,Physician Assistant Prep Master: 7th Ed.
Certification Quiz Bank
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 1–14)
1. A 6-year-old presents with unilateral, purulent
conjunctival discharge and crusting of the eyelids upon
waking. There is periorbital erythema but no pain with
eye movement. Which is the most likely diagnosis?
A. Viral conjunctivitis
B. Bacterial conjunctivitis
C. Allergic conjunctivitis
D. Dacryocystitis
Correct Answer: B
Rationale: Purulent discharge and lid crusting are classic
for bacterial conjunctivitis. Viral tends toward watery
discharge; allergic is bilateral with itching; dacryocystitis
presents with localized lacrimal sac swelling and
tenderness.
2. A 72-year-old complains of gradual, painless loss of
central vision in both eyes. Fundoscopy shows drusen
deposits beneath the macula. Which intervention best
reduces progression?
A. Intravitreal anti-VEGF injections
B. Laser photocoagulation
C. High-dose antioxidant vitamins and zinc
, D. Topical corticosteroids
Correct Answer: C
Rationale: Drusen and central vision loss indicate dry
(atrophic) macular degeneration; AREDS supplementation
slows progression. Anti-VEGF is for wet form; laser is not
indicated for dry AMD; steroids have no role.
3. A patient reports intermittent flashes of light
(“photopsias”) and new floaters, followed by a
curtain-like shadow in one eye. What is the immediate
next step?
A. Prescribe topical antibiotics
B. Dilated fundoscopic exam
C. Start oral corticosteroids
D. Order CT head without contrast
Correct Answer: B
Rationale: Flashes, floaters, and visual field defect suggest
retinal detachment—urgent dilated fundus exam by
ophthalmology confirms and guides treatment. Antibiotics
and steroids are inappropriate; CT won’t visualize retina.
4. Which physical finding differentiates an open-angle
glaucoma from acute angle-closure glaucoma?
A. Mid-dilated, nonreactive pupil
B. Halos around lights
C. Gradual peripheral vision loss
D. Severe ocular pain
Correct Answer: C
, Rationale: Open-angle causes gradual peripheral field loss;
angle-closure presents acutely with pain, halos, and fixed
mid-dilated pupil. Both can produce halos, but only
open-angle is typically painless and insidious.
5. A 45-year-old diabetic presents for routine care. Which
test is most sensitive for detecting early diabetic
retinopathy?
A. Visual acuity chart
B. Direct ophthalmoscopy
C. Fluorescein angiography
D. Slit-lamp examination with fundus lens
Correct Answer: D
Rationale: Slit-lamp with fundus lens provides magnified
view sensitive for microaneurysms and hemorrhages.
Direct ophthalmoscope has lower sensitivity; fluorescein
angiography is more invasive and reserved for macular
edema assessment.
6. A child presents with strabismus noted by asymmetric
corneal light reflex. Which is the next best action?
A. Prescribe occlusion therapy
B. Order MRI brain
C. Refer for ophthalmology evaluation
D. Start atropine drops in the unaffected eye
Correct Answer: C
Rationale: Any strabismus in a child warrants prompt
ophthalmology referral to prevent amblyopia. Occlusion
, and penalization (atropine) may follow specialist
evaluation; MRI only if neurologic signs present.
7. A 55-year-old reports gradual dimming of vision and glare
at night. Exam shows opacity of the lens. What is the
most appropriate definitive treatment?
A. UV-blocking sunglasses
B. Topical NSAIDs
C. Phacoemulsification with intraocular lens implant
D. Oral antioxidants
Correct Answer: C
Rationale: Cataract extraction via phacoemulsification
with lens implant is definitive. Sunglasses and antioxidants
may slow progression but do not restore vision; NSAIDs
have no effect on lens opacity.
8. A patient complains of sudden, painful redness of the eye
with a peaked pupil and ↑ intraocular pressure (IOP).
Which physical sign distinguishes this from conjunctivitis?
A. Conjunctival injection
B. Corneal clouding
C. Eyelid edema
D. Photophobia
Correct Answer: B
Rationale: Corneal clouding (hazy cornea) and ↑IOP
suggest acute angle-closure glaucoma. Conjunctivitis
causes injection but not corneal haze; edema and
photophobia can accompany many ocular conditions.
, 9. A 30-year-old presents with monocular vision loss
described as “shade coming down.” He has no pain.
Fundoscopy reveals a pale retina with a “cherry red”
macula. The most likely diagnosis is:
A. Central retinal artery occlusion
B. Central retinal vein occlusion
C. Optic neuritis
D. Vitreous hemorrhage
Correct Answer: A
Rationale: Acute, painless monocular loss with pale retina
and cherry-red spot is CRAO. CRVO shows “blood and
thunder” hemorrhages; optic neuritis is painful; vitreous
hemorrhage causes floaters and obscured fundus view.
10. Which symptom is most characteristic of open-angle
glaucoma?
A. Periorbital headache
B. Tunnel vision
C. Photophobia
D. Eye pain
Correct Answer: B
Rationale: Peripheral field constriction (“tunnel vision”) is
hallmark of open-angle glaucoma. Pain and headache
occur in acute angle-closure; photophobia is nonspecific.
