CME Review Courses

Choosing a PANRE review course isn’t just about finding a question bank; it’s about choosing how to spend your limited time and your employer’s CME budget. Most PAs are looking for three things: a high pass rate, maximum CME credit efficiency, and a way to make that CME money work harder for them.

The market is saturated with options like Blueprint, Rosh Review, and Kaplan. While these platforms offer high-quality question banks, they often lack the flexibility that modern PAs need regarding "bonus" value. When you are comparing courses, you need to look at the logistical deliverables first.

PANRE Review Course Logistics:

• Price: Starting at $399.99 (varies with gift card add-ons)
• Access: 30 Months
• Deliverables: 1,672 Board-Style Questions
• CME Credit: 100 Hours of AAPA Category 1 Credit
• Gift Card Options: $100 – $1500 (Amazon or Apple)

Comparing the Top PANRE Review Options

When you look at Blueprint or Rosh, you are paying for a premium interface and a massive volume of questions. Blueprint typically offers 100 AMA PRA Category 1 credits with their bundles, but the price point often exceeds $600 for the full package. Kaplan provides a deep dive but is often criticized by PAs for being "content-heavy," which can lead to burnout rather than exam readiness.

Our PANRE Review Course focuses on high-yield content written by physician assistants for physician assistants. We know exactly what the NCCPA is looking for because we’ve been through it. We offer 100 hours of AAPA Category 1 credit, which is the gold standard for PA recertification.

The Gift Card Advantage: Amazon and Apple Add-Ons

The biggest differentiator for our program is the ability to maximize your CME budget. Most employers provide a yearly CME allowance. If you don't use it, you lose it. We allow you to add an Amazon Gift Card or Apple Gift Card ranging from $100 to $1500 to your purchase.

This allows you to get your 100 hours of Category 1 credit and the study materials you need, while also receiving a gift card that you can use to further enrich your education: whether that’s buying a new iPad for clinical use or purchasing medical textbooks on Amazon. It is an efficient way to ensure your CME money isn't wasted.

Who Else Can Use This Course?

While this course is specifically built for PAs preparing for the PANRE or PANRE-LA, other professionals find significant value here:

• Internal Medicine Physicians: Find high value in the clinical content, though it counts as Category 2 CME for physicians, not Category 1.
• Nurse Practitioners: Can claim credit for AAPA Category 1 in many states, but you must check your specific state board requirements.
• Specialties: Our content covers Emergency Medicine, Family Medicine, Cardiology, OB/GYN, and more.

Clinical Practice Questions

To get a feel for the level of detail in our PANRE Review Course, review the following clinical vignettes.

Question 1

Your patient is a 68-year-old male with a history of hypertension and DM2 who presents to the clinic complaining of palpitations and mild shortness of breath for the last three days. On exam, his HR is 118 bpm and irregular. His BP is 134/82 mmHg. An EKG confirms Atrial Fibrillation. He has no history of valvular disease. What is the most appropriate next step in managing his stroke risk?

A. Initiate Oral Anticoagulation (e.g., Apixaban or Rivaroxaban)
B. Aspirin 81mg daily
C. Dual Antiplatelet Therapy (DAPT)
D. Observation and repeat EKG in 24 hours

Explanation: The correct answer is A. Based on the CHA2DS2-VASc score, this patient (Age 65-74 = 1, HTN = 1, DM = 1) has a score of at least 3. Current guidelines recommend oral anticoagulation for a score of 2 or greater in males to reduce the risk of thromboembolic stroke. Aspirin (Choice B) is no longer recommended as monotherapy for stroke prevention in Afib. DAPT (Choice C) is used for ACS or post-stenting, not primary Afib stroke prevention. Observation (Choice D) is inappropriate given the documented arrhythmia and high stroke risk.

Question 2

Your patient is a 24-year-old female who presents with an intensely pruritic, erythematous, circular lesion on her left forearm with central clearing and a raised, scaly border. She recently started working at a local animal shelter. What is the most likely diagnosis?

A. Tinea Corporis
B. Psoriasis
C. Nummular Eczema
D. Granuloma Annulare

Explanation: The correct answer is A. The classic "ringworm" appearance: annular lesion with peripheral scaling and central clearing: combined with exposure to animals strongly suggests a fungal infection. Psoriasis (Choice B) typically presents with silver scales on extensor surfaces and lacks the central clearing. Nummular eczema (Choice C) is "coin-shaped" but usually lacks the central clearing and is more exudative. Granuloma annulare (Choice D) is an annular lesion but does not have the scale seen in fungal infections.

Question 3

Your patient is a 32-year-old male presenting with a 3-week history of low mood, anhedonia, and insomnia. He reports significant difficulty concentrating at work. He denies suicidal ideation. You decide to start him on Sertraline. Which of the following is the most common side effect he should be counseled on?

A. Sexual Dysfunction
B. Weight Loss
C. Hypertensive Crisis
D. Acute Glaucoma

Explanation: The correct answer is A. Sexual dysfunction (decreased libido, anorgasmia) is one of the most common and persistent side effects of SSRIs like Sertraline. Weight gain is more common than weight loss (Choice B) over long-term use. Hypertensive crisis (Choice C) is a risk associated with MAOIs, not SSRIs. Acute glaucoma (Choice D) is a rare side effect mostly associated with anticholinergic medications.

Final Thoughts on Choosing Your Course

The best PANRE review course is the one that fits your learning style and provides the most utility. If you need 100 hours of AAPA Category 1 credit and want to utilize your CME funds to their full potential via Amazon or Apple gift cards, CME Review Courses provides the most pragmatic and efficient solution on the market.

Don't just study hard; study smart by choosing a course that rewards your professional development.

Recertifying as a Physician Assistant requires a strategic approach to both education and time management. Whether you are preparing for the traditional PANRE or the PANRE-LA, the goal is to master the NCCPA Blueprint while simultaneously fulfilling your continuing medical education requirements.

At CME Review Courses, we provide a streamlined solution that allows you to earn your entire cycle’s worth of credits in one comprehensive package. Our panre review course is designed specifically for the busy clinician who needs high-yield information and flexible learning options.

Essential Course Logistics and Deliverables

When selecting a pance prep course or PANRE review, the quantifiable value is the most important factor. Here are the core details of our premium offering:

• Course Title: Comprehensive 100-Credit PANRE Review
• Credit Type: 100 AAPA Category 1 CME Credits
• Question Bank: 1,672 Board-Style Review Questions with detailed explanations
• Format: On-demand video lectures and digital question banks
• Access Duration: 12 months of unlimited access
• Add-On Options: CME gift cards (Amazon or Apple) available from $100 to $1500

Understanding the CME Gift Card Add-On

One of the most frequent questions we receive concerns our cme gift cards. It is important to understand the structure of these purchases. When you select a package at CME Review Courses, you are purchasing a professional education product.

You have the option to include an Amazon or Apple Gift Card add-on ranging from $100 to $1500. These are NOT free gifts. They are value-added components that are built into the total purchase price of your educational package. This allows you to consolidate your professional development expenses while receiving the high-quality review materials necessary for exam success.

Clinical Application: Emergency Medicine and Internal Medicine

The NCCPA Blueprint covers a vast array of organ systems. Our course breaks these down into manageable sections, such as Endocrine and Gastrointestinal. To be successful on the PANRE, you must be able to apply clinical knowledge to complex vignettes.

