The #1 AAPA Physician Assistant PANCE/PANRE Review

Med-Challenger PA

Online Pass-Guaranteed PANCE/PANRE review course with AAPA CME and more.

Med-Challenger PA is the highest quality, easiest to use, and most-trusted physician assistant review question bank and knowledge improvement suite for PA exam review, PANCE initial certification exams, PANRE recertification exams, and annual maintenance of certification requirement compliance. Med-Challenger’s physician assistant review course is 100% pass-guaranteed and provides over 2000 case-based Q&A following the National Commission on Certification of Physician Assistants (NCCPA) exam blueprint, media banks, and ongoing content updates.

What’s more, with 195 NCCPA-approved AMA & 20 AAPA-approved Category 1 CME credits built-in, Med-Challenger’s PA exam review Qbank, gives physician assistants everything needed to ace PA exams and fulfill requirements year after year with less time, labor, and worry.

Join the over 120,000 physician assistants who’ve used Med-Challenger to outperform on exams – and protect their practice. Try it for free today.

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Awesome product! I won’t use anything else to study for the PANCE Exam. The life subscription is definitely worth it’s weight in gold!!!!Sandra Randolph, PA-C
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Med-Challenger Physician Assistant Board Review and Medical Education Platform

Pass PANCE/PANRE exams, guaranteed.

Satisfy PA MOC requirements too.

See why Med-Challenger PA is the #1 Physician Assistant Board Review in addition to having the MOST Q&A and HIGHEST pass-rate.

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    Time-saving adaptive learning engine leaves nothing behind

    Time-saving adaptive learning engine prioritizes missed and yet-to-be-seen content so you get every ounce of value from your review purchase.

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    Automatic prescriptive remediation takes you where you need to go next

    Automatic prescriptive remediation guidance offers “deeper dives” to repair your weak areas of knowledge.

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    Adaptive AAPA blueprint-based exam simulation

    Simulate the board examination instantly, while taking Q&A in the right subject areas and in the right amounts, everytime.

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    Practice, NCCPA Review & Assessment modes for enhanced retention

    Work the way you want. No pressure practice mode, read-friendly Review mode, and CME credit assessments

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    Create your own custom exams!

    Create your own exams with our Custom Exam Builder. Save your custom exams and re-use them for study or routine self-assessment.

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    Earn CME credits as you study

    Earn CME credits within assets quickly. Manage credit claims and produce CME certificates.

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    Dashboards, analytics & reports keep things on track

    Track your progress and scores, compare against global averages, maximize your purchases, and maximize your time.

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    Daily content updates & new Q&A, plus peer-to-peer fun

    With your Med-Challenger account, you can play our weekly Quick Quiz game with new content and peer leaderboards

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    Work anywhere, anytime, on any device - in less time

    Work on any device from anywhere. 100% responsive design and time-saving adaptive tools.

Proven PA Boards Success

After 25 years in PA board review, we know how to get results – and fast.

Board Exam Pass-rate
Avg. Score Improvement
Avg. Study Time Saved
Over 0
Physician Assistants Served

Included Content & Questions

in Med-Challenger PA Physician Assistant Exam Review Qbank

Topics Covered
Board-style Questions

Physician Assistant Question Topics

NCCPA publishes a content blueprint of the material that will appear on the exam.

This is how we determine which material appears in your adaptive Qbank.

Eyes, Ears, Nose, and Throat7%
Neurologic System6%
Infectious Diseases3%

High-Yield PA Board Review Questions

NBME-style, blueprint-based Q&A.
Just like you’ll see on the actual PANCE & PANRE exams.

Positively-stated, Case-based Question Stems

No “negatively phrased” questions, no “A and B”…you know what we mean. Our questions always address important “key point” blueprint-based content in a well structured manner.

A 19-year-old girl presents to you for a sports physical examination. You discover that she has splenomegaly. Urine dipstick analysis is positive for red blood cells (RBCs), but microscopic urinalysis shows no RBCs.

