PANRE-LA case studies
PANRE-LA · Put your knowledge to work in context.
PANRE-LA is the longitudinal alternative to the Physician Assistant National Recertifying Examination, one of two recertification assessment options NCCPA offers Board Certified PAs - the traditional PANRE, administered at Pearson VUE test centers, remains available. Instead of a single high-stakes sitting, PANRE-LA spreads assessment across quarterly blocks of 25 questions delivered online, anywhere, anytime, on any compatible device, with a five-minute limit per question and online or printed references permitted while answering. The PANRE-LA case studies are 5 cases and about 3,340 words.
1Anticoagulation After Gastrointestinal Bleeding in Atrial Fibrillation
A 74-year-old man with permanent atrial fibrillation, heart failure with reduced ejection fraction (EF 35%), hypertension, and type 2 diabetes returns for review. He had a transient ischemic attack in 2019 and a duodenal ulcer bleed in 2021 that resolved with endoscopic therapy; he has had no rebleeding since.
648 words, about 3 min2Suspected Pulmonary Embolism After Ankle Surgery
A 42-year-old woman presents to urgent care with sudden right-sided pleuritic chest pain and dyspnea that began 6 hours ago while she was sitting at her desk. Three weeks ago she had open reduction and internal fixation of a right ankle fracture and was non-weight-bearing for 10 days; she started combined oral contraceptives 4 months ago.
692 words, about 3 min3Warfarin Reversal for GI Bleeding With a Mechanical Mitral Valve
A 68-year-old woman with a St. Jude mechanical mitral valve placed in 2016 and atrial fibrillation takes warfarin, with a usual INR of 2.5–3.5.
633 words, about 3 min4Hot Swollen Knee: Gout Versus Septic Arthritis
A 62-year-old man with a history of two gout attacks and stage 3 chronic kidney disease (eGFR 44 mL/min/1.73 m²) presents with 3 days of worsening right knee pain, swelling, and inability to bear weight. He takes hydrochlorothiazide 25 mg daily and allopurinol 300 mg daily; he has not had an injection or recent antibiotic.
697 words, about 3 min5Severe Hyperkalemia in Advanced CKD and Heart Failure
A 71-year-old woman with heart failure with reduced ejection fraction (EF 30%) and stage 4 chronic kidney disease (baseline creatinine 2.6 mg/dL, eGFR 22 mL/min/1.73 m²) presents with 3 days of nausea, poor oral intake, and generalized weakness. Medications are sacubitril/valsartan 97/103 mg twice daily, spironolactone 25 mg daily, furosemide 40 mg daily, and metoprolol succinate 50 mg daily.
670 words, about 3 min