,7th Edition PA Quiz Companion
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
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
, 7 Gynecology 8 Obstetrics
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
Maculopapular and Plaque Disorders Sepsis
Vesiculobullous Disorders Bacterial Infections
, 13 Dermatology 14 Infectious Disease
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 (1–13)
1. A 24-year-old contact lens wearer presents with acute
onset of unilateral eye pain, blurred vision, and a hazy
cornea on slit-lamp exam. Which organism is the most
likely cause?
A. Staphylococcus aureus
B. Pseudomonas aeruginosa
C. Chlamydia trachomatis
D. Haemophilus influenzae
Answer: B. Pseudomonas aeruginosa
Rationale: Contact lens–associated keratitis is most often due
to Pseudomonas, which can rapidly invade the cornea and
cause ulceration. Staph aureus more often causes blepharitis or
conjunctivitis; Chlamydia causes chronic conjunctivitis; H.
influenzae rarely causes keratitis.
2. A 60-year-old diabetic patient reports gradual, painless
loss of central vision in both eyes. Funduscopic exam
shows drusen deposits and geographic atrophy of the
macula. What is the most appropriate initial management?
A. Intravitreal antivascular endothelial growth factor (anti-
VEGF) injections
B. Oral high-dose corticosteroids
,C. Laser photocoagulation
D. Low-vision rehabilitation and Amsler grid monitoring
Answer: D. Low-vision rehabilitation and Amsler grid
monitoring
Rationale: Dry (atrophic) age-related macular degeneration has
no proven drug therapy; recommended management is vision
aids and self-monitoring. Anti-VEGF and laser are for wet AMD
with neovascularization.
3. A 30-year-old woman presents with itching, tearing, and a
cobblestone appearance of the palpebral conjunctiva.
What is the most likely diagnosis?
A. Viral conjunctivitis
B. Bacterial conjunctivitis
C. Vernal keratoconjunctivitis
D. Allergic conjunctivitis
Answer: C. Vernal keratoconjunctivitis
Rationale: Cobblestone papillae on the upper tarsal conjunctiva
with severe itching suggest vernal, an allergic condition seen in
young adults. Viral and bacterial lack cobblestone changes;
simple allergic lacks papillae.
4. A patient complains of sudden onset of floaters and a
'curtain coming down' over one eye. What is the most
likely diagnosis?
A. Central retinal artery occlusion
B. Retinal detachment
,C. Vitreous hemorrhage
D. Acute angle-closure glaucoma
Answer: B. Retinal detachment
Rationale: Painless curtain-like shadow and floaters are classic
for detachment. CRAO causes sudden painless vision loss
without floaters; vitreous hemorrhage causes red hue; angle
closure causes severe pain and halos.
5. Examination reveals an afferent pupillary defect (Marcus
Gunn pupil). Which condition best explains this finding?
A. Optic neuritis
B. Oculomotor nerve palsy
C. Cranial III compression
D. Horner syndrome
Answer: A. Optic neuritis
Rationale: Afferent pupillary defect indicates optic nerve
dysfunction. Oculomotor palsy affects efferent limb; Horner
affects sympathetic but not afferent.
6. A newborn fails the red reflex test. Which condition is
most concerning?
A. Strabismus
B. Congenital cataract
C. Retinoblastoma
D. Coloboma
Answer: C. Retinoblastoma
Rationale: An absent or white reflex (leukocoria) in infants is a
,red flag for retinoblastoma, requiring urgent referral.
Congenital cataract also causes leukocoria but retinoblastoma
is life-threatening.
7. A 70-year-old complains of halos around lights and severe
eye pain after using dim lighting. Exam shows mid-dilated,
nonreactive pupils and a firm globe. Diagnosis?
A. Open-angle glaucoma
B. Acute angle-closure glaucoma
C. Uveitis
D. Endophthalmitis
Answer: B. Acute angle-closure glaucoma
Rationale: Acute angle closure presents with halos, pain, fixed
mid-dilated pupil, and increased intraocular pressure. Open-
angle is painless.
8. Which finding differentiates chalazion from hordeolum?
A. Painful eyelid nodule
B. Localized eyelid swelling
C. Granulomatous inflammation of meibomian gland
D. Presence of purulent discharge
Answer: C. Granulomatous inflammation of meibomian gland
Rationale: Chalazion is a nonpainful granulomatous nodule of
meibomian gland; hordeolum (stye) is painful and may have
purulence.
9. A patient with suspected optic neuritis should undergo
which imaging study?
, A. Noncontrast head CT
B. MRI of brain and orbits with contrast
C. Ultrasound of orbit
D. X-ray of skull
Answer: B. MRI of brain and orbits with contrast
Rationale: MRI with contrast is the gold standard to evaluate
optic nerve inflammation and rule out demyelinating lesions.
10. A 25-year-old complains of episodes of visual flashing
lights and photopsia but no vision loss. What retinal
condition does this suggest?
A. Retinal detachment
B. Macular degeneration
C. Central serous retinopathy
D. Diabetic retinopathy
Answer: A. Retinal detachment
Rationale: Flashes (photopsia) signal vitreoretinal traction
preceding detachment. Other conditions do not typically cause
flashes.
11. Which test is most appropriate for distinguishing
conductive from sensorineural hearing loss at the bedside?