11. A 4-year-old child is noted to have a white pupillary
reflex on photoscreening. This finding most suggests:
A. Retinoblastoma
Certification Quiz Bank
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 1–14)
1. A 6-year-old presents with unilateral, purulent
conjunctival discharge and crusting of the eyelids upon
waking. There is periorbital erythema but no pain with
eye movement. Which is the most likely diagnosis?
A. Viral conjunctivitis
B. Bacterial conjunctivitis
C. Allergic conjunctivitis
D. Dacryocystitis
Correct Answer: B
Rationale: Purulent discharge and lid crusting are classic
for bacterial conjunctivitis. Viral tends toward watery
discharge; allergic is bilateral with itching; dacryocystitis
presents with localized lacrimal sac swelling and
tenderness.
2. A 72-year-old complains of gradual, painless loss of
central vision in both eyes. Fundoscopy shows drusen
deposits beneath the macula. Which intervention best
reduces progression?
A. Intravitreal anti-VEGF injections
B. Laser photocoagulation
C. High-dose antioxidant vitamins and zinc
, D. Topical corticosteroids
Correct Answer: C
Rationale: Drusen and central vision loss indicate dry
(atrophic) macular degeneration; AREDS supplementation
slows progression. Anti-VEGF is for wet form; laser is not
indicated for dry AMD; steroids have no role.
3. A patient reports intermittent flashes of light
(“photopsias”) and new floaters, followed by a
curtain-like shadow in one eye. What is the immediate
next step?
A. Prescribe topical antibiotics
B. Dilated fundoscopic exam
C. Start oral corticosteroids
D. Order CT head without contrast
Correct Answer: B
Rationale: Flashes, floaters, and visual field defect suggest
retinal detachment—urgent dilated fundus exam by
ophthalmology confirms and guides treatment. Antibiotics
and steroids are inappropriate; CT won’t visualize retina.
4. Which physical finding differentiates an open-angle
glaucoma from acute angle-closure glaucoma?
A. Mid-dilated, nonreactive pupil
B. Halos around lights
C. Gradual peripheral vision loss
D. Severe ocular pain
Correct Answer: C
, Rationale: Open-angle causes gradual peripheral field loss;
angle-closure presents acutely with pain, halos, and fixed
mid-dilated pupil. Both can produce halos, but only
open-angle is typically painless and insidious.
5. A 45-year-old diabetic presents for routine care. Which
test is most sensitive for detecting early diabetic
retinopathy?
A. Visual acuity chart
B. Direct ophthalmoscopy
C. Fluorescein angiography
D. Slit-lamp examination with fundus lens
Correct Answer: D
Rationale: Slit-lamp with fundus lens provides magnified
view sensitive for microaneurysms and hemorrhages.
Direct ophthalmoscope has lower sensitivity; fluorescein
angiography is more invasive and reserved for macular
edema assessment.
6. A child presents with strabismus noted by asymmetric
corneal light reflex. Which is the next best action?
A. Prescribe occlusion therapy
B. Order MRI brain
C. Refer for ophthalmology evaluation
D. Start atropine drops in the unaffected eye
Correct Answer: C
Rationale: Any strabismus in a child warrants prompt
ophthalmology referral to prevent amblyopia. Occlusion
, and penalization (atropine) may follow specialist
evaluation; MRI only if neurologic signs present.
7. A 55-year-old reports gradual dimming of vision and glare
at night. Exam shows opacity of the lens. What is the
most appropriate definitive treatment?
A. UV-blocking sunglasses
B. Topical NSAIDs
C. Phacoemulsification with intraocular lens implant
D. Oral antioxidants
Correct Answer: C
Rationale: Cataract extraction via phacoemulsification
with lens implant is definitive. Sunglasses and antioxidants
may slow progression but do not restore vision; NSAIDs
have no effect on lens opacity.
8. A patient complains of sudden, painful redness of the eye
with a peaked pupil and ↑ intraocular pressure (IOP).
Which physical sign distinguishes this from conjunctivitis?
A. Conjunctival injection
B. Corneal clouding
C. Eyelid edema
D. Photophobia
Correct Answer: B
Rationale: Corneal clouding (hazy cornea) and ↑IOP
suggest acute angle-closure glaucoma. Conjunctivitis
causes injection but not corneal haze; edema and
photophobia can accompany many ocular conditions.
, 9. A 30-year-old presents with monocular vision loss
described as “shade coming down.” He has no pain.
Fundoscopy reveals a pale retina with a “cherry red”
macula. The most likely diagnosis is:
A. Central retinal artery occlusion
B. Central retinal vein occlusion
C. Optic neuritis
D. Vitreous hemorrhage
Correct Answer: A
Rationale: Acute, painless monocular loss with pale retina
and cherry-red spot is CRAO. CRVO shows “blood and
thunder” hemorrhages; optic neuritis is painful; vitreous
hemorrhage causes floaters and obscured fundus view.
10. Which symptom is most characteristic of open-angle
glaucoma?
A. Periorbital headache
B. Tunnel vision
C. Photophobia
D. Eye pain
Correct Answer: B
Rationale: Peripheral field constriction (“tunnel vision”) is
hallmark of open-angle glaucoma. Pain and headache
occur in acute angle-closure; photophobia is nonspecific.
11. A 4-year-old child is noted to have a white pupillary
reflex on photoscreening. This finding most suggests:
A. Retinoblastoma
