CME Review Courses

If you are a PA planning for the PANRE and also trying to use your CME allowance efficiently, the purchase structure matters. The PANRE Review Course with Gift Card combines exam preparation, CME completion, and an optional Amazon or Apple gift card add-on in one online package.

Course Price, Access, CME, and Practice Content

• Base course price: $399.99
• Access: 30 months from purchase
• CME: Up to 100 hours of AAPA Category 1 CME through the PANRE Review Course
• Question bank: 2,500+ board-style practice questions
• Full-length practice exams: Five 240-question exams, or 1,200 questions total
• Gift card add-ons: $100–$1,500
• Delivery: Online, self-paced, and mobile-friendly

The 100 hours of AAPA Category 1 CME apply specifically to the PANRE Review Course. They do not refer to the separate Pharmacology CME course. To claim credit, complete the module content, pass the post-test with the required score, and complete the activity evaluation. Claim only the amount of credit that matches your participation.

The activity is designated through the American Academy of Physician Associates, with approval listed through August 26, 2027, under AAPA reference number CME-2016187. Review the current course details on the PANRE Review Course with Gift Card page.

Amazon and Apple Gift Cards Are Paid Add-Ons

This point requires clear explanation: the Amazon and Apple gift cards are not free gifts.

They are optional, paid add-ons that increase the total price of your purchase. The base course is listed at $399.99. If you select a $100 Amazon or Apple gift card, your package total becomes the course price plus the $100 add-on. A $1,500 gift card adds $1,500 to the course price.

Examples:

• PANRE Review Course: $399.99
• Course plus $100 gift card: $499.99
• Course plus $500 gift card: $899.99
• Course plus $1,500 gift card: $1,899.99

The available add-on amount is selected at checkout. You can also purchase the PANRE Review Course without a gift card. Check your employer’s CME policy before purchasing because organizations differ in how they handle bundled educational expenses and add-ons.

Amazon gift cards are processed and emailed within approximately two to three business days. The course page states that gift card packages are nonrefundable after processing. CME Review Courses is not affiliated with Amazon.

Apple gift cards are also paid add-ons available in multiple tiers up to $1,500. They are processed and delivered by email within approximately two to three business days. CME Review Courses is not affiliated with Apple.

How to Maximize Your CME Budget

1. Start with the amount of CME you actually need

Before selecting an add-on, check your NCCPA certification maintenance timeline, employer allowance, and any state-specific requirements that apply to you. The PANRE Review Course can provide up to 100 hours of AAPA Category 1 CME, which may cover a substantial portion of a two-year CME cycle.

The course is designed for practicing PAs preparing for the traditional PANRE or PANRE-LA. It covers the clinical content areas represented in the NCCPA Blueprint and provides question-based review across multiple organ systems.

2. Separate educational value from the add-on amount

The primary purchase is the PANRE preparation and CME activity. The gift card is an optional paid addition. Select the amount based on your approved CME budget, not simply on the largest available tier.

For example, if your employer allows $900 for CME and you want the course, a $500 gift card would bring the total to approximately $899.99 before any applicable taxes or fees. That may fit your allowance, but you should confirm the policy first.

3. Use the 30-month access period strategically

Thirty months of access gives you time to use the course across more than one study phase. You can begin with a diagnostic practice block, identify weak systems, complete the educational content, and return later for additional full-length exams.

A practical schedule is:

• Month 1: Complete a baseline question set.
• Months 2–6: Review weaker organ systems.
• Months 7–12: Complete additional question modules and track performance.
• Months 13–24: Work through the full-length practice examinations.
• Months 25–30: Complete targeted remediation and final exam preparation.

The course includes performance tracking, question flagging, and repeated access to the online materials. That makes the package useful beyond a single weekend review period.

4. Compare the course with other PANCE prep courses carefully

Many PANCE prep courses and PANRE resources focus primarily on question volume. That can be useful, but it does not always include AAPA Category 1 CME.

When comparing products, look at four separate variables:

1. Is the course designed for PANRE, PANCE, or both?
2. How many questions are included?
3. How long does access remain active?
4. Does the course offer recognized CME credit?

The PANRE Review Course combines 2,500+ questions, five 240-question practice examinations, 30 months of access, and up to 100 hours of AAPA Category 1 CME in one package.

Study Tip: Use Questions to Direct Your Review

Do not begin by rereading every topic from the beginning. Start with a timed question block. Classify each missed question as one of three problems:

• Knowledge deficit
• Misinterpretation of the vignette
• Failure to identify the next best step

Then review the explanation and cited source. This approach is more efficient than repeatedly reading material you already know.

For additional short practice blocks, use the PAtopia web version, the PAtopia iOS app, or the PAtopia Android app. PAtopia is a separate study resource and should not be confused with the PANRE Review Course’s AAPA Category 1 CME activity.

Clinical Practice Question

Vignette

Your patient is a 68-year-old man with fever, dysuria, and left flank pain. He is confused and appears ill. Vital signs are: T 39.2°C, HR 124/min, BP 84/52 mm Hg, RR 26/min, and SaO₂ 94% on room air. Laboratory testing shows WBC 19,000/mm³ and lactate 4.6 mmol/L. You administer broad-spectrum IV antibiotics and 30 mL/kg of crystalloid. His MAP remains 58 mm Hg.

Which of the following is the next best intervention?

A. Administer IV furosemide
B. Begin a norepinephrine infusion
C. Administer an additional dose of broad-spectrum antibiotics
D. Start dopamine as first-line vasopressor therapy
E. Obtain CT angiography of the chest

Answer and Explanation

B. Begin a norepinephrine infusion.

This patient has septic shock with persistent hypotension after adequate initial fluid resuscitation. Norepinephrine is the first-line vasopressor to restore vascular tone and maintain MAP, generally targeting at least 65 mm Hg.

Furosemide would worsen intravascular depletion. Additional antibiotics should not delay hemodynamic support. Dopamine is not preferred because of its higher risk of tachyarrhythmias. CT angiography of the chest does not address the immediate shock state.

This is the type of next-step management question that should be part of your PANRE review routine: identify the syndrome, assess the immediate threat, and select the intervention that changes short-term mortality or stabilization.

Confirm the Details Before Checkout

The CME with Gift Card package is structured as follows:

• $399.99 base price
• Optional paid Amazon or Apple add-ons from $100 to $1,500
• 30 months of course access
• Up to 100 hours of AAPA Category 1 CME through the PANRE Review Course
• 2,500+ practice questions
• Five full-length 240-question practice exams
• Gift card delivery by email, generally within two to three business days

Nurse practitioners should verify whether their state board or employer accepts AAPA Category 1 credit for their specific renewal requirements. Physicians may find the clinical content useful, but the AAPA Category 1 designation is intended for PAs; physicians should confirm how the activity applies to their own CME requirements.

Author Credentials

Jeremy Boroff, MPAS, PA-C, has 24 years of Emergency Medicine experience and has worked extensively as a clinician, educator, and medical education author. He is the founder of CME Review Courses and develops board-style review content for practicing physician assistants, including PANRE preparation and Category 1 CME activities.

PANCE®, PANRE®, and PANRE-LA are trademarks of the National Commission on Certification of Physician Assistants. CME Review Courses is not affiliated with NCCPA, Amazon, or Apple.

If you are approaching recertification, you have two assessment options: PANRE-LA or the traditional PANRE. Both evaluate core medical knowledge using the same NCCPA PANRE/PANRE-LA Content Blueprint, but the testing experience is substantially different.

Your decision should be based on your certification-cycle timeline, schedule, testing preferences, and ability to maintain a consistent review routine.

Course Details at a Glance

• Price: $399.99 for the PANRE Review Course
• Access: 30 months
• CME: Up to 100 hours of AAPA Category 1 CME through the PANRE Clinical Review Module
• Deliverables: More than 2,500 board-style practice questions, 15 body-system modules, full-length mock exams, answer rationales, cited references, downloadable study materials, and performance tracking
• Optional add-ons: Paid Amazon or Apple Gift Cards from $100 to $1,500

The gift card add-ons are not free gifts. The amount you select is added to the total purchase price. Review your employer’s CME policy before choosing an add-on.

Explore the PANRE Review Course and CME gift cards

PANRE-LA vs. Traditional PANRE: The Core Difference

The traditional PANRE is a single, proctored examination completed at a Pearson VUE testing center. PANRE-LA is an online, longitudinal assessment completed over multiple quarters.

According to NCCPA’s current certification-maintenance information, both options require you to maintain your CME and complete the applicable recertification assessment before the end of your 10-year certification cycle. The application fee is currently the same for both options.

