Click Study Flashcards above to open the flashcard hub — hundreds of PANRE cards you can flip, match, type, or quiz yourself on. Every card is drawn from the NCCPA organ-system content areas and written to the practicing PA-C certification level, so you refresh exactly what the PANRE tests.[1] Pair them with our free practice questions and study guide.
PANRE Flashcard Study Modes
Flip mode moves you card by card for plain study. Match turns term-to-definition recall into a timed game. Type shows the definition and asks you to produce the term, so you have to generate Beck’s triad from its description instead of just recognizing it. Quiz builds multiple-choice questions from the same cards when you want a test-like rhythm.
Why Flashcards Work for the PANRE
Cardiovascular System is the largest domain at 37 cards, drilling lab markers, syndrome definitions, and risk tools through fronts like BNP, Unstable angina, and CHA₂DS₂-VASc. Gastrointestinal System and/or Nutrition follows with 23 cards on presentation and management patterns, including Appendicitis, Celiac disease, and H. pylori treatment. Professional Practice adds 21 cards on the non-clinical rules you still get tested on, such as HIPAA, EMTALA, and PANRE-LA.
Endocrine System holds 20 cards built around emergencies and diagnostic cutoffs, with DKA, Thyroid storm, and Prediabetes A1c among the fronts. Pulmonary System has 19 cards that lean on scoring systems and acute findings like CURB-65, Wells criteria, and Tension pneumothorax. Musculoskeletal System also carries 19 cards on joint and injury patterns, including Septic arthritis, Scaphoid fracture, and Pseudogout (CPPD).
Reproductive System contributes 19 cards spanning obstetric and gynecologic red flags such as Preeclampsia, Placenta previa, and Ovarian torsion. Psychiatry/Behavioral Science has 18 cards on diagnostic criteria and mnemonics, with SIGECAPS, Panic disorder, and Opioid overdose. Neurologic System matches that with 18 cards on localization and time-sensitive findings, including Cushing’s triad, Myasthenia gravis, and Delirium vs dementia.
Infectious Diseases covers 17 cards on definitions and treatment, from Septic shock to Lyme disease and C. difficile colitis. Eyes, Ears, Nose, and Throat has 16 cards mixing common complaints with sight-threatening problems, such as Centor criteria, Otitis externa, and Retinal detachment. Dermatologic System brings another 16, including Erythema migrans, Impetigo, and ABCDEs of melanoma.
Hematologic System closes out the 16-card group with coagulation and anemia workup fronts like PT/INR, Anemia by MCV, and Sickle cell crisis. Renal System, also 16 cards, drills AKI categories, Hyperkalemia ECG, and Nephrotic syndrome. Genitourinary System is the smallest at 12 cards, covering Testicular torsion, Pyelonephritis, and Most common kidney stone.
That fits a busy practicing PA preparing for recert, where facts like Beck’s triad, the STEMI vs NSTEMI split, the diabetes thresholds, and the sepsis bundle must be instantly available. Used alongside our practice questions and study guide, flashcards turn review time into measurable progress.
PANRE Flashcards by Topic
The cards are organized by the NCCPA organ-system content areas. Weight your study toward the heaviest ones — Cardiovascular (the largest at ~13%), Pulmonary (~10%), and GI (~10%) together are about a third of the exam — but review every system, since all 14 are tested:[1]
| NCCPA organ-system content area | Approx. weight |
|---|---|
| Cardiovascular | ~13% |
| Pulmonary | ~10% |
| Gastrointestinal & Nutrition | ~10% |
| Musculoskeletal | ~8% |
| EENT (Eyes, Ears, Nose, Throat) | ~8% |
| Endocrine | ~8% |
| Psychiatry / Behavioral Science | ~7% |
| Infectious Diseases | ~7% |
| Dermatologic | ~5% |
| Genitourinary | ~5% |
| Neurologic | ~5% |
| Reproductive | ~5% |
| Hematologic | ~4% |
| Renal | ~4% |
Professional Practice is a separate task area (ethics, consent, HIPAA, scope), not an organ-system area, so its cards are studied alongside the eight clinical task areas rather than in the organ-system table above. Weights are approximate — verify the current PANRE blueprint on nccpa.net.
How to Get the Most Out of These Flashcards
- Start with Cardiovascular System. At 37 cards it is the biggest block in the deck, and its markers and scoring tools resurface inside the pulmonary, renal, and hematologic cards.
- Type-drill the calculations and criteria. Fronts like CHA₂DS₂-VASc and CURB-65 reward exact recall, and typing them exposes the components you skip when you only flip.
- Use Match for look-alike pairs. Timed matching is well suited to the contrast cards, such as HFrEF vs HFpEF, Delirium vs dementia, and Nephrotic syndrome against Nephritic syndrome.
- Move to the practice test once Quiz stops surprising you. When multiple-choice rounds in a domain feel routine, switch to full-length questions and use the study guide for the gaps they reveal.
- Work two or three domains per sitting. With 287 cards across fifteen domains, a rotation that revisits Professional Practice and Genitourinary System regularly keeps the smaller blocks from going stale.