She is found to have normocytic anemia with a hemoglobin level of 8.6 g/dL. She has a reticulocyte count of 5% and a low-normal ferritin level. Her lactate dehydrogenase level is elevated, as is her indirect bilirubin level. Her haptoglobin levels are low. Her family history is significant for gallbladder disease.

A Coombs test is performed and is negative. Hemoglobin electrophoresis is negative. Peripheral blood smear shows many rounded RBCs approximately two-thirds of their normal size.

Which of the following tests should be ordered to confirm your suspicions?

Clear Answer Options

A question’s difficulty is defined by the choice of distractors. Good distractors determine the difficulty level of a question. Therefore, good distractors are one of the most important features of a high quality question.

repeat Coombs test
osmotic fragility testing
glucose-6-phosphate dehydrogenase (G6PD) levels
chromosome analysis
sickle cell preparation

High-yield Remediation

Understanding why an answer choice is incorrect is just as important as knowing why it is correct. Med-Challenger questions contain detailed explanations for the correct and incorrect answer choices along with integrated media for those that learn best by visual stimuli.

Educational Objective:

Recognize clinical and laboratory findings associated with hereditary spherocytosis.

Key Point:

The diagnosis of hereditary spherocytosis is based on clinical findings, spherocytes, and positive osmotic fragility testing.


Osmotic fragility testing should be ordered. Hereditary spherocytosis is an autosomal dominant disorder that causes a weakened RBC membrane skeleton. Anemia, jaundice, and splenomegaly are the most common clinical features of hereditary spherocytosis. The degree of anemia is extremely variable and may be absent, mild, moderate, or severe. The spherocytes are hemolyzed in the spleen. The condition is distinguished from autoimmune spherocytosis by the Coombs test. The diagnosis is made based on the clinical presentation, presence of spherocytes, and a positive screening test such as osmotic fragility testing.

Although splenectomy can cure chronic hemolytic anemia due to hereditary spherocytosis, it is usually delayed as long as possible due to considerations for risk of sepsis, particularly in children. Due to the chronic bilirubinemia, patients with hereditary spherocytosis often have gallstones.


Christensen RD, Yaish HM, Gallagher PG. A pediatrician’s practical guide to diagnosing and treating hereditary spherocytosis in neonates. Pediatrics. 2015;135(6):1107-1114.

Luzatto L. Hemolytic anemias and anemia due to acute blood loss. In: Longo D, et al., eds. Harrison’s Principles of Internal Medicine. 18th ed., 2011:872-886.

Table of Contents

Everything you need to know for PA exams.

Abdominal Pain
Acute Pelvic Pain in Women
Acute Vaginal Bleeding
Back Pain
Chest Pain
Depressed Consciousness and Coma
Dizziness and Vertigo
Fever in the Adult Patient
Gastrointestinal Bleeding
Headache: Initial Approach
Nausea and Vomiting
Seizures: Initial Approach
Congenital Heart Disease in the Adult
Congestive Heart Failure
Dysrhythmias / Conduction Defects
Ischemic Heart Disease
Myocardial Disease
Pediatric Cardiovascular Disease
Pericardial Disease
Valvular Heart Disease
Vascular Disease
Hypotension and Shock
Eye: Assessment
Eye: Glaucoma
Eye: Inflammation & Infection
Eye: Pharmacology
Eye: Vascular Disorders
Nose: Infection & Inflammation
Oral Cavity: Medical Disorders
Otologic Infections
Otologic Signs, Symptoms & Presentations
Pediatric Eye, Ear, Nose & Throat Disorders
Throat & Soft Tissue Neck: Medical Disorders
Biliary Tract Disease
Colonic and Anorectal Disease
Esophageal Disorders
Liver Disease
Pancreatic Disease
Pediatric Gastrointestinal Disorders
Small Intestinal Disease
Stomach or Duodenum
Undiagnosed Gastrointestinal Hemorrhage
Acid Base Disorders
Acute Renal Failure
Chronic Kidney Disease
Glomerular Disorders
Pediatric Nephrology and Urology
Penile Disorders
Prostate Disorders
Sexually Transmitted Infections: Male
Testicular Disorders
Urinary Incontinence
Urinary Tract Infections
Water and Electrolyte Balance
Bone Tumors
Breast Cancer
Disseminated Intravascular Coagulation
Gastrointestinal or Hepatic Cancer
Gynecological 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