Feature	Traditional PANRE	PANRE-LA
Testing environment	Pearson VUE testing center	Online using a compatible device
Timing	Years 9 or 10 of the certification cycle	Apply in year 6; questions administered during years 7–9
Question structure	240 questions in four 60-question blocks	25 questions per quarter
Time per question	60 minutes per 60-question block	Five minutes per question
References	Closed-book testing environment	Printed or online references permitted
Participation	One scheduled examination event	Complete at least eight of 12 available quarters
Feedback	Results are typically available after testing	Immediate feedback, rationale, and references
Content	Same NCCPA recertification content	Same NCCPA recertification content

Who May Prefer PANRE-LA?

PANRE-LA may be appropriate if you prefer a distributed assessment rather than one high-stakes examination day.

You may be a good fit for PANRE-LA if you:

• Prefer shorter assessment sessions spread across several years
• Can protect time each quarter to complete the required questions
• Like using references to verify uncertain answers
• Want immediate feedback after each question
• Prefer identifying knowledge gaps gradually
• Have difficulty scheduling travel or a full day away from clinical practice

PANRE-LA is not an open-book shortcut. You still need a working knowledge of the material. Each question has a five-minute limit, so you must recognize the relevant diagnosis, management issue, or next-best step before consulting a reference.

NCCPA provides 12 quarters for the assessment. You must complete at least eight quarters, including participation requirements during the earlier years of the process. Your final performance is based on your best eight quarters. If you do not complete the PANRE-LA successfully, NCCPA provides a traditional PANRE pathway before certification expiration under its current policies.

A practical PANRE-LA strategy is to divide each quarterly question set into two or three planned sessions. Complete the questions early enough to review the rationales and correct knowledge gaps before the quarter closes.

Who May Prefer Traditional PANRE?

The traditional PANRE may be a better fit if you want to prepare for one defined examination date and finish the assessment in a single event.

You may prefer traditional PANRE if you:

• Perform well under timed, closed-book conditions
• Want to complete the assessment in one scheduled session
• Prefer a concentrated study period
• Do not want a multiyear quarterly commitment
• Can travel to a Pearson VUE testing center
• Are comfortable answering mixed clinical questions without outside references

The traditional PANRE consists of four 60-question blocks. Each block allows 60 minutes, with scheduled breaks and a tutorial period. The total appointment is approximately five hours.

Preparation should include timed blocks that approximate this structure. Reviewing isolated questions while checking references will not adequately prepare you for the pacing, concentration, and decision-making required on test day.

How the Same Review Course Supports Both Paths

The assessment formats differ, but the clinical content overlaps. A focused PANRE review course can support either pathway when you use it according to your testing format.

For PANRE-LA preparation:

1. Complete smaller question sets consistently.
2. Use rationales to identify recurring knowledge gaps.
3. Practice locating information quickly in one or two reliable references.
4. Track errors by organ system and clinical task.
5. Avoid waiting until the end of the quarter.

For traditional PANRE preparation:

1. Start with a baseline mixed question set.
2. Review each major NCCPA content area.
3. Use timed, closed-book 60-question blocks.
4. Practice changing topics rapidly.
5. Analyze incorrect answers rather than simply reviewing correct ones.

The course includes more than 2,500 board-style questions, 15 body-system modules, five full-length practice examinations with 240 questions each, answer explanations, cited sources, and 30 months of access. You can study by organ system early in your preparation and transition to mixed practice later.

Although PANCE prep courses are primarily designed for initial certification, many of the same study methods apply to PANRE preparation: active recall, clinical vignettes, error tracking, and timed practice. However, a dedicated PANRE course is more appropriate when your goal is recertification.

The Value of 100 AAPA Category 1 CME Credits

The PANRE Review Course provides up to 100 hours of AAPA Category 1 CME through the PANRE Clinical Review Module. These credits apply specifically to the PANRE Review Course. They do not automatically apply to every CME Review Courses product.

To claim credit, complete the course requirements, including the post-test and evaluation, and claim only the amount commensurate with your participation. Review current NCCPA CME and certification-maintenance requirements before logging your credit.

The 100-credit package can help you address a significant portion of a two-year CME cycle while reviewing the same clinical domains relevant to PANRE and PANRE-LA.

The Pharmacology Review Course is a separate CME activity with its own credit designation. Do not assume that completing one product awards the credit associated with another product.

For physicians, AAPA Category 1 credit may generally be reported as Category 2 CME rather than Category 1 physician CME. Nurse practitioner acceptance varies by state board and employer. NPs should verify requirements with their state board of nursing before purchase.

How to Maximize Your CME Budget With Gift Card Add-Ons

The CME with Gift Card package allows you to purchase the PANRE Review Course and add an Amazon or Apple Gift Card in amounts from $100 to $1,500.

These are paid add-ons, not complimentary gifts. The selected gift card amount increases the total purchase price. The course itself is priced at $399.99, and the add-on is selected separately at checkout.

This option may be useful if your employer provides a defined CME allowance and permits the purchase structure. Before ordering:

• Confirm that your employer allows this type of CME expenditure.
• Select an add-on that fits your available budget.
• Verify whether your organization has restrictions on gift cards.
• Remember that gift card purchases are subject to the product’s stated terms.

Common PANRE Review Mistakes

Treating PANRE-LA as an open-book shortcut

References can support your reasoning, but they cannot replace preparation. Five minutes is not enough time to search broadly for every question.

Waiting until the final year

Traditional PANRE preparation becomes compressed when started only a few weeks before the examination. PANRE-LA also requires ongoing participation. Start early enough to identify weak systems and correct them.

Studying only familiar conditions

Your daily clinical practice may not expose you to every NCCPA content area. Review renal medicine, dermatology, infectious disease, psychiatry, hematology, endocrine disorders, and other areas outside your routine practice.

Reading without answering questions

Passive review creates familiarity but does not prove that you can apply information to a clinical vignette. Use questions to test diagnosis, treatment, contraindications, screening, and next-best-step decisions.

Ignoring the testing format

For PANRE-LA, practice five-minute decisions with limited reference searching. For traditional PANRE, complete timed, closed-book blocks.

Practice Question: Traditional PANRE Style

Clinical vignette: Your patient is a 68-year-old man with atrial fibrillation who presents with sudden left-sided weakness and aphasia. Symptoms began 75 minutes ago. HR is 118/min and irregular, BP is 174/96 mmHg, SaO₂ is 97% on room air, and glucose is 104 mg/dL. Noncontrast CT shows no hemorrhage.

What is the most appropriate next step?

A. Administer IV alteplase after confirming no contraindication
B. Start warfarin immediately
C. Perform a lumbar puncture
D. Administer aspirin and defer further evaluation

Correct answer: A. Administer IV alteplase after confirming no contraindication.

The patient has an acute ischemic stroke with disabling neurologic deficits and presentation within the thrombolysis window. IV thrombolysis is appropriate after rapid assessment of contraindications.

Warfarin is not an immediate treatment for acute stroke. Lumbar puncture is unnecessary and delays treatment. Aspirin may be used when thrombolysis is not given or after the appropriate post-thrombolysis interval, but it is not the best initial answer here.

Practice Question: PANRE-LA Style

Clinical vignette: Your patient is a 27-year-old woman with lower abdominal pain, fever, dyspareunia, and mucopurulent cervical discharge. Temperature is 38.3°C. Pelvic examination demonstrates cervical motion tenderness and bilateral adnexal tenderness. Pregnancy testing is negative.

What is the most appropriate treatment?

A. Oral fluconazole alone
B. Empiric treatment for PID with coverage for gonorrhea, chlamydia, and anaerobes
C. Immediate diagnostic laparoscopy in all cases
D. Observation until cervical cultures return

Correct answer: B. Empiric treatment for PID with coverage for gonorrhea, chlamydia, and anaerobes.

Pelvic inflammatory disease should be treated empirically when pelvic or lower abdominal pain is accompanied by cervical motion, uterine, or adnexal tenderness and no better alternative diagnosis is identified.

Fluconazole treats vulvovaginal candidiasis, not PID. Diagnostic laparoscopy is reserved for selected cases, including diagnostic uncertainty or failure of outpatient treatment. Waiting for cultures increases the risk of complications and does not reflect standard initial management.

Bottom Line

Choose PANRE-LA if you prefer distributed testing, immediate feedback, reference-supported questions, and a structured quarterly process. Choose the traditional PANRE if you prefer one proctored examination, closed-book testing, and a concentrated preparation period.

Whichever path you select, begin with the official NCCPA timeline and content requirements. Then use a structured PANRE review course to build clinical recall, practice the correct testing format, and address weak areas.

The CME Review Courses PANRE package combines exam preparation with up to 100 hours of AAPA Category 1 CME, 30 months of access, and optional paid Amazon or Apple cme gift cards ranging from $100 to $1,500. Confirm your employer’s policies, verify current NCCPA requirements, and use the course consistently rather than waiting until the final weeks.

Review the PANRE Course and CME Gift Card Options

Educational content only. Confirm current eligibility, deadlines, scoring policies, and certification requirements directly with NCCPA.