Taking the initial certification exam instead of recertifying? Use our PANCE flashcards.
PANRE Flashcards FAQ
Hundreds of free PANRE flashcards, organized across the 14 NCCPA organ-system content areas tested on the Physician Assistant National Recertifying Examination — from cardiovascular and pulmonary through professional practice. They're free with no account required.
Yes. Flashcards use active recall — retrieving an answer from memory — which research shows is one of the most effective ways to make information stick, especially in short sessions spread over several days. That suits a busy practicing PA refreshing facts like Beck's triad, the diabetes thresholds, and the sepsis bundle for recert.
Every NCCPA organ-system area: Cardiovascular (the largest at ~13%), Pulmonary, GI and Nutrition, Musculoskeletal, EENT, Endocrine, Psychiatry, Infectious Diseases, Dermatology, Genitourinary, Neurology, Reproductive, Hematology, and Renal — plus the eight task areas, including Professional Practice.
Yes. The PANRE-LA (Longitudinal Assessment) tests the same general medical content as the standard PANRE, just delivered in small quarterly sets over the cycle. These cards refresh that same clinical knowledge, so they help whether you sit the standard PANRE or take the longitudinal path.
Mix the modes: flip to learn, type to test recall, match for speed, and quiz to check yourself. Spend the most time on Cardiovascular (~13%), Pulmonary (~10%), and GI (~10%) — together about a third of the exam — and review every system, since all 14 appear.
Yes — 100% free, all four study modes, no paywall.
PANRE flashcard bank
All 287 cards, by topic
A reference copy of every card in this deck. Each answer stays hidden until you choose to show it. To study with Flip, Match, Type and Quiz modes and track what you have mastered, use Study Flashcards at the top of the page.
Cardiovascular System (37)
- Beck's triad
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Hypotension + jugular venous distension + muffled heart sounds = cardiac tamponade.
- STEMI
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ST elevation at least 1 mm in at least 2 contiguous leads (or new LBBB); transmural occlusion → emergent reperfusion (primary PCI).
- NSTEMI
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Elevated troponin with ST depression/T inversion but no ST elevation; partial occlusion → medical therapy + early angiography (no lytics).
- Unstable angina
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Ischemic chest pain at rest/crescendo with a NORMAL troponin (no necrosis yet).
- Troponin
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Cardiac biomarker of myocyte injury; elevated separates MI (STEMI/NSTEMI) from unstable angina.
- STEMI treatment
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Emergent reperfusion — primary PCI preferred; fibrinolysis if PCI unavailable within the time window.
- Most common cause of sudden cardiac death in young athletes
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Hypertrophic cardiomyopathy (asymmetric septal hypertrophy).
- Aortic dissection clue
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Tearing chest pain radiating to the back + unequal arm blood pressures; widened mediastinum on CXR.
- HFrEF four pillars
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ACE inhibitor/ARB or ARNI, beta-blocker, mineralocorticoid antagonist (MRA), and an SGLT2 inhibitor.
- HFrEF vs HFpEF
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HFrEF = ejection fraction up to 40% (systolic); HFpEF = preserved EF (diastolic dysfunction).
- Left-sided heart failure signs
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Pulmonary congestion: dyspnea, orthopnea, paroxysmal nocturnal dyspnea, crackles.
- Right-sided heart failure signs
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Systemic congestion: peripheral edema, JVD, hepatomegaly, ascites.
- BNP
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Natriuretic peptide elevated in heart failure; helps distinguish cardiac from pulmonary dyspnea.
- Stage 1 hypertension (ACC/AHA)
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Systolic 130–139 mmHg or diastolic 80–89 mmHg.
- Stage 2 hypertension (ACC/AHA)
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Systolic at least 140 mmHg or diastolic at least 90 mmHg.
- First-line antihypertensives
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Thiazide diuretic, ACE inhibitor/ARB, or calcium channel blocker.
- Atrial fibrillation ECG
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Irregularly irregular rhythm with NO discrete P waves.
- CHA₂DS₂-VASc
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Stroke-risk score in non-valvular AFib guiding anticoagulation (CHF, HTN, Age, DM, Stroke, Vascular, Age 65–74, Sex).
- Warfarin monitoring
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PT/INR; target INR 2–3 for most indications including AFib.
- Aortic stenosis murmur
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Crescendo–decrescendo systolic murmur radiating to the carotids; triad of syncope, angina, dyspnea.
- Mitral regurgitation murmur
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Holosystolic murmur best at the apex, radiating to the axilla.
- Mitral stenosis murmur
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Mid-diastolic rumble with an opening snap; often from rheumatic heart disease.
- Acute pericarditis
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Pleuritic chest pain relieved by sitting forward; diffuse ST elevation + PR depression; friction rub.
- Cardiac tamponade physiology
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Pericardial fluid → impaired filling; pulsus paradoxus, Beck's triad, electrical alternans.
- Wolff-Parkinson-White
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Accessory pathway → short PR, delta wave, wide QRS; risk of tachyarrhythmias.
- Stable angina treatment
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Sublingual nitroglycerin for symptoms; beta-blocker and risk-factor control to prevent.
