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Med-Challenger is the most effective, easiest to use Physician Assistant board review question bank for the PANCE, PANRE and Certification of Added Qualifications in Emergency Medicine (CAQ-EM) NCCPA board examinations. Med-Challenger's physician assistant board reviews with intelligent PA self-assessment provides everything you need to pass physician assistant certification exams and fulfill other PA certification requirements such as AAPA CME credits, all in one powerful, effective, and convenient access point online.

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Our pass-guaranteed physician assistant board review courses gets you prepared for PA boards fast, thanks to our constantly updated physician assistant review questions, detailed answer explanations, and intelligent PA board exam simulators. Plus, our online PANCE / PANRE board review course keeps serving you after exams too. PANCE or PANRE, Physician Assistant board review has never been so easy, effective, or efficient. It's more than just the best physician assistant question bank, it's lifelong physician assistant education and AAPA MOC convenience.

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2600+ Physician Assistant Exam Review Questions

High-Yield Physician Assistant exam practice questions mapped to the PANCE / PANRE exam blueprints.

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Physician Assistant Course Information

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Post-Rotation Exams

Post-Rotation Exam - Allergy/Immunology
Post-Rotation Exam - Cardiology
Post-Rotation Exam - Dermatology
Post-Rotation Exam - EENT
Post-Rotation Exam - Emergency Medicine
Post-Rotation Exam - Family Medicine
Post-Rotation Exam - Geriatrics
Post-Rotation Exam - Internal Medicine
Post-Rotation Exam - OBGYN
Post-Rotation Exam - Orthopedics
Post-Rotation Exam - Pediatrics
Post-Rotation Exam - Psychiatry
Post-Rotation Exam - Surgery
Post-Rotation Exam - Underserved Care
Post-Rotation Exam - Urgent Care

CME Bank - Signs, Symptoms, and Presentations (AAPA Credit)

Abdominal Pain
Acute Pelvic Pain in Women
Acute Vaginal Bleeding
Back Pain
Chest Pain
Confusion
Constipation
Cyanosis
Depressed Consciousness and Coma
Diarrhea
Dizziness and Vertigo
Dyspnea
Fever in the Adult Patient
Gastrointestinal Bleeding
Headache: Initial Approach
Hemoptysis
Jaundice
Nausea and Vomiting
Seizures: Initial Approach
Syncope
Weakness

CME Bank - Allergy/Immunology

Auto-Immune Collagen Vascular Disorders
Drug Allergy
Food Allergy
Hypersensitivity Reactions
Pediatric Allergy and Immunology
Primary Immunodeficiency Disorders
The Immunocompromised / Solid-Organ Transplant Patient

CME Bank - Cardiovascular System

Congenital Heart Disease in the Adult
Congestive Heart Failure
Dysrhythmias/Conduction Defects
Endocarditis
Hypertension
Ischemic Heart Disease
Myocardial Disease
Pediatric Cardiovascular Disease
Pericardial Disease
Valvular Heart Disease
Vascular Disease

CME Bank - Dermatology

Acne/Rosacea
Cancers of the Skin
Cutaneous Infections
Dermatitis (non-infectious)
Maculopapular Lesions
Papular/Nodular Lesions
Pediatric Dermatology
Ulcerative Lesions
Vesicular / Bullous Lesions

CME Bank - EENT (Eyes, Ears, Nose and Throat) System

Eye: Assessment
Eye: Glaucoma
Eye: Inflammation and Infection
Eye: Pharmacology
Eye: Vascular Disorders
Nose: Infection and Inflammation
Oral Cavity: Medical Disorders
Otologic Infections
Otologic Signs, Symptoms, Presentations
Pediatric Eye, Ear, Nose and Throat Disorders
Throat and Soft Tissue Neck: Medical Disorders

CME Bank - Endocrinology, Metabolism, and Nutrition

Adrenal Disorders
Diabetes Mellitus
Disorders of Calcium Metabolism and Bone
Hypoglycemia
Lipid Disorders
Obesity
Thyroid Disorders
Pediatric Endocrine Disorders

CME Bank - Gastroenterology/Nutritional System

Biliary Tract Disease
Colonic and Anorectal Disease
Esophageal Disorders
Liver Disease
Pancreatic Disease
Pediatric Gastrointestinal Disorders
Small Intestinal Disease
Stomach or Duodenum