Course price: $399.99
Access: 30 months
Practice content: More than 2,500 board-style questions
Full-length exams: Five 240-question practice exams
CME: Up to 100 AAPA Category 1 CME credits through the PANRE Clinical Review Module
Optional add-ons: Paid Amazon or Apple gift cards from $100 to $1,500

The gift card options are paid add-ons. They increase the total purchase price and are not free gifts, discounts, rebates, or additional CME. Review your employer’s CME policy before selecting an add-on.

Preparing for the PANRE while working full-time requires more than collecting review materials. You need a plan that matches your recertification pathway, identifies knowledge gaps, and uses your CME budget for a clinically relevant activity.

Below are five common PANRE review mistakes and the more efficient approach for avoiding each one.

Mistake 1: Using PANCE Preparation as Your Primary PANRE Strategy

PANCE preparation and PANRE preparation overlap clinically, but they serve different points in a PA’s career.

The PANCE is an initial certification examination for PA students and recent graduates. PANRE is a recertification assessment for practicing PAs. A PANCE resource may still help with foundational review, but relying on PANCE prep courses alone can leave your preparation poorly organized for recertification.

PANRE review should address broad clinical reasoning across the organ systems and task areas identified in the NCCPA Blueprint. This includes cardiovascular, pulmonary, gastrointestinal, endocrine, infectious disease, neurology, psychiatry, dermatology, musculoskeletal, renal, reproductive, hematologic, and emergency medicine topics.

Your clinical practice may be concentrated in one specialty. The PANRE is not. A PA practicing primarily in orthopedics may need to spend more time on cardiology, infectious disease, or endocrine management than on familiar musculoskeletal conditions.

Better approach

Begin with mixed board-style questions. Sort missed items by:

• Organ system
• Diagnosis versus management
• Pharmacology
• Diagnostic sequencing
• Misread stem or incorrect prioritization

Then direct your study time toward weak areas rather than reviewing only familiar material.

Mistake 2: Relying on Passive Review

Reading notes can create a false sense of competence. Recognizing that you have seen information before does not confirm that you can retrieve and apply it under exam conditions.

PANRE questions require you to identify the key clinical finding, select the next best step, and distinguish the correct option from plausible distractors. Active recall is more efficient than repeated rereading.

A practical daily routine is:

1. Complete 20 to 40 questions before viewing explanations.
2. Mark questions answered incorrectly or by guessing.
3. Read the rationale for the correct answer and each distractor.
4. Record the clinical principle behind the error.
5. Revisit the topic later in a mixed question set.

A question bank is most useful when the explanations teach decision-making. The goal is not merely to increase the number of questions completed. The goal is to improve your ability to recognize patterns and choose appropriate management.

PANRE-Style Clinical Vignette

Your patient is a 63-year-old man who is two days postoperative from total knee arthroplasty. He develops sudden dyspnea and pleuritic right-sided chest pain. His HR is 112/min, BP is 128/76 mm Hg, RR is 24/min, and SaO₂ is 91% on room air. Lung examination is clear. His left calf is swollen and tender. He has no known renal disease or contrast allergy.

Which diagnostic study is most appropriate next?

A. D-dimer assay
B. CT pulmonary angiography
C. Bilateral lower-extremity venous ultrasound only
D. Exercise stress testing
E. Transthoracic echocardiography as the first test

Correct answer: B. CT pulmonary angiography

CT pulmonary angiography is correct because this patient has a high pretest probability for acute pulmonary embolism based on recent surgery, tachycardia, hypoxemia, pleuritic chest pain, and unilateral leg findings. He is hemodynamically stable and has no stated contraindication to iodinated contrast.

D-dimer testing is less useful with high clinical suspicion and recent surgery. Lower-extremity ultrasound alone may identify DVT but does not directly assess the pulmonary vasculature. Exercise stress testing is inappropriate during an acute presentation concerning for PE. Transthoracic echocardiography may help evaluate right-heart strain, particularly in an unstable patient, but it is not the preferred initial confirmatory study here.

Mistake 3: Studying for PANRE and PANRE-LA With the Same Testing Strategy

Traditional PANRE and PANRE-LA assess overlapping clinical content, but the testing environments differ.

Feature	Traditional PANRE	PANRE-LA
Format	Single, proctored examination	Online longitudinal assessment
Questions	240 questions in one testing session	25 questions per quarter
References	Closed-book	Open-book, with permitted references
Timing	Concentrated exam-day performance	Repeated quarterly participation
Preparation emphasis	Pacing, endurance, and mixed-system review	Consistent review and efficient reference use

The traditional PANRE is generally taken during years 9 and 10 of the certification cycle. PANRE-LA is an alternative longitudinal pathway conducted over multiple quarters. Confirm your eligibility, deadlines, scoring requirements, and current policies directly with the NCCPA PANRE-LA information page.

PANRE-LA is not an open-book shortcut. Five minutes per question is limited when you must interpret a vignette, identify the relevant issue, search a reference, and make a decision. You still need a broad knowledge base.

Better approach

If you plan to take the traditional PANRE, use timed mixed blocks and full-length practice exams. Practice remaining focused across a long testing session.

If you plan to participate in PANRE-LA, establish a consistent weekly or monthly review routine. Use references selectively and practice identifying the central clinical problem before searching.

Mistake 4: Taking Full-Length Exams Too Late

A full-length exam should identify problems early enough for you to correct them. Waiting until the final week may reveal weaknesses without leaving sufficient time to address them.

The PANRE Review Course includes five full-length 240-question practice exams. Use them as progress checkpoints:

• Exam 1: Establish a baseline.
• Exam 2: Reassess your highest-priority weak areas.
• Exam 3: Practice pacing across mixed systems.
• Exam 4: Identify persistent errors.
• Exam 5: Simulate test-day conditions.

Do not review only the total score. Analyze performance by organ system, question type, and timing. A missed question may reflect a knowledge gap, a misread stem, incorrect sequencing, or fatigue.

For traditional PANRE preparation, complete at least one simulation under closed-book, timed conditions. For PANRE-LA preparation, use the full-length exams to identify content gaps, then convert those gaps into shorter, focused question blocks.

Mistake 5: Separating PANRE Preparation From CME Planning

Purchasing one product for exam preparation and another for CME can increase cost and divide your attention. A focused activity can support both goals when its credit designation matches your needs.

The PANRE Review Course costs $399.99, includes 30 months of access, and provides more than 2,500 board-style questions. It also includes five full-length 240-question exams and a complete PANRE Study Library.

The up to 100 AAPA Category 1 CME credits apply specifically to the PANRE Clinical Review Module within the PANRE Review Course. They do not automatically apply to the separate Pharmacology Course or other CME products. To earn the available credit, complete the required educational content, pass the post-test, and complete the activity evaluation. Claim only the credit commensurate with your participation.

Optional cme gift cards are available through Amazon and Apple in amounts from $100 to $1,500. The selected amount is added to the course price.

For example:

• Course only: $399.99
• Course plus $100 add-on: $499.99
• Course plus $500 add-on: $899.99
• Course plus $1,500 add-on: $1,899.99

The gift card is a separate paid component. It does not increase the number of CME credits and is not a free gift, discount, or rebate. Confirm that your employer permits this type of purchase before using CME funds.

A More Efficient Daily PANRE Routine

A short, consistent routine is more useful than irregular marathon sessions.

1. Complete a focused question block

Use 20 to 40 questions. Choose mixed topics for traditional PANRE preparation or shorter, system-based blocks when addressing a specific weakness.

2. Review errors immediately

Read the explanation even when you selected the correct answer by guessing. Identify why the correct option is preferred and why the distractors are less appropriate.

3. Reinforce one topic

Review one related section in the study library, then complete several new questions on that topic. Avoid opening multiple unrelated resources during the same session.

4. Reassess regularly

Use full-length exams to measure progress. Adjust your study plan based on performance data, not familiarity with the material.

PANCE Preparation Versus PANRE Preparation

PA students preparing for initial certification should use resources designed for the PANCE. PAtopia’s web version provides PANCE, PACKRAT, EOC, and EOR preparation resources.

PAtopia is also available through:

• PAtopia for iOS
• PAtopia for Android

These resources are separate from the PANRE Review Course. PAtopia does not provide the up to 100 AAPA Category 1 CME credits associated with the PANRE Clinical Review Module.

Final Checklist

Before purchasing or beginning your review plan, confirm:

• Your certification-cycle year
• Whether traditional PANRE or PANRE-LA fits your schedule
• Your weakest organ systems and task areas
• The required CME amount for your current cycle
• The post-test and evaluation requirements
• Your employer’s policy for paid add-ons
• The total price after selecting a gift card
• That the gift card does not provide additional CME

The PANRE Review Course provides a structured way to combine recertification preparation and CME planning: $399.99, 30 months of access, more than 2,500 board-style questions, five full-length 240-question exams, and up to 100 AAPA Category 1 CME credits through the PANRE Clinical Review Module.

Review the PANRE Review Course and optional gift card add-ons.