Clinical Vignette 1: Cardiology

Your patient is a 64-year-old male with a history of hypertension and tobacco use who presents to the Emergency Department with sudden onset of substernal chest pain radiating to the left jaw. He appears diaphoretic. His vital signs are: BP 155/94, HR 98, RR 20, SaO2 96% on room air. An EKG is performed immediately and shows ST-segment elevation in leads II, III, and aVF.

Which of the following is the most appropriate next step in management?

A. Administer sublingual nitroglycerin and monitor for symptom relief.
B. Obtain a chest X-ray to rule out aortic dissection.
C. Initiate therapy with intravenous beta-blockers.
D. Activate the cardiac catheterization lab for primary percutaneous coronary intervention (PCI).

Explanation: The correct answer is D. This patient is presenting with an inferior wall ST-elevation myocardial infarction (STEMI). The standard of care for a STEMI is immediate reperfusion therapy, with primary PCI being the preferred method if available within 90 minutes of medical contact. Nitroglycerin (A) should be used with extreme caution or avoided in inferior MIs, as these often involve the right ventricle and are highly preload-dependent; nitroglycerin can cause profound hypotension. While an X-ray (B) is helpful in the workup of chest pain, it should not delay the definitive treatment of a confirmed STEMI. Beta-blockers (C) are part of long-term management but are not the primary emergent intervention for reperfusion.

Mastering the NCCPA Blueprint by Organ System

To maximize your score, you must focus on the highest-weighted sections of the exam. For example, Family Medicine and Internal Medicine topics make up a significant portion of the PANRE. Our course structure follows the NCCPA Blueprint content areas rigorously to ensure no gaps in your knowledge.

Our pharmacology review cme is integrated throughout the course, as pharmacotherapy is a recurring theme across all organ systems. You will face questions not just on diagnosis, but on the mechanisms, side effects, and contraindications of first-line medications.

Clinical Vignette 2: Pulmonology

Your patient is a 28-year-old female with a known history of asthma who presents to the urgent care complaining of increased cough and wheezing over the past three days. She has been using her Albuterol inhaler every 4 hours with minimal relief. On physical exam, she has diffuse expiratory wheezing and a prolonged expiratory phase. Her peak expiratory flow (PEF) is 65% of her predicted personal best.

What is the most appropriate addition to her current treatment regimen?

A. Start a short course of oral corticosteroids (e.g., Prednisone).
B. Add a long-acting beta-agonist (LABA) for immediate symptom control.
C. Prescribe a 5-day course of Azithromycin.
D. Switch her SABA to an anticholinergic inhaler (e.g., Ipratropium).

Explanation: The correct answer is A. This patient is experiencing an acute asthma exacerbation that is not responding adequately to her short-acting beta-agonist (SABA). According to standard guidelines, patients with a PEF between 50-80% who do not have an immediate response to SABA require oral systemic corticosteroids to reduce airway inflammation. LABAs (B) are not indicated for acute symptom relief and should only be used in combination with an inhaled corticosteroid (ICS) for maintenance. Antibiotics (C) are not indicated for asthma exacerbations unless there is clear evidence of a bacterial infection (e.g., fever, purulent sputum). Ipratropium (D) can be an adjunct to SABA in the ED setting but does not replace the need for corticosteroids in this scenario.

Why 100 Credits Matter

The NCCPA requires 100 CME credits every two years, with at least 50 of those being Category 1. By completing our 100-hour PANRE Review, you satisfy the entire Category 1 requirement for your cycle in one effort. This is particularly beneficial for PAs who prefer to focus their learning into a single, high-intensity window rather than piecing together small credits throughout the year.

The value of this course extends beyond the credits. With 1,672 questions, you are exposed to nearly every possible iteration of the NCCPA Blueprint topics. This high volume of practice is the most effective way to build the "stamina" required for a long board exam.

Strategic Study with Gift Card Flexibility

When you invest in your education at CME Review Courses, you are choosing a path that respects your professional time. The inclusion of cme gift cards as an add-on purchase is designed to fit the budgetary needs of PAs who have a set CME allowance from their employers.

Whether you need a new tablet for your clinical rounds or reference books for your home office, the Apple or Amazon gift card add-ons allow you to direct your professional development funds where you need them most. Again, please note that these gift cards are part of the total package price and are NOT free gifts.

Clinical Vignette 3: Gastroenterology

Your patient is a 45-year-old female who presents with a 24-hour history of steady, aching pain in the right upper quadrant that radiates to her right scapula. She also reports nausea and one episode of vomiting. On exam, she has a positive Murphy's sign. Her temperature is 100.8°F. Labs reveal a mild leukocytosis.

Which diagnostic study is the most appropriate initial step in the evaluation of this patient?

A. Computed Tomography (CT) of the abdomen and pelvis.
B. Right upper quadrant ultrasound.
C. Hepatobiliary iminodiacetic acid (HIDA) scan.
D. Magnetic resonance cholangiopancreatography (MRCP).

Explanation: The correct answer is B. This clinical presentation is highly suggestive of acute cholecystitis. The initial imaging study of choice for suspected gallbladder disease is a right upper quadrant ultrasound, as it is highly sensitive, non-invasive, and cost-effective. A HIDA scan (C) is the most sensitive test for acute cholecystitis but is typically reserved for cases where the ultrasound is inconclusive. CT (A) can show gallbladder wall thickening but is less sensitive than ultrasound for gallstones. MRCP (D) is used primarily to visualize the bile ducts if choledocholithiasis is suspected.

Conclusion: Preparing for Success

Success on the PANRE or PANRE-LA requires a combination of clinical experience and dedicated review. By utilizing the NCCPA Blueprint by organ system, you can ensure that you are studying the right material. Our 100-credit PANRE review course provides the depth and breadth necessary to pass the exam while providing the administrative ease of fulfilling your CME requirements.

Don't forget to check our sitemap for specialized modules in areas like Psychiatry and Genitourinary to further refine your study plan.

Quick Recap of Benefits:

• 100 AAPA Category 1 CME Credits – One course, one cycle finished.
• 1,672 Questions – Extensive practice to ensure retention.
• Flexible Add-Ons – Choose an Amazon or Apple Gift Card ($100-$1500) to enhance your package (purchased add-on, not free).
• NCCPA Blueprint Aligned – Stay focused on what is actually on the exam.

Stay ahead of your certification cycle and ensure your clinical knowledge is up to date with the most efficient pance prep courses available.

Title: Comprehensive PANCE Review Book: Follows NCCPA Topic List
Author: Jeremy Boroff PA-C
Format: Paperback / Digital
Deliverables: 300 Board Style Questions & Answers
Purchase Link: Amazon Link

Physician assistants and students preparing for the Physician Assistant National Certifying Examination (PANCE) require streamlined, high-yield study materials that align strictly with the NCCPA Topic List. The Comprehensive PANCE Review Book by Jeremy Boroff PA-C is designed to meet this demand by providing 300 board-style questions that mirror the complexity and content distribution of the actual exam. This resource is engineered for efficiency, allowing candidates to identify knowledge gaps and master clinical concepts without the distractions of extraneous information.

While this book is a primary tool for PANCE preparation, established physician assistants often find it a valuable refresher for maintaining clinical competency. For those moving into the recertification phase, we offer a comprehensive PANRE Review Course that provides 100 hours of AAPA Category 1 CME credit. This course is specifically designed for the PANRE and PANRE-LA, ensuring you remain compliant with NCCPA requirements while gaining practical, clinical knowledge.

