Special Purpose Exam Review Question Bank

Med-Challenger SPEX is the highest quality, easiest to use (SPEX) Special Purpose Examination review question bank for the shelf exam, and weighted based on the Federation of State Medical Boards (FSMB) and National Board of Medical Examiners’ (NBME) exam specifications. With built-in CME credits and ongoing updates, the Med-Challenger SPEX Qbank provides everything you need to ace exams and fulfill requirements without having to attend an in-person board review course or buy products over and over.

Useful year after year for Exams, MOC & CME requirements.
With Med-Challenger, it’s well in hand.

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Med-Challenger SPEX

Special Purpose Exam Review, Med-Challenger SPEX, Complete Review, Ongoing Updates, CME Credits

Asset Overview

Up-to-date content and Q&A for SPEX exam review, self-assessment, and CME requirements – year after year.

  • Adaptive NBME board exam prep & SPEX review Qbank
  • 3500+ SPEX blueprint-based board exam questions
  • Earn AMA Category 1 CME credits annually
  • 100% Pass-guaranteed

Combined with the adaptive tools in your account,
Our platform gives you the most benefits.

Special Purpose Exam Review, Med-Challenger Assets, SPEX Assessment, Adaptive Assessment, Board Review

Ace the SPEX Exam.
And everything else.

Get prepared in the shortest amount of time.
Take care of annual requirements after.

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    100% Pass-guaranteed

    There’s little risk given our 99% pass-rate. But, if you use Med-Challenger, and don’t pass, we’ll refund your asset purchase.

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    Blueprint-based Board Exam Simulation

    Tailored to the actual exam content specifications so you get the right amount of study in each area.

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    Time-saving Adaptive Learning

    Every use finds and fixes knowledge gaps by re-issuing missed Q&A. Ensures you see and master all content without repeats or wasted time.

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    Automatic Prescriptive Guidance

    Instantly receive paths to remediative content based on missed questions. Complete prescribed topic assessments and earn CME credit too.

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    Works Anytime, Anywhere

    Enjoy 24/7/365 access to your assets and tools via any Internet-enabled computer, tablet or smartphone.

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    Great After Exams Too

    New and newly-revised content is constantly being applied to your assets. Self-assess and repair your specialty knowledge using the most up-to-date information anytime – exams or not.

Board Exam Pass-rate
Avg. Score Improvement
Avg. Study Time Saved

Special Purpose Exam Review, Med-Challenger SPEX, Ace SPEX Exam, pass guarantee, exam simulation, adaptive learning

Content + Q&A

For Med-Challenger SPEX Special Purpose Exam Review Qbank

Topics Covered
Board-style Questions

Special Purpose Question Topics

NBME 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.

General Principles
Disorders of Blood
Disorders of the Nervous System/Special Senses
Mental Disorders
Disorders of the Skin
Disorders of the Musculoskeletal System
Disorders of the Respiratory System
Cardiovascular Disorders
Gastrointestinal Disorders
Renal and Urinary Disorders
Disorders of the Male Reproductive System
Female Reproductive System and Pregnancy
Disorders of the Endocrine System
Immunologic Disorders

Author Information

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

Chief Editors:
Andrea Cecilia Eberly, MD, M.S., FAAEM

Mark E. Deutchman, MD, FAAFP
Professor, Department of Family Medicine
Director, Advanced Training Track
Director, Rural Health Track
University of Colorado Health Sciences Center
Denver, CO

Contributing Authors:

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

Jennifer Amani, MD
Attending Physician
MBI Occupational Healthcare
Phoenix, AZ

David Auerbach, MD
Attending Physician
Montgomery Radiology Associates
Pottstown, PA

Kelly Bradley-Dodds, MD, FAAP
Program Director, Pediatric Residency
Attending Physician – Pediatrics, Emergency Medicine
Crozer-Chester Medical Center
Upland, PA

Gina Chung, MD
Assistant Professor
Dept. of Internal Medicine, Section of Medical Oncology
Yale University School of Medicine
New Haven, CT

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

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

Michael France, MD
Emergency Room Physician
Memorial Hospital of Carbon County
Rawlins, WY

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

Gerard Kiernan, MD
Dartmouth Hitchcock Clinic
Keene, NH

Daniel Hayes, MD
Internal Medicine Physician
West Linn, OR

Michael J. Hodgman, MD
Assistant Clinical Professor
SUNY Upstate Medical University
Upstate New York Poison Center
Syracuse, NY

Jassin M. Jouria, Jr., MD
University of Miami
Leonard M. Miller School of Medicine
Miami, FL

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

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

Jeanna M. Marraffa, Pharm.D., DABAT
Clinical Assistant Professor, Department of Emergency Medicine
SUNY Upstate Medical University
Clinical Toxicologist
Upstate New York Poison Center
Syracuse, NY

Luis A. Mojicar, MD
Center for Living Well Clinic
Orlando, FL

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

Pranav Virmani, MD
Dept. of Emergency Medicine
Inova Loudoun Hospital and Medical Center
Leesburg, VA

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

Mary Wilson, MD
Emergency Medicine Physician
Mercy Hospital
Coon Rapids, MN

Cezary Wojcik, MD, PhD
Deaconess Hospital
Assistant Professor
Dept. of Anatomy & Cell Biology
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

Our SPEX Questions

NBME-style, blueprint-based Q&A.
Just like you’ll see on the actual SPEX exam.

