,PA Certification Challenge: 7th Edition
Question Compendium
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 (14 Questions)
1. A 7-year-old child presents with acute onset of red,
tearing eye and a palpable preauricular lymph node. On
exam, there is conjunctival injection without corneal
involvement. What is the most likely diagnosis?
A. Bacterial conjunctivitis
B. Viral conjunctivitis
C. Allergic conjunctivitis
D. Keratitis
Answer: B. Viral conjunctivitis
Rationale: Preauricular lymphadenopathy and watery
discharge point to adenoviral infection; bacterial would
have purulent discharge, allergic would be bilateral with
itching, keratitis involves corneal ulceration.
2. A contact-lens wearer complains of severe eye pain,
photophobia, and a hazy corneal ulcer on slit-lamp exam.
Gram stain shows gram-negative rods. The most
appropriate next step is:
A. Topical antiviral therapy
B. Oral doxycycline
C. Topical fortified aminoglycoside
D. Warm compresses and lubrication
, Answer: C. Topical fortified aminoglycoside
Rationale: Pseudomonas keratitis in lens users requires
aggressive topical antibiotics (e.g., tobramycin); antivirals
won’t help bacterial; doxycycline systemic is insufficient;
warm compresses are supportive only.
3. A 68-year-old with gradual, painless vision loss has an
intraocular pressure of 28 mm Hg and cupping of the
optic disc. Initial management should include:
A. Laser peripheral iridotomy
B. Topical beta-blocker drops
C. Intravenous mannitol
D. Orbital decompression
Answer: B. Topical beta-blocker drops
Rationale: Chronic open-angle glaucoma is managed first
with topical agents (e.g., timolol); iridotomy is for
narrow-angle; mannitol is for acute angle closure;
decompression is for orbital compartment syndrome.
4. A 55-year-old with poorly controlled diabetes reports
sudden loss of central vision. Fundoscopy shows new
fragile vessels on the retina surface. This finding is
characteristic of:
A. Non-proliferative diabetic retinopathy
B. Proliferative diabetic retinopathy
C. Hypertensive retinopathy
D. Central retinal artery occlusion
Answer: B. Proliferative diabetic retinopathy
, Rationale: Neovascularization distinguishes proliferative
from non-proliferative; hypertension shows AV nicking,
flame hemorrhages; CRAO shows cherry-red spot.
5. A patient complains of sudden curtain-like darkening of
vision in one eye. Fundoscopy reveals a grey, mobile flap.
Treatment is:
A. Emergent laser photocoagulation
B. Intravitreal steroids
C. Oral acetazolamide
D. Warm compresses
Answer: A. Emergent laser photocoagulation
Rationale: Retinal detachment (“flap”) requires urgent
laser or surgery; steroids and acetazolamide are for
macular edema and glaucoma, respectively.
6. A 22-year-old with rheumatoid arthritis reports gritty
sensation and redness worse in the morning. Exam shows
mucopurulent discharge and conjunctival scarring. Likely
diagnosis:
A. Molluscum contagiosum
B. Cicatricial conjunctivitis
C. Stevens-Johnson syndrome
D. Trachoma
Answer: D. Trachoma
Rationale: Chronic Chlamydia trachomatis infection causes
scarring, follicles, and morning discharge; cicatricial from
burns, SJS is acute, molluscum shows papules.
,7. A diabetic patient’s annual eye exam shows
microaneurysms and hard exudates but no
neovascularization. This stage is:
A. Background retinopathy
B. Preproliferative retinopathy
C. Proliferative retinopathy
D. Macular degeneration
Answer: A. Background retinopathy
Rationale: Background (non-proliferative) shows
microaneurysms, dot hemorrhages, exudates;
preproliferative has cotton-wool spots; proliferative has
neovascularization.
8. A patient presents with acute painful vision loss, a red
eye, and a fixed mid-dilated pupil. Intraocular pressure is
50 mm Hg. First-line therapy is:
A. Topical prostaglandin analog
B. IV mannitol
C. Topical antibiotic
D. Oral acetazolamide
Answer: D. Oral acetazolamide
Rationale: Acute angle-closure glaucoma requires
immediate IOP reduction with acetazolamide; mannitol is
second-line; prostaglandins are slower; antibiotics are
irrelevant.
9. A 40-year-old complains of progressive peripheral vision
loss. Family history is positive. This describes:
, A. Macular degeneration
B. Open-angle glaucoma
C. Retinitis pigmentosa
D. Optic neuritis
Answer: C. Retinitis pigmentosa
Rationale: RP causes peripheral “tunnel” vision, often
hereditary; glaucoma also affects peripheral but without
pigmentary changes; macular affects central; optic neuritis
is painful with central loss.
10. A child presents with leukocoria and strabismus.
Suspicion is:
A. Retinoblastoma
B. Congenital cataract
C. Vitreous hemorrhage
D. Coat’s disease
Answer: A. Retinoblastoma
Rationale: White pupillary reflex (leukocoria) in a child is
retinoblastoma until proven otherwise; congenital cataract
can cause leukocoria but less likely with strabismus.