Author Box

Jeremy Boroff, MPAS, PA-C

Jeremy Boroff is a physician assistant, educator, CME developer, and founder of CME Review Courses with 24 years of Emergency Medicine experience. He develops PANRE, PANCE, EOR, and specialty review materials focused on practical clinical reasoning, board-style questions, and evidence-informed explanations.

Educational requirements and credit acceptance can change. Confirm current policies with NCCPA, AAPA, your employer, state licensing board, or certifying organization before claiming CME or using CME funds.

Price: $399.99 for the PANRE Review Course
Access: 30 months
CME: Up to 100 AAPA Category 1 CME credits through the PANRE Clinical Review Module
Practice questions: More than 2,500 board-style questions, including five full-length 240-question exams
Optional add-ons: Paid Amazon or Apple gift cards from $100 to $1,500

The Amazon and Apple gift card options are paid add-ons, not free gifts. The amount selected is added to the course price, and the gift card does not provide additional CME credit.

For PAs preparing for PANRE or PANRE-LA, AAPA Category 1 credit can support both exam preparation and NCCPA certification maintenance. However, the terms “Category 1,” “AAPA Category 1,” and “100 credits” should not be treated as interchangeable in every situation.

Here are five facts to review before selecting a PANRE Review Course.

Fact 1: AAPA Category 1 CME is accepted by NCCPA for Category 1 requirements

NCCPA accepts several recognized CME designations for certification maintenance, including AAPA Category 1 CME. This is why the accrediting organization and exact credit designation matter when you select a course.

For a PA who remains continuously certified, NCCPA generally requires:

• 100 total CME credits every two-year cycle
• At least 50 Category 1 CME credits
• The remaining credits as Category 1, Category 2, or a combination

The current NCCPA continuing medical education requirements explain the applicable credit categories and logging requirements.

The PANRE Clinical Review Module within the PANRE Review Course is designated for up to 100 AAPA Category 1 CME credits. This can provide a substantial portion of a PA’s CME requirement while the PA reviews core medical knowledge for recertification.

That does not mean every PA must earn exactly 100 Category 1 credits in a routine cycle. It means the activity offers up to 100 credits that may be claimed based on completion and participation.

Fact 2: The 100-credit PANRE course is different from the routine 50-credit Category 1 minimum

A common misunderstanding is that every PA must earn 100 Category 1 credits during every two-year cycle. For most continuously certified PAs, the standard requirement is 100 total credits, including at least 50 Category 1 credits.

A separate 100-credit Category 1 requirement may apply to a PA who is attempting to regain certification after a lapse. If your certification has expired, review the applicable NCCPA policy before assuming that the routine maintenance rules apply.

The PANRE Review Course can still be useful under either situation because it provides up to 100 AAPA Category 1 CME credits through its PANRE Clinical Review Module. However, you are responsible for confirming:

1. Your current certification status
2. Your CME earning window
3. The number and type of credits you still need
4. Whether you are preparing for traditional PANRE or PANRE-LA
5. Whether the course approval period covers your completion date

The course is listed under AAPA reference number CME-2016187, with approval valid from August 26, 2026, through August 26, 2027. Verify current approval details on the PANRE Review Course product page before beginning the activity.

Fact 3: Category 1 CME is not limited to one educational format

AAPA Category 1 CME may include standard educational activities, self-assessment activities, and performance-improvement activities. These formats have different structures and may receive different treatment when logged with NCCPA.

For example, NCCPA applies additional weighting to certain activities:

• AAPA Category 1 Self-Assessment CME receives a 50% increase when logged with NCCPA.
• The first 20 eligible PI-CME credits in a two-year cycle may be doubled.

The additional weighting applies to the NCCPA certification-maintenance calculation. It does not automatically change the number of credits awarded by the course provider or the number of credits accepted by a state licensing board.

The PANRE Review Course should be evaluated according to the designation stated for the specific activity. Do not assume that every question bank or exam-preparation product is automatically self-assessment CME. The course requirements, credit designation, and completion instructions control what you may claim.

Fact 4: You must complete the activity requirements before claiming the available credit

The PANRE Review Course provides educational content and practice questions, but selecting the course does not automatically award 100 CME credits.

To claim the available AAPA Category 1 CME through the PANRE Clinical Review Module, you must complete the required activity components. These include:

• Reviewing the applicable course content
• Completing the module post-test
• Achieving the required passing score of at least 70%
• Completing the activity evaluation
• Claiming only the credit supported by your participation

This distinction is important when using an online PANRE review course. Access to a question bank is not the same as completion of an accredited CME activity.

After completing the activity, log the credit with NCCPA according to its current instructions. AAPA recommends having the program title, provider, number of credits, and sponsoring organization available when logging CME. Keep documentation of completed Category 1 activities for the period required by NCCPA in case of an audit.

The credit belongs to the educational activity. It does not come from the gift card add-on, the purchase transaction, or the number of dollars spent.

Fact 5: AAPA Category 1 credit may not satisfy every state or profession-specific requirement

AAPA Category 1 CME is designed primarily for physician assistant education and is accepted by NCCPA for PA certification maintenance. State licensing boards may apply additional or different requirements.

Nurse practitioners should confirm whether their state board of nursing or certifying organization accepts AAPA Category 1 credit. Acceptance varies by state and by the specific renewal requirement.

Physicians should also verify how the activity is classified under their applicable CME system. Clinical content may be useful, but AAPA Category 1 credit does not automatically satisfy a physician’s Category 1 requirement.

The same principle applies to employer reimbursement. Before purchase, confirm that your organization permits the course and any associated paid add-on.

What the PANRE Review Course includes

The PANRE Review Course is designed for practicing PAs preparing for broad recertification review. The course includes:

• Up to 100 AAPA Category 1 CME credits through the PANRE Clinical Review Module
• More than 2,500 board-style questions
• Five full-length practice exams
• 240 questions per full-length exam
• Detailed rationales and cited sources
• Organ-system review across the current NCCPA Blueprint
• A PANRE study library
• 30 months of access

The five full-length examinations provide 1,200 questions in a comprehensive testing format. The additional question bank allows you to focus on specific areas such as cardiology, pulmonary medicine, gastroenterology, neurology, dermatology, infectious disease, endocrinology, renal medicine, psychiatry, reproductive health, and emergency medicine.

How the paid CME gift card add-ons work

CME Review Courses offers optional cme gift cards through Amazon and Apple. Available amounts range from $100 to $1,500.

These are paid add-ons. They are not free gifts, rebates, discounts, or additional CME.

Examples include:

• Course only: $399.99
• Course plus $100 gift card: $499.99
• Course plus $500 gift card: $899.99
• Course plus $1,000 gift card: $1,399.99
• Course plus $1,500 gift card: $1,899.99

The selected gift card amount increases the total purchase price. It does not increase the number of AAPA Category 1 credits, add practice questions, or alter the access period.

Gift cards are generally processed and delivered by email within two to three business days. Gift card packages are nonrefundable after issuance. CME Review Courses is not affiliated with or sponsored by Amazon or Apple.

PANRE-style clinical practice question

Vignette

Your patient is a 64-year-old man who is two days postoperative from total knee arthroplasty. He develops sudden dyspnea and pleuritic right-sided chest pain. His HR is 114/min, BP is 126/78 mm Hg, RR is 25/min, and SaO₂ is 90% on room air. He has unilateral left calf swelling and tenderness. He is alert and hemodynamically stable, with no history of renal disease or contrast allergy.

Which diagnostic study is most appropriate next?

A. D-dimer assay
B. CT pulmonary angiography
C. Bilateral lower-extremity venous ultrasound only
D. Transthoracic echocardiography as the first test
E. Exercise stress testing

Answer and explanation

B. CT pulmonary angiography is correct. This patient has a high pretest probability for acute pulmonary embolism based on recent surgery, tachycardia, hypoxemia, pleuritic chest pain, and unilateral leg findings. He is stable and has no stated contraindication to iodinated contrast, making CT pulmonary angiography the appropriate next diagnostic study.

D-dimer testing is not useful when the clinical probability is high and postoperative elevation is expected. Lower-extremity ultrasound alone may identify DVT but does not directly evaluate the pulmonary circulation. Echocardiography is useful for assessing right-heart strain, especially in an unstable patient, but it is not the preferred initial confirmatory test here. Stress testing is inappropriate in an acute presentation concerning for PE.

Do not confuse PANCE prep courses with PANRE resources

PANCE prep courses are designed primarily for PA students preparing for initial certification. PANRE preparation is intended for practicing PAs completing recertification requirements.

The content overlaps because both examinations assess core medical knowledge. The preparation context differs. A PA preparing for PANRE should use resources that address broad review, recertification timing, full-length practice, and the current NCCPA Blueprint.

For PA students and recent graduates, PAtopia’s web version provides preparation for the PANCE, PACKRAT, EOC, and EOR examinations. PAtopia is also available through the PAtopia iOS app and PAtopia Android app.

