,PA Cert & Recert Drillbook: 7th Edition
MCQs
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
1. A 65-year-old patient presents with gradually
progressive, painless vision loss in both eyes described as
blurred or dulled vision, especially at night. On
examination, there is glare and decreased visual acuity.
Which is the most likely diagnosis?
A. Age-related macular degeneration
B. Cataract
C. Glaucoma
D. Diabetic retinopathy
Answer: B
Rationale: Cataracts typically cause painless, progressive
opacification of the lens leading to blurred vision and
glare, especially in low light. AMD affects central vision;
glaucoma often initially spares central vision; diabetic
retinopathy shows hemorrhages and exudates.
2. A 55-year-old diabetic patient complains of sudden onset
of floaters, flashes of light, and a “curtain” descending
over vision in the right eye. Fundoscopy reveals a gray,
wrinkled retina. What is the next best step?
A. Intravitreal anti-VEGF injection
B. Emergent surgical repair (vitrectomy)
C. Panretinal photocoagulation
, D. Observation and follow-up in one week
Answer: B
Rationale: These findings indicate retinal detachment;
emergent surgical repair is required. Anti-VEGF and
photocoagulation are for macular edema or proliferative
retinopathy. Observation risks permanent vision loss.
3. A 30-year-old contact lens wearer presents with a red,
painful eye, photophobia, and mucopurulent discharge.
Slit-lamp exam shows a corneal ulcer with an epithelial
defect and stromal infiltrate. The most appropriate initial
management is:
A. Topical corticosteroids
B. Topical broad-spectrum antibiotics
C. Oral acyclovir
D. Warm compresses and artificial tears
Answer: B
Rationale: Suspected bacterial keratitis in contact lens
wearers requires urgent topical broad-spectrum
antibiotics. Corticosteroids are contraindicated initially;
acyclovir is for herpetic keratitis.
4. A 45-year-old patient complains of sudden, unilateral,
painless vision loss. Fundoscopy reveals a cherry-red spot
on the macula and a pale retina. Which artery is likely
occluded?
A. Central retinal artery
B. Central retinal vein
, C. Posterior ciliary artery
D. Ophthalmic artery
Answer: A
Rationale: Central retinal artery occlusion presents with
sudden painless vision loss and a cherry-red spot. Vein
occlusion causes hemorrhages; posterior ciliary supplies
choroid; ophthalmic occlusion affects multiple structures.
5. A patient presents with a painful, erythematous eyelid
nodule that is tender and involves the meibomian gland.
What is the correct diagnosis?
A. Chalazion
B. Hordeolum (stye)
C. Blepharitis
D. Dacryocystitis
Answer: B
Rationale: A hordeolum (stye) is an acute infection of
eyelid glands causing a tender nodule. A chalazion is non-
tender. Blepharitis is chronic lid margin inflammation;
dacryocystitis is lacrimal sac infection.
6. A 25-year-old patient presents with redness, tearing, and
foreign-body sensation after a fingernail scratch to the
cornea. Fluorescein stain shows a linear epithelial defect.
Management should include:
A. Topical NSAIDs and patching
B. Topical antibiotics and patching
C. Oral antibiotics
, D. Observation only
Answer: B
Rationale: Corneal abrasions require topical antibiotic
prophylaxis and patching for comfort. NSAIDs alone are
insufficient; oral antibiotics not indicated.
7. A patient with a history of rheumatoid arthritis presents
with eye pain, photophobia, and a ring-shaped stromal
infiltrate on the cornea. What is the most likely
diagnosis?
A. Peripheral ulcerative keratitis
B. Band keratopathy
C. Pterygium
D. Keratoconus
Answer: A
Rationale: Peripheral ulcerative keratitis is associated with
systemic autoimmune disease, presenting with corneal
ulceration at the periphery. Band keratopathy shows
calcium deposition; pterygium is conjunctival overgrowth;
keratoconus is corneal thinning.
8. A patient complains of seeing halos around lights, has
headache, and elevated IOP of 36 mmHg. Gonioscopy
shows a narrow angle. What is the most appropriate
immediate treatment?
A. Pilocarpine
B. Latanoprost
C. Oral acetazolamide
, D. Timolol
Answer: C
Rationale: Acute angle-closure glaucoma requires rapid
IOP reduction with acetazolamide. Pilocarpine is
contraindicated until pressure is lowered. Timolol is
adjunctive; latanoprost is for chronic open-angle
glaucoma.
9. A patient has painless vision loss and fundus exam shows
cotton wool spots and microaneurysms. Which condition
is most likely?
A. Nonproliferative diabetic retinopathy
B. Proliferative diabetic retinopathy
C. Hypertensive retinopathy
D. Central retinal vein occlusion
Answer: A
Rationale: Nonproliferative diabetic retinopathy presents
with microaneurysms, hemorrhages, cotton wool spots.
Proliferative has neovascularization.
10. A 70-year-old presents with drusen and gradual
central vision loss. Which diagnostic test most accurately
confirms the wet form requiring treatment with anti-
VEGF?
