,PA Gold Standard QBank: Based on the
7th Edition Review
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)
1. A 6-year-old child presents with acute onset of red, itchy
eyes and a stringy, white discharge in both eyes. He
complains of seasonal sneezing and nasal congestion.
What is the most likely diagnosis?
A. Bacterial conjunctivitis
B. Viral conjunctivitis
C. Allergic conjunctivitis
D. Keratitis
Correct Answer: C
Rationale: Allergic conjunctivitis presents with bilateral
itching, redness, and a stringy, white discharge, often in
association with other allergic symptoms such as sneezing
and nasal congestion. Bacterial conjunctivitis usually
produces purulent discharge, viral conjunctivitis often has
watery discharge and preauricular lymphadenopathy, and
keratitis presents with severe pain and photophobia.
2. A 68-year-old patient complains of gradual, painless
vision loss in both eyes, worse at night, and reports
“halos” around lights. On exam, the lenses appear cloudy
on slit-lamp examination. What is the most likely
diagnosis?
A. Acute narrow-angle glaucoma
B. Age-related cataract
, C. Diabetic retinopathy
D. Macular degeneration
Correct Answer: B
Rationale: Age-related cataracts cause gradual, painless
bilateral vision loss, glare, and halos around lights, with
lens opacification on slit lamp. Acute narrow-angle
glaucoma is painful with headache and rapid vision loss;
diabetic retinopathy presents with floaters and
microaneurysms; macular degeneration causes central
vision loss.
3. A 45-year-old diabetic patient reports seeing “floaters”
and a shadow descending across his visual field in one
eye. Fundoscopy shows a pale retina with a “curtain-like”
appearance. What is the most likely diagnosis?
A. Central retinal artery occlusion
B. Retinal detachment
C. Vitreous hemorrhage
D. Optic neuritis
Correct Answer: B
Rationale: Retinal detachment presents with sudden
floaters, flashes, and a curtain-like shadow. Central retinal
artery occlusion causes sudden, painless vision loss with a
cherry-red spot; vitreous hemorrhage shows blood in the
vitreous; optic neuritis presents with painful vision loss
and afferent pupillary defect.
,4. A patient complains of gradual peripheral vision loss in
both eyes and difficulty adapting to low light. Intraocular
pressure is elevated, and the optic disc shows cupping.
Which condition is most consistent?
A. Open-angle glaucoma
B. Closed-angle glaucoma
C. Diabetic retinopathy
D. Age-related macular degeneration
Correct Answer: A
Rationale: Open-angle glaucoma presents with gradual
peripheral vision loss, elevated intraocular pressure, and
optic disc cupping. Closed-angle glaucoma is acute with
severe pain and vision changes; diabetic retinopathy and
macular degeneration affect central vision.
5. A 25-year-old contact lens wearer presents with severe
eye pain, photophobia, and a white spot on the cornea.
Which is the most appropriate initial diagnosis?
A. Bacterial keratitis
B. Herpetic keratitis
C. Scleritis
D. Conjunctivitis
Correct Answer: A
Rationale: Contact lens use predisposes to bacterial
keratitis, which presents with corneal ulcer (white spot),
pain, and photophobia. Herpetic keratitis has dendritic
lesions on fluorescein stain; scleritis causes deep, boring
, pain; conjunctivitis primarily involves conjunctival injection
without corneal ulceration.
6. A 70-year-old smoker complains of gradual, bilateral
central vision loss. Fundoscopy shows drusen deposits
under the macula. What is the most likely diagnosis?
A. Wet macular degeneration
B. Dry macular degeneration
C. Diabetic maculopathy
D. Retinal vein occlusion
Correct Answer: B
Rationale: Dry (atrophic) macular degeneration features
drusen, gradual central vision loss. Wet AMD has
neovascularization and rapid vision loss. Diabetic
maculopathy is related to diabetic changes; retinal vein
occlusion presents with sudden vision loss and retinal
hemorrhages.
7. A 30-year-old presents with sudden onset of flashes and
floaters without pain. Visual acuity remains intact. What
is the next best step?
A. Prescribe topical antibiotics
B. Emergent ophthalmology referral for retinal evaluation
C. Trial of anti-inflammatory drops
D. Schedule routine eye exam in 1 month
Correct Answer: B
Rationale: Sudden flashes and floaters suggest possible
retinal tear or detachment; requires emergent
, ophthalmology evaluation. Antibiotics or
anti-inflammatories are inappropriate, and waiting risks
permanent vision loss.
8. A patient with poorly controlled diabetes notes
progressive blurry vision. Fundoscopy reveals
microaneurysms, dot-blot hemorrhages, and
neovascularization. Which type of diabetic retinopathy is
indicated?
A. Nonproliferative retinopathy
B. Proliferative retinopathy
C. Hypertensive retinopathy
D. Central serous retinopathy
Correct Answer: B
Rationale: Neovascularization indicates proliferative
diabetic retinopathy. Nonproliferative shows
microaneurysms and hemorrhages but no new vessels.
Hypertensive retinopathy shows flame hemorrhages and
cotton-wool spots; central serous retinopathy involves
serous detachment.
9. A 50-year-old patient complains of intermittent blurring
more pronounced when reading near objects and
difficulty focusing on close tasks. Which is the most likely
explanation?
