,7th Ed. PA Recertification Rapid Review
Questions
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 (1–12)
1. A 6-year-old child presents with erythematous, swollen
eyelids, mucopurulent discharge, and conjunctival
injection in both eyes. Which is the most likely cause?
A. Viral conjunctivitis
B. Bacterial conjunctivitis
C. Allergic conjunctivitis
D. Subconjunctival hemorrhage
Answer: B. Bacterial conjunctivitis
Rationale: Bacterial conjunctivitis presents with mucopurulent
discharge and eyelid swelling. Viral typically causes watery
discharge; allergic is bilateral with itching and stringy discharge;
subconjunctival hemorrhage is painless and nonpurulent.
2. A 45-year-old diabetic patient reports sudden, painless
vision loss in one eye. Fundoscopy reveals a cherry-red
spot at the macula and a pale retina. What is the most
likely diagnosis?
A. Central retinal artery occlusion
B. Central retinal vein occlusion
C. Glaucomatous optic neuropathy
D. Diabetic retinopathy
,Answer: A. Central retinal artery occlusion
Rationale: Sudden painless vision loss with a cherry-red macula
and pale retina indicates arterial occlusion. Vein occlusion
shows hemorrhages and edema; glaucoma is gradual, painful if
acute; diabetic retinopathy has microaneurysms and
hemorrhages.
3. A patient presents with halos around lights and mid-
dilated, nonreactive pupil with a hard, painful eye. Which
intervention is most appropriate initially?
A. Topical beta-blocker
B. IV acetazolamide
C. Topical antibiotic drops
D. Oral antihistamine
Answer: B. IV acetazolamide
Rationale: Acute angle-closure glaucoma requires rapid
reduction of IOP; IV acetazolamide is first-line. Beta-blocker eye
drops help but systemic acetazolamide acts faster. Antibiotics
and antihistamines are irrelevant.
4. An elderly patient complains of difficulty reading and
notices a "shadow" in peripheral vision. Slit-lamp exam
shows opacification of the lens. Which type of cataract is
most common with aging?
A. Nuclear sclerotic
B. Cortical
C. Posterior subcapsular
D. Congenital
,Answer: A. Nuclear sclerotic
Rationale: Age-related cataracts are typically nuclear sclerotic.
Cortical and posterior subcapsular can occur but are less
common; congenital occurs in infancy.
5. A 30-year-old presents with repeated episodes of flashes
and floaters followed by a curtain-like shadow over the
visual field. What is the most urgent next step?
A. Prescribe NSAIDs
B. Immediate ophthalmology referral for scleral buckle
C. Schedule routine follow-up in 1 week
D. Perform YAG laser photocoagulation
Answer: B. Immediate ophthalmology referral for scleral buckle
Rationale: Symptoms indicate retinal detachment; urgent
surgical management (e.g., scleral buckle) is required. NSAIDs
and routine follow-up are inadequate. YAG laser is for posterior
capsulotomy, not detachment.
6. A 50-year-old patient with long-standing hypertension
presents with sudden, painless visual field loss in one
quadrant. Fundoscopy reveals a sector of retina with
cotton-wool spots. Diagnosis?
A. Branch retinal artery occlusion
B. Branch retinal vein occlusion
C. Retinal detachment
D. Macular degeneration
Answer: B. Branch retinal vein occlusion
Rationale: Painless quadrant vision loss with sector
,hemorrhages and cotton-wool spots suggests vein occlusion.
Artery occlusion shows pale retina; detachment shows curtain;
macular degeneration affects central vision.
7. A contact lens wearer presents with severe eye pain,
photophobia, and a corneal ulcer on slit-lamp exam. The
best initial therapy is:
A. Oral antivirals
B. Topical broad-spectrum antibiotics
C. Topical steroids
D. Warm compresses and observation
Answer: B. Topical broad-spectrum antibiotics
Rationale: Corneal ulcers in contact lens users often bacterial;
start intensive topical antibiotics. Antivirals are for herpetic
keratitis; steroids worsen infection; warm compresses are
adjunctive.
8. A patient complains of persistent floaters and photopsias
without vision loss. Examination reveals vitreous
degeneration with fluid pockets. This finding is consistent
with:
A. Posterior vitreous detachment
B. Vitreous hemorrhage
C. Uveitis
D. Macular edema
Answer: A. Posterior vitreous detachment
Rationale: Floaters and photopsias without vision loss indicate
PVD. Vitreous hemorrhage causes sudden vision decrease;
, uveitis shows inflammation; macular edema causes central
blur.
9. A patient with rheumatoid arthritis on
hydroxychloroquine presents for screening. Which test is
essential to detect early toxicity?
A. Visual acuity
B. Dilated fundoscopy
C. Optical coherence tomography (OCT)
D. Tonometry
Answer: C. Optical coherence tomography (OCT)
Rationale: Hydroxychloroquine toxicity is detected early by OCT
showing parafoveal thinning. Fundoscopy may miss early
changes; acuity is late; tonometry measures IOP.
10. Which condition presents with a manually reducible
eyelid eversion, chronic tearing, and possible conjunctival
inflammation in an elderly patient?
A. Entropion
B. Ectropion
C. Blepharitis
D. Chalazion
Answer: B. Ectropion
Rationale: Ectropion is outward eyelid turning causing tear
overflow. Entropion is inward turning; blepharitis is lid margin
inflammation; chalazion is lipogranuloma in eyelid.