PAtopia is separate from the PANRE Review Course and does not provide the 100 AAPA Category 1 CME credits associated with the PANRE Clinical Review Module.

Final checklist before purchasing

Before selecting a PANRE CME course, confirm:

• The exact AAPA Category 1 credit designation
• The number of credits available
• Your current NCCPA cycle and certification status
• The course completion requirements
• The course approval period
• Your employer’s reimbursement policy
• Whether paid gift card add-ons are permitted
• Whether you need PANRE or PANRE-LA preparation
• Whether the course provides sufficient practice questions and full-length exams

The PANRE Review Course costs $399.99, provides 30 months of access, includes more than 2,500 board-style questions, and offers up to 100 AAPA Category 1 CME credits through the PANRE Clinical Review Module specifically.

Optional Amazon and Apple gift card add-ons range from $100 to $1,500. They are paid additions to the course price and do not provide additional CME.

Review the PANRE Review Course with gift card options or browse CME Review Courses.

Author Box

Jeremy Boroff, MPAS, PA-C

Jeremy Boroff is a physician assistant with 24 years of Emergency Medicine experience. He is an educator, author, CME developer, and founder of CME Review Courses. His review materials emphasize practical clinical reasoning, board-style vignettes, evidence-informed explanations, and efficient preparation for PA certification and recertification examinations.

CME requirements and credit acceptance can change. Verify current requirements with AAPA, NCCPA, your state licensing board, certifying organization, and employer before claiming CME or using CME funds.

Price: $399.99 for the PANRE Review Course
Access: 30 months
CME: Up to 100 AAPA Category 1 CME credits through the PANRE Clinical Review Module
Practice questions: 1,200 board-style questions across five 240-question exams
Optional add-ons: Paid Amazon or Apple gift cards from $100 to $1,500

The gift cards are not free gifts. They are paid add-ons that increase the total purchase price, and they do not provide additional CME credit.

For a PA approaching recertification, the first decision is not which review book to open. It is which NCCPA recertification pathway fits your testing style, schedule, and current point in the 10-year certification cycle: the traditional PANRE or the PANRE Longitudinal Assessment, commonly called PANRE-LA.

Traditional PANRE vs PANRE-LA: The Essential Comparison

Both pathways assess core medical knowledge across the NCCPA Blueprint. The difference is how and when you demonstrate that knowledge.

Feature	Traditional PANRE	PANRE-LA
Testing window	Years 9–10 of the certification cycle	Questions administered during years 7–9
Format	Single-day, closed-book, proctored exam	At-home, online, open-book assessment
Question schedule	240 questions in one sitting	25 questions per quarter
Participation requirement	One examination attempt at a time	Complete at least 8 of up to 12 quarters
Scoring	Passing scaled score of 379	Best-8 cumulative score of 1150
Testing environment	Proctored testing center	Home or another appropriate location using approved technology
Study approach	Concentrated preparation before one high-stakes exam	Repeated preparation and review over multiple quarters

The NCCPA’s PANRE-LA information explains that PANRE-LA participants receive 25 questions each quarter, may use online or printed references, and can skip up to four quarters. Scores are recalculated using the best eight quarters.

The traditional PANRE remains a more concentrated assessment: 240 questions, closed-book, proctored, and completed in a single testing session. You generally take this route during years 9 or 10.

Which path is better for you?

Choose the traditional PANRE if you:

• Prefer to prepare for one defined exam date.
• Perform well in a proctored testing environment.
• Want to complete the assessment in one sitting.
• Are already in years 9–10 of your certification cycle.
• Prefer not to manage quarterly deadlines.

Choose PANRE-LA if you:

• Prefer shorter assessment periods distributed throughout the year.
• Want to use references while answering questions.
• Are eligible during the years 7–9 testing window.
• Prefer ongoing feedback instead of one final exam score.
• Can consistently dedicate time to quarterly preparation.

PANRE-LA is not an easier version of the traditional PANRE. It is a different assessment structure. You still need broad knowledge of the NCCPA Blueprint, including cardiovascular, pulmonary, infectious disease, neurology, psychiatry, dermatology, musculoskeletal, reproductive, gastrointestinal, renal, endocrine, hematology, and emergency medicine topics.

Two Distinct CME Review Course Options

CME Review Courses offers two separate preparation products. Both are designed for practicing PAs and provide access for 30 months.

PANRE Review Course

The PANRE Review Course is designed for PAs preparing for the traditional PANRE while also supporting review for core medical content assessed by PANRE-LA.

The purchase includes:

• $399.99 base price
• 30 months of access
• 1,200 board-style questions
• Five 240-question practice examinations
• Detailed rationales and cited sources
• A comprehensive PANRE Study Library
• Up to 100 AAPA Category 1 CME credits

The 100-credit designation applies specifically to the PANRE Clinical Review Module within the PANRE Review Course. It is not a blanket designation for unrelated courses, and it does not refer to the Pharmacology course.

PANRE-LA Review Course

The PANRE-LA Review Course is a separate course for PAs preparing for the longitudinal assessment.

It includes:

• $399.99 base price
• 30 months of access
• 1,200 board-style questions
• Five 240-question practice examinations
• Organ-system review and cited rationales
• PANRE-LA-focused study organization
• Its own separate designation of up to 100 AAPA Category 1 CME credits

The PANRE Clinical Review Module and the PANRE-LA Module are distinct educational products. If you select the PANRE-LA course, the 100 AAPA Category 1 credits are attributed to the PANRE-LA Module, not the PANRE Clinical Review Module.

Use Your CME Allowance Efficiently

A recertifying PA often needs both exam preparation and a substantial amount of CME. A single purchase can address both needs when the course is completed according to the activity requirements.

The practical strategy is simple:

1. Select the review course that matches your recertification pathway.
2. Use the 30-month access period to build a sustained study schedule.
3. Complete the educational content, post-test, and evaluation.
4. Claim only the AAPA Category 1 credit that matches your participation.
5. Apply the course purchase to your employer’s CME allowance if permitted by your workplace policy.

The base course is $399.99. You may also select an Amazon or Apple gift card add-on in amounts from $100 to $1,500. The add-on is included in the total package price, but it does not increase the CME credit awarded. It also should not be treated as a free promotional item. Confirm that your employer permits this type of CME package before purchase.

Gift cards are delivered by email after processing. CME credit is earned by completing the course requirements, not by selecting a gift card.

PAs should also confirm current NCCPA requirements and their employer’s reimbursement policy. Nurse practitioners may find value in the clinical content, but acceptance of AAPA Category 1 credit for NP licensure or certification varies by state. Physicians may use the clinical material as professional education, but they should verify how their own accrediting body classifies the activity.

PANRE-Style Practice Question

Clinical Vignette

Your patient is a 67-year-old man who presents with sudden-onset pleuritic chest pain and dyspnea. He underwent total knee replacement 10 days ago. His HR is 118/min, BP is 128/74 mm Hg, RR is 26/min, and SaO₂ is 92% on room air. He has no hemoptysis. His lungs are clear to auscultation, and his left calf is mildly swollen and tender.

Which of the following is the most appropriate next step?

A. D-dimer testing
B. Immediate systemic thrombolysis
C. CT pulmonary angiography
D. Outpatient venous duplex ultrasound only
E. Reassurance and follow-up with his surgeon

Correct Answer: C. CT pulmonary angiography

CT pulmonary angiography is correct because this patient has a high clinical suspicion for pulmonary embolism based on recent major surgery, tachycardia, hypoxemia, pleuritic chest pain, and unilateral calf findings. He is hemodynamically stable, so diagnostic imaging should be obtained promptly.

D-dimer testing is not useful when the pretest probability is high. Systemic thrombolysis is generally reserved for massive PE with hemodynamic instability. Venous duplex ultrasound alone does not adequately evaluate suspected pulmonary embolism, and reassurance is inappropriate.

This is the type of core medical knowledge tested across both traditional PANRE and PANRE-LA. A strong review plan should emphasize clinical reasoning, not only memorization of isolated facts.

PANCE Prep Courses Are Not the Same as PANRE Resources

The PANCE is the initial certification examination for PA students and recent graduates. PANCE prep courses are designed around that stage of training.

Practicing PAs preparing for recertification need PANRE-focused or PANRE-LA-focused resources. The exam timing, assessment format, and recertification context are different. If you are already certified and approaching the later years of your cycle, select materials organized for the traditional PANRE or PANRE-LA rather than relying only on an initial-certification review product.

For the current NCCPA topic structure, review the NCCPA PANRE/PANRE-LA core content document.