Affective Disorders
Anxiety Disorders
Dissociative Disorders
Eating Disorders
Factitious Disorders & Malingering
Obsessive-Compulsive Disorders
Personality Disorders
Psychological Factors Affecting Medical Disorders
Somatoform Disorders
Substance Abuse
Suicidal behavior
Thought Disorders

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
Auto-Immune Collagen Vascular Disorders
Drug Allergy
Food Allergy
Hypersensitivity Reactions
Pediatric Allergy/Immunology
Primary Immunodeficiency Disorders
The Immunocompromised/Solid-Organ Transplant Patient
Bacterial Infections: Diphtheria, Pertussis, Tetanus
Bacterial Infections: Meningococcemia, Pneumococcemia
Bacterial Infections: MRSA, VRE, ESBL
Bacterial Infections: Tuberculosis
Parasitic Infections
Pediatric Infectious Diseases
Sepsis Syndromes
Systemic Fungal Infections
Tick-Borne Illnesses
Viral Infections: HIV & AIDS
Viral Infections: Influenza, Mononucleosis, Herpes
Viral Infections: Rabies
Bone and Joint Infections
Crystal-induced Arthropathy
Deep Soft Tissue Infections
Disorders of Muscles
Infectious, Inflammatory, and Reactive Arthritis
Neck and Back Pain
Pediatric Rheumatology and Musculoskeletal Disorders
Rheumatoid Arthritis
Sports Injuries/Trauma
Systemic Lupus Erythematosus
Systemic Sclerosis
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
Adrenal Disorders
Diabetes Mellitus
Disorders of Calcium Metabolism and Bone
Lipid Disorders
Pediatric Endocrine Disorders
Thyroid Disorders

Written and Maintained by Experts

Continually Updated
All content is continually maintained by clinical expert peer-review.


Mark W. Perdue, PA-C
Former Faculty Instructor
University of Oklahoma Tulsa Physician Assistant Program
Physician Assistant
Mednow Urgent Care

Contributing Editors / Clinical Reviewers:

Kathleen K. Aiello, MD, FAAP
Ambler Pediatrics
Ambler, PA

Deborah Brunson, MD
Boulder, CO

Joseph Cama, MD
Carabou Medical
Towanda, PA

Adam Cohen, MD
Depatment of Oncology
Huntsman Cancer Institute
Salt Lake City, UT

Kimberly Collins, MD
Emergency Physician
MedExpress Urgent Care
Tampa, FL

Michael Anthony Darracq, MD, MPH
Emergency Physician
Kaiser Permanente Medical Group, Southern California
San Diego, CA

Arthur Frazzano, MD, FAAFP
Founding Director, Area Health Education Center of RI Network
Director, Division of Health Policy and Advocacy and Associated
Fellowship Program
Associate Professor
Department of Family Medicine
Warren Alpert Medical School
Brown University
Providence, Rhode Island

Alex Kadner, PhD
Medical Writer/Scientific Consultant, Neuroscience
Ballston Spa, NY

Gerard Kiernan, MD
Dartmouth Hitchcock Clinic
Keene, NH

Miguel G. Madariaga, MD, MSc, FACP, DLSHTM
Director, Center for Wound Healing and Hyperbaric Medicine
Physician, Infectious Disease
Doylestown Hospital
Doylestown, Pennsylvania

Amy Marcini, MD
General and Orthopedic Surgeon
Boston, MA

Laeth Nasir, MBBS
Professor and Chairman
Department of Family Medicine
Creighton University
Omaha, NE