A. Presbyopia
B. Hyperopia
C. Myopia
7th Edition Review
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)
1. A 6-year-old child presents with acute onset of red, itchy
eyes and a stringy, white discharge in both eyes. He
complains of seasonal sneezing and nasal congestion.
What is the most likely diagnosis?
A. Bacterial conjunctivitis
B. Viral conjunctivitis
C. Allergic conjunctivitis
D. Keratitis
Correct Answer: C
Rationale: Allergic conjunctivitis presents with bilateral
itching, redness, and a stringy, white discharge, often in
association with other allergic symptoms such as sneezing
and nasal congestion. Bacterial conjunctivitis usually
produces purulent discharge, viral conjunctivitis often has
watery discharge and preauricular lymphadenopathy, and
keratitis presents with severe pain and photophobia.
2. A 68-year-old patient complains of gradual, painless
vision loss in both eyes, worse at night, and reports
“halos” around lights. On exam, the lenses appear cloudy
on slit-lamp examination. What is the most likely
diagnosis?
A. Acute narrow-angle glaucoma
B. Age-related cataract
, C. Diabetic retinopathy
D. Macular degeneration
Correct Answer: B
Rationale: Age-related cataracts cause gradual, painless
bilateral vision loss, glare, and halos around lights, with
lens opacification on slit lamp. Acute narrow-angle
glaucoma is painful with headache and rapid vision loss;
diabetic retinopathy presents with floaters and
microaneurysms; macular degeneration causes central
vision loss.
3. A 45-year-old diabetic patient reports seeing “floaters”
and a shadow descending across his visual field in one
eye. Fundoscopy shows a pale retina with a “curtain-like”
appearance. What is the most likely diagnosis?
A. Central retinal artery occlusion
B. Retinal detachment
C. Vitreous hemorrhage
D. Optic neuritis
Correct Answer: B
Rationale: Retinal detachment presents with sudden
floaters, flashes, and a curtain-like shadow. Central retinal
artery occlusion causes sudden, painless vision loss with a
cherry-red spot; vitreous hemorrhage shows blood in the
vitreous; optic neuritis presents with painful vision loss
and afferent pupillary defect.
,4. A patient complains of gradual peripheral vision loss in
both eyes and difficulty adapting to low light. Intraocular
pressure is elevated, and the optic disc shows cupping.
Which condition is most consistent?
A. Open-angle glaucoma
B. Closed-angle glaucoma
C. Diabetic retinopathy
D. Age-related macular degeneration
Correct Answer: A
Rationale: Open-angle glaucoma presents with gradual
peripheral vision loss, elevated intraocular pressure, and
optic disc cupping. Closed-angle glaucoma is acute with
severe pain and vision changes; diabetic retinopathy and
macular degeneration affect central vision.
5. A 25-year-old contact lens wearer presents with severe
eye pain, photophobia, and a white spot on the cornea.
Which is the most appropriate initial diagnosis?
A. Bacterial keratitis
B. Herpetic keratitis
C. Scleritis
D. Conjunctivitis
Correct Answer: A
Rationale: Contact lens use predisposes to bacterial
keratitis, which presents with corneal ulcer (white spot),
pain, and photophobia. Herpetic keratitis has dendritic
lesions on fluorescein stain; scleritis causes deep, boring
, pain; conjunctivitis primarily involves conjunctival injection
without corneal ulceration.
6. A 70-year-old smoker complains of gradual, bilateral
central vision loss. Fundoscopy shows drusen deposits
under the macula. What is the most likely diagnosis?
A. Wet macular degeneration
B. Dry macular degeneration
C. Diabetic maculopathy
D. Retinal vein occlusion
Correct Answer: B
Rationale: Dry (atrophic) macular degeneration features
drusen, gradual central vision loss. Wet AMD has
neovascularization and rapid vision loss. Diabetic
maculopathy is related to diabetic changes; retinal vein
occlusion presents with sudden vision loss and retinal
hemorrhages.
7. A 30-year-old presents with sudden onset of flashes and
floaters without pain. Visual acuity remains intact. What
is the next best step?
A. Prescribe topical antibiotics
B. Emergent ophthalmology referral for retinal evaluation
C. Trial of anti-inflammatory drops
D. Schedule routine eye exam in 1 month
Correct Answer: B
Rationale: Sudden flashes and floaters suggest possible
retinal tear or detachment; requires emergent
, ophthalmology evaluation. Antibiotics or
anti-inflammatories are inappropriate, and waiting risks
permanent vision loss.
8. A patient with poorly controlled diabetes notes
progressive blurry vision. Fundoscopy reveals
microaneurysms, dot-blot hemorrhages, and
neovascularization. Which type of diabetic retinopathy is
indicated?
A. Nonproliferative retinopathy
B. Proliferative retinopathy
C. Hypertensive retinopathy
D. Central serous retinopathy
Correct Answer: B
Rationale: Neovascularization indicates proliferative
diabetic retinopathy. Nonproliferative shows
microaneurysms and hemorrhages but no new vessels.
Hypertensive retinopathy shows flame hemorrhages and
cotton-wool spots; central serous retinopathy involves
serous detachment.
9. A 50-year-old patient complains of intermittent blurring
more pronounced when reading near objects and
difficulty focusing on close tasks. Which is the most likely
explanation?
A. Presbyopia
B. Hyperopia
C. Myopia