Maximizing Your CME Budget

Education is a significant investment. We offer an efficient way to utilize your employer-provided CME funds. Our programs allow the addition of Amazon or Apple Gift Cards ranging from $100 to $1500 to your purchase. This "CME with gift card" model enables you to acquire the necessary educational credits while also obtaining tools to further enrich your professional development.

Our course catalog includes specialized content in:

• Emergency Medicine
• Family Medicine
• Internal Medicine / Hospitalist
• Orthopedics
• Dermatology
• Psychiatry
• Neurology
• Cardiology
• OB/GYN

For those requiring specialized pharmacology credits, our Pharmacology Course provides AAPA Category 1 CME Credit. Note that while our content is written by PAs for PAs, nurse practitioners and physicians also find value in these packages. Physicians should note that our courses count for Category 2 CME credit rather than Category 1.

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Clinical Assessment: Cardiovascular and Pulmonary Systems

The following clinical vignettes represent the style and depth of questions found in the Comprehensive PANCE Review Book and our pa board review course.

Scenario 1

Your patient is a 64-year-old male with a history of hypertension and tobacco use who presents to the emergency department complaining of sudden onset, tearing chest pain that radiates to his back between the scapulae. His blood pressure is 185/110 mmHg in the right arm and 155/95 mmHg in the left arm. A chest X-ray reveals a widened mediastinum.

Which of the following is the most appropriate initial diagnostic study of choice in a hemodynamically stable patient?
A. Transeophageal Echocardiogram (TEE)
B. Computed Tomography Angiography (CTA)
C. Magnetic Resonance Angiography (MRA)
D. Aortography

Explanation:
The correct answer is Computed Tomography Angiography (CTA). In a hemodynamically stable patient with suspected aortic dissection, CTA is the preferred initial diagnostic study due to its high sensitivity, specificity, and rapid availability. It accurately identifies the presence of an intimal flap and the extent of the dissection. A TEE (Choice A) is highly accurate and is the preferred study for patients who are hemodynamically unstable or have renal failure where IV contrast is contraindicated. MRA (Choice C) is highly accurate but time-consuming and often not practical in an acute setting. Aortography (Choice D) was historically the gold standard but has been largely replaced by non-invasive imaging.

Scenario 2

Your patient is a 28-year-old female presenting with a 3-day history of non-productive cough, low-grade fever, and malaise. Physical examination reveals diffuse wheezing and crackles. A chest X-ray shows patchy interstitial infiltrates in the lower lobes. Laboratory results show an elevated cold agglutinin titer.

What is the most likely causative organism?
A. Streptococcus pneumoniae
B. Klebsiella pneumoniae
C. Mycoplasma pneumoniae
D. Legionella pneumophila

Explanation:
The correct answer is Mycoplasma pneumoniae. This is a classic presentation of "walking pneumonia" or atypical pneumonia, which is common in young adults. The presence of interstitial infiltrates on X-ray rather than lobar consolidation, combined with elevated cold agglutinins, is highly suggestive of Mycoplasma. S. pneumoniae (Choice A) typically presents with high fever, productive cough, and lobar consolidation. Klebsiella (Choice B) is more common in alcoholics and presents with "currant jelly" sputum. Legionella (Choice C) often involves gastrointestinal symptoms and hyponatremia.

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Clinical Assessment: Gastrointestinal and Renal Systems

Scenario 3

Your patient is a 45-year-old female who presents with severe right upper quadrant pain that radiates to her right shoulder. She reports the pain began shortly after eating a large meal. On physical exam, there is an arrest of inspiration upon deep palpation of the right upper quadrant.

What is the initial diagnostic study of choice for this condition?
A. Ultrasound of the Right Upper Quadrant
B. Hepatobiliary Iminodiacetic Acid (HIDA) Scan
C. Computed Tomography (CT) of the Abdomen
D. Endoscopic Retrograde Cholangiopancreatography (ERCP)

Explanation:
The correct answer is Ultrasound of the Right Upper Quadrant. The patient’s presentation is consistent with acute cholecystitis (positive Murphy's sign). Ultrasound is the initial test of choice due to its high sensitivity for gallstones, gallbladder wall thickening, and pericholecystic fluid. A HIDA scan (Choice B) is the most sensitive test and is indicated if the ultrasound is inconclusive. CT scans (Choice C) are less sensitive for gallstones but may be used to rule out other pathology. ERCP (Choice D) is a therapeutic and diagnostic tool for choledocholithiasis, not primary cholecystitis.

Scenario 4

Your patient is a 72-year-old male with a history of chronic kidney disease and heart failure who presents with generalized weakness and palpitations. An EKG is performed and shows peaked T waves, a widened QRS complex, and a prolonged PR interval.

Which of the following is the most appropriate immediate step in the management of this patient?
A. Sodium Polystyrene Sulfonate (Kayexalate)
B. Calcium Gluconate
C. Intravenous Insulin and Glucose
D. Hemodialysis

Explanation:
The correct answer is Calcium Gluconate. The EKG findings are pathognomonic for severe hyperkalemia. Calcium gluconate (or calcium chloride) is the immediate priority to stabilize the cardiac membrane and prevent life-threatening arrhythmias. It does not lower the potassium level but provides cardioprotection. Insulin and glucose (Choice C) or inhaled albuterol are used to shift potassium into the cells. Kayexalate (Choice A) and hemodialysis (Choice D) are used to remove potassium from the body, but they do not act fast enough to address immediate cardiac instability.

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Clinical Assessment: Behavioral Health and Endocrinology

Scenario 5

Your patient is a 24-year-old male brought to the clinic by his family because of a 1-month history of decreased sleep, rapid speech, and excessive spending. He recently quit his job, claiming he has developed a "secret formula for infinite wealth" and has been seen dancing on top of his car at 3:00 AM. He has no prior psychiatric history.

What is the most likely diagnosis?
A. Major Depressive Disorder with Psychotic Features
B. Schizoaffective Disorder
C. Bipolar I Disorder
D. Cyclothymic Disorder

Explanation:
The correct answer is Bipolar I Disorder. The patient is experiencing a manic episode, characterized by grandiosity, decreased need for sleep, pressured speech, and impulsive behavior (spending). A single manic episode is sufficient for the diagnosis of Bipolar I Disorder. Schizoaffective disorder (Choice B) requires a period of at least two weeks of delusions or hallucinations in the absence of a major mood episode. Cyclothymic disorder (Choice D) involves milder swings (hypomania and mild depression) over at least two years.

Scenario 6

Your patient is a 52-year-old female with Type 2 Diabetes Mellitus who presents for a routine follow-up. Her hemoglobin A1c is 8.4% despite adherence to metformin at maximum dose. She has a history of atherosclerotic cardiovascular disease (ASCVD).

Which of the following classes of medication should be added next to her regimen?
A. Sulfonylurea
B. GLP-1 Receptor Agonist
C. DPP-4 Inhibitor
D. Thiazolidinedione

Explanation:
The correct answer is GLP-1 Receptor Agonist. Current clinical guidelines recommend the addition of a GLP-1 receptor agonist or an SGLT2 inhibitor in patients with Type 2 Diabetes and established ASCVD, regardless of A1c levels, due to their proven cardiovascular benefits. Sulfonylureas (Choice A) increase the risk of hypoglycemia and weight gain without providing cardiovascular protection. DPP-4 inhibitors (Choice C) and Thiazolidinediones (Choice D) are generally considered later-line or in specific patient populations without the same level of ASCVD benefit.