Questions
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 (1–12)
1. A 6-year-old child presents with erythematous, swollen
eyelids, mucopurulent discharge, and conjunctival
injection in both eyes. Which is the most likely cause?
A. Viral conjunctivitis
B. Bacterial conjunctivitis
C. Allergic conjunctivitis
D. Subconjunctival hemorrhage
Answer: B. Bacterial conjunctivitis
Rationale: Bacterial conjunctivitis presents with mucopurulent
discharge and eyelid swelling. Viral typically causes watery
discharge; allergic is bilateral with itching and stringy discharge;
subconjunctival hemorrhage is painless and nonpurulent.
2. A 45-year-old diabetic patient reports sudden, painless
vision loss in one eye. Fundoscopy reveals a cherry-red
spot at the macula and a pale retina. What is the most
likely diagnosis?
A. Central retinal artery occlusion
B. Central retinal vein occlusion
C. Glaucomatous optic neuropathy
D. Diabetic retinopathy
,Answer: A. Central retinal artery occlusion
Rationale: Sudden painless vision loss with a cherry-red macula
and pale retina indicates arterial occlusion. Vein occlusion
shows hemorrhages and edema; glaucoma is gradual, painful if
acute; diabetic retinopathy has microaneurysms and
hemorrhages.
3. A patient presents with halos around lights and mid-
dilated, nonreactive pupil with a hard, painful eye. Which
intervention is most appropriate initially?
A. Topical beta-blocker
B. IV acetazolamide
C. Topical antibiotic drops
D. Oral antihistamine
Answer: B. IV acetazolamide
Rationale: Acute angle-closure glaucoma requires rapid
reduction of IOP; IV acetazolamide is first-line. Beta-blocker eye
drops help but systemic acetazolamide acts faster. Antibiotics
and antihistamines are irrelevant.
4. An elderly patient complains of difficulty reading and
notices a "shadow" in peripheral vision. Slit-lamp exam
shows opacification of the lens. Which type of cataract is
most common with aging?
A. Nuclear sclerotic
B. Cortical
C. Posterior subcapsular
D. Congenital
,Answer: A. Nuclear sclerotic
Rationale: Age-related cataracts are typically nuclear sclerotic.
Cortical and posterior subcapsular can occur but are less
common; congenital occurs in infancy.
5. A 30-year-old presents with repeated episodes of flashes
and floaters followed by a curtain-like shadow over the
visual field. What is the most urgent next step?
A. Prescribe NSAIDs
B. Immediate ophthalmology referral for scleral buckle
C. Schedule routine follow-up in 1 week
D. Perform YAG laser photocoagulation
Answer: B. Immediate ophthalmology referral for scleral buckle
Rationale: Symptoms indicate retinal detachment; urgent
surgical management (e.g., scleral buckle) is required. NSAIDs
and routine follow-up are inadequate. YAG laser is for posterior
capsulotomy, not detachment.
6. A 50-year-old patient with long-standing hypertension
presents with sudden, painless visual field loss in one
quadrant. Fundoscopy reveals a sector of retina with
cotton-wool spots. Diagnosis?
A. Branch retinal artery occlusion
B. Branch retinal vein occlusion
C. Retinal detachment
D. Macular degeneration
Answer: B. Branch retinal vein occlusion
Rationale: Painless quadrant vision loss with sector
,hemorrhages and cotton-wool spots suggests vein occlusion.
Artery occlusion shows pale retina; detachment shows curtain;
macular degeneration affects central vision.
7. A contact lens wearer presents with severe eye pain,
photophobia, and a corneal ulcer on slit-lamp exam. The
best initial therapy is:
A. Oral antivirals
B. Topical broad-spectrum antibiotics
C. Topical steroids
D. Warm compresses and observation
Answer: B. Topical broad-spectrum antibiotics
Rationale: Corneal ulcers in contact lens users often bacterial;
start intensive topical antibiotics. Antivirals are for herpetic
keratitis; steroids worsen infection; warm compresses are
adjunctive.
8. A patient complains of persistent floaters and photopsias
without vision loss. Examination reveals vitreous
degeneration with fluid pockets. This finding is consistent
with:
A. Posterior vitreous detachment
B. Vitreous hemorrhage
C. Uveitis
D. Macular edema
Answer: A. Posterior vitreous detachment
Rationale: Floaters and photopsias without vision loss indicate
PVD. Vitreous hemorrhage causes sudden vision decrease;
, uveitis shows inflammation; macular edema causes central
blur.
9. A patient with rheumatoid arthritis on
hydroxychloroquine presents for screening. Which test is
essential to detect early toxicity?
A. Visual acuity
B. Dilated fundoscopy
C. Optical coherence tomography (OCT)
D. Tonometry
Answer: C. Optical coherence tomography (OCT)
Rationale: Hydroxychloroquine toxicity is detected early by OCT
showing parafoveal thinning. Fundoscopy may miss early
changes; acuity is late; tonometry measures IOP.
10. Which condition presents with a manually reducible
eyelid eversion, chronic tearing, and possible conjunctival
inflammation in an elderly patient?
A. Entropion
B. Ectropion
C. Blepharitis
D. Chalazion
Answer: B. Ectropion
Rationale: Ectropion is outward eyelid turning causing tear
overflow. Entropion is inward turning; blepharitis is lid margin
inflammation; chalazion is lipogranuloma in eyelid.