- Deep vein thrombosis
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Unilateral leg swelling/pain; diagnose with compression ultrasound; anticoagulate.
- Peripheral arterial disease
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Intermittent claudication, ↓ ankle-brachial index (ABI < 0.9), diminished pulses.
- Cardiogenic shock
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Pump failure (often post-MI): ↓ cardiac output, ↑ preload, ↑ SVR, cold/clammy.
- Hypovolemic shock
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Volume loss (hemorrhage/dehydration): ↓ preload, ↑ SVR, cold; treat the cause + fluids.
- Distributive shock
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Sepsis/anaphylaxis/neurogenic: vasodilation, ↓ SVR, warm early; norepinephrine for sepsis.
- Obstructive shock
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Tamponade, tension pneumothorax, or massive PE block flow; relieve the obstruction.
- Anaphylaxis treatment
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Intramuscular epinephrine FIRST, then airway, fluids, antihistamines, and steroids.
- Ventricular fibrillation
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Pulseless, chaotic rhythm — immediate defibrillation + CPR.
- Third-degree (complete) heart block
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AV dissociation (P waves and QRS independent); needs a pacemaker.
- Pulmonary hypertension
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Elevated pulmonary pressures → right heart strain; loud P2, dyspnea on exertion.
- Statin indication
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Lower LDL in clinical ASCVD, LDL at least 190, diabetes 40–75, or elevated 10-year risk.
Pulmonary System (19)
- Asthma vs COPD reversibility
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Asthma reverses (FEV₁ ↑ at least 12% and at least 200 mL post-bronchodilator); COPD obstruction is fixed.
- Obstructive pattern on spirometry
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FEV₁/FVC ratio < 0.70.
- COPD risk factor
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Cigarette smoking.
- Asthma stepwise therapy
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Inhaled corticosteroids are the controller backbone; add LABA as needed.
- CURB-65
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Pneumonia severity: Confusion, Urea, Respiratory rate, Blood pressure, age at least 65.
- Pulmonary embolism workup
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Low Wells + negative D-dimer rules out; high Wells → CT pulmonary angiography.
- Wells criteria
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Pretest probability score for pulmonary embolism (and DVT).
- Tension pneumothorax
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Hypotension, absent breath sounds, tracheal deviation away — immediate needle decompression.
- Spontaneous pneumothorax
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Tall, thin young smokers; sudden pleuritic pain and dyspnea.
- Tuberculosis presentation
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Apical disease, chronic cough, night sweats, weight loss, hemoptysis.
- ARDS
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Acute bilateral infiltrates + hypoxemia not from heart failure; low-tidal-volume ventilation.
- Pleural effusion (Light's criteria)
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Distinguishes exudate from transudate using protein and LDH ratios.
- Obstructive sleep apnea
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Snoring, daytime sleepiness, witnessed apneas; diagnose with polysomnography.
- Lung cancer (small cell)
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Central, aggressive, strongly smoking-related; paraneoplastic syndromes (SIADH).
- Croup
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Barking cough and inspiratory stridor in young children; 'steeple sign' on X-ray.
- Bronchiolitis
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RSV in infants; wheezing and respiratory distress; supportive care.
- Sarcoidosis
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Bilateral hilar lymphadenopathy + noncaseating granulomas; often in young Black adults.
- Right lower lobe pneumonia mimic
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Can present as RUQ/abdominal pain — consider CXR with abdominal complaints.
- Foreign body aspiration
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Sudden choking, unilateral wheeze; often right mainstem in adults.
Gastrointestinal System and/or Nutrition (23)
- Peptic ulcer disease causes
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H. pylori and NSAIDs are the two most common causes.
- H. pylori treatment
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Triple/quadruple therapy: PPI + antibiotics (e.g., clarithromycin + amoxicillin).
- GERD treatment
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Lifestyle change + proton-pump inhibitor; alarm features (dysphagia, weight loss, bleeding) → endoscopy.
- Crohn disease
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Transmural inflammation, skip lesions, mouth-to-anus; fistulas; non-bloody diarrhea common.
- Ulcerative colitis
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Continuous mucosal inflammation limited to the colon; bloody diarrhea; ↑ colon cancer risk.
- Appendicitis
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Periumbilical pain migrating to McBurney point (RLQ), rebound tenderness, low-grade fever.
- Acute cholecystitis
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RUQ pain after fatty meals, positive Murphy sign; gallstones; ultrasound first.
- Diverticulitis
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LLQ pain and fever in older adults; CT shows inflamed diverticula.
- Acute pancreatitis
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Epigastric pain radiating to the back; elevated lipase; gallstones or alcohol.
- Pancreatitis causes (mnemonic)
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'GET SMASHED' — Gallstones and Ethanol are the two most common.
- Cirrhosis complications
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Portal hypertension → varices, ascites, hepatic encephalopathy, hepatorenal syndrome.
- Hepatitis B serology (HBsAg)
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Surface antigen positive = active infection (acute or chronic).
- Hepatitis A transmission
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Fecal–oral; self-limited; prevented by vaccine.
- Celiac disease
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Gluten-triggered autoimmune enteropathy; anti-tissue transglutaminase antibodies; villous atrophy.