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Strategic Study for PANCE Success

Utilizing resources that strictly follow the NCCPA Topic List is the most effective way to prepare for the PANCE and PANRE exams. The Comprehensive PANCE Review Book provides the necessary volume of practice questions to build clinical stamina and diagnostic accuracy.

As you progress through your career, remember that CME Review Courses is your partner in maintaining professional excellence. Whether you need the 100 hours of AAPA Category 1 credit from our PANRE Review Course or specific pharmacology credits, we provide high-quality content developed by physician assistants.

Enhance your education today and maximize your CME funds by selecting a package with an Amazon or Apple Gift Card add-on.

Explore our courses:

• CME with Gift Card Packages
• PANRE Review Course
• Pharmacology CME

Invest in your clinical knowledge and your career with tools designed for the modern medical professional.

Price: $399.99 (Base Course Fee)
Duration of access: 30 months
Quantifiable deliverables: 100 Hours of Category 1 AAPA CME Credit (PANRE Review Course)

As a Physician Assistant or healthcare provider, your annual Continuing Medical Education (CME) allowance is a vital resource. Maximizing that budget often means looking for packages that offer high-yield content alongside added value. CME Review Courses offers a unique "CME with gift card" model that allows you to purchase a high-quality review course and add an Amazon or Apple gift card to your transaction.

While this is an efficient way to utilize your educational funds, there are technical, financial, and logistical details you must understand before making a purchase.

1. The 100-Hour AAPA Category 1 Credit Rule

The primary value of the PANRE Review Course is its accreditation. This specific course provides 100 hours of AAPA Category 1 CME credit. For PAs approaching their recertification cycle, this single course can satisfy the entire Category 1 requirement for a two-year cycle. Note that while other courses like our Pharmacology review offer Category 1 credit, only the full PANRE Review package is designated for the 100-hour total.

2. Gift Card Add-On Ranges

Our system is designed for flexibility. You are not limited to a static gift card amount. When you select a CME with Gift Card package, you can customize the add-on. You can add an Amazon or Apple gift card ranging from $100 to $1500 to your purchase. This allows you to scale the total price to match your specific employer-provided CME budget.

3. Tax Implications and IRS Reporting

It is a common misconception that gift cards bundled with CME are "tax-free." According to IRS standards and accreditation guidelines, gift cards are considered cash equivalents. This means the value of the gift card is generally treated as taxable income. Clinicians should consult with a tax professional, as you may need to report the value of the incentive on your annual tax filings.

4. Receipt Itemization Options

Transparency is critical when submitting expenses for reimbursement. Some employers require a breakdown of the CME cost versus the gift card value, while others do not. At CME Review Courses, we provide options regarding how your purchase is documented. We offer a CME with gift card "not on receipt" tag for specific administrative needs, though you must ensure this aligns with your organization's compliance policy.

5. Credit Applicability for Nurse Practitioners

While our content is written by PAs, many Nurse Practitioners utilize our packages. However, AAPA Category 1 Credit acceptance for NPs varies significantly by state. Most state boards accept AAPA credit for NP continuing education requirements, but you should verify with your state board or the AANP before purchasing to ensure the 100 hours will count toward your specific licensure.

6. Physician Value: Category 2 Credit

Internal Medicine and Family Medicine physicians are frequent buyers of our packages, particularly the Internal Medicine Hospitalist CME Package. It is important to note that for MDs and DOs, this credit counts as Category 2 CME, not Category 1. Physicians often find high clinical value in the PA-authored content for daily practice, even if the credit category differs from their primary requirements.

7. Content Depth and Breadth

Our review courses are not generic. They are designed to mirror the actual blueprints required for certification. The content covers:

• Cardiology
• Emergency Medicine
• Family Medicine
• Internal Medicine/Hospitalist
• Orthopedics
• Dermatology
• Psychiatry
• Neurology
• OB/GYN

8. Long-Term Access

Medical knowledge requires constant refreshing. Unlike some providers that limit access to 6 or 12 months, our CME packages provide 30 months of access. This allows you to utilize the material across multiple years of practice or to prepare for the PANRE well in advance of your exam date.

9. Clinical Relevance: By PAs for PAs

The clinical pearls and high-yield facts in our Emergency Medicine CME Package and others are authored by practicing Physician Assistants. This ensures the perspective is practical and focused on the diagnostic and management decisions you face in the clinic or hospital setting.

10. Efficiency of the "Gift Card Add-On"

The gift card add-on serves as a tool for further education. Many clinicians use their $100-$1500 Amazon gift cards to purchase medical textbooks, specialized equipment like stethoscopes, or ergonomic office supplies that improve their clinical environment. It is an efficient way to ensure your CME budget is fully utilized within the fiscal year.

CLINICAL ASSESSMENT AND REVIEW

Practice Question 1

Your patient is a 64-year-old male presenting to the Emergency Department with a sudden onset of "ripping" chest pain that radiates to his back between the scapulae. His medical history is significant for long-standing, poorly controlled hypertension. On physical examination, his BP is 190/110 mmHg in the right arm and 165/95 mmHg in the left arm. His HR is 105 bpm, and SaO2 is 96% on room air. A new grade II/VI diastolic murmur is noted at the right sternal border.

Which of the following is the most appropriate next step in the management of this patient?

A) Immediate administration of intravenous thrombolytics
B) Emergent CT Angiography (CTA) of the chest and abdomen
C) Initiate intravenous beta-blocker therapy to reach a target systolic BP of 100-120 mmHg
D) Bedside transthoracic echocardiogram (TTE)

Explanation:
The correct answer is C) Initiate intravenous beta-blocker therapy to reach a target systolic BP of 100-120 mmHg.

In a patient with a suspected aortic dissection (indicated by the ripping pain, BP discrepancy, and history of hypertension), the immediate priority is heart rate and blood pressure control to reduce "shear stress" on the aortic wall. Esmolol or labetalol are typically first-line agents to lower the HR below 60 bpm and systolic BP to 100-120 mmHg.

A is incorrect because thrombolytics are contraindicated in aortic dissection and would likely lead to fatal hemorrhage. B is incorrect as the initial priority is stabilization (rate/pressure control) before the patient is moved to the CT suite, though CTA is the definitive diagnostic tool. D is incorrect because while TTE might show signs of an intimal flap or aortic insufficiency, it is less sensitive than Transesophageal Echocardiogram (TEE) or CTA and should not delay the initiation of blood pressure control.

Practice Question 2

Your patient is a 28-year-old female presenting with acute pelvic pain and vaginal spotting. Her last menstrual period was 6 weeks ago. Her BP is 90/60 mmHg, HR is 115 bpm, and she appears pale and diaphoretic. Physical exam reveals significant cervical motion tenderness and right adnexal fullness. A bedside urine pregnancy test is positive.

What is the most definitive diagnostic step to confirm the suspected diagnosis while preparing for surgical intervention?

A) Quantitative serum Beta-hCG
B) Transvaginal Ultrasound (TVUS)
C) Comprehensive Metabolic Panel (CMP)
D) Pelvic MRI

Explanation:
The correct answer is B) Transvaginal Ultrasound (TVUS).

