,PA Exam Edge: 7th Edition MCQ Review
Workbook
Based on A Comprehensive Review for the
Certification and Recertification
Examinations for PAs, 7th Edition
By Claire Babcock O’Connell & Thea
Cogan-Drew
“Your Ultimate PA Exam MCQ Workbook: All Chapters, All
Topics, Fully Explained”
“Ace the PANCE & PANRE: 7th Edition-Based Complete
Question Review Guide”
table of contents
1 Ophthalmology and Otolaryngology 2 Pulmonology
Disorders of the Eyes Infectious Disorders
Disorders of the Ears Neoplastic Diseases
Disorders of the Nose, Sinus, and Throat Obstructive Pulmonary Diseases
Pleural Diseases
Pulmonary Circulation
Restrictive Pulmonary Diseases
, 1 Ophthalmology and Otolaryngology 2 Pulmonology
Other Pulmonary Diseases
3 Cardiovascular Medicine 4 Hematology
Major Principles of Cardiac Care Red Cell Disorders
Hypertension White Cell Disorders
Heart Failure (HF) Lymphomas and Myeloma
Shock Platelet and Bleeding Disorders
Hypotension Thrombotic Disorders and Hypercoagulable Conditions
Atherosclerosis
Ischemic Heart Disease (Angina)
Acute Coronary Syndromes
Valvular Disorders
Cardiomyopathies
Congenital Heart Anomalies
Rate and Rhythm Disorders
Conduction Disturbances
Pericardial Disorders
Infective Endocarditis
Rheumatic Heart Disease
Peripheral Vascular Disorders
Giant Cell Arteritis
Aortic Aneurysms
5 Gastroenterology 6 Nephrology and Urology
Diseases of the Esophagus Renal Failure
Diseases of the Stomach Glomerular Disorders
Diseases of the Small Intestine and Colon Polycystic Kidney Disease
Diseases of the Rectum and Anus Nephrolithiasis
Appendicitis Disorders of Salt and Water
Diseases of the Pancreas Electrolyte Disorders
Diseases of the Biliary Tract Acid–Base Disorders
Diseases of the Liver Urinary Tract Infection
Hernias Benign Prostatic Hyperplasia (BPH)
Congenital Abnormalities Incontinence
Nutritional Deficiencies Neoplasms of the Urinary Tract
Metabolic Disorders Male Reproductive Disorders
, 7 Gynecology 8 Obstetrics
Menstrual Disorders Routine Prenatal Care and Prenatal Diagnostic Testing
Uterine Disorders High-Risk Pregnancy
Ovarian Disorders Complications of Pregnancy
Cervical Dysplasia and Neoplasia Labor and Delivery
Vaginal and Vulvar Neoplasms Puerperium
Breast Disorders
Contraceptive Methods
Infertility
Pelvic Inflammatory Disease
9 Rheumatology and Orthopedics (Musculoskeletal System) 10 Endocrinology
Arthritis/Rheumatologic Conditions Parathyroid Disorders
Bone and Joint Disorders Thyroid Disorders
Fractures, Dislocations, Sprains, and Strains Pituitary Gland
Disorders of the Head and Neck Diabetes Mellitus
Disorders of the Shoulder and Upper Extremity Hyperlipidemia
Disorders of the Back Adrenal Gland Disorders
Disorders of the Hip and Lower Extremity
11 Neurology 12 Psychiatry
Diagnosis of Neurologic Disorders Diagnosis of Psychiatric Disorders
Schizophrenia and Other Psychotic
Cerebrovascular Disease
Disorders
Seizure Disorders Somatic Symptom Disorders
Multiple Sclerosis Mood Disorders
Dementia Personality Disorders
Headache Anxiety Disorders
Movement Disorders Trauma- and Stressor-Related Disorders
Diseases of Peripheral Nerves Eating Disorders
Central Nervous System Infection Substance-Related and Addictive Disorders
Central Nervous System Trauma Childhood Disorders
Primary Central Nervous System
Abuse and Neglect
Neoplasms
Sleep Disorders Sexual Violence and Rape
Uncomplicated Bereavement
13 Dermatology 14 Infectious Disease
Diagnosis Fever
, 13 Dermatology 14 Infectious Disease
Maculopapular and Plaque Disorders Sepsis
Vesiculobullous Disorders Bacterial Infections
Papulopustular Inflammatory Disorders Viral Infections
Localized Skin Infections Fungal Infections
Dermatophytosis Parasitic Infections