A. Tympanometry
B. Pure-tone audiometry
C. Weber and Rinne tests
D. Acoustic reflex testing
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
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
, 7 Gynecology 8 Obstetrics
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
Maculopapular and Plaque Disorders Sepsis
Vesiculobullous Disorders Bacterial Infections
, 13 Dermatology 14 Infectious Disease
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 (1–13)
1. A 24-year-old contact lens wearer presents with acute
onset of unilateral eye pain, blurred vision, and a hazy
cornea on slit-lamp exam. Which organism is the most
likely cause?
A. Staphylococcus aureus
B. Pseudomonas aeruginosa
C. Chlamydia trachomatis
D. Haemophilus influenzae
Answer: B. Pseudomonas aeruginosa
Rationale: Contact lens–associated keratitis is most often due
to Pseudomonas, which can rapidly invade the cornea and
cause ulceration. Staph aureus more often causes blepharitis or
conjunctivitis; Chlamydia causes chronic conjunctivitis; H.
influenzae rarely causes keratitis.
2. A 60-year-old diabetic patient reports gradual, painless
loss of central vision in both eyes. Funduscopic exam
shows drusen deposits and geographic atrophy of the
macula. What is the most appropriate initial management?
A. Intravitreal antivascular endothelial growth factor (anti-
VEGF) injections
B. Oral high-dose corticosteroids
,C. Laser photocoagulation
D. Low-vision rehabilitation and Amsler grid monitoring
Answer: D. Low-vision rehabilitation and Amsler grid
monitoring
Rationale: Dry (atrophic) age-related macular degeneration has
no proven drug therapy; recommended management is vision
aids and self-monitoring. Anti-VEGF and laser are for wet AMD
with neovascularization.
3. A 30-year-old woman presents with itching, tearing, and a
cobblestone appearance of the palpebral conjunctiva.
What is the most likely diagnosis?
A. Viral conjunctivitis
B. Bacterial conjunctivitis
C. Vernal keratoconjunctivitis
D. Allergic conjunctivitis
Answer: C. Vernal keratoconjunctivitis
Rationale: Cobblestone papillae on the upper tarsal conjunctiva
with severe itching suggest vernal, an allergic condition seen in
young adults. Viral and bacterial lack cobblestone changes;
simple allergic lacks papillae.
4. A patient complains of sudden onset of floaters and a
'curtain coming down' over one eye. What is the most
likely diagnosis?
A. Central retinal artery occlusion
B. Retinal detachment
,C. Vitreous hemorrhage
D. Acute angle-closure glaucoma
Answer: B. Retinal detachment
Rationale: Painless curtain-like shadow and floaters are classic
for detachment. CRAO causes sudden painless vision loss
without floaters; vitreous hemorrhage causes red hue; angle
closure causes severe pain and halos.
5. Examination reveals an afferent pupillary defect (Marcus
Gunn pupil). Which condition best explains this finding?
A. Optic neuritis
B. Oculomotor nerve palsy
C. Cranial III compression
D. Horner syndrome
Answer: A. Optic neuritis
Rationale: Afferent pupillary defect indicates optic nerve
dysfunction. Oculomotor palsy affects efferent limb; Horner
affects sympathetic but not afferent.
6. A newborn fails the red reflex test. Which condition is
most concerning?
A. Strabismus
B. Congenital cataract
C. Retinoblastoma
D. Coloboma
Answer: C. Retinoblastoma
Rationale: An absent or white reflex (leukocoria) in infants is a
,red flag for retinoblastoma, requiring urgent referral.
Congenital cataract also causes leukocoria but retinoblastoma
is life-threatening.
7. A 70-year-old complains of halos around lights and severe
eye pain after using dim lighting. Exam shows mid-dilated,
nonreactive pupils and a firm globe. Diagnosis?
A. Open-angle glaucoma
B. Acute angle-closure glaucoma
C. Uveitis
D. Endophthalmitis
Answer: B. Acute angle-closure glaucoma
Rationale: Acute angle closure presents with halos, pain, fixed
mid-dilated pupil, and increased intraocular pressure. Open-
angle is painless.
8. Which finding differentiates chalazion from hordeolum?
A. Painful eyelid nodule
B. Localized eyelid swelling
C. Granulomatous inflammation of meibomian gland
D. Presence of purulent discharge
Answer: C. Granulomatous inflammation of meibomian gland
Rationale: Chalazion is a nonpainful granulomatous nodule of
meibomian gland; hordeolum (stye) is painful and may have
purulence.
9. A patient with suspected optic neuritis should undergo
which imaging study?
, A. Noncontrast head CT
B. MRI of brain and orbits with contrast
C. Ultrasound of orbit
D. X-ray of skull
Answer: B. MRI of brain and orbits with contrast
Rationale: MRI with contrast is the gold standard to evaluate
optic nerve inflammation and rule out demyelinating lesions.
10. A 25-year-old complains of episodes of visual flashing
lights and photopsia but no vision loss. What retinal
condition does this suggest?
A. Retinal detachment
B. Macular degeneration
C. Central serous retinopathy
D. Diabetic retinopathy
Answer: A. Retinal detachment
Rationale: Flashes (photopsia) signal vitreoretinal traction
preceding detachment. Other conditions do not typically cause
flashes.
11. Which test is most appropriate for distinguishing
conductive from sensorineural hearing loss at the bedside?
A. Tympanometry
B. Pure-tone audiometry
C. Weber and Rinne tests
D. Acoustic reflex testing