The clinical presentation of hypotension, tachycardia, and localized pelvic pain in a pregnant patient is highly suggestive of a ruptured ectopic pregnancy. TVUS is the gold standard for identifying an extrauterine pregnancy or the presence of free fluid (hemoperitoneum) in the Pouch of Douglas.

A is incorrect because while a serum Beta-hCG is helpful in the initial workup of stable patients, this patient is hemodynamically unstable and requires immediate imaging and surgical consultation. C is incorrect because laboratory values will not confirm the location of the pregnancy. D is incorrect as MRI is time-consuming and unnecessary given the efficacy and speed of ultrasound in an emergency setting.

Practice Question 3

Your patient is a 45-year-old male with a history of alcohol use disorder who presents with hematemesis and melena. His vitals are HR 120 bpm, BP 85/50 mmHg, and RR 22. He has visible caput medusae and jaundice. Two large-bore IVs have been placed and fluid resuscitation is underway.

In addition to fluid resuscitation and blood products, which of the following medications should be administered immediately?

A) Intravenous Pantoprazole and Octreotide
B) Oral Propranolol
C) Intravenous Vitamin K
D) Intramuscular Glucagon

Explanation:
The correct answer is A) Intravenous Pantoprazole and Octreotide.

In the setting of suspected esophageal variceal bleeding (indicated by portal hypertension signs like caput medusae), Octreotide is used to reduce portal venous pressure and splanchnic blood flow. Pantoprazole (a Proton Pump Inhibitor) is concurrently administered to manage potential peptic ulcer disease, which often coexists or mimics variceal bleeding.

B is incorrect because beta-blockers are used for primary or secondary prophylaxis of variceal bleeding, not for the management of acute, hemodynamically unstable hemorrhage. C is incorrect because while Vitamin K may be used later to address coagulopathy in cirrhosis, it does not provide acute hemostasis. D is incorrect as glucagon has no role in the management of gastrointestinal hemorrhage.

Price: Starting at $499 (Depending on Gift Card Add-On)
Duration of Access: 1 Year of Unlimited Access
Deliverables: Comprehensive Video Modules, Practice Question Bank, and AAPA Category 1 CME Credit

Staying current with the rapidly evolving landscape of obesity pharmacology is no longer optional for the modern clinician. Whether you are prepping for your PANRE or managing a high-volume primary care panel, understanding the nuances of GLP-1 receptor agonists and GIP/GLP-1 dual agonists is critical for 2026 practice.

Our Pharmacology Course provides a deep dive into these agents, offering AAPA Category 1 CME Credit. This course was written by PAs specifically for PAs, though nurse practitioners and physicians also find immense value in the clinically focused content. For those nearing their recertification cycle, our PANRE Review Course offers a full 100 hours of AAPA Category 1 Credit, making it the most efficient way to meet your requirements.

We also offer an efficient way to maximize your CME budget. Our CME with Gift Card packages allow you to add an Amazon or Apple Gift Card (ranging from $100 to $1500) to your purchase. This allows you to further enrich your professional education while receiving a "clean" receipt for reimbursement.

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The Current State of GLP-1 Pharmacology

Obesity management has shifted from a "lifestyle-first" paradigm to a "biologically-driven" approach. As of April 2026, the FDA-approved roster for chronic weight management includes several key agents that every PA must master.

Mechanism of Action: Beyond Appetite Suppression

Glucagon-like peptide-1 (GLP-1) and Glucose-dependent insulinotropic peptide (GIP) are incretin hormones. While GLP-1 primarily slows gastric emptying and increases postprandial satiety via the hypothalamus, GIP adds a layer of metabolic regulation, specifically improving insulin sensitivity and potentially reducing the nausea associated with GLP-1 monotherapy.

High-Yield Agent Profiles for 2026

1. Wegovy (semaglutide 2.4 mg): The established injectable standard. In the STEP 1 trials, it demonstrated roughly 15% weight loss over 68 weeks.
2. Wegovy Oral (semaglutide 25 mg): Approved in late 2025, this daily tablet offers a non-injectable alternative for patients with needle phobia, though it requires strict fasting and water restrictions for absorption.
3. Zepbound (tirzepatide): A dual GIP/GLP-1 agonist. Clinical data (SURMOUNT-5) shows superiority over semaglutide monotherapy, with weight loss reaching 20-22% over 72 weeks.
4. Foundayo (orforglipron): The newest addition to the 2026 toolkit. As a non-peptide, small-molecule oral GLP-1, it does not require the strict fasting conditions of oral semaglutide, allowing for much higher patient adherence.

Clinical Application and Eligibility

When evaluating a patient for these therapies, use the standard BMI benchmarks. A patient is eligible for pharmacological intervention if their BMI is ≥30 kg/m² or ≥27 kg/m² with at least one weight-related comorbidity such as hypertension, T2DM, or dyslipidemia.

PAs should monitor for common side effects: nausea, vomiting, and diarrhea: which are usually transient during the dose-escalation phase. More serious but rare risks include pancreatitis and biliary disease.

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Clinical Vignette: Practical Assessment

Your patient is a 44-year-old male presenting for a follow-up on his obesity management. He has a BMI of 34 kg/m² and a history of hypertension. He has been on Wegovy (semaglutide 2.4 mg) for six months but reports "plateauing" and is frustrated by the weekly injections. He asks about "the new dual-action shot" he heard about. His labs are unremarkable, and he has no history of medullary thyroid carcinoma or MEN 2.

Which of the following is the most appropriate pharmacological transition for this patient?

A) Transition to Wegovy Oral 25 mg daily
B) Transition to Zepbound (tirzepatide)
C) Add phentermine 15 mg daily to the current regimen
D) Discontinue semaglutide and start Foundayo (orforglipron)

Explanation:
The correct answer is B. Zepbound (tirzepatide) is a dual GLP-1/GIP receptor agonist that has shown superior weight loss efficacy compared to semaglutide monotherapy in head-to-head trials (SURMOUNT-5). It remains a weekly injection, but its dual mechanism addresses the patient's plateau more effectively than switching to an oral version of the same drug (Option A). While adding phentermine (Option C) is a possibility, the dual-agonist profile of tirzepatide is the next logical step in high-yield obesity management for patients failing monotherapy. Foundayo (Option D) is an oral option, but the patient specifically asked about the "dual-action shot."

Practice Questions

Question 1:
A 52-year-old female with a BMI of 31 kg/m² and controlled Type 2 Diabetes is interested in the new oral medication Foundayo (orforglipron). What is the primary pharmacological advantage of this agent over Wegovy Oral (semaglutide)?

A) It is a dual GLP-1/GIP agonist.
B) It has a higher percentage of weight loss than injectable tirzepatide.
C) It is a small-molecule non-peptide that does not require strict fasting for absorption.
D) It is administered once monthly rather than once daily.

Explanation:
The correct answer is C. Foundayo (orforglipron) is a small-molecule GLP-1 receptor agonist. Unlike oral semaglutide, which is a peptide requiring a large dose and specific fasting conditions to be absorbed, small molecules like orforglipron can be taken with or without food. Option A is incorrect as it is a monotherapy. Option B is incorrect; injectable tirzepatide still holds the lead in weight loss percentage. Option D is incorrect; it is a daily oral medication.

Question 2:
Which of the following is a contraindication for the initiation of GLP-1 receptor agonists in a patient with a BMI of 35 kg/m²?