Parasitic Infestations Sexually Transmitted Diseases
Warts (Verrucae) Tick-Borne Illnesses
Tumors
Ulcers, Burns, and Wounds
Hair and Nails
Pigmentation Disorders
Angioedema and Urticaria
15 Surgery 16 Geriatrics
Patient History Background
Preoperative Evaluation Patient Care
Selected Common Diseases and Disorders with Unique
Trauma
Features in the Elderly
Burns Legal, Ethical, and Financial Issues
Orthopedic Injuries
Postoperative Complications
Laparoscopic and Bariatric
Surgery
17 Pediatrics
Examination of the Newborn
Problems Common to the Term Newborn
Developmental Milestones and Disorders
Inborn Errors of Metabolism, Chromosomal Abnormalities, and Common Dysmorphic
Syndromes
Failure to Thrive, Growth Delay, and Selected Nutritional Disorders of Childhood
Immunization of Infants and Children
Common Pediatric Poisonings
Common Pediatric Disorders
Caring for the Adolescent
,Chapter 1: Ophthalmology and Otolaryngology (Disorders of
the Eyes; Disorders of the Ears; Disorders of the Nose, Sinus,
and Throat)
Disorders of the Eyes (Questions 1–17)
1. A 68-year-old presents with painless, gradual peripheral
vision loss in both eyes. Fundoscopy reveals an “cupped”
optic disc. Which is the most likely diagnosis?
A. Acute angle-closure glaucoma
B. Open-angle glaucoma
C. Retinal detachment
D. Optic neuritis
Answer: B
Rationale: Open-angle glaucoma presents insidiously with
peripheral field loss and optic disc cupping. Angle-closure
is acute and painful; detachment causes flashes/floaters;
optic neuritis causes painful vision loss and disc swelling.
2. A patient complains of flashing lights and a “curtain” over
vision of the right eye. Which finding confirms retinal
detachment?
A. Cherry-red spot on macula
B. Convex lens floaters
C. Grey, elevated retina on ophthalmoscopy
D. Papilledema
Answer: C
Rationale: Retinal detachment yields a grey, billowing
, retina. Cherry-red spots suggest central retinal artery
occlusion; papilledema is optic disc swelling; floaters
nonspecifically occur in vitreous hemorrhage.
3. Sudden, painless monocular vision loss with a pale retina
and “cherry-red” fovea indicates:
A. Central retinal artery occlusion
B. Central retinal vein occlusion
C. Ischemic optic neuropathy
D. Vitreous hemorrhage
Answer: A
Rationale: Artery occlusion causes a pale retina with a
cherry-red spot. Vein occlusion presents “blood and
thunder” hemorrhages; optic neuropathy has disc
swelling; hemorrhage obscures fundus view.
4. A 45-year-old diabetic reports gradual blurred vision.
Fundus exam shows microaneurysms and dot-blot
hemorrhages. Next step?
A. Immediate panretinal photocoagulation
B. Intravitreal anti-VEGF therapy
C. Emergent vitrectomy
D. Observation only
Answer: B
Rationale: Diabetic macular edema often responds to
anti-VEGF. Panretinal laser is for proliferative disease;
vitrectomy for non-clearing hemorrhage.
,5. A patient has red eye, photophobia, miosis, and a hazy
cornea. Intraocular pressure is 40 mmHg. The most likely
cause?
A. Open-angle glaucoma
B. Keratitis
C. Acute angle-closure glaucoma
D. Iritis
Answer: C
Rationale: Acute angle-closure causes sudden pain, red
eye, corneal haze, mid-dilated pupil, high IOP. Keratitis has
corneal ulcer; iritis has clear cornea.
6. A child presents with watering and discharge; eyeglasses
show yellowish discharge at medial canthus. On exam,
lacrimal sac is tender. Diagnosis?
A. Bacterial conjunctivitis
B. Dacryocystitis
C. Canaliculitis
D. Blepharitis
Answer: B
Rationale: Dacryocystitis is infection of lacrimal sac
causing medial swelling/tenderness. Canaliculitis involves
canaliculi with concretions; blepharitis affects eyelid
margins.
7. In a patient with thyroid eye disease, which finding is most
characteristic?
