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Exam Code: PANRE
Exam Name: NCCPA PANRE Physician Assistant National Recertifying Exam
Total Number of Questions: 240 multiple-choice questions
Exam Structure: Divided into four blocks of 60 questions each.
Time Allotted: 4 hours total (60 minutes per block)
Passing Score: The NCCPA uses a scaled score (ranging from 200 to 800) based on standard setting by PAs. The minimum passing scaled score is typically 379.

1. Cardiovascular System 13%

- Hypertension (essential, secondary, hypertensive emergency)
- Coronary artery disease / Acute coronary syndromes (STEMI, NSTEMI, unstable angina)
- Heart failure (systolic, diastolic, right-sided, acute decompensated)
- Valvular disorders (mitral stenosis/regurgitation, aortic stenosis/regurgitation, tricuspid regurgitation, pulmonic stenosis)
- Cardiomyopathies (dilated, hypertrophic, restrictive, peripartum)
- Pericardial diseases (pericarditis, pericardial effusion, tamponade)
- Arrhythmias (atrial fibrillation/flutter, SVT, ventricular tachycardia/fibrillation, bradycardias, heart block)
- Conduction disorders (1st, 2nd, 3rd degree AV block, bundle branch blocks)
- Congenital heart disease (ASD, VSD, PDA, tetralogy of Fallot, coarctation – adult presentation)
- Peripheral vascular disease (PAD, venous thrombosis, varicose veins, chronic venous insufficiency)
- Aortic disease (aneurysm, dissection)
- Shock (cardiogenic, hypovolemic, distributive)
- Syncope
- Dyslipidemia

2. Pulmonary System 10%

- Asthma (including occupational and exercise-induced)
- Chronic obstructive pulmonary disease (chronic bronchitis, emphysema)
- Acute/chronic bronchitis and bronchiolitis
- Pneumonia (community-acquired, healthcare-associated, aspiration, viral, fungal)
- Pulmonary embolism and deep vein thrombosis
- Lung cancer (small cell, non-small cell, solitary pulmonary nodule)
- Pleural diseases (pleural effusion, pneumothorax, hemothorax)
- Pulmonary hypertension
- Interstitial lung disease / Pulmonary fibrosis
- Obstructive sleep apnea
- Acute respiratory distress syndrome (ARDS)
- Sarcoidosis
- Occupational lung diseases (asbestosis, silicosis, coal workers pneumoconiosis)
- Cystic fibrosis (adult presentation)

3. Gastrointestinal System / Nutrition 9%

- Esophageal disorders (GERD, esophagitis, Barrett esophagus, motility disorders, strictures)
- Gastric disorders (peptic ulcer disease, gastritis, H. pylori, Zollinger-Ellison)
- Gallbladder and biliary disease (cholecystitis, cholelithiasis, cholangitis, biliary dyskinesia)
- Liver diseases (acute/chronic hepatitis, cirrhosis, alcoholic liver disease, NAFLD/NASH, portal hypertension, esophageal varices)
- Pancreatic disorders (acute and chronic pancreatitis, pancreatic insufficiency)
- Small intestine (malabsorption syndromes, celiac disease, Crohns disease, small bowel obstruction)
- Large intestine (ulcerative colitis, diverticulitis, appendicitis, ischemic colitis, C. difficile colitis)
- Colorectal cancer and screening
- Constipation and diarrhea (acute/chronic)
- GI bleeding (upper and lower)
- Hernias (inguinal, umbilical, incisional)
- Anorectal disorders (hemorrhoids, anal fissure, abscess, fistula)
- Nutrition (malnutrition, obesity, vitamin/mineral deficiencies)

4. Musculoskeletal System 8%

- Osteoarthritis and degenerative joint disease
- Rheumatoid arthritis
- Crystal-induced arthropathies (gout, pseudogout)
- Seronegative spondyloarthropathies (ankylosing spondylitis, psoriatic arthritis, reactive arthritis)
- Systemic lupus erythematosus and connective tissue diseases
- Osteoporosis and osteopenia
- Fractures and dislocations (common sites: hip, wrist, ankle, stress fractures)
- Sprains, strains, and overuse syndromes (rotator cuff, lateral/medial epicondylitis, plantar fasciitis)
- Low back pain (disc herniation, spinal stenosis, sciatica, cauda equina)
- Pediatric orthopedics (scoliosis, Osgood-Schlatter, slipped capital femoral epiphysis)
- Compartment syndrome
- Septic arthritis and osteomyelitis