- Colorectal cancer screening
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Begin at age 45 (average risk) — colonoscopy or stool-based testing (USPSTF).
- Upper vs lower GI bleed
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Upper = melena/hematemesis (above ligament of Treitz); lower = hematochezia.
- Small bowel obstruction
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Crampy pain, vomiting, distension, 'tinkling' or absent bowel sounds; air-fluid levels on X-ray.
- Acute mesenteric ischemia
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Pain out of proportion to exam in an older patient with vascular disease — surgical emergency.
- Vitamin B₁₂ deficiency
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Macrocytic anemia + neurologic signs (subacute combined degeneration).
- Diverticulosis vs diverticulitis
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Diverticulosis = asymptomatic outpouchings (painless bleeding); diverticulitis = inflamed/infected.
- Cholangitis (Charcot triad)
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Fever, jaundice, and RUQ pain from biliary obstruction + infection.
- Hemorrhoids vs anal fissure
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Hemorrhoids = painless bright-red bleeding; fissure = painful bleeding with defecation.
- Hernia (incarcerated vs strangulated)
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Incarcerated = irreducible; strangulated = ischemic (tender, systemic signs) — surgery.
Endocrine System (20)
- Diabetes A1c threshold
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Hemoglobin A1c at least 6.5% diagnoses diabetes.
- Diabetes fasting glucose threshold
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Fasting plasma glucose at least 126 mg/dL on two occasions.
- Prediabetes A1c
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Hemoglobin A1c 5.7–6.4%.
- Type 1 vs type 2 diabetes
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Type 1 = autoimmune insulin deficiency (insulin required); type 2 = insulin resistance (metformin first-line).
- First-line type 2 diabetes drug
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Metformin (plus lifestyle change).
- DKA
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Type 1; hyperglycemia + ketosis + anion-gap metabolic acidosis; treat with IV fluids, insulin, K⁺ repletion.
- HHS
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Type 2; profound hyperglycemia (> 600 mg/dL) + high osmolality + minimal ketosis; altered mental status.
- Thyroid screening test
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TSH — high TSH = hypothyroidism; low TSH = hyperthyroidism.
- Hypothyroidism treatment
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Levothyroxine; symptoms include fatigue, weight gain, cold intolerance, constipation.
- Graves disease
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Most common hyperthyroidism; TSH-receptor antibodies; exophthalmos, goiter, pretibial myxedema.
- Adrenal insufficiency (Addison)
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Fatigue, hypotension, hyperpigmentation, hyponatremia, hyperkalemia; low cortisol.
- Cushing syndrome
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Cortisol excess: central obesity, moon facies, striae, hyperglycemia, hypertension.
- Hyperparathyroidism
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High PTH + high calcium; 'stones, bones, groans, psychiatric overtones'.
- Hypocalcemia signs
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Chvostek (facial tap) and Trousseau (cuff-induced spasm) signs; perioral numbness.
- Pheochromocytoma
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Catecholamine-secreting tumor: episodic headache, palpitations, sweating, hypertension.
- Diabetic neuropathy
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Stocking-glove distal sensory loss; tight glucose control slows progression.
- SIADH
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Excess ADH → euvolemic hyponatremia with concentrated urine.
- Diabetes insipidus
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ADH deficiency (central) or resistance (nephrogenic) → polyuria, dilute urine.
- Hypothyroidism in pregnancy
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Increase levothyroxine; untreated risks fetal neurodevelopment.
- Thyroid storm
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Life-threatening hyperthyroidism: fever, tachyarrhythmia, agitation — emergency.
Eyes, Ears, Nose, and Throat (16)
- Acute angle-closure glaucoma
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Painful red eye, fixed mid-dilated pupil, halos, hard globe, nausea — emergency, lower IOP immediately.
- Otitis media
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Bulging, immobile tympanic membrane; first-line amoxicillin.
- Otitis externa
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Pain on tragus traction ('swimmer's ear'); topical antibiotic drops.
- Bacterial vs viral conjunctivitis
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Bacterial = purulent discharge; viral = watery, often with URI; allergic = itchy/bilateral.
- Centor criteria
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Group A strep score: exudate, tender anterior nodes, fever, no cough, plus age.
- Strep throat treatment
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Penicillin or amoxicillin to prevent rheumatic fever (cephalosporin/macrolide if allergic).
- Epistaxis (anterior)
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Most common at Kiesselbach plexus; direct pressure first-line.
- Acute bacterial sinusitis
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Symptoms > 10 days or worsening after improvement; most resolve without antibiotics.
- Peritonsillar abscess
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Severe sore throat, muffled 'hot potato' voice, uvular deviation; needs drainage.
- Central retinal artery occlusion
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Sudden painless monocular vision loss; 'cherry-red spot' — emergency.
- Retinal detachment
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Flashes, floaters, and a 'curtain' over vision; urgent ophthalmology referral.
- Open-angle glaucoma
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Painless, gradual peripheral vision loss with ↑ cup-to-disc ratio; chronic.
- Cataract
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Painless, gradual clouding of the lens → blurred vision and glare.