A. Optic disc pallor
, B. Proptosis with eyelid retraction
C. Painless vision loss
D. Retinal arterial narrowing
Answer: B
Rationale: Graves’ ophthalmopathy presents with
proptosis and lid retraction. Optic disc pallor appears in
optic neuropathy; painless loss suggests vascular event.
8. A contact lens user has severe eye pain, photophobia, and
a corneal ulcer on slit lamp. Most appropriate treatment?
A. Topical corticosteroids
B. Topical antibiotics
C. Oral antivirals
D. Warm compresses
Answer: B
Rationale: Contact-lens keratitis (pseudomonas) requires
topical fortified antibiotics. Steroids worsen infection,
antivirals for HSV, compresses for blepharitis.
9. A farmer presents after eye trauma with a whitish opaque
spot on the cornea and a small epithelial defect. Likely
pathogen?
A. Staphylococcus aureus
B. Pseudomonas aeruginosa
C. Fusarium species
D. Adenovirus
Answer: C
Rationale: Fungal keratitis (eg, Fusarium) often follows
, vegetative trauma. Pseudomonas in lenses, staph in lid
infections, adenovirus causes viral conjunctivitis.
10. Which visual field deficit is most consistent with a
lesion at the optic chiasm?
A. Right homonymous hemianopia
B. Bitemporal hemianopia
C. Left superior quadrantanopia
D. Central scotoma
Answer: B
Rationale: Chiasmal lesions (eg, pituitary tumor) cause
bitemporal field loss. Homonymous deficits localize
post-chiasm; quadrantanopias to radiations.
11. A 55-year-old complains of halos around lights,
decreased vision, and an opaque lens on exam. Diagnosis?
A. Cortical cataract
B. Nuclear sclerotic cataract
C. Posterior subcapsular cataract
D. Angle-closure glaucoma
Answer: B
Rationale: Nuclear sclerotic cataracts produce gradual
vision loss, nuclear yellowing. Cortical has spoke-like
opacities; PSC affects near vision; glaucoma acute.
12. A patient with giant cell arteritis reports blurred
vision. Which test is most urgent?
A. Slit-lamp exam
B. Temporal artery biopsy
Workbook
Based on A Comprehensive Review for the
Certification and Recertification
Examinations for PAs, 7th Edition
By Claire Babcock O’Connell & Thea
Cogan-Drew
“Your Ultimate PA Exam MCQ Workbook: All Chapters, All
Topics, Fully Explained”
“Ace the PANCE & PANRE: 7th Edition-Based Complete
Question Review Guide”
table of contents
1 Ophthalmology and Otolaryngology 2 Pulmonology
Disorders of the Eyes Infectious Disorders
Disorders of the Ears Neoplastic Diseases
Disorders of the Nose, Sinus, and Throat Obstructive Pulmonary Diseases
Pleural Diseases
Pulmonary Circulation
Restrictive Pulmonary Diseases
, 1 Ophthalmology and Otolaryngology 2 Pulmonology
Other Pulmonary Diseases
3 Cardiovascular Medicine 4 Hematology
Major Principles of Cardiac Care Red Cell Disorders
Hypertension White Cell Disorders
Heart Failure (HF) Lymphomas and Myeloma
Shock Platelet and Bleeding Disorders
Hypotension Thrombotic Disorders and Hypercoagulable Conditions
Atherosclerosis
Ischemic Heart Disease (Angina)
Acute Coronary Syndromes
Valvular Disorders
Cardiomyopathies
Congenital Heart Anomalies
Rate and Rhythm Disorders
Conduction Disturbances
Pericardial Disorders
Infective Endocarditis
Rheumatic Heart Disease
Peripheral Vascular Disorders
Giant Cell Arteritis
Aortic Aneurysms
5 Gastroenterology 6 Nephrology and Urology
Diseases of the Esophagus Renal Failure
Diseases of the Stomach Glomerular Disorders
Diseases of the Small Intestine and Colon Polycystic Kidney Disease
Diseases of the Rectum and Anus Nephrolithiasis
Appendicitis Disorders of Salt and Water
Diseases of the Pancreas Electrolyte Disorders
Diseases of the Biliary Tract Acid–Base Disorders
Diseases of the Liver Urinary Tract Infection
