,PA Exam Prep Essentials: 7th Edition MCQ
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 (12 Questions)
1. A 65-year-old diabetic patient presents with sudden,
painless vision loss described as a “curtain coming down”
over one eye. On fundoscopic exam you see a pale retina
with a cherry‐red spot at the fovea. Which is the most
likely diagnosis?
A. Central retinal artery occlusion
B. Central retinal vein occlusion
C. Ischemic optic neuropathy
D. Vitreous hemorrhage
Correct Answer: A
Rationale: Painless, sudden vision loss with a pale retina and
cherry-red spot is classic for central retinal artery occlusion. In
CRVO, retina is “blood and thunder” with hemorrhages;
ischemic optic neuropathy shows optic disc swelling; vitreous
hemorrhage presents with floaters and hazy view of fundus.
2. A 23-year-old wearing contact lenses overnight develops
eye pain, photophobia, and a white corneal opacity.
Which finding on slit-lamp exam most strongly suggests
bacterial keratitis?
A. Dendritic ulceration
B. Geographic ulcer
, C. Dense stromal infiltrate with epithelial defect
D. Punctate epithelial erosions
Correct Answer: C
Rationale: Bacterial keratitis produces a dense stromal infiltrate
with overlying epithelial defect. Dendritic ulcers indicate
herpes; geographic ulcers suggest HSV progression; punctate
erosions occur in dry eye or mild keratitis.
3. A 30-year-old presents with sudden onset of floaters and
photopsias (“flashes of light”), and fundus exam shows a
gray, mobile membrane. What is the next best step?
A. Prescribe topical steroids
B. Urgent ophthalmology referral for retinal detachment
repair
C. Observation and reassurance
D. Begin antiviral drops
Correct Answer: B
Rationale: Floaters, photopsias, and a mobile retinal membrane
indicate retinal detachment, which requires urgent surgical
repair. Steroids/antivirals are inappropriate; observation risks
permanent vision loss.
4. A patient with hypertension complains of blurred vision.
Funduscopic exam shows arteriolar narrowing and silver
wiring. These findings are most consistent with which
grade of hypertensive retinopathy?
A. Grade I
B. Grade II
, C. Grade III
D. Grade IV
Correct Answer: B
Rationale: Grade II features arteriolar narrowing and
arteriovenous crossing changes (“AV nicking”). Grade I only
mild narrowing; Grade III includes hemorrhages/exudates;
Grade IV has papilledema.
5. A 45-year-old woman reports intermittent episodes of
seeing halos around lights and periorbital headache. On
exam, intraocular pressure is 32 mm Hg, cornea is hazy,
and pupil mid-dilated and sluggish. Diagnosis?
A. Chronic open-angle glaucoma
B. Acute angle-closure glaucoma
C. Uveitis
D. Optic neuritis
Correct Answer: B
Rationale: Acute angle-closure glaucoma presents with acute
pain, halos, headache, mid-dilated pupil, high IOP, and corneal
haze. Open-angle is chronic, painless; uveitis shows ciliary
injection, miosis; optic neuritis causes pain with eye movement,
not raised IOP.
6. Which sign on red-reflex testing in a 2-year-old warrants
immediate referral to ophthalmology?
A. Brown reflex
B. Black reflex in one eye
, C. Bright red reflex in both eyes
D. Unequal red reflex intensity
Correct Answer: B
Rationale: A black reflex suggests opacity (e.g., cataract,
retinoblastoma) and demands urgent evaluation. Brown reflex
may be pigment; unequal intensity requires follow-up but black
reflex is highest priority. Bright bilateral reflex is normal.
7. A 28-year-old presents with painful, red eyelid lump. It is
tender, well-circumscribed, and on the lid margin. Likely
diagnosis?
A. Chalazion
B. Hordeolum externum (stye)
C. Preseptal cellulitis
D. Sebaceous carcinoma
Correct Answer: B
Rationale: A tender, localized lesion on lid margin is a stye
(hordeolum). Chalazion is nontender, deeper. Preseptal
cellulitis has diffuse swelling, systemic signs. Sebaceous
carcinoma is painless and nodular.
8. In viral conjunctivitis, which feature helps differentiate it
from bacterial conjunctivitis?
A. Purulent discharge
B. Preauricular lymphadenopathy
C. Unilateral involvement only
D. Absence of photophobia
, Correct Answer: B
Rationale: Preauricular lymphadenopathy is common in viral
conjunctivitis (e.g., adenovirus). Purulent discharge suggests
bacterial; viral often bilateral; photophobia can occur in both
but isn’t distinguishing.
9. A child presents with watery discharge and cobblestone
papillae under the upper eyelid. History reveals seasonal
allergies. Best management?
A. Topical sulfonamide drops
B. Cool compresses and topical antihistamine/mast-cell
stabilizer
C. IV antibiotics
D. Corticosteroid injection
Correct Answer: B
Rationale: Allergic conjunctivitis produces cobblestone papillae
and watery discharge; treat with cool compresses and topical
antihistamines/mast-cell stabilizers. Sulfonamides/IV antibiotics
are for bacterial; steroid injection is overkill.
10. A farmer reports eye pain after agricultural work;
exam reveals a small corneal epithelial defect and an
adjacent thin, branching, gray membrane. Which
organism is most likely?