- Hordeolum (stye)
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Acute, tender, localized eyelid abscess; warm compresses.
- Vertigo (peripheral, BPPV)
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Brief positional vertigo from otolith displacement; Dix-Hallpike test, Epley maneuver.
- Macular degeneration
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Central vision loss in older adults; dry (drusen) and wet (neovascular) forms.
Musculoskeletal System (19)
- Ottawa ankle rules
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Decision rule that identifies which ankle/foot injuries actually need an X-ray.
- Salter-Harris classification
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Grades pediatric growth-plate (physeal) fractures, types I–V.
- Osteoarthritis
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Non-inflammatory wear; morning stiffness < 30 min; Heberden (DIP) and Bouchard (PIP) nodes.
- Rheumatoid arthritis
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Symmetric inflammatory polyarthritis; stiffness > 1 h; positive RF/anti-CCP; spares DIP.
- Gout
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Acute monoarthritis (classically first MTP); NEGATIVELY birefringent needle-shaped crystals.
- Pseudogout (CPPD)
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POSITIVELY birefringent rhomboid crystals; often the knee.
- Septic arthritis
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Hot, swollen, painful joint with fever; arthrocentesis (WBC often > 50,000) — emergency.
- Cauda equina syndrome
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Saddle anesthesia + bowel/bladder dysfunction + bilateral leg weakness — surgical emergency.
- Low back pain red flags
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Fever, weight loss, cancer history, neuro deficit, bowel/bladder changes → imaging.
- Compartment syndrome
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Pain out of proportion + pain on passive stretch; the 6 P's — emergency fasciotomy.
- Scaphoid fracture
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Snuffbox tenderness after fall on outstretched hand; risk of avascular necrosis.
- Anterior shoulder dislocation
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Most common dislocation; arm abducted/externally rotated; check axillary nerve.
- Osteoporosis screening
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DEXA scan in women at least 65; T-score up to −2.5 defines osteoporosis.
- Carpal tunnel syndrome
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Median nerve compression; numbness in thumb–middle fingers; positive Phalen/Tinel.
- ACL tear
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'Pop' with pivoting injury, effusion, positive Lachman test.
- Rotator cuff tear
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Shoulder pain and weakness with abduction; supraspinatus most common.
- Gout treatment (acute)
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NSAIDs, colchicine, or steroids acutely; urate-lowering therapy (allopurinol) later.
- Osteomyelitis
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Bone infection; MRI is most sensitive; often S. aureus; prolonged antibiotics.
- De Quervain tenosynovitis
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Radial wrist pain; positive Finkelstein test.
Psychiatry/Behavioral Science (18)
- Major depressive disorder
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at least 5 of 9 symptoms at least 2 weeks; depressed mood or anhedonia required.
- SIGECAPS
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Depression symptoms: Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor, Suicidality.
- Depression first-line treatment
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SSRI plus psychotherapy.
- Bipolar I disorder
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At least one manic episode; treat with mood stabilizers (lithium, valproate) — not an SSRI alone.
- Generalized anxiety disorder
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Excessive worry most days at least 6 months; SSRI/SNRI and CBT.
- Panic disorder
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Recurrent unexpected panic attacks + fear of future attacks.
- Schizophrenia
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at least 6 months of psychosis; positive (hallucinations/delusions) and negative symptoms.
- Serotonin syndrome
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Autonomic instability, hyperreflexia/clonus, agitation; from serotonergic drug excess.
- Neuroleptic malignant syndrome
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Fever, 'lead-pipe' rigidity, altered mental status, autonomic instability; from antipsychotics.
- Alcohol withdrawal / DTs
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Tremor, autonomic hyperactivity, seizures, delirium tremens; benzodiazepines.
- Opioid overdose
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Respiratory depression + pinpoint pupils; reverse with naloxone.
- PTSD
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Re-experiencing, avoidance, hyperarousal, and negative cognition after trauma > 1 month.
- Anorexia nervosa
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Restriction with low body weight and intense fear of weight gain; medical complications.
- ADHD
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Inattention and/or hyperactivity-impulsivity; stimulants first-line.
- OCD
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Intrusive obsessions and compulsions; SSRI (often higher dose) and CBT/ERP.
- Suicide risk factors (SAD PERSONS)
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Older age, male, prior attempt, substance use, and a specific plan raise risk.
- Substance use screening
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Use validated tools (e.g., CAGE for alcohol) and offer brief intervention.
- Lithium toxicity
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Tremor, confusion, ataxia; narrow therapeutic index — monitor levels and renal function.
Infectious Diseases (17)
- Sepsis
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Life-threatening organ dysfunction from a dysregulated response to infection.
- Septic shock
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Sepsis with persistent hypotension requiring vasopressors + elevated lactate.
- Sepsis bundle priorities
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Cultures before antibiotics, early broad-spectrum antibiotics, fluids, and lactate measurement.
- First-line septic-shock vasopressor
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Norepinephrine, to maintain MAP at least 65 mmHg.
- HIV screening
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4th-generation antigen/antibody combination immunoassay; confirm with differentiation assay.