Bottom Line

Your choice should match your timeline and testing preferences:

• Traditional PANRE: one-day, closed-book, proctored, 240-question exam with a passing scaled score of 379.
• PANRE-LA: at-home, open-book, 25 questions per quarter, at least 8 of up to 12 quarters, with a best-8 cumulative passing score of 1150.
• PANRE Review Course: $399.99, 30 months of access, 1,200 questions, and up to 100 AAPA Category 1 credits through the PANRE Clinical Review Module.
• PANRE-LA Review Course: a separate $399.99 product with 30 months of access, 1,200 questions, and its own up to 100-credit AAPA Category 1 designation through the PANRE-LA Module.
• CME gift cards: optional paid Amazon or Apple add-ons from $100 to $1,500 that increase the total price but do not add CME credit.

Plan around your certification year, then use your CME budget for a course that supports both your exam preparation and your continuing education requirements.

About the Author

Jeremy Boroff, MPAS, PA-C, is the founder of CME Review Courses, an author, educator, and practicing physician assistant with 24 years of emergency medicine experience. He develops board-style clinical education and CME review materials for physician assistants preparing for certification, recertification, and ongoing clinical practice.

Course price: $399.99
Access: 30 months
CME: Up to 100 AAPA Category 1 CME credits
Practice content: Five full-length exams with 1,200 board-style questions
Gift card options: Paid Amazon or Apple add-ons from $100 to $1,500

Daily CME Tip: Use Your CME Allowance Strategically

Many PAs receive a defined annual CME allowance. The challenge is using that budget for something that provides measurable professional value rather than spending it on disconnected courses that do not support your certification goals.

The PANRE Review Course with Gift Card combines structured PANRE preparation with up to 100 hours of AAPA Category 1 CME. You can then select a paid Amazon or Apple gift card add-on in an amount that fits your available CME budget.

The gift card is not a free gift, rebate, or discount. It is a separate paid add-on that increases the total package price. It also does not increase the number of CME credits awarded.

Review the current PANRE Review Course with Gift Card details before purchasing. Employer and institutional CME policies differ, so confirm that your organization permits this type of package.

What the PANRE Review Course Includes

The course is designed for practicing PAs preparing for the PANRE or PANRE-LA while completing CME requirements. It includes:

• Up to 100 AAPA Category 1 CME credits for the PANRE Clinical Review Module
• Five full-length practice examinations
• 1,200 total board-style questions, with 240 questions per examination
• Five answer choices per question
• Written rationales and cited sources
• A comprehensive PANRE Study Library
• Online, self-paced access for 30 months
• A post-test and evaluation required to claim CME credit

To earn the available CME, you must complete the course content, pass the post-test with a score of at least 70%, and complete the activity evaluation. Claim only the amount of credit that corresponds to your participation.

The NCCPA PANRE and PANRE-LA content document should remain your primary reference for current examination content. A review course is a preparation resource, not a replacement for official NCCPA information.

How the Paid CME Gift Card Add-Ons Work

At checkout, you can select either an Amazon or Apple gift card. Available amounts range from $100 to $1,500, depending on the brand and tier selected.

Examples using the $399.99 base course price include:

Selection	Total package price
PANRE Review Course only	$399.99
Course + $100 gift card	$499.99
Course + $500 gift card	$899.99
Course + $1,000 gift card	$1,399.99
Course + $1,500 gift card	$1,899.99

These are paid CME gift cards. The selected amount is added to the course price. The card is not a bonus supplied at no cost, and purchasing a higher gift card amount does not provide additional CME hours.

Amazon and Apple gift cards are generally processed and sent by email within 2–3 business days. Gift card purchases are nonrefundable after processing. CME Review Courses is not affiliated with Amazon or Apple.

Choosing Between Amazon and Apple

Select the gift card based on how you expect to use it.

Amazon Gift Card

An Amazon gift card may be useful for professional or educational purchases available through Amazon, such as:

• Medical reference books
• Desk or office equipment
• Computer accessories
• Organization and study supplies
• Select clinical tools and technology

Confirm that any intended purchase is permitted under your employer’s CME policy. A CME allowance may cover education and related professional expenses, but not every organization treats gift card add-ons the same way.

Apple Gift Card

An Apple gift card may be appropriate if you plan to purchase:

• Clinical reference applications
• Educational applications
• Apple accessories used for professional study
• Tablet or device-related tools
• Digital resources available through Apple services

Again, verify your organization’s rules before placing the order. The responsibility for determining whether the expense qualifies rests with the purchaser and the employer or institution providing the CME funds.

A Simple Budget Calculation

Suppose your annual CME allowance is $1,000. The PANRE Review Course costs $399.99. Adding a $600 paid gift card creates a total package price of $999.99.

That package provides:

• A PANRE-focused review resource
• Up to 100 AAPA Category 1 CME credits
• 30 months of course access
• A $600 Amazon or Apple gift card
• A total cost that closely matches a $1,000 allowance

If your allowance is $2,000, the course plus a $1,500 gift card totals $1,899.99, leaving approximately $100 of the allowance unused. Do not select an amount solely to spend the full allowance. First confirm that the course meets your certification needs and that the add-on is permitted by your CME policy.

This approach can be more practical than purchasing several unrelated activities simply because they are available. The course supports both PANRE preparation and CME completion, while the paid add-on gives you flexibility in how you use the remainder of your professional education budget.

PANRE Preparation Versus PANCE Prep Courses

Searches for PANCE prep courses often return resources intended for PA students preparing for initial certification. Those products may be useful for PANCE preparation, but the PANRE is a recertification examination for practicing PAs.

The PANRE Review Course is designed around recertification-level review across the organ systems and clinical areas assessed on the PANRE and PANRE-LA. If you are preparing for initial certification, use a PANCE-specific resource. If you are preparing for recertification, select a PANRE-focused course and confirm that it matches your examination pathway.

CME Review Courses also offers separate options, including PANRE/PANRE-LA review exams with a gift card add-on. Compare the included questions, examination format, CME designation, and access period before choosing.

Clinical Practice Question

Vignette

Your patient is a 58-year-old woman with 24 hours of fever, RUQ pain, jaundice, and vomiting. Her temperature is 39.3°C, HR 122/min, BP 88/54 mm Hg, and SaO₂ 97% on room air. Laboratory studies show leukocytosis, direct hyperbilirubinemia, and elevated alkaline phosphatase. RUQ ultrasonography demonstrates biliary ductal dilation and a common bile duct stone. After blood cultures and initial IV fluid resuscitation, which is the most appropriate next step?

A. Elective laparoscopic cholecystectomy
B. Urgent ERCP with biliary decompression
C. HIDA scan
D. MRCP before any intervention
E. Oral ursodeoxycholic acid

Answer

B. Urgent ERCP with biliary decompression

This patient has acute ascending cholangitis with sepsis caused by biliary obstruction. After cultures, broad-spectrum IV antibiotics and hemodynamic stabilization, urgent biliary drainage with ERCP is indicated.

Elective cholecystectomy does not address the immediate infected obstruction. HIDA scanning is unnecessary because the diagnosis is supported by the clinical findings and ultrasound. MRCP may define biliary anatomy but delays decompression in an unstable patient. Ursodeoxycholic acid is not appropriate for acute obstruction or sepsis.

Final CME Budget Checklist

Before purchasing, confirm the following:

1. Your CME allowance and deadline
2. Whether your employer permits paid gift card add-ons
3. Whether you need PANRE preparation, general CME, or pharmacology-specific CME
4. Whether you can use up to 100 AAPA Category 1 credits during your current cycle
5. The gift card brand and amount that fit your planned use
6. That the gift card amount is added to the course price
7. That the gift card does not provide additional CME credit
8. That you understand the gift card is nonrefundable after processing

For PAs who need substantial Category 1 credit and structured recertification preparation, the PANRE Review Course with Gift Card provides a single online package with 30 months of access, 1,200 practice questions, five full-length examinations, and up to 100 AAPA Category 1 CME credits.

If you need a different clinical focus, browse the complete CME with Amazon and Apple gift card package catalog. The catalog includes options in internal medicine, emergency medicine, family medicine, cardiology, orthopedics, dermatology, neurology, psychiatry, OB/GYN, and pharmacology. The Pharmacology CME Review Package offers a separate 12.5 AAPA Category 1 CME credits and should not be confused with the 100-credit PANRE course.

Course price: $399.99
Access: 30 months
Question bank: 2,500+ board-style questions
Full-length exams: Five 240-question practice exams
CME: Up to 100 hours of AAPA Category 1 CME through the PANRE Clinical Review Module
Optional add-on: Amazon or Apple gift card from $100 to $1,500

A CME gift card add-on can be useful when it is evaluated correctly. The common mistake is treating the gift card as part of the educational value of the course rather than as a separate, optional purchase.

The Amazon and Apple add-ons are paid add-ons: not free gifts. The amount selected is added to the course price. A $500 Amazon gift card, for example, adds $500 to the $399.99 course price. The gift card also does not increase CME credit. It does not create additional AAPA Category 1 hours, and it should not be logged as a CME activity.

The correct way to evaluate the package is to assess the PANRE Review Course first, then decide whether the optional add-on fits your employer’s CME policy and your intended use.