A. Staphylococcus aureus
B. Fusarium species (fungus)
C. Acanthamoeba
D. Pseudomonas aeruginosa
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 (12 Questions)
1. A 65-year-old diabetic patient presents with sudden,
painless vision loss described as a “curtain coming down”
over one eye. On fundoscopic exam you see a pale retina
with a cherry‐red spot at the fovea. Which is the most
likely diagnosis?
A. Central retinal artery occlusion
B. Central retinal vein occlusion
C. Ischemic optic neuropathy
D. Vitreous hemorrhage
Correct Answer: A
Rationale: Painless, sudden vision loss with a pale retina and
cherry-red spot is classic for central retinal artery occlusion. In
CRVO, retina is “blood and thunder” with hemorrhages;
ischemic optic neuropathy shows optic disc swelling; vitreous
hemorrhage presents with floaters and hazy view of fundus.
2. A 23-year-old wearing contact lenses overnight develops
eye pain, photophobia, and a white corneal opacity.
Which finding on slit-lamp exam most strongly suggests
bacterial keratitis?
A. Dendritic ulceration
B. Geographic ulcer
, C. Dense stromal infiltrate with epithelial defect
D. Punctate epithelial erosions
Correct Answer: C
Rationale: Bacterial keratitis produces a dense stromal infiltrate
with overlying epithelial defect. Dendritic ulcers indicate
herpes; geographic ulcers suggest HSV progression; punctate
erosions occur in dry eye or mild keratitis.
3. A 30-year-old presents with sudden onset of floaters and
photopsias (“flashes of light”), and fundus exam shows a
gray, mobile membrane. What is the next best step?
A. Prescribe topical steroids
B. Urgent ophthalmology referral for retinal detachment
repair
C. Observation and reassurance
D. Begin antiviral drops
Correct Answer: B
Rationale: Floaters, photopsias, and a mobile retinal membrane
indicate retinal detachment, which requires urgent surgical
repair. Steroids/antivirals are inappropriate; observation risks
permanent vision loss.
4. A patient with hypertension complains of blurred vision.
Funduscopic exam shows arteriolar narrowing and silver
wiring. These findings are most consistent with which
grade of hypertensive retinopathy?
A. Grade I
B. Grade II
, C. Grade III
D. Grade IV
Correct Answer: B
Rationale: Grade II features arteriolar narrowing and
arteriovenous crossing changes (“AV nicking”). Grade I only
mild narrowing; Grade III includes hemorrhages/exudates;
Grade IV has papilledema.
5. A 45-year-old woman reports intermittent episodes of
seeing halos around lights and periorbital headache. On
exam, intraocular pressure is 32 mm Hg, cornea is hazy,
and pupil mid-dilated and sluggish. Diagnosis?
A. Chronic open-angle glaucoma
B. Acute angle-closure glaucoma
C. Uveitis
D. Optic neuritis
Correct Answer: B
Rationale: Acute angle-closure glaucoma presents with acute
pain, halos, headache, mid-dilated pupil, high IOP, and corneal
haze. Open-angle is chronic, painless; uveitis shows ciliary
injection, miosis; optic neuritis causes pain with eye movement,
not raised IOP.
6. Which sign on red-reflex testing in a 2-year-old warrants
immediate referral to ophthalmology?
A. Brown reflex
B. Black reflex in one eye
, C. Bright red reflex in both eyes
D. Unequal red reflex intensity
Correct Answer: B
Rationale: A black reflex suggests opacity (e.g., cataract,
retinoblastoma) and demands urgent evaluation. Brown reflex
may be pigment; unequal intensity requires follow-up but black
reflex is highest priority. Bright bilateral reflex is normal.
7. A 28-year-old presents with painful, red eyelid lump. It is
tender, well-circumscribed, and on the lid margin. Likely
diagnosis?
A. Chalazion
B. Hordeolum externum (stye)
C. Preseptal cellulitis
D. Sebaceous carcinoma
Correct Answer: B
Rationale: A tender, localized lesion on lid margin is a stye
(hordeolum). Chalazion is nontender, deeper. Preseptal
cellulitis has diffuse swelling, systemic signs. Sebaceous
carcinoma is painless and nodular.
8. In viral conjunctivitis, which feature helps differentiate it
from bacterial conjunctivitis?
A. Purulent discharge
B. Preauricular lymphadenopathy
C. Unilateral involvement only
D. Absence of photophobia
, Correct Answer: B
Rationale: Preauricular lymphadenopathy is common in viral
conjunctivitis (e.g., adenovirus). Purulent discharge suggests
bacterial; viral often bilateral; photophobia can occur in both
but isn’t distinguishing.
9. A child presents with watery discharge and cobblestone
papillae under the upper eyelid. History reveals seasonal
allergies. Best management?
A. Topical sulfonamide drops
B. Cool compresses and topical antihistamine/mast-cell
stabilizer
C. IV antibiotics
D. Corticosteroid injection
Correct Answer: B
Rationale: Allergic conjunctivitis produces cobblestone papillae
and watery discharge; treat with cool compresses and topical
antihistamines/mast-cell stabilizers. Sulfonamides/IV antibiotics
are for bacterial; steroid injection is overkill.
10. A farmer reports eye pain after agricultural work;
exam reveals a small corneal epithelial defect and an
adjacent thin, branching, gray membrane. Which
organism is most likely?
A. Staphylococcus aureus
B. Fusarium species (fungus)
C. Acanthamoeba
D. Pseudomonas aeruginosa