- AIDS definition
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HIV with CD4 count < 200 cells/µL or an AIDS-defining illness.
- Influenza treatment
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Oseltamivir, most effective within 48 hours of symptom onset.
- Meningitis empiric treatment
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Do not delay empiric antibiotics for the LP; add steroids in suspected bacterial meningitis.
- CSF in bacterial meningitis
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High neutrophils, high protein, LOW glucose, high opening pressure.
- Tuberculosis treatment (RIPE)
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Rifampin, Isoniazid, Pyrazinamide, Ethambutol.
- Lyme disease
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Erythema migrans (early); doxycycline; can progress to carditis and arthritis.
- Cellulitis vs abscess
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Cellulitis = diffuse spreading infection (antibiotics); abscess = walled-off collection (drain).
- Most common community-acquired pneumonia organism
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Streptococcus pneumoniae.
- Infective endocarditis
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Fever + new murmur; Duke criteria; blood cultures + echocardiography.
- C. difficile colitis
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Antibiotic-associated watery diarrhea; treat with oral vancomycin or fidaxomicin.
- Adult immunization (influenza)
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Annual influenza vaccine recommended for everyone at least 6 months (CDC).
- Pertussis
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Paroxysmal cough with inspiratory 'whoop'; treat with a macrolide.
Dermatologic System (16)
- ABCDEs of melanoma
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Asymmetry, Border irregularity, Color variation, Diameter > 6 mm, Evolution.
- Melanoma prognosis
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Breslow depth (thickness of invasion) is the most important prognostic factor.
- Basal cell carcinoma
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Pearly papule with telangiectasias; most common skin cancer; rarely metastasizes.
- Squamous cell carcinoma
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Scaly, ulcerated lesion on sun-damaged skin; can arise from actinic keratosis.
- Psoriasis
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Well-demarcated silvery scaly plaques on extensor surfaces; Auspitz sign.
- Atopic dermatitis (eczema)
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Pruritic, flexural rash; part of the atopic triad with asthma and allergic rhinitis.
- Cellulitis
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Warm, tender, spreading erythema of skin/subcutaneous tissue; usually strep or staph.
- Stevens-Johnson syndrome / TEN
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Drug-induced mucocutaneous emergency with skin sloughing; stop the offending drug.
- Tinea (dermatophyte)
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Annular scaly patch with central clearing; KOH prep shows hyphae; topical antifungals.
- Impetigo
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Honey-colored crusted lesions, common in children; topical or oral antibiotics.
- Acne pathophysiology
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Follicular plugging, Cutibacterium acnes, sebum, and inflammation.
- Seborrheic keratosis
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Benign, waxy, 'stuck-on' pigmented papule in older adults.
- Erythema migrans
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Expanding target-shaped rash of early Lyme disease.
- Contact dermatitis
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Localized eczematous reaction to an allergen (e.g., poison ivy) or irritant.
- Urticaria (hives)
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Transient, pruritic wheals from histamine release; treat with antihistamines.
- Pressure injury staging
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Stage 1 non-blanchable erythema → Stage 4 full-thickness with exposed bone/tendon.
Genitourinary System (12)
- Testicular torsion
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Sudden severe testicular pain, high-riding testis, ABSENT cremasteric reflex — surgery within ~6 h.
- Nephrolithiasis
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Colicky flank pain radiating to the groin + hematuria; non-contrast CT is the test of choice.
- Most common kidney stone
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Calcium oxalate.
- Uncomplicated UTI treatment
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Nitrofurantoin or trimethoprim-sulfamethoxazole (per local resistance).
- Pyelonephritis
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Flank pain, fever, costovertebral angle tenderness with UTI symptoms.
- Benign prostatic hyperplasia
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Older men with obstructive urinary symptoms; alpha-blockers and 5-alpha-reductase inhibitors.
- Prostate cancer screening
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Shared decision-making on PSA testing (USPSTF) ages 55–69.
- Epididymitis
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Gradual testicular pain, positive Prehn sign (pain relief with elevation); often STI in young men.
- Erectile dysfunction first-line
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PDE-5 inhibitors (e.g., sildenafil); avoid with nitrates.
- Bladder cancer clue
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Painless gross hematuria in an older smoker.
- Varicocele
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'Bag of worms' scrotal mass, usually left-sided; can affect fertility.
- Acute urinary retention
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Inability to void with a distended bladder; immediate catheterization.
Neurologic System (18)
- FAST stroke
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Face drooping, Arm weakness, Speech difficulty, Time to call emergency services.
- Ischemic vs hemorrhagic stroke
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Non-contrast CT first: no blood = ischemic (thrombolysis window); blood = hemorrhagic (no lytics).
- Ischemic stroke treatment
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IV thrombolysis within the window; mechanical thrombectomy for large-vessel occlusion.
- TIA
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Transient focal deficit without infarction; warns of impending stroke — urgent workup.
- Subarachnoid hemorrhage
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'Worst headache of my life' (thunderclap); CT then LP (xanthochromia).
- Bacterial meningitis triad
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Fever, neck stiffness (nuchal rigidity), and altered mental status.