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 39-year-old man with no significant past medical history presents with a “swollen eye.” He was working in his yard a few days ago and was hit by small twig. He did not notice any symptoms immediately but subsequently developed prominent swelling of his left eye and a temperature of 102.2°F.

He complains of pain with ocular movements. He cannot spontaneously open his eye because of marked palpebral edema. The area looks very swollen and the globe is proptotic (see figure).


When the ocular eye is examined, his vision is blurry and ocular movements cannot be properly evaluated because of intense pain with movement in all directions.

What is the appropriate management for this patient’s condition?

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.

Obtain orbital CT and if no orbital involvement is identified discharge on oral antibiotics with close follow-up.
Immediately begin intravenous antibiotics and obtain orbital computed tomography (orbital CT) and admit for treatment of orbital cellulitis.
Immediately begin intravenous antibiotics and obtain orbital or sinus plain radiographs to look for retro-orbital gas or abscess formation.
Discharge on oral antibiotics with strict instructions to return promptly for worsening eye pain or decreased ocular mobility.
Discharge on topical antibiotic ophthalmic drops every 2 hours while awake and ophthalmic antibiotic ointment at bedtime.

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.


The above patient is presenting with signs of orbital cellulitis

Orbital cellulitis and periorbital cellulitis, which is also called preseptal cellulitis, may present with some similar external manifestations, including swelling of the eyelid, discoloration of the orbital skin, redness, and warmth. Traumatic injury may precede either condition. But periorbital cellulitis never presents with involvement of vision, ocular pain with movement, or limitations in ocular movement. Patients with orbital cellulitis, on the other hand, may have proptosis, loss of trigeminal nerve sensation, decreased ocular mobility, ocular pain, tenderness with eye movement, and increased intraocular pressure.

Orbital cellulitis requires admission to the hospital, treatment with intravenous antibiotics, imaging, and evaluation by surgery. Periorbital cellulitis may be followed on an outpatient basis for the first 24-48 hours of antibiotic therapy. Orbital computed tomography scans are extremely useful for diagnosing orbital cellulitis or abscesses; sinus and orbital radiography tend to be less specific.


Aldemir-Kocabaş, Bilge, et al. “Periorbital and Orbital Cellulitis: From Presentation to Outcome.” (2014).

Sharma R, Brunette DD. Ophthalmology. In: Marx JA, et al., eds. Rosen’s Emergency Medicine. 8th ed. 2014: 909-930.

Media Enhanced Learning

High-resolution media – radiographs, ECG, photos, diagrams, video, audio, and more – are included in Q&A case stems and answer explanations to clarify meaning of core concepts. Select topics also provide media galleries for additional reference.

  • media enhanced learning
  • high resolution media
  • QA answer explanations
  • clarify core concepts

CME Credits Included

Earn while you learn. Knock out requirements fast.

Earn Up To
AMA PRA Category 1 CME Credits™

Earn and Claim Credits Easily

  • 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

Earn CME, Med-Challenger CME, Earn and Claim CME Credits

You don’t just get the best content.
You get the best tools too.

Great content does nothing on it’s own. You have to use it.
We give you the most tools to “get it done” – your way.

Features & Utilities

board exam simulation

Board Exam Simulation

Prepare in less time, dive deep when needed.

All QBanks come with comprehensive exam simulations that emulate the exact content specifications of exams every time.

  • Case-based NBME-style Q&A
  • Instant Feedback
  • Prescriptive Remediation

Adaptive Learning

Smarter exams. Better results.

Our adaptive learning engine is always working to find and fix weak areas of knowledge.

  • Targets Weaknesses
  • Ensures 100% Mastery
  • Shortens Review Time
smarter board exam review
create custom exams

Build Custom Exams

Self-assess or train your crew - your way.

While we provide standard board-focused exams, you can also make your own - and save them for re-use.

  • Easy-to-use Wizard
  • Save and Re-use
  • Assignable by PDs

Custom Assignments

Control activities & monitor performance.

Program directors can assign self-assessment and testing adjunct to existing rotational programs.

  • Assignment Manager
  • Calendaring & Notifications
  • Custom Workflow Options
custom assignments
powerful education analytics

Powerful Analytics

Easily document results

Flexible reports allow PDs to get the data they want in hand.

  • Score Cards
  • Compliance Reports
  • PDF Outputs

Amazingly Efficient

Big benefits for all.

Ultimately, everyone has the tools they need to "get it done" with less time, hassle, risk, and cost.