A) Personal or family history of Medullary Thyroid Carcinoma (MTC).
B) History of Cholelithiasis.
C) BMI between 27 and 30 kg/m².
D) History of Gastroesophageal Reflux Disease (GERD).

Explanation:
The correct answer is A. A personal or family history of Medullary Thyroid Carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) is a boxed warning and absolute contraindication for GLP-1 and dual agonists due to risks identified in rodent studies. While cholelithiasis (Option B) and GERD (Option D) require cautious monitoring as these drugs can exacerbate these conditions via delayed gastric emptying, they are not absolute contraindications. Option C describes the eligibility range for patients with comorbidities.

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Maximize your 2026 CME experience by choosing a program that respects your time and your budget. Visit CME Review Courses today to explore our PANRE Review and Pharmacology packages. Don't forget to take advantage of our CME with Gift Card options to get the most out of your employer-provided CME funds.

Choosing a board review course is one of the most critical professional decisions a Physician Assistant (PA) makes every few years. Whether you are preparing for the traditional PANRE or participating in the PANRE-LA, the sheer volume of medical knowledge required to satisfy the NCCPA Blueprint can be overwhelming. Not all courses are created equal, and many fail to respect the limited time and specific needs of a practicing clinician.

At CME Review Courses, we understand that your time is valuable and your CME budget should work for you. Our content is written by PAs for PAs, ensuring that the clinical complexity and high-yield focus match the reality of the profession.

Before you invest your time and money, here are 10 things you should know about selecting the right board review course.

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1. NCCPA Blueprint Alignment is Mandatory

The first and most important criterion for any board review course is its alignment with the NCCPA Blueprint. The NCCPA periodically updates the exam content, shifting percentages across organ systems. A course that relies on outdated materials from three years ago will leave you over-prepared for rare conditions and under-prepared for the core content categories like Cardiology (13%), Pulmonary (10%), and GI (9%). Ensure your course covers all 15 official content categories in the correct proportions.

2. Credit Types Matter: AAPA Category 1

Not all CME credits are created equal for the PA-C. While many courses offer AMA PRA Category 1 Credit™, PAs should prioritize AAPA Category 1 Credit. This is the gold standard for our profession. Our PANRE Review Course provides 100 hours of AAPA Category 1 credit, which is specifically designed to fulfill your major credit requirements in one efficient package. If you are a Nurse Practitioner, keep in mind that the acceptance of AAPA credits varies from state to state, so always verify with your state board.

3. Maximize Your CME Budget with Gift Card Add-ons

Most employers provide a dedicated CME allowance, but many PAs struggle to spend the entire amount or find it difficult to justify high costs for materials that expire. An efficient way to use your CME money is to select a course that offers Amazon or Apple Gift Card add-ons. This allows you to add a $100 to $1,500 gift card to your purchase, which can be used to further enrich your education by purchasing medical equipment, reference books, or technology.

4. Content Written by PAs for PAs

There is a distinct difference between board review content written by academic physicians and content written by practicing PAs. PAs understand the nuances of the "Physician Assistant" perspective, focusing on the diagnostic and management steps most likely to appear on the exam. Our courses are developed by Jeremy Boroff, PA-C, ensuring the content is peer-relevant and practical.

5. Demand Flexible Formats

Avoid courses that force you into a rigid subscription model or require multiple logins that expire after 90 days. As a working professional, you need a course that you can own. Our review exams are available in formats that allow you to own the content permanently, with no expiration and no recurring fees. This is particularly useful for the PANRE-LA, where you may need to reference specific organ system reviews over a three-year period.

6. Retrieval Practice Over Passive Reading

Passive reading of textbooks is the least effective way to retain medical information. The most effective method is retrieval practice. When choosing a course, look for a "forced recall" design. For example, our practice exams reveal the correct answer only after the choices, forcing you to commit to an answer before checking. This simulates the high-stakes environment of the actual testing center.

7. Organ System Specificity

A generic review is often not enough. If you work in a specialty like Orthopedics or Dermatology, you may feel rusty in Cardiology or OB/GYN. Your review course should allow you to dive deep into specific domains. We offer comprehensive content across:

• Emergency Medicine
• Family Medicine
• Internal Medicine/Hospitalist
• Orthopedics
• Dermatology
• Psychiatry
• Neurology
• Cardiology
• OB/GYN

8. Clinical Vignette Complexity

The PANRE has moved away from "first-order" questions (simple recall) and toward complex clinical vignettes. A high-quality course will provide vignettes that include patient demographics, vitals, and physical exam findings, requiring you to make a multi-step diagnostic or management decision.

9. Pharmacology Credit Requirements

Many states and hospital systems now require specific pharmacology CME hours. It is highly efficient to choose a provider that offers both a general PANRE review and a dedicated Pharmacology Course. Our Pharmacology Course also carries AAPA Category 1 Credit, making it easy to satisfy those specific requirements while preparing for boards.

10. Cost-Effectiveness and Deliverables

Before purchasing, look for clear, bolded logistics. You should know exactly what you are getting, for how much, and how long you will have access to it.

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Course Spotlight: 100-Hour PANRE Review Course

• Price: $495 (Base course, plus gift card add-on options)
• Deliverable: 100 Hours of AAPA Category 1 Credit
• Access: No subscription, no expiration, no login required for the book/exam series.
• Content: Aligned to the NCCPA Blueprint, covering all 15 organ systems.

View the PANRE Review Course Options Here

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Clinical Assessment: Case Study

Your patient is a 64-year-old male with a history of hypertension and tobacco use who presents to the emergency department with sudden onset of severe, tearing chest pain that radiates to his back. His blood pressure in the right arm is 190/110 mmHg, and in the left arm, it is 160/95 mmHg. His heart rate is 105 bpm. A chest X-ray reveals a widened mediastinum.

Which of the following is the most appropriate initial pharmacological management for this patient?

A. Intravenous Nitroprusside
B. Intravenous Esmolol
C. Intravenous Hydralazine
D. Oral Amlodipine
E. Intravenous Heparin

Explanation:
The correct answer is B. Intravenous Esmolol.

The patient’s presentation is classic for an acute aortic dissection (tearing pain, blood pressure discrepancy, widened mediastinum). The primary goal in the management of aortic dissection is "anti-impulse therapy" to reduce the shear stress on the aortic wall. This requires lowering both the heart rate and the blood pressure.

Esmolol (or another IV beta-blocker like Labetalol) is the first-line treatment because it reduces the heart rate (target < 60 bpm) and the contractility of the heart (dP/dt). Only after the heart rate is controlled should vasodilators like Nitroprusside (A) be added, as vasodilators can cause reflex tachycardia, which increases the shear stress on the dissection and may propagate the tear. Hydralazine (C) is contraindicated for the same reason: it can cause reflex tachycardia. Amlodipine (D) is an oral medication and is inappropriate for an acute hypertensive emergency. Heparin (E) is contraindicated in suspected or confirmed aortic dissection as it can worsen the hemorrhage.

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Why Choose CME Review Courses?

Preparation for the PANRE should not be a months-long marathon through 2,000 irrelevant questions. It should be a focused, high-yield review of the topics the NCCPA actually tests. By choosing a course written by PAs, you ensure that you are studying the right material in the most efficient way possible.

Whether you are looking for the full 100-hour PANRE Review Course or looking to bolster your knowledge in a specific area like Internal Medicine or Emergency Medicine, we provide the tools you need to pass your exams and improve your clinical practice.