CME Bank - Genitourinary System

Acute Renal Failure
Chronic Kidney Disease
Glomerular Disorders
Nephrolithiasis
Pediatric Nephrology and Urology
Penile Disorders
Prostate Disorders
Sexually Transmitted Infections - Male
Testicular Disorders
Urinary Incontinence
Urinary Tract Infections
Water and Electrolyte Balance

CME Bank - Hematology and Oncology

Anemia
Bone Tumors
Breast Cancer
Coagulopathies
Disseminated Intravascular Coagulation
Gastrointestinal or Hepatic Cancer
Gynecologic Cancer
Hematologic Malignancies
Lung Cancer
Management of Malignant Pain
Neoplasms of the Head and Neck
Oncologic Emergencies
Pediatric Hematology and Oncology
Sickle Cell Disease
Transfusion Medicine (Principles and Complications)
Urological Cancer

CME Bank - Infectious Diseases

Coronavirus (SARS-COV-2, COVID-19)
COVID-19 During Pregnancy
Diphtheria, Pertussis, Tetanus
Meningococcemia, Pneumococcemia
MRSA, VRE, ESBL
Tuberculosis
Parasitic Infections
Pediatric Infectious Diseases
Sepsis Syndromes
Systemic Fungal Infections
Tick-Borne Illnesses
Hantavirus HIV and AIDS
Influenza, Mononucleosis, Herpes
Rabies

CME Bank - Musculoskeletal System

Bone and Joint Infections
Crystal-Induced Arthropathy
Deep Soft Tissue Infections
Disorders of Muscles
Infectious, Inflammatory, and Reactive Arthritis
Neck and Back Pain
Osteoarthritis Rheumatoid Arthritis
Sports Injuries / Trauma
Systemic Lupus Erythematosus
Systemic Sclerosis Vasculitis
Pediatric Rheumatology and Musculoskeletal Disorders

CME Bank - Neurological System

Central Nervous System Disorders: Delirium and Dementia
Central Nervous System Disorders: Demyelinating/Inflammatory Diseases
Central Nervous System Disorders: Diseases of Movement Control
Central Nervous System Disorders: Seizures
Central Nervous System Disorders: Spinal Cord Syndromes
Central Nervous System Infections
Cerebrovascular Accidents: Epidemiology and Presentation
Cerebrovascular Accidents: Initial Work-Up
Cerebrovascular Accidents: Preventive Care
Cerebrovascular Accidents: Treatment
Headache: Cervical Neck Vessels, Subarachnoid, and Venous Emergencies
Headache: Cluster, Migraine, and Tension
Headache: Less Common Etiologies
Neurologic Assessment
Pediatric Neurologic Disorders
Peripheral Nervous System Disorders: Neuromuscular Junction Disease
Peripheral Nervous System Disorders: Neuropathies
Selected Cranial Nerve Disorders

CME Bank - Psychiatry/Behavioral System

Affective Disorders
Antidepressants
Anxiety Disorders
Anxiolytics
Dissociative Disorders
Eating Disorders
Factitious Disorders and Malingering
Geriatric Psychology
Obsessive-Compulsive Disorder
Pediatric Psychiatric Disorders
Personality Disorders
Psychiatric Assessment
Psychological Factors Affecting Medical Disorders
Schizophrenia
Somatoform Disorders
Substance Abuse
Suicidal Behavior
Thought Disorders

CME Bank - Pulmonary System

Asthma and Other Obstructive Lung Disease
Interstitial Lung Disease
Lower Respiratory Tract Infections
Occupational and Environmental Lung Disease
Pediatric Respiratory Disorders
Pleural Disease
Pulmonary Vascular Disease
Sleep Medicine
Upper Respiratory Tract Infections

CME Bank - Reproductive System

Acute Complications of Pregnancy
Chronic Medical Illness During Pregnancy
Contraception
General Approach to the Pregnant Patient
Gynecological Assessment
Menopause and Hormonal Therapy
Screening and Regular Health Care in Adult Women
Sexual Assault Sexually Transmitted Infections: Female

Sample Question 1

A 38-year-old woman presents to you with rapid-onset headache. This headache is not the worst of her life. You note that the patient has her head tilted to the left on your initial inspection. When asked, she states that when she holds her head straight, she has diplopia. Further examination reveals the inability to move the eye downward and laterally, indicating a trochlear (fourth cranial nerve [CN-IV]) palsy. There is no other neurologic deficit or papilledema present. Because isolated CN-IV palsy is usually traumatic, you ask the patient about this but she denies any injury.

