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Preparing for recertification requires more than reviewing familiar diagnoses. You need a study plan that matches the exam format, targets your weak areas, and uses your CME budget efficiently.

Course price: $499.99 for the PANRE Review Course
Access: 30 months
Questions: 2,500+ board-style questions
Practice exams: Five full-length 240-question practice exams, totaling 1,200 questions
CME: Up to 100 hours of Category 1 AAPA CME through the PANRE Review Course specifically

The course is designed for PAs preparing for the traditional PANRE or PANRE-LA. Optional Amazon and Apple Gift Card add-ons are available in amounts from $100 to $1,500. These are paid add-ons that increase the total purchase price. They are not free gifts, rebates, discounts, or extra CME. Review your employer’s CME policy before using CME funds for any product or add-on.

The goal is simple: avoid common preparation errors that waste study time and reduce the value of your CME purchase.

Mistake 1: Using Generic PANCE Prep as Your Primary PANRE Strategy

Many PAs begin studying with old PANCE notes or broad pance prep courses. Those materials may contain useful clinical information, but they are not automatically organized for PANRE preparation.

PANRE review should cover the full range of adult medicine, emergency care, chronic disease management, pharmacology, diagnostic reasoning, and professional practice topics represented in the NCCPA Blueprint.

A PANCE resource may also be written for a learner who is still building a first-pass foundation. PANRE preparation is different. You are usually returning to material you have encountered clinically, but you may have gaps in areas outside your current practice setting.

Correct approach

Start with a PANRE-specific diagnostic block. Then divide your missed questions into categories:

• Knowledge gap
• Misread question
• Incorrect diagnostic sequencing
• Medication or guideline error
• Changed answer after initially choosing correctly

Do not spend equal time on every topic. Your study plan should respond to performance data.

Mistake 2: Reading and Watching Without Testing Yourself

Passive review feels productive because the information is familiar. Recognition, however, is not the same as recall.

Reading a summary of adrenal insufficiency does not confirm that you can identify it in a patient with hypotension, hyponatremia, hyperkalemia, abdominal pain, and hypoglycemia. You need to retrieve the diagnosis and management plan from a clinical presentation.

Use questions early in your preparation, not only during the final week. After each question, identify why you selected your answer. Then read the explanation for the correct answer and the distractors.

Daily method

1. Complete a defined question block.
2. Answer before viewing the rationale.
3. Record missed concepts by organ system.
4. Write one sentence explaining the error.
5. Reattempt the question after a delay.

This method is more efficient than repeatedly rereading the same notes. It also improves confidence because you can measure what you know instead of relying on familiarity.

Clinical vignette

Your patient is a 67-year-old man who is 2 days postoperative from total knee arthroplasty. He develops sudden dyspnea and pleuritic chest pain. His vital signs are HR 118, BP 128/76, RR 26, and SaO₂ 91% on room air. He is alert and not hypotensive.

What is the most appropriate next step?

A. D-dimer testing
B. CT pulmonary angiography
C. Lower-extremity venous duplex ultrasound only
D. Systemic thrombolysis
E. Chest radiography as the definitive test

Correct answer: B. CT pulmonary angiography

This patient has a high pretest probability for pulmonary embolism and is hemodynamically stable. CT pulmonary angiography is the appropriate diagnostic study when renal function and iodinated contrast are acceptable. A D-dimer is not useful in a patient with high clinical suspicion and recent surgery. Lower-extremity ultrasound may identify DVT but does not directly evaluate the pulmonary circulation. Thrombolysis is reserved for selected patients with hemodynamic compromise or other high-risk features. Chest radiography may evaluate alternative diagnoses but does not confirm PE.

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

The traditional PANRE and PANRE-LA require overlapping clinical knowledge, but preparation should account for their different testing environments.

