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The Ultimate Guide to PANRE-LA: Everything You Need to Succeed with Category 1 Credits

Price: $500.00 – $2,000.00 (depending on gift card add-on)
Access: 1 Year of Unlimited Access
Deliverables: 100 Hours of AAPA Category 1 CME Credit (PANRE Review Course), Comprehensive Video Library, Practice Questions, and Gift Card Add-ons ($100 – $1500)

Navigating the transition from the traditional high-stakes recertification exam to the longitudinal assessment (PANRE-LA) requires a shift in how you prepare. As a Physician Assistant, your time is your most valuable asset. The PANRE-LA offers flexibility, but it also demands a consistent level of clinical readiness over a multi-year period. Understanding the format of the assessment and how to maximize your continuing medical education (CME) credits is essential for maintaining your certification without disrupting your clinical practice.

The PANRE-LA is designed to be a less stressful, more integrated way to demonstrate core medical knowledge. However, the requirement to answer 25 questions every quarter means you need a reliable source of information that is easily accessible and clinically relevant. This is where the CME Review Courses PANRE Review becomes your primary tool for success. Written by PAs for PAs, our content is tailored to the specific demands of the NCCPA Blueprint, ensuring that every minute you spend studying translates directly to your performance on the assessment.

Understanding the PANRE-LA Format and Requirements

The PANRE-LA process begins in the sixth year of your certification maintenance cycle. Unlike the traditional PANRE, which is a four-hour proctored exam, the PANRE-LA is spread across three years. You are required to participate in 12 quarters of assessments, with each quarter consisting of 25 multiple-choice questions.

To remain eligible and succeed, you must meet specific participation requirements:

  • Initial Participation: You must participate in at least one quarter during both the first and second years of the program.
  • Scoring: Your final score is calculated based on the best eight quarters of performance.
  • Credit: Completing all 25 questions in a quarter earns you 2 AAPA Category 1 Self-Assessment CME credits.

While the NCCPA provides the platform, they do not provide the comprehensive review materials needed to ensure you are answering those 25 questions correctly. Relying solely on clinical experience is a common pitfall. The PANRE-LA still covers the full breadth of the NCCPA Blueprint, including areas you may not see daily in your specialized practice, such as Infectious Disease or Neurology.

PANRE Book Cover

Maximize Your Credits: 100 Hours of Category 1 AAPA Credit

One of the most significant advantages of choosing the CME Review Courses PANRE Review is the ability to earn 100 hours of AAPA Category 1 CME credit. This is a massive deliverable that allows you to satisfy a large portion of your biennial CME requirements in one efficient package. It is important to note that while we offer various courses, the 100 hours of Category 1 AAPA credit applies specifically to our PANRE Review course.

Our Pharmacology course also offers Category 1 AAPA credit, which is particularly useful for meeting state-specific requirements for prescribing controlled substances or general pharmacology hours. However, for the PA looking to knock out the bulk of their requirements while preparing for the PANRE-LA, the PANRE Review package is the gold standard.

Physicians and Nurse Practitioners also find value in these credits. For physicians, our courses typically count for Category 2 CME. For Nurse Practitioners, AAPA Category 1 credit is often accepted by state boards, though we recommend verifying with your specific state board to ensure compliance.

Strategic CME Spending: Amazon and Apple Gift Cards

The way you spend your employer-provided CME allowance should benefit your long-term career and education. We offer a unique CME with Gift Card option that allows you to add an Amazon or Apple Gift Card to your purchase. This add-on ranges from $100 to $1500, providing an efficient way to use your CME funds to purchase medical equipment, textbooks, or technology that will further enrich your clinical practice.

Gift Card Visual

By selecting a package that includes a $1500 gift card, you are not just buying a review course; you are investing in your clinical infrastructure. Whether you need a new iPad for patient education or a high-quality stethoscope, this program allows you to facilitate those purchases legally and professionally within your CME budget.

Clinical Content Written by PAs for PAs

The credibility of your study material matters. Our content is written by PAs who have navigated the same certification hurdles you are currently facing. We cover all major systems found on the NCCPA Blueprint, including:

The depth of coverage in these modules ensures that when you encounter a complex question during your PANRE-LA quarter, you have the foundational knowledge to arrive at the correct diagnosis and management plan quickly.