Computed tomography reveals no pathology. A "champagne tap" lumbar puncture shows no xanthochromia. The most likely diagnosis is which of the following?

malingering syndrome
central venous thrombosis
ammonia poisoning
Cotard delusion
chikungunya infection

Central venous thrombosis is a rare disease and can have multiple neurologic findings. Headache is the most prominent. Papilledema is a helpful diagnostic sign, but it is present in less than one-half of cases. Likewise, seizure with headache may be indicative, but it is present only 50% of the time. It is important to remember that, even once subarachnoid hemorrhage has been ruled out, serious underlying pathology may exist, and neurologic consult is indicated. In Cotard delusion, patients believe they are already dead and can usually smell the stench of their own corpse. Malingering is not feasible because voluntary control of the extraocular muscles is not unilateral. Ammonia poisoning gives primarily respiratory symptoms. Chikungunya infection is a mosquito-borne, flu-like illness with prominent arthralgias seen in travelers, typically to Africa, Asia, or South America.

Reference:

Stettler B. Brain and cranial nerve disorders. In: Marx JA, et al. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 8th ed., 2013:1415.

Sample Question 2

A 65-year-old male smoker with a known history of hypertension presents to your office complaining of pain in the right flank and hematuria. He reports that the pain started a couple of months ago, and is vague, dull, and persistent, without alleviation or exacerbating factors. He says he cannot really localize the pain, but reports that it is generally limited to his right side and “wraps around the back.” Last week he also noticed blood in his urine, which has continued intermittently.. He denies dysuria, urgency, hesitancy, and post-void dribbling. He denies fever, headache, shortness of breath, or chest pain. He has no other complaints, and denies any other symptoms. He admits to a 45 pack/year smoking history. He is a retired chemical company worker. He denies alcohol or drug use. He is currently taking lisinopril 20 mg once daily for hypertension, and 81 mg aspirin once daily. He has no known drug allergies. On physical exam his temperature is 99.1^o F; blood pressure is 142/90 mm Hg; pulse is 90/minute, and respirations are 20/minute. The physical exam is unremarkable. Complete blood count was normal; basic metabolic panel showed deficient renal function with a blood urea nitrogen of 84 mg/dL and creatinine of 2.1 mg/dL. Urinalysis was positive for microscopic hematuria. An abdominal ultrasound was negative.

Intravenous pyelogram showed the following filling defect:

What is the most likely diagnosis?

renal pelvis carcinoma
pyelonephritis
ureteral stricture
nephrolithiasis

Although urothelial carcinoma is relatively rare, it is the most common tumor of the renal pelvis in the United States. The majority of cases (>90%) are transitional cell carcinoma (TCC) type. Incidence of TCC increases with age. This patient’s smoking and occupational history put him at increased risk of developing TCC of the upper urinary tract. Exposure to aromatic amines is associated with urothelial carcinoma. The intravenous pyelogram demonstrates a radiolucent filling defect that is irregular and in continuity with the wall of the collecting system, which is characteristic of a renal pelvis carcinoma. The absence of colicky pain and a stone on abdominal ultrasound make nephrolithiasis a less likely diagnosis. The absence of a high-grade fever or an abnormal complete blood count makes pyelonephritis an unlikely diagnosis. Although a ureter stricture is a possibility, given this patient’s history and clinical presentation, renal pelvis carcinoma is the most likely diagnosis.

References:
Olgac S, Mazumdar M, Dalbagni G, Reuter VE. Urothelial carcinoma of the renal pelvis: a clinicopathologic study of 130 cases. Am J Surg Pathol. 2004 Dec;28(12):1545-52.
Munakata S, Tahara H, Kojima K, Kishimoto T. Micropapillary urothelial carcinoma of the renal pelvis: report of a case and review of the literature. Med Sci Monit. 2007 Apr;13(4):CS47-52.

Sample Question 3

A 33-year-old woman is being treated for anorexia nervosa on an inpatient basis, but she continues to lose weight despite the use of maximally intensive care. Pharmacologic treatment is considered. Which medication is contraindicated for this patient?

monoamine oxidase inhibitors
clozapine
citalopram
tricyclic antidepressants
bupropion

Of the medications listed, only bupropion is contraindicated in this patient population because it carries a black box warning due to its increased seizure risk in patients with anorexia nervosa. Although they are not contraindicated, tricyclic antidepressants and monoamine oxidase inhibitors can cause increased adverse events in patients with anorexia nervosa, so they should be avoided in this patient population. Selective serotonin uptake inhibitors, such as citalopram, have no proven efficacy in helping patients gain weight. Second-generation antipsychotics may be helpful in patients with severe, unremitting resistance to gaining weight, severe obsessional thinking, and denial that reaches delusional proportions.