For the traditional PANRE, you need to develop:

• Timed-question pacing
• Concentration over long testing blocks
• Rapid movement between organ systems
• Endurance during the final portion of the exam
• A consistent process for answering unfamiliar questions

For PANRE-LA, the emphasis is more longitudinal. You need a repeatable routine for short question sets, careful reading, and efficient use of approved reference resources. The goal is not to spend unlimited time researching every item. The goal is to identify the clinical issue, use references selectively, and maintain consistent performance over the assessment period.

Practical adjustment

If you are preparing for the traditional PANRE, schedule mixed, timed blocks and full-length simulations.

If you are preparing for PANRE-LA, practice shorter timed sets. Before opening a reference, state the problem representation in one sentence:

“Older adult with acute dyspnea, tachycardia, recent surgery, and hypoxemia: high suspicion for PE.”

This prevents unfocused searching. Always verify current NCCPA policies, assessment windows, and permitted resources before beginning PANRE-LA.

Mistake 4: Taking Practice Exams Too Late: or Ignoring the Results

A full-length practice exam should not be reserved for the final days before your test date. By then, the score may identify a problem without leaving enough time to correct it.

The PANRE Review Course includes five full-length 240-question practice exams. Use them as checkpoints rather than simply as final tests.

A useful schedule is:

• First exam: Establish a baseline.
• Second exam: Confirm whether your first weak areas are improving.
• Third exam: Practice pacing and mixed-system transitions.
• Fourth exam: Reassess persistent gaps.
• Fifth exam: Simulate exam-day conditions.

Do not focus only on the total score. Review:

• Accuracy by organ system
• Performance on diagnosis versus management questions
• Questions missed because of timing
• Questions changed from correct to incorrect
• Performance during the final 60 questions

For the traditional PANRE, complete at least one simulation under realistic timing. For PANRE-LA, use the practice exams to strengthen broad clinical reasoning, then convert the findings into shorter, focused study blocks.

Mistake 5: Treating CME Completion and PANRE Review as Separate Projects

Buying one product for CME and another for exam preparation can divide your time, increase cost, and create two unrelated tracking systems.

The PANRE Review Course combines clinical review with up to 100 hours of Category 1 AAPA CME. The CME applies to the PANRE Review Course specifically. It does not mean that an optional gift card add-on provides additional CME, and it does not transfer Category 1 credit to a separate Pharmacology course.

To earn the applicable CME, complete the course requirements, including the content, post-test, and evaluation. Claim only the credit commensurate with your participation.

The course includes:

• 2,500+ board-style questions
• Five full-length 240-question practice exams
• Detailed answer explanations
• Coverage across the tested organ systems and task areas
• A self-paced online format
• 30 months of access

If you are comparing cme gift cards, understand the purchase structure. The base PANRE Review Course is $499.99. An optional Amazon or Apple Gift Card add-on costs an additional $100 to $1,500, depending on the amount selected. The add-on is not a rebate or a credit toward the course price. It is a separate paid component of the transaction, and it does not increase the number of CME hours.

A More Efficient Daily PANRE Routine

A practical daily session can be completed in three phases:

1. Question block

Complete 20 to 40 questions. Use mixed topics if you are preparing for the traditional PANRE. Use shorter sets if you are building a PANRE-LA routine.

2. Error review

Read the entire rationale. Explain why the correct option is correct and why each distractor is wrong. Flag questions that represent a recurring gap.

3. Targeted reinforcement

Review one focused topic from your notes or study library. Avoid opening multiple unrelated resources. End by answering several new questions on the same topic.

This approach protects your time and creates a direct connection between study effort, exam performance, and CME completion.

Final Takeaway

The most expensive PANRE mistakes are usually process mistakes:

1. Using generic PANCE material without a PANRE-specific plan
2. Relying on passive review
3. Ignoring the differences between traditional PANRE and PANRE-LA
4. Delaying full-length practice or failing to analyze results
5. Separating CME completion from exam preparation or misunderstanding paid gift card add-ons

The PANRE Review Course provides 30 months of access, 2,500+ questions, five full-length 240-question practice exams, and up to 100 hours of Category 1 AAPA CME through the PANRE Clinical Review Module. The course is available through CME Review Courses.