Exam 2 Book Cover


Clinical Review and Assessment

Question 1

Your patient is a 45-year-old male presenting with a 2-day history of acute onset of severe pain, redness, and swelling of the first metatarsophalangeal (MTP) joint. He reports no recent trauma. His medical history is significant for hypertension, for which he takes hydrochlorothiazide. On physical examination, the joint is exquisitely tender, erythematous, and warm to the touch. Vital signs are: T 99.1°F, HR 88 bpm, BP 142/92 mmHg, SaO2 98% on room air. Arthrocentesis is performed. What is the most likely finding on synovial fluid analysis?

A. Negatively birefringent, needle-shaped crystals
B. Positively birefringent, rhomboid-shaped crystals
C. WBC count > 50,000 cells/mm³ with > 75% neutrophils
D. Presence of Borrelia burgdorferi DNA via PCR

Explanation: A is the correct answer. The clinical presentation of acute, exquisitely tender monoarthritis in the first MTP joint (podagra) is highly suggestive of gout. The use of a thiazide diuretic (hydrochlorothiazide) is a known risk factor as it decreases renal urate excretion. Synovial fluid analysis in gout reveals monosodium urate crystals, which are characteristically needle-shaped and show strong negative birefringence under polarized light.

  • B describes calcium pyrophosphate deposition disease (pseudogout), which typically affects larger joints like the knee and shows different crystal morphology.
  • C is indicative of septic arthritis, which would be a primary differential but is less likely given the specific involvement of the first MTP and the history of diuretic use.
  • D would be found in Lyme arthritis, which usually presents as a subacute or chronic oligoarthritis, often involving the knee.

Question 2

Your patient is a 68-year-old female with a history of smoking and COPD who presents with progressive shortness of breath and a chronic cough productive of thin, white sputum. On examination, she has a barrel chest and decreased breath sounds bilaterally. PFTs show an FEV1/FVC ratio of 0.62. A chest X-ray is ordered. What is the most likely finding on the radiograph?

A. Flattening of the diaphragm and increased retrosternal air space
B. Kerley B lines and peribronchial cuffing
C. Hilar lymphadenopathy and non-caseating granulomas
D. Wedge-shaped opacity in the periphery (Hampton’s hump)

Explanation: A is the correct answer. The patient’s history, clinical findings, and obstructive PFT pattern (FEV1/FVC < 0.70) are diagnostic of COPD, specifically emphysema. Radiographic findings of emphysema include hyperinflation, which manifests as flattening of the diaphragms and an increased retrosternal air space on the lateral view.

  • B is characteristic of congestive heart failure and pulmonary edema.
  • C describes sarcoidosis, which usually presents in younger patients and often includes systemic symptoms.
  • D is a rare but classic sign of pulmonary embolism, which would present with acute, not progressive, shortness of breath.

Clinical Practice

Question 3

Your patient is a 28-year-old female presenting with pelvic pain, vaginal discharge, and dyspareunia. On examination, she has a temperature of 101.4°F and exquisite cervical motion tenderness (chandelier sign). You suspect Pelvic Inflammatory Disease (PID). What is the most appropriate outpatient treatment regimen?

A. Ceftriaxone 500 mg IM once + Doxycycline 100 mg BID for 14 days + Metronidazole 500 mg BID for 14 days
B. Azithromycin 1g PO once
C. Ciprofloxacin 500 mg BID for 7 days
D. Penicillin G 2.4 million units IM once

Explanation: A is the correct answer. Per the CDC guidelines, outpatient treatment for PID must cover the most common pathogens, including Neisseria gonorrhoeae and Chlamydia trachomatis, as well as anaerobes. The recommended regimen is a single dose of IM Ceftriaxone combined with a 14-day course of oral Doxycycline and Metronidazole.

  • B is appropriate for uncomplicated Chlamydia urethritis but insufficient for the polymicrobial nature of PID.
  • C is no longer recommended due to high rates of fluoroquinolone-resistant N. gonorrhoeae.
  • D is the treatment for primary or secondary syphilis.

Maintaining your certification through the PANRE-LA is a marathon, not a sprint. By utilizing the comprehensive PANRE Review Course and maximizing your CME budget with our gift card add-on options, you ensure that you remain at the top of your clinical game while efficiently managing your professional requirements. Reach out to CME Review Courses today to secure your 100 hours of AAPA Category 1 credit.

About the Author

Jeremy Boroff, PA-C — Emergency Medicine physician assistant with 24 years of clinical EM experience as a PA-C, plus an additional 7 years of experience as a Registered Respiratory Therapist. Author, PA educator, and CME developer — creator of the PANRE, PANCE, EOR, and specialty CME review courses at CME Review Courses.