5. EENT (Eyes, Ears, Nose, Throat) 7%

- Conjunctivitis, keratitis, corneal abrasion/ulcer
- Glaucoma (open-angle, acute angle-closure)
- Cataract, macular degeneration, diabetic retinopathy
- Retinal detachment, retinal vascular occlusion
- Otitis media, otitis externa, cerumen impaction
- Hearing loss (conductive vs sensorineural)
- Sinusitis (acute/chronic), allergic rhinitis
- Epistaxis
- Pharyngitis/tonsillitis, peritonsillar abscess
- Oral leukoplakia, oral cancer, salivary gland disorders
- Vertigo (BPPV, vestibular neuritis, Ménière disease)

6. Reproductive System (Female) 5% & Genitourinary System (Male and Female) 5%

- Menstrual disorders (amenorrhea, abnormal uterine bleeding, dysmenorrhea)
- Menopause and hormone replacement
- Breast diseases (fibrocystic changes, mastitis, breast cancer screening, fibroadenoma)
- Pelvic inflammatory disease, endometritis
- Cervical dysplasia and cancer screening
- Contraception and family planning
- Vaginitis (bacterial vaginosis, candida, trichomoniasis)
- Endometriosis, adenomyosis, uterine leiomyoma
- Polycystic ovarian syndrome
- Benign and malignant ovarian tumors
- Prostate disorders (BPH, prostatitis, prostate cancer)
- Erectile dysfunction
- Testicular torsion, epididymitis, orchitis
- Urinary incontinence (stress, urge, overflow)
- Urologic cancers (bladder, renal cell, testicular)

7. Endocrine System 5%

- Diabetes mellitus (Type 1, Type 2, gestational, complications: DKA, HHS)
- Thyroid disorders (hypothyroidism, hyperthyroidism, thyroiditis, nodules, cancer)
- Adrenal disorders (Addison disease, Cushing syndrome, pheochromocytoma)
- Pituitary disorders (diabetes insipidus, acromegaly, hypopituitarism)
- Parathyroid disorders (hyper/hypocalcemia, hyperparathyroidism)
- Metabolic syndrome
- Dyslipidemia (already listed under CV but tested again here)

8. Neurology 5%

- Headache (migraine, tension, cluster, secondary causes)
- Seizure disorders and epilepsy
- Stroke (ischemic, hemorrhagic, TIA)
- Dementia (Alzheimer, vascular, Lewy body)
- Parkinson disease and movement disorders
- Multiple sclerosis
- Peripheral neuropathy (diabetic, B12 deficiency, Guillain-Barré)
- Myasthenia gravis and neuromuscular junction disorders
- Meningitis and encephalitis
- Brain tumors and metastases

9. Psychiatry / Behavioral Health 5%

- Mood disorders (depression, bipolar disorder, dysthymia)
- Anxiety disorders (GAD, panic disorder, PTSD, OCD)
- Psychotic disorders (schizophrenia, schizoaffective)
- Substance use disorders (alcohol, opioid, stimulant, cannabis)
- ADHD (adult presentation)
- Eating disorders (anorexia, bulimia)
- Personality disorders
- Suicide risk assessment
- Somatoform and factitious disorders

10. Dermatology 5%

- Bacterial infections (impetigo, cellulitis, folliculitis, MRSA)
- Viral infections (herpes simplex, zoster, warts, molluscum)
- Fungal infections (tinea, candida, onychomycosis)
- Parasitic (scabies, lice)
- Acne, rosacea, hidradenitis suppurativa
- Psoriasis, lichen planus
- Eczema (atopic, contact, seborrheic)
- Urticaria and angioedema
- Drug eruptions
- Bullous diseases (pemphigus, bullous pemphigoid)
- Skin cancer (basal cell, squamous cell, melanoma, actinic keratosis)

11. Infectious Diseases 5%

- Sepsis and septic shock
- HIV/AIDS and opportunistic infections
- Tuberculosis and latent TB
- Sexually transmitted infections (gonorrhea, chlamydia, syphilis, herpes, HPV)
- Tick-borne diseases (Lyme, Rocky Mountain spotted fever, ehrlichiosis)
- Viral hepatitis (A, B, C)
- Osteomyelitis
- Endocarditis (native valve, prosthetic valve, culture-negative)
- Fever of unknown origin

12. Hematology 3%

- Anemias (iron deficiency, B12/folate deficiency, hemolytic, aplastic)
- Thrombocytopenia (ITP, TTP, HIT)
- Coagulopathies (hemophilia, von Willebrand, acquired)
- Leukemia (ALL, CLL, AML, CML)
- Lymphoma (Hodgkin, non-Hodgkin)
- Multiple myeloma and plasma cell disorders
- Transfusion reactions

13. Renal System 3%

- Acute kidney injury
- Chronic kidney disease and ESRD
- Glomerulonephritis and nephrotic syndrome
- Electrolyte disturbances (hyponatremia, hyperkalemia, etc.)
- Acid-base disorders
- Nephrolithiasis
- Pyelonephritis and urinary tract infections