For PA students looking for earlier exam preparation, PAtopia for PA students on the web includes resources for the PANCE, PACKRAT, EOC, and EOR exams. PAtopia is also available on iOS and Android.

About the Author

Jeremy Boroff, MPAS, PA-C, is an Emergency Medicine physician assistant with 24 years of Emergency Medicine experience. He is the founder and educator behind CME Review Courses and develops PANRE, PANCE, EOR, and specialty CME review content for physician assistants. He has also served as an APC director of an emergency department and is the author of multiple PA exam review resources.

Course price: $499.99 for the PANRE Review Course
Access: 30 months
CME: Up to 100 AAPA Category 1 CME credits through the PANRE Clinical Review Module
Practice material: 2,500+ questions, including five full-length 240-question practice exams
Gift card options: Paid Amazon or Apple Gift Card add-ons from $100 to $1,500

If you are approaching the recertification portion of your certification cycle in 2026, you have two exam pathways: the traditional PANRE or the PANRE-LA. Both assess core medical knowledge and use the same NCCPA Blueprint, but the testing experience, schedule, scoring system, and preparation strategy are different.

The important point is simple: choose the format that fits how you perform best, then prepare consistently for the content both assessments test.

PANRE vs PANRE-LA: The 2026 Comparison

Feature	Traditional PANRE	PANRE-LA
Testing format	Single-day, closed-book exam	At-home, open-book longitudinal assessment
Timing in certification cycle	Years 9–10	Years 7–9
Number of questions	240 questions in one exam	25 questions per quarter
Assessment window	One scheduled testing appointment	Up to 12 quarters
Minimum participation	One exam attempt	At least 8 quarters
Final scoring	Scaled score of 379 required	Cumulative score of 1150 required
Final score calculation	Performance on the exam form	Best 8 quarters
Testing environment	Proctored test center	Your own device and location

Traditional PANRE

The traditional PANRE is a single-day, closed-book, proctored examination taken at a Pearson VUE test center. It contains 240 questions, administered in four 60-question blocks. You receive 60 minutes for each block, with scheduled time for breaks and the examination tutorial.

Traditional PANRE eligibility occurs during years 9 and 10 of the certification maintenance cycle. A scaled score of 379 is required to pass. The PANRE score scale ranges from 200 to 800, so the passing score is not a percentage-correct calculation.

The main advantage is completion. You prepare, sit for one exam, and usually receive results within approximately two weeks. The main limitation is concentration. Your performance is concentrated into one testing day, and the exam is closed-book.

PANRE-LA

The PANRE-LA is an at-home, open-book longitudinal assessment. It provides 25 questions per quarter over a maximum 12-quarter window during years 7 through 9 of the certification cycle.

You must complete at least 8 quarters. Your final score is based on your best 8 quarters, and the cumulative passing score is 1150. You must participate at least once during year 7 and at least once during year 8. You may work through the questions at your own pace during each quarterly window, but all 25 questions for that quarter must be completed by the deadline.

The open-book format does not mean you can ask another person for help. You may use printed or online references, but you may not consult with others. Each question provides immediate feedback, including the correct response, explanation, and references.

The PANRE-LA can reduce the pressure of a single high-stakes exam day. However, it requires reliable follow-through over several years. Missing quarterly deadlines or postponing participation can create avoidable problems.

The two passing scores: 379 for PANRE and 1150 for PANRE-LA: are reported on different scales and are not directly comparable.

Which Path Is Better for You?

There is no universal best option. Your work habits, test-taking history, schedule, and preferred learning environment should guide the decision.