References:

McElroy, Susan L., et al. "Psychopharmacologic treatment of eating disorders: emerging findings." Current psychiatry reports 17.5 (2015): 1-7.

Tortorella, A., et al. "The role of drug therapies in the treatment of anorexia and bulimia nervosa: a review of the literature." Journal of Psychopathology 20 (2014): 50-65.

Sample Question 4

A 42-year-old woman presents with 6 months of chronic widespread pain. She has previously been relatively healthy, with her only surgery a C-section. Her only current medication is sertraline, which she has taken for depression for the past 6 years. She denies any recent injury. She has had fatigue and non-refreshing sleep. She reports that she feels as if she is “in a fog.” Her exam is unremarkable. Her physician suspects fibromyalgia. She orders laboratory testing including erythrocyte sedimentation rate, complete blood count, and a complete metabolic panel. What additional laboratory test is generally indicated in the initial workup of patients with suspected fibromyalgia?

thyroid stimulating hormone
Epstein-Barr virus serology
Lyme titer
hepatitis C serology
antinuclear antibody

Correct!

Reasonable testing in the workup of patients with chronic widespread pain includes thyroid stimulating hormone, erythrocyte sedimentation rate, complete blood count, and a complete metabolic panel. Further testing, such as viral serologies and autoimmune disease testing, should only be ordered when guided by the history and physical exam. Otherwise, the proportion of false positives to true positives will be unacceptably high. Similarly, radiology studies should only be ordered in a focused fashion stemming from physical exam and history. This is particularly true of advanced imaging such as MRI.

References
Crofford L. Fibromyalgia. In: Longo D et al., eds. Harrison’s Principles of Internal Medicine. 18th ed. New York: McGraw-Hill; 2012:2849-52.
Goroll A. Approach to the Patient with Fibromyalgia. In: Goroll A et al., eds. Primary Care Medicine. 6th ed. Philadelphia, Pa: Wolters Kluwer Lippincott Williams and Wilkins; 2009:1108-13.

Sample Question 5

A patient complains of an irritated, painful eye. Vertical linear abrasions are noted on the upper part of the cornea. This is caused by which of the following?

foreign body under the lower lid
foreign body in the superior cul-de-sac
granular corneal foreign body
foreign body under the upper lid

It is common for abrasive FBs to lodge under the upper lid and cause linear vertical corneal abrasions as the lid closes and opens.

Target Audience

Med-Challenger Physician Assistant is intended for practitioners of acute and primary care or clinicians otherwise involved in the diagnosis and treatment of acute, emergent, or chronic medical problems.

Educational Objectives

The objective of the Challenger academic continuing medical education programs is to provide an interactive review of the knowledge base of acute care and primary care medicine as appropriate by medical specialty. After completing this course, the participating clinician should be better equipped to:

Confidently manage the broad spectrum of acute and chronic medical problems encountered in the practice of medicine.
Formulate appropriate differential diagnoses for patients presenting with acute medical problems of uncertain etiology.
Efficiently initiate therapeutic and diagnostic procedures for patients presenting with acute and chronic medical disorders.
Cope effectively with the uncertainty that is inherent in the initial treatment of acute and chronic disorders.
Handle efficiently the spectrum of common disorders involving all organ systems. In particular, the physician will be better equipped to diagnose and treat acute and chronic: cardiovascular disorders; diseases of the eye, ear, nose, throat, skin and soft tissues; endocrinologic disorders; traumatic and environmental injuries; gastrointestinal diseases; gynecologic and obstetric disorders; hematologic and oncologic problems; immunologic, allergic and rheumatologic diseases; infectious diseases; life-threatening signs and symptoms; musculoskeletal disorders; pulmonary diseases; and intoxications and poisonings.
Demonstrate mastery of the knowledge and cognitive skills required to achieve objectives 1-5 by scoring at least 80% on all topics studied for CME credit.

Faculty

Mark W. Perdue, PA-C
Clinical Assistant Professor
University of Oklahoma (Tulsa)
Tulsa, OK

Joint Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of National Association for Continuing Education and Challenger Corporation.

The National Association for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation Statement

AMA Credit - The National Association for Continuing Education designates this enduring activity for a maximum of 215.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AAPA Credit - Earn up to 20 AAPA-approved CME credits (annual requirements)

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Free COVID-19 Vaccination CME Course for Healthcare Providers Reviews All Clinically Relevant Aspect of Moderna and Pfizer-BioNTech COVID-19 Vaccines

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