PANRE-LA study guide
PANRE-LA · Work through your exam, one topic at a time.
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 study guide has 12 sections and about 3,140 words.
01Cardiovascular System
The cardiovascular domain tests ischemic heart disease, heart failure, arrhythmias, valvular disease, hypertension, and lipid disorders, with emphasis on acute stabilization and guideline-directed long-term therapy. Acute chest pain: obtain a 12-lead ECG within 10 minutes.
294 words, about 1 min02Pulmonary System
The pulmonary domain tests obstructive lung disease, pneumonia, pulmonary embolism, pleural disease, sleep apnea, and interstitial lung disease, emphasizing spirometry interpretation and severity-based treatment. Asthma is variable airflow obstruction with symptoms and reversible FEV1 improvement after a bronchodilator.
259 words, about 1 min03Gastrointestinal System and Nutrition
The gastrointestinal and nutrition domain tests reflux, peptic ulcer disease, pancreatitis, liver disease, inflammatory bowel disease, and nutritional deficiencies, with attention to when to test, treat, and refer. GERD is diagnosed clinically when typical symptoms respond to a proton pump inhibitor.
278 words, about 1 min04Musculoskeletal System
The musculoskeletal domain tests osteoarthritis, inflammatory arthritis, crystal disease, fractures, low back pain, and osteoporosis, with emphasis on distinguishing mechanical from inflammatory and infectious problems. Osteoarthritis is activity-related pain with brief morning stiffness and bony enlargement.
269 words, about 1 min05Genitourinary System and Renal Disorders
The genitourinary and renal domain tests acute kidney injury, chronic kidney disease, glomerular disease, urinary tract infection, stones, and bladder outlet obstruction, focusing on cause identification and medication safety. Acute kidney injury follows KDIGO: creatinine rise of at least 0.3 mg/dL in 48 hours or 1.5 times baseline in seven days, or urine output below 0.5 mL/kg/h for six hours.
276 words, about 1 min06Neurologic System
The neurologic domain tests acute stroke, seizures, headache, neuropathy, multiple sclerosis, and dementia, emphasizing time-sensitive treatment and recognition of emergencies. Acute ischemic stroke: check glucose immediately, obtain noncontrast head CT to exclude hemorrhage, and determine last known well.
256 words, about 1 min07Endocrine System
The endocrine domain tests diabetes, thyroid disease, adrenal disorders, calcium metabolism, and pituitary disease, with emphasis on recognizing emergencies and avoiding overtreatment. Type 2 diabetes: metformin remains initial therapy unless contraindicated.
281 words, about 1 min08Hematologic and Oncologic Disorders
The hematologic and oncologic domain tests anemia, coagulation disorders, venous thromboembolism, neutropenic fever, transfusion, and cancer screening, with attention to urgent complications. Microcytic anemia with low ferritin indicates iron deficiency.
249 words, about 1 min09Dermatologic System
The dermatologic domain tests skin infections, inflammatory dermatoses, drug eruptions, and skin cancer, emphasizing pattern recognition and recognition of necrotizing emergencies. Cellulitis is a spreading, warm, tender, erythematous plaque without fluctuance.
230 words, about 1 min10Infectious Diseases
The infectious disease domain tests sepsis, pneumonia, urinary infection, sexually transmitted infections, HIV, tuberculosis, and vaccination, focusing on early treatment and appropriate diagnostic testing. Sepsis is life-threatening organ dysfunction from infection.
241 words, about 1 min11Behavioral and Mental Health
The behavioral and mental health domain tests depression, anxiety, bipolar disorder, substance use, and suicide risk, emphasizing safety and avoiding treatment that worsens underlying illness. Major depression: use a validated scale such as PHQ-9.
225 words, about 1 min12Reproductive System
The reproductive domain tests pregnancy care, ectopic pregnancy, hypertensive disorders of pregnancy, contraception, menopause, and polycystic ovary syndrome, with emphasis on safety in pregnancy and contraindications. Ectopic pregnancy: positive hCG with abdominal pain, adnexal mass, or an empty uterus on ultrasound.
282 words, about 1 min