Maintaining your NCCPA certification through the PANRE-LA (Physician Assistant National Recertification Exam – Longitudinal Assessment) provides a flexible alternative to the traditional high-stakes exam. While the format itself is designed to reduce stress, many Physician Assistants are unaware of the built-in efficiency for earning CME credits. By participating in the PANRE-LA, you are not just meeting a certification requirement; you are also accruing AAPA Category 1 Self-Assessment CME credits with a significant bonus multiplier.
The NCCPA and AAPA have designated the PANRE-LA as a Category 1 Self-Assessment activity. This designation is critical because self-assessment activities are weighted more heavily by the NCCPA. For every quarter in which you complete all 25 questions, you earn two Category 1 Self-Assessment credits. However, the NCCPA automatically applies a 50% bonus to all self-assessment activities. This means those two credits are automatically recorded as three credits in your NCCPA portal. Over the course of the assessment, these "bonus" credits accumulate with zero additional effort on your part, provided you complete the required quarters.
CME Course Logistics and Deliverables
If you are looking to maximize your CME utility alongside the PANRE-LA, our PANRE Review Course provides the most efficient way to secure your required hours while preparing for clinical practice.
- Price: $399.99 (Base Course)
- Duration of Access: 30 Months
- Deliverables: 100 Hours of AAPA Category 1 CME Credit
- Content: Over 1,200 lecture slides and 1,600+ practice questions, answers, and explanations.
- Gift Card Options: Add-on Amazon or Apple Gift Cards from $100 to $1,500.
Maximizing Your CME Budget with Gift Card Add-ons
The PANRE Review Course is specifically designed for Physician Assistants who need to fulfill a large block of Category 1 credit quickly and efficiently. While the course provides 100 hours of AAPA Category 1 credit, we also offer specialized content in Pharmacology which also carries Category 1 AAPA credit.
For those in Family Medicine, Internal Medicine, or Emergency Medicine, our packages cover the breadth of the PAEA and NCCPA blueprints, including Cardiology, Orthopedics, Dermatology, Psychiatry, Neurology, and OB/GYN. The content is written by PAs for PAs, ensuring the clinical pearls are relevant to your daily practice and board preparation.
One of the most popular features of our program is the CME with Gift Card option. This allows you to use your employer-provided CME fund to purchase high-quality educational material while adding an Amazon or Apple Gift Card to your package. The gift card amount is added to the total price of the CME purchase, allowing you to further enrich your education with books, electronics, or other professional tools.
For Nurse Practitioners, it is important to note that AAPA Category 1 Credit acceptance varies by state. While many state boards accept these credits for license renewal, you must verify with your individual board. For Physicians, these courses count as Category 2 CME credit.
CLINICAL VIGNETTES AND ASSESSMENT
Case 1: Cardiology
Your patient is a 68-year-old male with a history of hypertension and HTN. He presents to the emergency department complaining of sudden onset palpitations and mild shortness of breath. His vitals are: HR 142 (irregular), BP 118/74, RR 20, SaO2 96% on room air. An ECG is performed.
Based on the presentation and the ECG showing absent P-waves and irregular QRS complexes, which of the following is the most appropriate initial management for rate control in this stable patient?
A. Synchronized cardioversion
B. Diltiazem
C. Adenosine
D. Amiodarone
Explanation:
B. Diltiazem is the correct answer. The patient is stable but tachicardic due to Atrial Fibrillation with rapid ventricular response (RVR). Calcium channel blockers like diltiazem or beta-blockers (e.g., metoprolol) are first-line agents for rate control in stable AFib. Synchronized cardioversion (A) is reserved for unstable patients (e.g., hypotension, altered mental status, acute heart failure). Adenosine (C) is used for regular, narrow-complex tachycardias like SVT. Amiodarone (D) is typically used for rhythm control or in patients with heart failure where other agents are contraindicated.
Case 2: Dermatology
Your patient is a 54-year-old female who presents for a routine physical. During the skin exam, you note a pigmented lesion on her left upper back. She states the lesion has been there for years but "might have gotten darker" recently.
The lesion is 7mm in diameter, has irregular borders, and displays multiple shades of brown and black. What is the most appropriate next step in management?
A. Shave biopsy
B. Excisional biopsy with 1-3 mm margins
C. Cryotherapy
D. Topical imiquimod
Explanation:
B. Excisional biopsy with 1-3 mm margins is the correct answer. Any lesion suspicious for melanoma (based on ABCDE criteria: Asymmetry, Border irregularity, Color variegation, Diameter >6mm, Evolution) should undergo an excisional biopsy. A shave biopsy (A) is contraindicated if melanoma is suspected because it may not provide the necessary depth (Breslow thickness) for staging. Cryotherapy (C) and imiquimod (D) are inappropriate for suspicious pigmented lesions and can delay a definitive diagnosis.
Case 3: Orthopedics
Your patient is a 22-year-old male who presents after a fall onto an outstretched hand (FOOSH) during a basketball game. He reports immediate pain and swelling in the right wrist. On exam, there is a prominent "dinner fork" deformity. Neuvascular status is intact. Radiographs confirm a distal radius fracture with dorsal displacement.
What is the most likely diagnosis?
A. Smith’s fracture
B. Colles’ fracture
C. Scaphoid fracture
D. Boxer’s fracture
Explanation:
B. Colles’ fracture is the correct answer. A Colles’ fracture is a distal radius fracture with dorsal displacement of the distal fragment, typically resulting from a FOOSH injury and creating the classic "dinner fork" deformity. A Smith’s fracture (A) involves volar displacement (the opposite of Colles’). A scaphoid fracture (C) involves pain in the anatomical snuffbox and often lacks the dinner fork deformity. A Boxer’s fracture (D) is a fracture of the fifth metacarpal neck.
Case 4: Emergency Medicine/Pulmonary
Your patient is a 28-year-old female with no significant medical history who presents with sudden onset sharp, pleuritic chest pain and dyspnea that began 2 hours ago. She recently returned from a 12-hour flight. Vitals: HR 112, BP 122/80, RR 24, SaO2 91% on room air. Her lungs are clear to auscultation.
What is the most appropriate initial diagnostic study to confirm the suspected diagnosis?
A. Chest X-ray
B. D-dimer
C. CT Angiography of the chest
D. Ventilation-Perfusion (V/Q) scan
Explanation:
C. CT Angiography of the chest is the correct answer. Given the patient’s high clinical suspicion for Pulmonary Embolism (PE): tachycardia, hypoxia, pleuritic pain, and recent long-duration travel (immobilization): CT Angiography is the gold standard for diagnosis. While a D-dimer (B) has high sensitivity, it is only useful for ruling out PE in low-probability patients. Chest X-ray (A) is often normal in PE cases (Westermark sign or Hampton's hump are rare). A V/Q scan (D) is typically reserved for patients with a contraindication to CT contrast, such as renal failure or severe allergy.
For more practice and to secure your 100 hours of AAPA Category 1 credit, visit our full PANRE Review Course catalog.