1. Confirm What the Course Actually Delivers

The PANRE Clinical Review Module is the educational component that provides up to 100 hours of AAPA Category 1 CME. These hours apply specifically to the PANRE module.

The 100-hour figure does not apply to the separate Pharmacology course. Pharmacology is its own CME activity with its own credit amount. Do not combine the two courses when documenting or planning your CME.

To earn credit for the PANRE Clinical Review Module, you must complete the required educational content, pass the module post-test with a score of at least 70%, and complete the evaluation. You claim only the amount of credit that matches your participation.

For physician assistants, the course is designed to support both certification maintenance and exam preparation. Nurse practitioners should verify whether their state board or employer accepts AAPA Category 1 credit for their specific renewal requirements. Physicians should also verify how the activity applies to their individual CME requirements.

2. Evaluate the Question Volume and Exam Structure

A large question count is useful only when the questions are clinically relevant, organized, and supported by explanations.

This course includes 2,500+ board-style questions across the question bank and system-based review. It also includes five full-length practice examinations with 240 questions each, for 1,200 questions in the full-length exam set.

That distinction matters. The five 240-question exams provide repeated practice with exam-length sessions. The additional questions allow you to target specific organ systems and revisit weak areas without repeatedly taking the same comprehensive exam.

The material is organized around the current NCCPA Blueprint, including major clinical areas such as:

• Cardiovascular medicine
• Pulmonary disease
• Gastroenterology and nutrition
• Musculoskeletal conditions
• Neurology
• Psychiatry
• Dermatology
• Infectious disease
• Reproductive health
• Hematology
• Endocrinology
• Renal and genitourinary disease
• Emergency medicine

Each question includes answer rationales and cited sources. This is important because a practice question should teach you how to reason through the diagnosis and management: not simply tell you whether your selection was correct.

A strong panre review course should help you identify why an answer is correct, why the alternatives are less appropriate, and what clinical feature changes the decision.

3. Check Whether the Access Period Matches Your Exam Timeline

The course includes 30 months of access. This is a meaningful feature if your PANRE preparation will extend over multiple study phases, work obligations, or testing windows.

You can begin with a baseline assessment, use the system modules to target deficiencies, and return later for full-length exams. The extended access period also allows you to use the course for continuing review instead of purchasing a separate resource every few months.

Before purchasing, compare the access period with your expected PANRE or PANRE-LA schedule. A course that expires before your planned testing window may have less practical value, even if the initial question count looks impressive.

The access period should support a structured plan:

1. Take an initial practice exam.
2. Review performance by organ system.
3. Complete targeted system-based questions.
4. Repeat missed or flagged questions.
5. Take another full-length exam.
6. Adjust your study plan based on performance rather than familiarity.

4. Separate Educational Value From the Gift Card Value

The Amazon and Apple options are simply payment add-ons attached to the purchase. They do not change the course content, access period, question count, exam structure, or CME amount.

Available add-ons range from $100 to $1,500. You choose the brand and amount during checkout. The selected amount is added to the course price, and the gift card is generally delivered by email within two to three business days.

Use this calculation before purchasing:

Total purchase price = $399.99 course price + selected gift card amount

Examples:

• Course only: $399.99
• Course plus $100 add-on: $499.99
• Course plus $500 add-on: $899.99
• Course plus $1,500 add-on: $1,899.99

The add-on may help you use available CME funds for eligible educational or professional purchases, depending on your employer’s rules. However, you should confirm your policy before selecting an amount. Some organizations restrict CME funds to courses, books, conferences, software, or other approved resources.

Do not assume that the gift card is free. Do not assume that a larger gift card means more CME. The educational deliverable remains the same whether you purchase the course alone or select the largest add-on.

5. Review the Completion Requirements Before You Buy

The value of a CME course depends on whether you can complete it and claim the credit appropriately.

Before checkout, confirm that you understand:

• The PANRE Clinical Review Module provides up to 100 hours of AAPA Category 1 CME.
• You must complete the required course material.
• You must pass the post-test with at least 70%.
• You must complete the activity evaluation.
• You may claim only the credit commensurate with your participation.
• The gift card itself provides no CME credit.
• Gift card purchases are subject to the provider’s stated terms and refund policy.

This is also where you should verify your employer’s approval process. The relevant question is not whether the gift card increases the value of the CME activity. It does not. The question is whether your organization permits the selected package structure and the intended use of the add-on.

6. Look for Performance Feedback, Not Just More Questions

A question bank is more useful when it provides actionable performance information.

The PANRE review platform includes performance tracking by topic and organ system. Use those results to identify patterns. If your overall score is acceptable but your pulmonary and renal performance remains low, your next study block should address those areas directly.

Avoid spending most of your study time answering questions you already know. A more efficient approach is:

• Flag questions you missed or answered by guessing.
• Read the full rationale, including the distractors.
• Record the clinical finding that should have guided your decision.
• Review the relevant topic in the study library.
• Retest the subject later in a mixed-question block.

This method is more useful than judging a course solely by its total number of questions. The goal is improved clinical reasoning across the NCCPA Blueprint, not simply completing a high volume of items.

A PANRE-Style Clinical Practice Question

Your patient is a 64-year-old man with a history of hypertension and hyperlipidemia who presents with 45 minutes of substernal chest pressure radiating to the left arm. He is diaphoretic and nauseated. Vital signs are BP 158/92 mm Hg, HR 104/min, RR 20/min, and SaO2 96% on room air. ECG shows 2-mm ST-segment elevations in leads II, III, and aVF with reciprocal ST depressions in leads I and aVL.

What is the most appropriate next step?

A. Administer IV alteplase immediately
B. Obtain a D-dimer level
C. Activate the cardiac catheterization laboratory for emergent PCI
D. Perform an exercise stress test
E. Administer a beta blocker and reassess in 6 hours

Correct answer: C. Activate the cardiac catheterization laboratory for emergent PCI.

This patient has an acute inferior STEMI with ongoing symptoms and diagnostic ST-segment elevation. Emergent PCI is the preferred reperfusion strategy when it can be performed promptly. Alteplase is considered when timely PCI is unavailable, but it is not the first choice when catheterization is accessible. D-dimer testing and exercise stress testing are inappropriate in a patient with diagnostic STEMI. A beta blocker does not replace immediate reperfusion and may be harmful in patients with hemodynamic compromise or certain conduction abnormalities.

The question tests recognition of the diagnosis, interpretation of the ECG, and selection of time-sensitive management. Those are the same decision-making skills you should expect from a clinically focused PANRE preparation resource.

Study Efficiently With Additional PA Resources

If you are also reviewing for the PANCE or supporting a PA student, PAtopia’s web version provides browser-based access to PA exam preparation resources. The platform covers the PACKRAT, all seven EOR exams, the EOC, and the PANCE.

You can also study with the PAtopia iOS app or the PAtopia Android app. These resources are separate from the PANRE CME activity and should not be used to represent the 100 AAPA Category 1 CME hours associated with the PANRE Clinical Review Module.

For a direct review of the five full-length exams, visit the PANRE Practice Exams page. To review the complete package and optional add-ons, see the PANRE Review Course with Gift Card.

Final Pre-Purchase Checklist

Before selecting a CME gift card add-on, confirm each item:

• Course price: The base PANRE course is $399.99.
• Access: You receive 30 months of access.
• Questions: The course includes 2,500+ questions.
• Exams: You receive five 240-question practice exams.
• CME: Up to 100 AAPA Category 1 hours apply to the PANRE Clinical Review Module.
• Add-on cost: Amazon or Apple options range from $100 to $1,500.
• Payment structure: The add-on is paid and added to the course price.
• CME limitation: The gift card does not increase CME credit.
• Policy: Your employer permits the selected purchase structure.
• Completion: You understand the post-test and evaluation requirements.

The practical decision is straightforward: choose the PANRE course based on its CME, access period, question quality, exam structure, and performance tools. Consider the Amazon or Apple option only after confirming that the paid add-on fits your policy and intended use.

That approach prevents the most common misunderstanding: confusing a useful purchasing option with an educational deliverable.

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About the Author

Jeremy Boroff, MPAS, PA-C, is the founder of CME Review Courses and PAtopia. He is an educator and practicing emergency medicine physician assistant with 24 years of Emergency Medicine experience. Jeremy has also served for more than 20 years as an APC director of an emergency department and has authored multiple PA exam review books and educational resources.

His clinical and teaching work focuses on practical exam preparation, evidence-based decision-making, and efficient continuing medical education for practicing physician assistants.

Course price: $399.99
Access: 30 months from purchase
CME: Up to 100 hours of AAPA Category 1 CME through the PANRE Clinical Review Module
Study material: 2,500+ PANRE practice questions, including five full-length 240-question practice exams
Gift card options: Optional paid Amazon or Apple Gift Card add-ons from $100 to $1,500

If you are planning PANRE or PANRE-LA preparation, the type and amount of CME you complete matters. A course may provide useful clinical education without satisfying your Category 1 requirement. Before using your CME allowance, confirm the accreditation designation, number of credits, completion requirements, and whether the activity fits your current NCCPA certification cycle.

