropathy, and cardiac enlargement, resulting in congestive heart failure.
Question: 61
Which of the following laboratory findings support the diagnosis of
hypoparathyroidism?
A. Serum calcium = 10.0 mg/dL; Serum potassium = 5.5 mg/dL
B. Serum calcium = 8.7 mg/dL; Serum potassium = 3.0 mg/dL
C. Serum calcium = 11.0 mg/dL; Serum phosphorus =2.0 mg/dL
D. Serum calcium = 7.5 mg/dL; Serum phosphorus = 5.5 mg/dL
Answer: D
A patient with hypoparathyroidism has hypocalcemia and hyperphosphatemia.
The other options are not correct.
Question: 62
Which of the following is not a typical sign and symptom of renal cell carcinoma?
A. Abdominal mass
B. Hematuria
C. Flank pain
D. Oliguria
Answer: D
Renal cell carcinoma is the most common malignancy of the kidney. Renal
tumors in the early stages are asymptomatic. A presentation of abdominal mass
may indicate renal cell carcinoma. The symptoms of renal cell carcinoma include
hematuria, flank pain, and palpable flank mass.
Question: 63
A patient is scheduled to undergo needle biopsy of the kidney. Which of the
following is an important consideration before letting the patient undergo this
procedure?
A. Adequate fasting for at least 8 hours prior to procedure
B. Establish an IV line for hydration
C. Monitoring vital signs
D. Ensure that coagulation studies have been carried out
Answer: D
Preparations must be done before the patient undergoes biopsy. The most
important is the suspension of anticoagulant medications at least one week before
the procedure. Anticoagulant studies should be carried out at least two weeks
before the procedure. IV line, vital signs, and fasting are also important
preparations, but ensuring that coagulation studies are normal is more significant.
Question: 64
The Bartholin gland is responsible for secreting mucus to lubricate the vagina.
Where is it specifically located?
A. Anterior wall of the vagina
B. Above the urethral and vaginal opening
C. Below and to the left and right of the vaginal opening
D. Extends from the vulva to the cervix
Answer: C
The Bartholin gland is located below and to the left and right of the vaginal
opening. Option A refers to the Skene�s gland, option B refers to the clitoris,
while option D refers to the vagina.
Question: 65
The clinical feature of interstitial cystitis includes all of the following, except:
A. Continuous bladder pain
B. Nocturia
C. Frequent urinary urgency
D. Bacterial infection
Answer: D
Interstitial cystitis is the inflammation of the bladder in the absence of bacterial
infection. It is believed to be caused by an autoimmune process that alters the
cells of the bladder lining. The disease is characterized by frequent urination,
dysuria, nocturia, and continuous perineal, vaginal, or suprapubic pain.
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