Hernias Benign Prostatic Hyperplasia (BPH)
Congenital Abnormalities Incontinence
Nutritional Deficiencies Neoplasms of the Urinary Tract
Metabolic Disorders Male Reproductive Disorders
, 7 Gynecology 8 Obstetrics
Menstrual Disorders Routine Prenatal Care and Prenatal Diagnostic Testing
Uterine Disorders High-Risk Pregnancy
Ovarian Disorders Complications of Pregnancy
Cervical Dysplasia and Neoplasia Labor and Delivery
Vaginal and Vulvar Neoplasms Puerperium
Breast Disorders
Contraceptive Methods
Infertility
Pelvic Inflammatory Disease
9 Rheumatology and Orthopedics (Musculoskeletal System) 10 Endocrinology
Arthritis/Rheumatologic Conditions Parathyroid Disorders
Bone and Joint Disorders Thyroid Disorders
Fractures, Dislocations, Sprains, and Strains Pituitary Gland
Disorders of the Head and Neck Diabetes Mellitus
Disorders of the Shoulder and Upper Extremity Hyperlipidemia
Disorders of the Back Adrenal Gland Disorders
Disorders of the Hip and Lower Extremity
11 Neurology 12 Psychiatry
Diagnosis of Neurologic Disorders Diagnosis of Psychiatric Disorders
Schizophrenia and Other Psychotic
Cerebrovascular Disease
Disorders
Seizure Disorders Somatic Symptom Disorders
Multiple Sclerosis Mood Disorders
Dementia Personality Disorders
Headache Anxiety Disorders
Movement Disorders Trauma- and Stressor-Related Disorders
Diseases of Peripheral Nerves Eating Disorders
Central Nervous System Infection Substance-Related and Addictive Disorders
Central Nervous System Trauma Childhood Disorders
Primary Central Nervous System
Abuse and Neglect
Neoplasms
Sleep Disorders Sexual Violence and Rape
Uncomplicated Bereavement
13 Dermatology 14 Infectious Disease
Diagnosis Fever
, 13 Dermatology 14 Infectious Disease
Maculopapular and Plaque Disorders Sepsis
Vesiculobullous Disorders Bacterial Infections
Papulopustular Inflammatory Disorders Viral Infections
Localized Skin Infections Fungal Infections
Dermatophytosis Parasitic Infections
Parasitic Infestations Sexually Transmitted Diseases
Warts (Verrucae) Tick-Borne Illnesses
Tumors
Ulcers, Burns, and Wounds
Hair and Nails
Pigmentation Disorders
Angioedema and Urticaria
15 Surgery 16 Geriatrics
Patient History Background
Preoperative Evaluation Patient Care
Selected Common Diseases and Disorders with Unique
Trauma
Features in the Elderly
Burns Legal, Ethical, and Financial Issues
Orthopedic Injuries
Postoperative Complications
Laparoscopic and Bariatric
Surgery
17 Pediatrics
Examination of the Newborn
Problems Common to the Term Newborn
Developmental Milestones and Disorders
Inborn Errors of Metabolism, Chromosomal Abnormalities, and Common Dysmorphic
Syndromes
Failure to Thrive, Growth Delay, and Selected Nutritional Disorders of Childhood
Immunization of Infants and Children
Common Pediatric Poisonings
Common Pediatric Disorders
Caring for the Adolescent
,Chapter 1: Ophthalmology and Otolaryngology (Disorders of
the Eyes; Disorders of the Ears; Disorders of the Nose, Sinus,
and Throat)
Disorders of the Eyes (Questions 1–17)
1. A 68-year-old presents with painless, gradual peripheral
vision loss in both eyes. Fundoscopy reveals an “cupped”
optic disc. Which is the most likely diagnosis?
A. Acute angle-closure glaucoma
B. Open-angle glaucoma
C. Retinal detachment
D. Optic neuritis
Answer: B
Rationale: Open-angle glaucoma presents insidiously with
peripheral field loss and optic disc cupping. Angle-closure
is acute and painful; detachment causes flashes/floaters;
optic neuritis causes painful vision loss and disc swelling.
2. A patient complains of flashing lights and a “curtain” over
vision of the right eye. Which finding confirms retinal
detachment?