Efficient CME for Busy Professionals

We also cater to Internal Medicine Physicians who find value in our clinical content. While our courses count as Category 1 AAPA Credit for PAs, physicians can often claim them as Category 2 CME. This makes our packages a versatile option for the entire clinical team.

Stop overpaying for subscriptions you don't use. Invest in a review course that respects your profession and your wallet.

Explore our full catalog of CME with Gift Card options at CMEReviewCourses.com.

Price: $399.99 for core packages
Duration: 30 months of access
Deliverables: 100 Hours of AAPA Category 1 CME (PANRE Review), Practice Exams, Pharmacology Credit

Selecting a Continuing Medical Education (CME) package is a strategic decision for any practicing Physician Assistant (PA), Nurse Practitioner (NP), or physician. While the primary goal is always clinical competence and meeting licensure requirements, the method of delivery and the "add-ons" provided can significantly impact your professional development. CME packages that offer Amazon or Apple gift card add-ons have become a preferred choice for clinicians who want to maximize their annual employer-provided CME allowance.

At CME Review Courses, we provide a streamlined way to use your CME funds efficiently. By combining high-yield clinical review with flexible gift card options, you are able to invest in both your knowledge base and the physical tools required for your practice.

Understanding the Gift Card Add-on Structure

The logic behind a CME gift card package is simple: it allows you to bundle your educational course with a credit that can be used for further professional enrichment. We offer add-on options ranging from $100 to $1,500.

When you select a package, such as the Internal Medicine Hospitalist CME Package, you pay the base price of the course plus the cost of the gift card you choose. This total is reflected as a single educational expense. This is particularly useful for PAs who have a set annual allowance that must be used within a specific timeframe or it is lost.

Educational Value of Gift Cards

A common misconception is that gift cards are purely for "perks." In reality, an Amazon or Apple gift card is a versatile tool for professional development. Clinicians frequently use these credits to purchase:

• Medical Equipment: High-end stethoscopes (e.g., Littmann Cardiology IV), otoscopes, or dermatoscope attachments for smartphones.
• Reference Materials: Physical copies of the latest surgical manuals or internal medicine texts that are often too expensive for out-of-pocket purchase.
• Technology: iPads or tablets used for mobile EHR access, medical apps (e.g., UpToDate, Epocrates), and viewing our PANRE Review Course videos on the go.
• Office Essentials: Ergonomic equipment for your desk to reduce the physical strain of charting.

Choosing Your Specialty Content

The core of your purchase must be high-quality clinical content. We specialize in review courses that are written by physician assistants for physician assistants. Our packages cover a wide range of specialties, ensuring that your CME is relevant to your daily practice.

Emergency Medicine and Urgent Care

Our Emergency Medicine CME Package and Urgent Care Review focus on the high-acuity, rapid decision-making required in these settings. The content covers everything from pediatric emergencies to advanced cardiac life support (ACLS) concepts and traumatic injuries.

Family and Internal Medicine

For those in primary care, the Family Medicine CME Package provides a comprehensive update on chronic disease management, preventive medicine, and the latest treatment guidelines. The Internal Medicine Hospitalist package is specifically tailored to those managing complex, multi-system illness in the inpatient setting.

Orthopedics and Cardiology

The Orthopedics CME Package is designed to help you master joint exams, fracture management, and common sports medicine injuries. Similarly, our Cardiology review dives deep into EKG interpretation and the management of congestive heart failure (CHF) and coronary artery disease (CAD).

The PANRE Review: 100 Hours of AAPA Category 1 Credit

If you are approaching your recertification year, the PANRE Review Course is the most efficient choice. This course specifically offers 100 hours of AAPA Category 1 CME credit. This is a significant portion of your required hours, delivered in a format that directly prepares you for the NCCPA Blueprint.

While the course is built for PAs, physicians often purchase this package for the clinical review. It is important to note that for physicians, this counts as Category 2 CME, not Category 1. Nurse Practitioners can often claim these AAPA credits in many states, though you should verify your specific state board requirements.

Clinical Practice and Assessment

High-yield review is only effective if it includes active retrieval practice. Below are clinical vignettes designed to test your knowledge across several organ systems included in our CME packages.

Cardiovascular Assessment

Your patient is a 64-year-old male with a history of hypertension and tobacco use who presents to the emergency department with sudden onset substernal chest pain. The pain is described as "tearing" and radiates to the back between the scapulae.

Vitals:

• HR: 110 bpm
• BP: 185/95 mmHg (Right Arm), 150/80 mmHg (Left Arm)
• SaO2: 96% on RA

Which of the following is the most appropriate initial diagnostic study?
A. Exercise Stress Test
B. CT Angiogram of the Chest and Abdomen
C. Transthoracic Echocardiogram (TTE)
D. Cardiac Enzymes (Troponin I)
E. Chest X-ray

Correct Answer: B. CT Angiogram of the Chest and Abdomen
The correct answer is CT Angiogram. This patient's clinical presentation: sudden "tearing" chest pain radiating to the back with a significant blood pressure differential between arms: is highly suggestive of an aortic dissection. CTA is the gold standard for rapid, definitive diagnosis in a hemodynamically stable patient. Exercise stress tests are contraindicated in acute chest pain. TTE is often insufficient to visualize the descending aorta. While troponins and CXR (looking for a widened mediastinum) are often performed, they are not definitive for this diagnosis.

Orthopedic Assessment

Your patient is a 19-year-old female soccer player who sustained a non-contact injury to her right knee during a game. She reports hearing a "pop" followed by immediate swelling. On examination, she has a positive Lachman test and significant joint effusion.

What is the most likely diagnosis?
A. Medial Meniscus Tear
B. Medial Collateral Ligament (MCL) Sprain
C. Anterior Cruciate Ligament (ACL) Tear
D. Patellar Tendon Rupture
E. Tibial Plateau Fracture

Correct Answer: C. Anterior Cruciate Ligament (ACL) Tear
The correct answer is ACL Tear. A non-contact "pop" with immediate swelling (hemarthrosis) and a positive Lachman test (the most sensitive physical exam maneuver for ACL stability) is classic for an ACL rupture. Meniscal tears often have a more delayed swelling (over 12-24 hours). MCL sprains typically result from a valgus stress and show laxity with valgus testing, not the Lachman.

Dermatology Assessment

Your patient is a 42-year-old male presenting with a pruritic rash on his wrists and ankles. On physical exam, you observe flat-topped, violaceous, polygonal papules. Fine white lines (Wickham striae) are visible on the surface of the lesions.

What is the most appropriate first-line treatment?
A. Oral Griseofulvin
B. Topical Clobetasol Propionate
C. Oral Acyclovir
D. Topical Ketoconazole
E. Selenium Sulfide Lotion

Correct Answer: B. Topical Clobetasol Propionate
The correct answer is Topical Clobetasol Propionate. The "6 P's" (Planar, Purple, Polygonal, Pruritic, Papules, and Plaques) are the hallmark of Lichen Planus. First-line therapy for localized Lichen Planus consists of high-potency topical corticosteroids like clobetasol. Oral antifungals (Griseofulvin) or antivirals (Acyclovir) have no role in the treatment of this autoimmune condition.

Final Considerations for CME Packages

When selecting your CME with Amazon Gift Card package, consider the following checklist:

1. Credit Requirement: Do you need specifically Category 1 AAPA credit? If so, prioritize the PANRE Review or the Pharmacology Course.
2. Specialty Focus: Which content area will most improve your daily clinical outcomes?
3. Gift Card Value: Based on your remaining allowance, which add-on amount ($100-$1,500) maximizes your budget without exceeding your cap?

