PANCE case studies
PANCE · Put your knowledge to work in context.
The Physician Assistant National Certifying Examination (PANCE) is the multiple-choice certifying exam that physician assistants must pass to earn the PA-C credential and, in most states, to begin practicing. It is administered by the National Commission on Certification of Physician Assistants (NCCPA), an independent body with no affiliation with this study platform. The PANCE case studies are 5 cases and about 3,793 words.
1Worsening Heart Failure on Maximal Triple Therapy
A 64-year-old man with an anterior myocardial infarction two years ago and an ejection fraction of 28% returns for follow-up. He is NYHA class III, with dyspnea after walking two blocks.
745 words, about 4 min2Suspected Pulmonary Embolism with Severe Renal Impairment
A 38-year-old woman presents with 12 hours of sharp right-sided chest pain that worsens with inspiration, plus sudden dyspnea that began during a 14-hour return flight from Tokyo. She takes a combined oral contraceptive and has no prior venous thromboembolism.
805 words, about 4 min3Acute Monoarthritis in a Patient on Apixaban
A 71-year-old man with hypertension, atrial fibrillation, and CKD stage 3b (baseline creatinine 1.8 mg/dL) presents with 18 hours of severe left knee pain and cannot bear weight. Three weeks ago he received an intra-articular corticosteroid injection into that same knee for osteoarthritis; he also has a history of podagra.
755 words, about 4 min4Upper GI Bleeding on Dual Antiplatelet Therapy After a Recent Stent
A 58-year-old woman with a drug-eluting stent placed four months ago after a non-ST-elevation myocardial infarction takes aspirin 81 mg and clopidogrel 75 mg daily. She began naproxen two weeks ago for knee pain and now presents after two episodes of hematemesis and one black stool.
712 words, about 4 min5Diabetic Ketoacidosis with Hypokalemia and a Surgical Distraction
A 22-year-old woman with type 1 diabetes managed by an insulin pump presents with two days of vomiting, diffuse abdominal pain, and polyuria. Her pump site has not been changed in five days.
776 words, about 4 min