- Seizure first-line (status epilepticus)
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IV benzodiazepine (lorazepam), then a longer-acting agent.
- Parkinson disease
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Resting tremor, rigidity, bradykinesia, postural instability; dopamine deficiency.
- Multiple sclerosis
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Demyelination 'disseminated in time and space'; MRI plaques; optic neuritis common.
- Guillain-Barré syndrome
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Ascending symmetric weakness after infection; albuminocytologic dissociation in CSF.
- Bell palsy
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Acute unilateral facial paralysis INCLUDING the forehead (lower motor neuron).
- Migraine vs tension headache
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Migraine = unilateral, throbbing, photophobia, nausea; tension = bilateral, band-like, dull.
- Giant cell (temporal) arteritis
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New headache > 50, jaw claudication, ↑ ESR; steroids immediately to prevent blindness.
- Myasthenia gravis
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Fatigable weakness worse with use; ptosis, diplopia; anti-AChR antibodies.
- Delirium vs dementia
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Delirium = acute, fluctuating, reversible; dementia = chronic, progressive decline.
- Cushing's triad
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Hypertension, bradycardia, and irregular respirations — sign of rising intracranial pressure.
- Concussion management
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Cognitive/physical rest then graded return; watch for worsening (intracranial bleed).
- Trigeminal neuralgia
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Brief, severe, shock-like unilateral facial pain; carbamazepine first-line.
Reproductive System (19)
- Ectopic pregnancy
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First-trimester pain/bleeding + positive β-hCG + empty uterus on ultrasound — emergency.
- Preeclampsia
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New hypertension + proteinuria after 20 weeks; severe features need magnesium and delivery.
- Eclampsia
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Preeclampsia plus seizures; magnesium sulfate and delivery.
- Magnesium toxicity sign
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Loss of deep tendon reflexes (then respiratory depression); reverse with calcium gluconate.
- Cervical cancer screening
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Begin at age 21; cytology q3y (21–29); cytology/HPV q3–5y (30–65) per USPSTF.
- Chlamydia/gonorrhea treatment
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Treat both (ceftriaxone + doxycycline) due to co-infection; report and treat partners.
- Syphilis stages
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Primary (painless chancre), secondary (rash incl. palms/soles), tertiary; treat with penicillin.
- PCOS
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Oligomenorrhea, hyperandrogenism, polycystic ovaries; insulin resistance; lifestyle + OCPs/metformin.
- Placenta previa
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Painless third-trimester vaginal bleeding; no digital exam — ultrasound.
- Placental abruption
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Painful third-trimester bleeding with a rigid, tender uterus.
- Pelvic inflammatory disease
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Lower abdominal pain + cervical motion tenderness; risk of infertility; treat empirically.
- Menopause
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12 months of amenorrhea; ↑ FSH; hot flashes; consider risks before hormone therapy.
- Gestational diabetes screening
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Oral glucose tolerance test at 24–28 weeks.
- Breast cancer screening
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Mammography; USPSTF recommends starting at age 40 (biennial through 74).
- Endometrial cancer clue
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Postmenopausal vaginal bleeding — evaluate with endometrial biopsy.
- Ovarian torsion
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Sudden severe unilateral pelvic pain with an adnexal mass — surgical emergency.
- Mastitis
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Painful, erythematous breast in a lactating woman; continue breastfeeding + antibiotics.
- Postpartum hemorrhage
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Most common cause is uterine atony; massage, uterotonics (oxytocin).
- Bacterial vaginosis
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Thin gray discharge, clue cells, positive whiff test; treat with metronidazole.
Hematologic System (16)
- Anemia by MCV
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Microcytic (< 80), normocytic (80–100), macrocytic (> 100).
- Iron deficiency anemia
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Microcytic, low ferritin; most common anemia worldwide.
- Anemia of chronic disease
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Normocytic (or microcytic); low iron with NORMAL/high ferritin.
- Macrocytic anemia causes
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Vitamin B₁₂ deficiency (neuro signs) and folate deficiency (no neuro signs).
- B₁₂ vs folate deficiency
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B₁₂ deficiency has neurologic signs; folate deficiency does not.
- Reticulocyte count use
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High = blood loss/hemolysis (good marrow response); low = hypoproliferative anemia.
- Hemolysis labs
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↑ reticulocytes, ↑ LDH, ↑ indirect bilirubin, ↓ haptoglobin.
- Sickle cell crisis
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Vaso-occlusive pain; treat with hydration, oxygen, and analgesia; hydroxyurea prevents.
- PT/INR
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Tests the extrinsic pathway; monitors warfarin.
- aPTT
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Tests the intrinsic pathway; monitors unfractionated heparin.
- ITP
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Isolated thrombocytopenia (low platelets) with normal coagulation; immune platelet destruction.
- Heparin-induced thrombocytopenia (HIT)
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Platelets drop at least 50% with paradoxical clotting; stop heparin, start a non-heparin anticoagulant.
- DIC
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Widespread clotting + bleeding; ↓ platelets, ↑ PT/aPTT, ↓ fibrinogen, ↑ D-dimer.
- Acute leukemia clue
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Rapid onset of fatigue, infections, and bleeding with blasts on smear.