A. Cherry-red spot on macula
B. Convex lens floaters
C. Grey, elevated retina on ophthalmoscopy
D. Papilledema
Answer: C
Rationale: Retinal detachment yields a grey, billowing
, retina. Cherry-red spots suggest central retinal artery
occlusion; papilledema is optic disc swelling; floaters
nonspecifically occur in vitreous hemorrhage.
3. Sudden, painless monocular vision loss with a pale retina
and “cherry-red” fovea indicates:
A. Central retinal artery occlusion
B. Central retinal vein occlusion
C. Ischemic optic neuropathy
D. Vitreous hemorrhage
Answer: A
Rationale: Artery occlusion causes a pale retina with a
cherry-red spot. Vein occlusion presents “blood and
thunder” hemorrhages; optic neuropathy has disc
swelling; hemorrhage obscures fundus view.
4. A 45-year-old diabetic reports gradual blurred vision.
Fundus exam shows microaneurysms and dot-blot
hemorrhages. Next step?
A. Immediate panretinal photocoagulation
B. Intravitreal anti-VEGF therapy
C. Emergent vitrectomy
D. Observation only
Answer: B
Rationale: Diabetic macular edema often responds to
anti-VEGF. Panretinal laser is for proliferative disease;
vitrectomy for non-clearing hemorrhage.
,5. A patient has red eye, photophobia, miosis, and a hazy
cornea. Intraocular pressure is 40 mmHg. The most likely
cause?
A. Open-angle glaucoma
B. Keratitis
C. Acute angle-closure glaucoma
D. Iritis
Answer: C
Rationale: Acute angle-closure causes sudden pain, red
eye, corneal haze, mid-dilated pupil, high IOP. Keratitis has
corneal ulcer; iritis has clear cornea.
6. A child presents with watering and discharge; eyeglasses
show yellowish discharge at medial canthus. On exam,
lacrimal sac is tender. Diagnosis?
A. Bacterial conjunctivitis
B. Dacryocystitis
C. Canaliculitis
D. Blepharitis
Answer: B
Rationale: Dacryocystitis is infection of lacrimal sac
causing medial swelling/tenderness. Canaliculitis involves
canaliculi with concretions; blepharitis affects eyelid
margins.
7. In a patient with thyroid eye disease, which finding is most
characteristic?
A. Optic disc pallor
, B. Proptosis with eyelid retraction
C. Painless vision loss
D. Retinal arterial narrowing
Answer: B
Rationale: Graves’ ophthalmopathy presents with
proptosis and lid retraction. Optic disc pallor appears in
optic neuropathy; painless loss suggests vascular event.
8. A contact lens user has severe eye pain, photophobia, and
a corneal ulcer on slit lamp. Most appropriate treatment?
A. Topical corticosteroids
B. Topical antibiotics
C. Oral antivirals
D. Warm compresses
Answer: B
Rationale: Contact-lens keratitis (pseudomonas) requires
topical fortified antibiotics. Steroids worsen infection,
antivirals for HSV, compresses for blepharitis.
9. A farmer presents after eye trauma with a whitish opaque
spot on the cornea and a small epithelial defect. Likely
pathogen?
A. Staphylococcus aureus
B. Pseudomonas aeruginosa
C. Fusarium species
D. Adenovirus
Answer: C
Rationale: Fungal keratitis (eg, Fusarium) often follows
, vegetative trauma. Pseudomonas in lenses, staph in lid
infections, adenovirus causes viral conjunctivitis.
10. Which visual field deficit is most consistent with a
lesion at the optic chiasm?
A. Right homonymous hemianopia
B. Bitemporal hemianopia
C. Left superior quadrantanopia
D. Central scotoma
Answer: B
Rationale: Chiasmal lesions (eg, pituitary tumor) cause
bitemporal field loss. Homonymous deficits localize
post-chiasm; quadrantanopias to radiations.
11. A 55-year-old complains of halos around lights,
decreased vision, and an opaque lens on exam. Diagnosis?
A. Cortical cataract
B. Nuclear sclerotic cataract
C. Posterior subcapsular cataract
D. Angle-closure glaucoma
Answer: B
Rationale: Nuclear sclerotic cataracts produce gradual
vision loss, nuclear yellowing. Cortical has spoke-like
opacities; PSC affects near vision; glaucoma acute.
12. A patient with giant cell arteritis reports blurred
vision. Which test is most urgent?
A. Slit-lamp exam
B. Temporal artery biopsy