11. A patient notes halos around lights and cloudy
vision. On exam, lens opacities are present. The most
common type is:
A. Nuclear sclerotic cataract
B. Cortical spokes
C. Posterior subcapsular cataract
D. Traumatic cataract
Question Compendium
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 (14 Questions)
1. A 7-year-old child presents with acute onset of red,
tearing eye and a palpable preauricular lymph node. On
exam, there is conjunctival injection without corneal
involvement. What is the most likely diagnosis?
A. Bacterial conjunctivitis
B. Viral conjunctivitis
C. Allergic conjunctivitis
D. Keratitis
Answer: B. Viral conjunctivitis
Rationale: Preauricular lymphadenopathy and watery
discharge point to adenoviral infection; bacterial would
have purulent discharge, allergic would be bilateral with
itching, keratitis involves corneal ulceration.
2. A contact-lens wearer complains of severe eye pain,
photophobia, and a hazy corneal ulcer on slit-lamp exam.
Gram stain shows gram-negative rods. The most
appropriate next step is:
A. Topical antiviral therapy
B. Oral doxycycline
C. Topical fortified aminoglycoside
D. Warm compresses and lubrication
, Answer: C. Topical fortified aminoglycoside
Rationale: Pseudomonas keratitis in lens users requires
aggressive topical antibiotics (e.g., tobramycin); antivirals
won’t help bacterial; doxycycline systemic is insufficient;
warm compresses are supportive only.
3. A 68-year-old with gradual, painless vision loss has an
intraocular pressure of 28 mm Hg and cupping of the
optic disc. Initial management should include:
A. Laser peripheral iridotomy
B. Topical beta-blocker drops
C. Intravenous mannitol
D. Orbital decompression
Answer: B. Topical beta-blocker drops
Rationale: Chronic open-angle glaucoma is managed first
with topical agents (e.g., timolol); iridotomy is for
narrow-angle; mannitol is for acute angle closure;
decompression is for orbital compartment syndrome.
4. A 55-year-old with poorly controlled diabetes reports
sudden loss of central vision. Fundoscopy shows new
fragile vessels on the retina surface. This finding is
characteristic of:
A. Non-proliferative diabetic retinopathy
B. Proliferative diabetic retinopathy
C. Hypertensive retinopathy
D. Central retinal artery occlusion
Answer: B. Proliferative diabetic retinopathy
, Rationale: Neovascularization distinguishes proliferative
from non-proliferative; hypertension shows AV nicking,
flame hemorrhages; CRAO shows cherry-red spot.
5. A patient complains of sudden curtain-like darkening of
vision in one eye. Fundoscopy reveals a grey, mobile flap.
Treatment is:
A. Emergent laser photocoagulation
B. Intravitreal steroids
C. Oral acetazolamide
D. Warm compresses
Answer: A. Emergent laser photocoagulation
Rationale: Retinal detachment (“flap”) requires urgent
laser or surgery; steroids and acetazolamide are for
macular edema and glaucoma, respectively.
6. A 22-year-old with rheumatoid arthritis reports gritty
sensation and redness worse in the morning. Exam shows
mucopurulent discharge and conjunctival scarring. Likely
diagnosis:
A. Molluscum contagiosum
B. Cicatricial conjunctivitis
C. Stevens-Johnson syndrome
D. Trachoma
Answer: D. Trachoma
Rationale: Chronic Chlamydia trachomatis infection causes
scarring, follicles, and morning discharge; cicatricial from
burns, SJS is acute, molluscum shows papules.
,7. A diabetic patient’s annual eye exam shows
microaneurysms and hard exudates but no
neovascularization. This stage is:
A. Background retinopathy
B. Preproliferative retinopathy
C. Proliferative retinopathy
D. Macular degeneration
Answer: A. Background retinopathy
Rationale: Background (non-proliferative) shows
microaneurysms, dot hemorrhages, exudates;
preproliferative has cotton-wool spots; proliferative has
neovascularization.
8. A patient presents with acute painful vision loss, a red
eye, and a fixed mid-dilated pupil. Intraocular pressure is
50 mm Hg. First-line therapy is:
A. Topical prostaglandin analog
B. IV mannitol
C. Topical antibiotic
D. Oral acetazolamide
Answer: D. Oral acetazolamide
Rationale: Acute angle-closure glaucoma requires
immediate IOP reduction with acetazolamide; mannitol is
second-line; prostaglandins are slower; antibiotics are
irrelevant.
9. A 40-year-old complains of progressive peripheral vision
loss. Family history is positive. This describes:
, A. Macular degeneration
B. Open-angle glaucoma
C. Retinitis pigmentosa
D. Optic neuritis
Answer: C. Retinitis pigmentosa
Rationale: RP causes peripheral “tunnel” vision, often
hereditary; glaucoma also affects peripheral but without
pigmentary changes; macular affects central; optic neuritis
is painful with central loss.
10. A child presents with leukocoria and strabismus.
Suspicion is:
A. Retinoblastoma
B. Congenital cataract
C. Vitreous hemorrhage
D. Coat’s disease
Answer: A. Retinoblastoma
Rationale: White pupillary reflex (leukocoria) in a child is
retinoblastoma until proven otherwise; congenital cataract
can cause leukocoria but less likely with strabismus.
11. A patient notes halos around lights and cloudy
vision. On exam, lens opacities are present. The most
common type is:
A. Nuclear sclerotic cataract
B. Cortical spokes
C. Posterior subcapsular cataract
D. Traumatic cataract