A. Optical coherence tomography (OCT)
B. Slit-lamp examination
C. Fluorescein angiography
D. Fundus photography
MCQs
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
1. A 65-year-old patient presents with gradually
progressive, painless vision loss in both eyes described as
blurred or dulled vision, especially at night. On
examination, there is glare and decreased visual acuity.
Which is the most likely diagnosis?
A. Age-related macular degeneration
B. Cataract
C. Glaucoma
D. Diabetic retinopathy
Answer: B
Rationale: Cataracts typically cause painless, progressive
opacification of the lens leading to blurred vision and
glare, especially in low light. AMD affects central vision;
glaucoma often initially spares central vision; diabetic
retinopathy shows hemorrhages and exudates.
2. A 55-year-old diabetic patient complains of sudden onset
of floaters, flashes of light, and a “curtain” descending
over vision in the right eye. Fundoscopy reveals a gray,
wrinkled retina. What is the next best step?
A. Intravitreal anti-VEGF injection
B. Emergent surgical repair (vitrectomy)
C. Panretinal photocoagulation
, D. Observation and follow-up in one week
Answer: B
Rationale: These findings indicate retinal detachment;
emergent surgical repair is required. Anti-VEGF and
photocoagulation are for macular edema or proliferative
retinopathy. Observation risks permanent vision loss.
3. A 30-year-old contact lens wearer presents with a red,
painful eye, photophobia, and mucopurulent discharge.
Slit-lamp exam shows a corneal ulcer with an epithelial
defect and stromal infiltrate. The most appropriate initial
management is:
A. Topical corticosteroids
B. Topical broad-spectrum antibiotics
C. Oral acyclovir
D. Warm compresses and artificial tears
Answer: B
Rationale: Suspected bacterial keratitis in contact lens
wearers requires urgent topical broad-spectrum
antibiotics. Corticosteroids are contraindicated initially;
acyclovir is for herpetic keratitis.
4. A 45-year-old patient complains of sudden, unilateral,
painless vision loss. Fundoscopy reveals a cherry-red spot
on the macula and a pale retina. Which artery is likely
occluded?
A. Central retinal artery
B. Central retinal vein
, C. Posterior ciliary artery
D. Ophthalmic artery
Answer: A
Rationale: Central retinal artery occlusion presents with
sudden painless vision loss and a cherry-red spot. Vein
occlusion causes hemorrhages; posterior ciliary supplies
choroid; ophthalmic occlusion affects multiple structures.
5. A patient presents with a painful, erythematous eyelid
nodule that is tender and involves the meibomian gland.
What is the correct diagnosis?
A. Chalazion
B. Hordeolum (stye)
C. Blepharitis
D. Dacryocystitis
Answer: B
Rationale: A hordeolum (stye) is an acute infection of
eyelid glands causing a tender nodule. A chalazion is non-
tender. Blepharitis is chronic lid margin inflammation;
dacryocystitis is lacrimal sac infection.
6. A 25-year-old patient presents with redness, tearing, and
foreign-body sensation after a fingernail scratch to the
cornea. Fluorescein stain shows a linear epithelial defect.
Management should include:
A. Topical NSAIDs and patching
B. Topical antibiotics and patching
C. Oral antibiotics
, D. Observation only
Answer: B
Rationale: Corneal abrasions require topical antibiotic
prophylaxis and patching for comfort. NSAIDs alone are
insufficient; oral antibiotics not indicated.
7. A patient with a history of rheumatoid arthritis presents
with eye pain, photophobia, and a ring-shaped stromal
infiltrate on the cornea. What is the most likely
diagnosis?
A. Peripheral ulcerative keratitis
B. Band keratopathy
C. Pterygium
D. Keratoconus
Answer: A
Rationale: Peripheral ulcerative keratitis is associated with
systemic autoimmune disease, presenting with corneal
ulceration at the periphery. Band keratopathy shows
calcium deposition; pterygium is conjunctival overgrowth;
keratoconus is corneal thinning.
8. A patient complains of seeing halos around lights, has
headache, and elevated IOP of 36 mmHg. Gonioscopy
shows a narrow angle. What is the most appropriate
immediate treatment?
A. Pilocarpine
B. Latanoprost
C. Oral acetazolamide
, D. Timolol
Answer: C
Rationale: Acute angle-closure glaucoma requires rapid
IOP reduction with acetazolamide. Pilocarpine is
contraindicated until pressure is lowered. Timolol is
adjunctive; latanoprost is for chronic open-angle
glaucoma.
9. A patient has painless vision loss and fundus exam shows
cotton wool spots and microaneurysms. Which condition
is most likely?
A. Nonproliferative diabetic retinopathy
B. Proliferative diabetic retinopathy
C. Hypertensive retinopathy
D. Central retinal vein occlusion
Answer: A
Rationale: Nonproliferative diabetic retinopathy presents
with microaneurysms, hemorrhages, cotton wool spots.
Proliferative has neovascularization.
10. A 70-year-old presents with drusen and gradual
central vision loss. Which diagnostic test most accurately
confirms the wet form requiring treatment with anti-
VEGF?
A. Optical coherence tomography (OCT)
B. Slit-lamp examination
C. Fluorescein angiography
D. Fundus photography