The PANRE Review Course from CME Review Courses combines recertification preparation with up to 100 hours of AAPA Category 1 CME. The 100 hours apply specifically to the PANRE Clinical Review Module, not automatically to other products such as the separate Pharmacology Review Course.

What AAPA Category 1 CME Means

AAPA Category 1 CME is formally reviewed educational activity intended to maintain or improve the knowledge, skills, and professional performance used in PA practice. The content should be relevant to patient care, healthcare systems, or the PA profession.

Category 1 CME is not simply any medical education you complete. The activity must have an identified credit designation and defined requirements for participation and completion.

For a self-assessment activity, requirements may include:

• Multiple-choice questions
• Explanations or rationales for the answers
• References supporting the educational content
• A graded post-test
• A minimum passing score
• An evaluation completed by the learner
• Documentation of the credit awarded

For the PANRE Review Course, you must complete the course requirements, pass the post-test with a score of at least 70%, and complete the activity evaluation. Claim only the credit amount supported by your actual participation.

Review the AAPA CME FAQs and NCCPA continuing medical education requirements for current policies.

How Category 1 CME Applies to Recertification

For a PA who remains continuously certified, NCCPA generally requires:

• 100 total CME credits during each two-year cycle
• At least 50 Category 1 CME credits
• The remaining credits may be Category 1, Category 2, or a combination
• Completion of the applicable recertification examination requirement during the certification cycle

This means that 100 hours of accepted Category 1 CME can satisfy the total credit quantity for a routine two-year CME cycle, provided the activity is completed during the appropriate period and meets NCCPA requirements. It does not replace PANRE or PANRE-LA when an examination or longitudinal assessment is due.

The requirement is different for some PAs regaining certification after a lapse. NCCPA may require 100 Category 1 CME credits earned within the two-year period ending on the PANRE application date. If your certification has expired, review the specific NCCPA policy for regaining certification.

The practical point is simple: do not assume that every PA has the same CME requirement. Check your certification status, cycle dates, and NCCPA account before deciding how many credits you need.

What the PANRE Review Course Includes

The PANRE Review Course is designed for practicing PAs preparing for traditional PANRE or PANRE-LA. It includes:

• More than 2,500 board-style questions
• Five full-length practice examinations
• 240 questions per full-length exam
• 1,200 questions across the five exams
• Questions covering the major organ systems and task areas in the NCCPA Blueprint
• Detailed rationales and cited sources
• A complete PANRE Study Library
• Performance tracking and question flagging
• 30 months of online access

The format supports several study approaches. You can begin with a full-length examination to establish a baseline, complete system-based modules to address knowledge gaps, and then return to full-length testing to assess pacing and endurance.

A comprehensive panre review course is particularly useful if your clinical practice is concentrated in one specialty. PANRE preparation requires broad review across cardiovascular, pulmonary, GI, endocrine, infectious disease, neurology, psychiatry, dermatology, musculoskeletal, reproductive, renal, hematologic, EENT, genitourinary, and professional practice content.

The 100 Hours Apply to the PANRE Review Course Specifically

The course’s 100 hours of AAPA Category 1 CME apply to the PANRE Clinical Review Module. They should not be attributed to every course offered by CME Review Courses.

For example, the Pharmacology Review Course has its own credit designation and should be evaluated separately. If you purchase multiple courses, document the credit amount assigned to each activity rather than combining them without supporting documentation.

The current PANRE Clinical Review Module is listed under AAPA reference number CME-2016187, with approval valid from August 26, 2026, through August 26, 2027. Verify current approval information on the product page before beginning an activity.

How CME Gift Cards Work

CME Review Courses offers optional cme gift cards through Amazon and Apple. Available add-on amounts range from $100 to $1,500.

These gift cards are paid add-ons, not free gifts. The selected amount is added to the base course price.

Examples include:

• Course only: $399.99
• Course plus $100 gift card: $499.99
• Course plus $500 gift card: $899.99
• Course plus $1,000 gift card: $1,399.99
• Course plus $1,500 gift card: $1,899.99

The add-on does not increase the number of CME credits. The PANRE Review Course provides the up to 100 hours of AAPA Category 1 CME. The gift card is a separate paid component of the purchase.

Before selecting an add-on, confirm that your employer or institution permits this type of bundled CME purchase. Policies may differ regarding online review courses, board-preparation materials, gift card add-ons, and the maximum amount reimbursed.

Amazon and Apple gift cards are processed by email, generally within two to three business days. Gift card packages are nonrefundable after issuance. CME Review Courses is not affiliated with or sponsored by Amazon or Apple.

Clinical Practice Question

Vignette

Your patient is a 63-year-old man who is two days postoperative from total knee arthroplasty. He develops sudden dyspnea and pleuritic right-sided chest pain. His HR is 114/min, BP is 126/78 mm Hg, RR is 25/min, and SaO₂ is 90% on room air. Examination demonstrates unilateral left calf swelling and tenderness. He is alert and hemodynamically stable. There is no history of renal disease or contrast allergy.

Which diagnostic study is most appropriate next?

A. D-dimer assay
B. CT pulmonary angiography
C. Bilateral lower-extremity venous ultrasound only
D. Exercise stress testing
E. Transthoracic echocardiography as the first test

Correct answer: B. CT pulmonary angiography.

This patient has a high pretest probability for acute pulmonary embolism based on recent surgery, tachycardia, hypoxemia, pleuritic chest pain, and unilateral leg findings. Because he is stable and has no stated contraindication to iodinated contrast, CT pulmonary angiography is the preferred next diagnostic study.

D-dimer testing is less useful when the clinical probability is high and is commonly elevated after surgery. Lower-extremity ultrasound may identify DVT but does not directly evaluate the pulmonary vasculature. Echocardiography is useful for assessing right-heart strain, particularly in an unstable patient, but it is not the preferred initial confirmatory study here. Stress testing is inappropriate in an acute presentation concerning for PE.

The management principle is to establish pretest probability, assess hemodynamic stability, and select the diagnostic test that provides the most useful information without unnecessary delay, cost, or radiation exposure.

Who Should Consider This Course?

The PANRE Review Course is intended primarily for physician assistants who need broad recertification preparation and Category 1 CME.

Nurse practitioners may find the clinical material useful, but acceptance of AAPA Category 1 credit varies by state board, employer, and certifying organization. NPs should verify requirements with their state board of nursing before purchasing.

Physicians may also find value in the clinical content. However, AAPA Category 1 credit does not automatically fulfill a physician’s Category 1 CME requirement. Physicians should confirm whether the activity can be reported under their applicable CME rules.

The course may be appropriate if you need:

• A broad review of the current NCCPA Blueprint
• Structured PANRE or PANRE-LA preparation
• A substantial amount of Category 1 CME
• Full-length practice examinations
• Long-term access for a demanding clinical schedule
• A way to use an approved CME allowance for education and an optional paid add-on

PANCE Prep Courses and PAtopia

If you are a PA student rather than a practicing PA preparing for recertification, you may need PANCE prep courses instead of a PANRE review product.

PAtopia is a separate PA exam-preparation platform covering the PANCE, PACKRAT, End of Curriculum examination, and all seven EOR exams. It includes board-style questions, study libraries, full-length practice exams, explanations, and cited references.

PAtopia is available through:

• PAtopia web version
• PAtopia for iOS
• PAtopia for Android

PAtopia is separate from the PANRE Review Course and does not provide the 100 hours of AAPA Category 1 CME discussed in this article.

Final CME Checklist

Before purchasing a CME course, confirm:

1. The exact Category 1 designation
2. The number of credits available
3. Whether the activity falls within your CME cycle
4. The post-test and evaluation requirements
5. Whether your employer accepts the activity
6. Whether a paid gift card add-on is permitted
7. Whether the product is designed for PANRE, PANRE-LA, PANCE, or another exam

The PANRE Review Course is $399.99, includes 30 months of access, provides 2,500+ practice questions, and offers up to 100 hours of AAPA Category 1 CME through the PANRE Clinical Review Module. Optional Amazon and Apple gift card add-ons from $100 to $1,500 are paid additions to the package price and do not create additional CME credit.

Review the PANRE Review Course with Gift Card options or browse CME Review Courses.

Author Box

Jeremy Boroff, MPAS, PA-C

Jeremy Boroff is a physician assistant with 24 years of Emergency Medicine experience. He is an educator, author, CME developer, and founder of CME Review Courses. His clinical review materials emphasize practical decision-making, board-style clinical vignettes, evidence-informed explanations, and efficient preparation for PA certification and recertification examinations.

Educational requirements and credit acceptance can change. Verify current requirements with AAPA, NCCPA, your employer, state licensing board, or certifying organization before claiming CME or using CME funds.