Our courses offer 30 months of access, providing plenty of time to review the material even after you have submitted your credits for the current cycle. This long-term access makes the investment even more valuable as a clinical reference tool.

By choosing a package that aligns with the NCCPA Blueprint and provides the flexibility of a gift card, you are making a smart, professional decision that benefits both your career and your clinical practice. Explore our full catalog of CME Review Courses today to find the package that fits your needs.

Deciding how to maintain your NCCPA certification as a Physician Assistant has changed significantly with the permanent addition of the PANRE-LA. Choosing between the traditional PANRE and the longitudinal assessment (PANRE-LA) isn’t just about how you test: it’s about how you live and work.

Whether you prefer a high-stakes, "one and done" approach or a slow-burn, quarterly commitment, your preparation strategy needs to be efficient. At CME Review Courses, we specialize in high-yield content that respects your time and maximizes your CME budget.

The Logistics: PANRE vs. PANRE-LA

PANRE (Traditional)

• Price: $350 registration fee.
• Format: 240 multiple-choice questions.
• Setting: Proctored at a Pearson VUE testing center.
• Time Limit: 4 hours total (approx. 60 seconds per question).
• Access: High-stakes exam taken once every 10 years.
• Status: Closed book.

PANRE-LA (Longitudinal)

• Price: $350 registration fee (spread over the cycle).
• Format: 25 questions per quarter over 12 quarters (3 years).
• Setting: Remote; take it on your laptop or tablet at home or in the clinic.
• Time Limit: 5 minutes per question.
• Access: Ongoing assessment; only 8 of 12 quarters are required for a passing score.
• Status: Open book.

Which One Fits Your Lifestyle?

The PANRE-LA is designed for the PA-C who wants to integrate learning into their daily routine. Since it is open book, it reduces the "test day anxiety" that many clinicians feel. You have five minutes per question, allowing you to consult resources like UpToDate or your CME Review Courses materials. It also offers 2 Category 1 Self-Assessment CME credits per quarter.

The traditional PANRE is for the PA who wants to get the requirement over with. If you are a strong test-taker and prefer to dedicate one weekend to intensive review rather than three years of quarterly deadlines, the traditional exam is your best bet.

Regardless of the format, you still need to master the NCCPA Blueprint.

Maximize Your CME Dollars with Gift Card Add-Ons

We know that PAs often have a "use it or lose it" CME allowance. We offer an efficient way to utilize those funds. Our PANRE Review Course provides 100 hours of AAPA Category 1 Credit. This course covers the entire NCCPA Blueprint, including Cardiovascular, Pulmonary, GI, and more, written by PAs, for PAs.

To further enrich your education, we offer CME with Amazon or Apple Gift Card add-ons. You can add a $100 to $1,500 Gift Card to your purchase. This allows you to get the high-yield review you need while also securing funds for medical equipment, textbooks, or technology to support your practice.

Our PANRE/PANRE-LA Review Series is designed for "forced commitment" retrieval practice.

The Power of Forced Commitment

Passive reading is the least effective way to study. Our practice exams use a "forced commitment" model. In our PANRE Review Exam series, the correct answer is revealed only after the choices, forcing you to commit to an answer before checking your work. This mimics the real exam environment and strengthens clinical recall.

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Clinical Assessment: Practice Questions

Testing your knowledge is the only way to identify gaps. Below are two clinical scenarios typical of what you will encounter on either the PANRE or PANRE-LA.

Scenario 1

Patient Demographics: 58-year-old male.
Chief Complaint: Progressive shortness of breath and a chronic productive cough for the last 6 months.
History: 40-pack-year smoking history.
Vital Signs: HR: 92, BP: 138/88, RR: 20, SaO2: 91% on room air.
Physical Exam: Increased AP diameter of the chest, distant heart sounds, and expiratory wheezing bilaterally.

Question: Which of the following is the most appropriate initial diagnostic study to confirm the suspected diagnosis?

A) Chest X-ray
B) High-resolution CT scan
C) Spirometry
D) Arterial Blood Gas (ABG)
E) Peak expiratory flow rate

Explanation:
The correct answer is C) Spirometry.
Spirometry is the gold standard for diagnosing Chronic Obstructive Pulmonary Disease (COPD). A post-bronchodilator FEV1/FVC ratio of less than 0.70 confirms persistent airflow limitation. A) Chest X-ray may show hyperinflation or a flattened diaphragm but is not diagnostic. B) CT scans are useful for evaluating complications like bronchiectasis or lung cancer but are not first-line for diagnosis. D) ABG is reserved for patients with severe symptoms or suspected respiratory failure. E) Peak flow is more useful for monitoring asthma than diagnosing COPD.

Scenario 2

Patient Demographics: 32-year-old female.
Chief Complaint: Sudden onset of sharp, pleuritic chest pain and dyspnea.
History: Recently returned from a 12-hour flight. Takes oral contraceptive pills.
Vital Signs: HR: 118, BP: 110/70, RR: 26, SaO2: 93% on room air.
Physical Exam: Tachycardia, lungs clear to auscultation, no lower extremity edema noted.

Question: What is the most appropriate next step in the management of this patient?

A) D-dimer assay
B) Ventilation-Perfusion (V/Q) scan
C) CT Pulmonary Angiography (CTPA)
D) Venous Duplex Ultrasound
E) Start IV Heparin immediately

Explanation:
The correct answer is C) CT Pulmonary Angiography (CTPA).
This patient has a high clinical suspicion for Pulmonary Embolism (PE) based on her recent immobilization (long flight), OCP use, tachycardia, and pleuritic pain (Wells Criteria score > 4). In patients with high clinical probability, C) CTPA is the preferred initial imaging study. A) D-dimer is only useful in patients with low to moderate clinical probability to "rule out" PE; it should not be used when suspicion is high. B) V/Q scan is an alternative if CTPA is contraindicated (e.g., renal failure). D) Ultrasound may confirm a DVT but does not diagnose the PE. E) Heparin is indicated, but definitive diagnosis is prioritized in a stable patient.

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Comprehensive Content Coverage

Whether you are treating a patient with a PE in the ER or managing chronic COPD in Family Medicine, our courses cover the high-yield topics you need. Our content includes:

• Cardiovascular
• Pulmonary
• Internal Medicine Hospitalist
• Orthopedics
• Dermatology
• OB/GYN

While our courses are written by physician assistants for physician assistants, many Nurse Practitioners find value in our Pharmacology Course, which also offers AAPA Category 1 Credit. Physicians can also find value in our packages, though the credit typically counts as Category 2 for MD/DOs.

Final Thoughts on Your Choice

If you value flexibility and the ability to use clinical resources, the PANRE-LA is a revolutionary shift in how we maintain certification. However, it requires you to stay on top of quarterly deadlines for three years. If you prefer to study hard, take one exam, and move on with your life, the PANRE remains a solid choice.

Whatever you choose, CME Review Courses is here to ensure you pass. Our PANRE Review Course gives you 100 hours of AAPA Category 1 credit and the specific, blueprint-aligned practice questions you need to walk into your exam: or log into your quarterly assessment: with total confidence.

Don't just read the blueprint; master it with our Exam 2 and Exam 3 practice series.