- Hodgkin lymphoma
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Reed-Sternberg cells; often a contiguous nodal spread; good prognosis.
- Von Willebrand disease
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Most common inherited bleeding disorder; mucocutaneous bleeding, prolonged bleeding time.
Renal System (16)
- AKI categories
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Prerenal (hypoperfusion), intrinsic (acute tubular necrosis), and postrenal (obstruction).
- Prerenal AKI clue
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BUN:creatinine ratio > 20:1; responds to volume.
- Chronic kidney disease
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GFR < 60 mL/min/1.73 m2 for at least 3 months; slow progression with ACEi/ARB.
- Hyperkalemia first step
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IV calcium (gluconate/chloride) to stabilize the myocardium.
- Hyperkalemia ECG
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Peaked T waves → widened QRS → sine wave; can cause fatal arrhythmia.
- Hyperkalemia shift therapy
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Insulin with glucose (and a beta-agonist) shift K⁺ into cells.
- Hyponatremia approach
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Assess volume status; correct slowly to avoid osmotic demyelination.
- Nephrotic syndrome
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Proteinuria > 3.5 g/day, hypoalbuminemia, edema, hyperlipidemia.
- Nephritic syndrome
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Hematuria, RBC casts, hypertension, mild proteinuria; glomerular inflammation.
- Acute tubular necrosis
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Most common intrinsic AKI; 'muddy brown' granular casts; from ischemia or toxins.
- Metabolic acidosis (anion gap)
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MUDPILES causes (e.g., DKA, lactic acidosis, toxins).
- Indications for emergent dialysis (AEIOU)
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Acidosis, Electrolytes (K⁺), Intoxication, Overload, Uremia.
- Diabetic nephropathy
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Leading cause of CKD/ESRD; screen with urine albumin; ACEi/ARB protective.
- Contrast-induced nephropathy
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AKI 48–72 h after iodinated contrast; hydrate and minimize contrast in at-risk patients.
- Hypertensive emergency
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Severe BP elevation WITH end-organ damage; lower BP in a controlled, gradual way.
- Rhabdomyolysis
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Muscle breakdown → ↑ CK, myoglobinuria, AKI, hyperkalemia; aggressive IV fluids.
Professional Practice (21)
- Informed consent
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Capacity + disclosure of risks/benefits/alternatives + voluntariness, documented before a procedure.
- Decision-making capacity
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Ability to understand, appreciate, reason, and communicate a choice — task-specific.
- HIPAA
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Protects patient health information; disclose only the minimum necessary with authorization.
- Medical ethics principles
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Autonomy, beneficence, nonmaleficence, and justice.
- USPSTF
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Issues graded preventive-service recommendations (screening, counseling, prevention).
- Sensitivity vs specificity
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Sensitivity = true positives (rules out, SnNout); specificity = true negatives (rules in, SpPin).
- Positive predictive value
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Probability that a positive test is a true positive; rises with disease prevalence.
- Number needed to treat (NNT)
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1 / absolute risk reduction — patients treated to prevent one bad outcome.
- Levels of evidence
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Systematic reviews/RCTs rank highest; expert opinion/case reports lowest.
- Sentinel event
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Unexpected occurrence causing death or serious harm — triggers root-cause analysis.
- PA scope of practice
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PAs practice in a team-based model; scope is set by state law and practice agreement.
- Negligence (malpractice) elements
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Duty, breach (deviation from standard), causation, and damages.
- EMTALA
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Requires a medical screening exam and stabilization of emergencies regardless of ability to pay.
- Advance directive
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Documents a patient's wishes (living will) or surrogate (healthcare proxy) for future care.
- Tobacco cessation counseling (5 A's)
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Ask, Advise, Assess, Assist, Arrange — the USPSTF-recommended framework.
- Reportable conditions
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Certain infectious diseases must be reported to public-health authorities (CDC/state).
- PANRE-LA
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PANRE Longitudinal Assessment — recertify by answering ~25 questions online each quarter over the cycle, with immediate rationale and open resources, instead of one standard PANRE exam.
- PANRE passing score
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A scaled score of about 379 on a 200–800 scale; not a fixed percent-correct (verify the current standard on nccpa.net).
- HIPAA Breach Notification Rule
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After a breach of unsecured protected health information, a covered entity must notify the affected individuals and the Secretary of Health and Human Services.
- Implied consent
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In a true emergency, when a patient cannot consent and no surrogate is available, the law presumes a reasonable person would consent to life- or limb-saving treatment.
- Colorectal cancer screening start age
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Age 45 for average-risk adults (USPSTF) — a high-yield recert update lowered from 50.
References
- 1.National Commission on Certification of Physician Assistants (NCCPA). “PANRE Content Blueprint.” NCCPA. ↑
- 2.American Heart Association / American College of Cardiology. “About Heart Attacks (ACS).” heart.org. ↑
- 3.Centers for Disease Control and Prevention (CDC). “About Sepsis.” CDC.gov. ↑
- 4.American Diabetes Association (ADA). “Standards of Care — Diagnosis.” diabetes.org. ↑
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