PANRE study guide
PANRE · Work through your exam, one topic at a time.
The Physician Assistant National Recertifying Examination (PANRE) is the assessment Certified PAs use to demonstrate continuing core medical knowledge and maintain NCCPA certification. Beginning in 2023, PAs have two recertification assessment options. The PANRE study guide has 10 sections and about 3,161 words.
01Cardiovascular
Cardiovascular items cluster into four buckets: ischemia, pump failure, rhythm, and vascular catastrophe. For ischemia, the diagnosis rests on symptoms plus ECG plus troponin; ST elevation in two contiguous leads defines STEMI and drives immediate reperfusion.
324 words, about 2 min02Pulmonary
Obstructive disease dominates this domain. Asthma is episodic, reversible, and eosinophilic; COPD is persistent, tobacco-associated, and neutrophilic.
302 words, about 2 min03Gastrointestinal and Nutrition
Organize GI around location and acuity. Esophagus: GERD is clinical; alarm features (dysphagia, odynophagia, weight loss, anemia, vomiting, age over 60 with new symptoms) trigger endoscopy.
312 words, about 2 min04Musculoskeletal
Separate mechanical from inflammatory disease. Osteoarthritis is activity-related with brief morning stiffness (under 30 minutes), bony enlargement, and minimal swelling; rheumatoid arthritis is symmetric, small-joint, with prolonged morning stiffness (over an hour) and systemic features.
306 words, about 2 min05Eyes, Ears, Nose, and Throat
Ear: acute otitis media requires bulging tympanic membrane or otorrhea, not just redness; observe mild cases in older children, treat with amoxicillin when severe or in young infants. Otitis externa is painful with canal manipulation and is treated with topical antibiotic plus steroid drops; malignant otitis externa occurs in diabetes.
337 words, about 2 min06Reproductive
Obstetrics: establish dating (crown-rump length in the first trimester), offer aneuploidy screening, and screen for gestational diabetes at 24-28 weeks. Hypertensive disorders of pregnancy begin after 20 weeks; preeclampsia is new hypertension with proteinuria or end-organ dysfunction, and severe features (blood pressure 160/110 or higher, platelets under 100, elevated transaminases, renal insufficiency, pulmonary edema, visual or cerebral symptoms) mandate magnesium for seizure prophylaxis and delivery.
322 words, about 2 min07Endocrine
Diabetes: diagnose with A1c 6.5% or higher, fasting glucose 126 or higher, 2-hour glucose 200 or higher, or random glucose 200 or higher with symptoms; confirm an asymptomatic abnormal result. Metformin is first-line; add a GLP-1 receptor agonist or SGLT2 inhibitor when atherosclerotic disease, heart failure, or chronic kidney disease is present.
296 words, about 1 min08Neurologic
Stroke is the highest-yield topic. Sudden focal deficit gets a noncontrast CT to exclude hemorrhage and a glucose check; thrombolysis is considered within 4.5 hours of onset in eligible patients, and thrombectomy for large vessel occlusion in selected patients well beyond that window.
303 words, about 2 min09Psychiatric and Behavioral
Depression: screen with PHQ-2 then PHQ-9. Treat moderate to severe disease with psychotherapy plus an SSRI; allow 4-6 weeks at therapeutic dose before declaring failure.
299 words, about 1 min10Renal and Genitourinary
Acute kidney injury is staged by creatinine rise and urine output and sorted into prerenal, intrinsic, and postrenal causes. Prerenal states improve with volume; fractional excretion of sodium under 1% suggests it, but diuretics, ACE inhibitors, and contrast make the index unreliable.
360 words, about 2 min