Jahan Porhomayon, MD. CBA, FCCP
Clinical Associate Professor of Anesthesiology
University at Buffalo
Buffalo, New York

Joseph Scott Savage, DO, FAAEM, FACHE, FSCP, FAIHQ
Staff Physician
Emergency Dept.
Yale-New Haven Health System
Bridgeport Hospital
New Haven, CT

George Smolinksi III, MD
Major, Medical Corps, U.S. Army
Physical Medicine Clinic
Landstuhl Regional Medical Center
Landstuhl, Germany

Richard Snyder, DO
Integrative Medicine Practitioner
LeHigh Valley Nephrology Associates

Rodrigo Tanchanco, MD, FACP
Christiana Medical Group
Newark, DE

Frank Townsend, III, MD, JD
Attending Physician
Greater Baltimore Medical Center
Baltimore, MD

Tricia A. Walters, MD
Family Medicine w/ Obstetrics
Wyatt, IN

Cezary Wojcik, MD, PhD
Deaconess Hospital
Assistant Professor
Indiana University School of Medicine
Evansville, IN

Melissa Wolf, MD
Bozeman Deaconess Women’s Specialists
Bozeman, MT

Sean Wormuth, MD
Emergency Medicine Physician
Kaiser Permanente Medical Center
Vallejo, CA

Built-in CME Credit Resources

Earn CME credit while you study. Knock out requirements fast.

Earn Up To
NCCPA-Approved AMA Category 1 CME Credits

Earn up to
AAPA-Approved Category 1 CME Credits

CME Accreditation

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.

Earn and Claim Credits in a snap.

  • Score 80% or better on topic-based CME assessments
  • CME earnings will appear in your CME Claims Center
  • Produce PDF CME Certificates (claim credits) instantly
  • PDFs list all topics claimed for hassle-free submission
  • Return anytime to reprint or review historical earnings
PANCE exam prep


This is the best PA test bank I’ve ever used! The questions are great, and the answers are very thorough! I am so thankful for having access to your question bank! Thank you!D. Williams
Your physician assistant question bank has been so helpful for me. I can’t thank you enough!S. Scott

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All Features & Benefits


Other “QBanks” stop short.
With Med-Challenger, you not only get the largest PA QBank – you get a complete system of self-assessment, knowledge upkeep, and career MOC efficiency that serves you now and forever.

Med-Challenger's unique objective based user interface

Better than the best “QBank.”

Built for PANCE & PANRE exams – and everything beyond.

We give you over 2000 PA board review questions with detailed explanations – more than any PANRE Board Practice Question Bank.

But we also give you additional review tools, content assets, media banks, and time-saving career conveniences – like satisfying MOC requirements on-demand – useful every year.

Our PA review doesn’t just get you through exams, it keeps an eye toward your future, your ongoing practice needs, and your quality of life.

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Only $199 / year renews access to ALL of your purchased Med-Challenger assets for another full year of use.
We keep everything current and ready at all times, even adding new materials to annual MOC subscription products.
No more re-buys! No more worries. Enjoy everything you need, on-demand, every year - for less.

With Med-Challenger, you can do everything your PA career requires, more easily, now and forever.

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Benefits included:

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  • Renew access to ALL PURCHASED ACCOUNT ASSETS for only $199/yr
  • Content updates and annual subscription product additions FREE with active Premium Membership
  • Time-saving adaptive learning engine prioritizes missed and yet-to-be-seen content
  • Automatic prescriptive remediation guidance targets weak areas
  • Ready-made blueprint-based exams
  • Create your own custom exams!
  • Find and earn CME credits within assets quickly
  • Easy CME certificate production
  • Dashboards
  • Analytics & Reports
  • Free weekly Quick Quiz game with new content and peer leaderboards
  • Fully responsive for use on all devices
  • Free customer support

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How it Works
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And, by the way…

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