  • A Single Login for Everything
  • Great for Quality Improvement
  • Great for Quality of Life
efficient board review

Standard Features

  • Time-saving Adaptive Learning Engine
  • Blueprint-based Exam Simulation
  • Detailed Answer Explanations
  • Practice & Review Study Options
  • Create Custom Exams
  • Instant Answer Feedback
  • Learning Prescriptions
  • Auto-Guided Remediation
  • Boards Pass-Guarantee
  • Low-cost Access Renewal (No re-buys!)
  • Content Search
  • CME Credit Search
  • Ongoing Content Updates
  • Board-Certified Physician Authors
  • Progress and Utility Dashboards
  • Report Suite
  • Earn CME Credits (Various Types)
  • CME Credit Claims Manager
  • On-demand CME Certificate Output
  • 24/7 Use from Any Web-enabled Device
  • Single Account Access to All Assets
  • Add Additional Assets Anytime
  • Weekly Quick Quiz CME Game
  • Peer Leaderboards
  • Free Technical Support

Additional features for Group Education applications.

Extra Benefits

Super Straight-forward

We’ve built Med-Challenger to be more than some one time use question bank solution. After all, you have a specialized career with unique mandates and MOC requirements. And everyone loves flexible tools.

Just pick what you want to do.

  • Study for exams with time-saving adaptive learning
  • Earn multiple types of CME credit requirements
  • Play weekly games for fun against your peers
  • Discover new information and content updates

Board Review Questions, Med-Challenger Extra Benefits
Med-Challenger Board Review, Extra Benefits, Earn CME

One Place for Everything

Stop the endless cycle of requirement scrambles. You can assemble everything under one account and never be caught off guard by your recurring career requirements.

Have everything at your fingertips.

  • Add multiple Qbank assets to a single account
  • Use assets in multiple ways for ‘my way’ education flexibility
  • Earn, print, and maintain various CME credit activities

Buy once, renew for pennies

Take care of costs along with hassles. Our premium membership plan allows you to craft your career need “go-to” at cost ONCE. Renew EVERYTHING for one low annual fee.

Enjoy lasting career efficiency.

  • Round out your needs and have them handy anytime, anywhere
  • Stop the full price re-buys year after year
  • Get new subscription-based materials annually for free

Premium Membership Plan, Med-Challenger Premium Membership, Continuous Access and Updates


  • david bauer md
    Improved residency training and ongoing performance quality control, instantly, as easy as turning a key.David Bauer, MD - FM Residency Director
  • mark perdue PA-C
    By far the best product for knowledge review and cme. Great for exams, but even better for my practice life!Mark Perdue, PA-C, MHS
  • mary alice obrien dnp
    Challenger makes sure you have the very best content and the very best tools for getting the most out of your time.Mary Alice O'Brien, DNP, ARNP, FNP-BC
  • andrea eberly md
    Outstanding resources for practicing clinicians. You get everything you need in one spot. Takes a huge burden off.Andrea Eberly, MD, MS, FAAEM

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Option 1

SPEX Basic

Everything for SPEX Exam

Special Purpose Exam Review, Med-Challenger SPEX, SPEX Exam, Complete Review, Ongoing Updates, CME Credits
One Time Purchase*

Asset included:

  • Special Purpose Exam Comprehensive Review
  • Adaptive Qbank with 3500+ SPEX-style questions
  • Board simulation with guided remediation
  • 266AMA PRA Cat. 1 Credits™
  • Money-back, pass guarantee

Benefits included:

  • One year of access (Premium Membership) free with purchase
  • One-time Purchase! Purchased assets remain in your account forever – No more re-buys!
  • 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

72 hour free trial available

Try / Buy SPEX Basic


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Everything, Ever

Board Review Library, Med-Challenger Library Subscription, Every Specialty, Annual MOC, Exam Review, Ongoing Updates, CME Credits, Special CME's, New Products
One Time Purchase*

Assets included:

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  • Pediatric Emergency
  • OB/GYN
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  • Special Purpose
  • Physician Assistant
  • Nurse Practitioner: Primary
  • Nurse Practitioner: Emergency
  • RN / NCLEX
  • EM LLSA Subscription
  • FM MC-FP KSA Subscription
  • PEDS MOC Part 2
  • Auscultation (Cardio & Pulm)
  • Dermatology
  • Ultrasound
  • ECG Interpretation
  • Radiology Interpretation
  • Risk Management & Malpractice
  • Self-Defense
  • State-required CME
  • Cardiac Center CME
  • Stroke Center CME
  • Trauma Center CME

  • AMA PRA Cat. 1 Credits™ and other CME types included
  • New Med-Challenger course assets including new titles and editions FREE as they are released.

Benefits included:

  • One year of access (Premium Membership) free with purchase
  • One-time Purchase! Purchased assets remain in your account forever – No more re-buys!
  • 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

72 hour free trial available

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Try / Buy The Library

Our Premium model is a better plan.
You buy assets once - and can use them year after year!

  • Create a single account.
  • Buy content assets - once.
  • Get one year of access free with purchase.
  • Assemble everything you need in one spot.
  • Fulfill your career needs easily, every time.

Renew access to ALL PURCHASED ASSETS in your account for only $199/yr.
No more re-buys!   No more scrambles.

With active Premium Membership, all your purchases remain up-to-date and useful - year after year.

Subscription-based MOC assets receive new materials annually for free too.

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