Traditional PANRE may fit you if:

• You prefer to complete the recertification exam in one session.
• You perform well under a defined deadline.
• You want a clear separation between studying and testing.
• You prefer a proctored, standardized environment.
• You are comfortable taking a closed-book examination.

PANRE-LA may fit you if:

• You prefer smaller assessment blocks over time.
• You want to use references while answering questions.
• You can reliably monitor quarterly deadlines.
• You value immediate feedback and repeated exposure to core topics.
• You want multiple opportunities to improve your cumulative performance.

Do not select PANRE-LA simply because it is open-book. The questions still require clinical reasoning, and the assessment continues across multiple quarters. Likewise, do not select traditional PANRE solely because it is familiar. A single 240-question exam requires sustained concentration and broad preparation.

How to Prepare for Either Assessment

Both options test the same core medical knowledge. Your preparation should therefore begin with the NCCPA Blueprint rather than with isolated specialty review.

A practical preparation plan includes four steps:

1. Assess your baseline. Complete a diagnostic set of mixed questions. Do not focus only on your practice specialty. PANRE content covers multiple areas, including cardiovascular, pulmonary, GI, endocrine, infectious disease, neurology, psychiatry, dermatology, musculoskeletal, reproductive, and emergency topics.

2. Identify weak systems. Track incorrect answers by organ system and task. A missed question may represent a knowledge gap, a diagnostic reasoning error, or a failure to identify the key detail in the vignette.

3. Study the rationale. Correct answers are not enough. Review why the correct option is preferred and why the distractors are less appropriate. This approach is particularly important for PANRE-LA, where immediate feedback is part of the learning process.

4. Use spaced repetition. For traditional PANRE, spaced study prevents a rushed final review. For PANRE-LA, a consistent weekly or monthly routine helps you remain prepared for each quarterly assessment.

The PANRE Review Course from CME Review Courses is designed for both pathways. It includes more than 2,500 board-style questions, five full-length 240-question practice examinations, system-based modules, cited explanations, and a complete PANRE study library. The content is delivered online and remains available for 30 months.

Use PANRE Preparation to Complete CME Requirements

Passing PANRE or PANRE-LA is only one part of maintaining NCCPA certification. You must also meet the applicable CME requirements for your certification maintenance cycle.

The PANRE Clinical Review Module provides up to 100 AAPA Category 1 CME credits when you complete the required course content, post-test, and evaluation. These credits apply to the PANRE Review Course specifically. The separate Pharmacology Course has its own credit designation and should not be represented as providing the PANRE course’s 100 AAPA Category 1 credits.

The course is listed at $499.99 with 30 months of access. It can be used as a structured review program while also helping you apply your CME budget toward certification maintenance.

CME Gift Card Add-Ons

The course also offers optional cme gift cards through Amazon and Apple. These are paid add-ons, not free gifts. Available add-on amounts range from $100 to $1,500, and the selected gift card cost is added to the total package price.

Gift cards are generally delivered by email within two to three business days. Before purchasing, confirm that your employer or CME allowance permits this type of bundled expense. The gift card add-on is separate from the AAPA Category 1 CME credit.

Review the PANRE Review Course with Gift Card options

Practice Question: PANRE-Style Clinical Vignette

Your patient is a 64-year-old man with a history of hypertension and tobacco use who presents with sudden-onset substernal chest pressure that began 45 minutes ago. The pain radiates to his left arm. HR is 104/min, BP is 156/92 mm Hg, RR is 20/min, and SaO₂ is 96% on room air. ECG demonstrates ST-segment elevation in leads II, III, and aVF. The nearest percutaneous coronary intervention-capable facility is 35 minutes away.

What is the most appropriate next step?

A. Administer IV alteplase immediately
B. Administer aspirin and activate the cardiac catheterization laboratory
C. Obtain a CT angiogram of the chest
D. Perform a treadmill stress test
E. Administer warfarin and arrange outpatient cardiology follow-up

Correct answer: B. Administer aspirin and activate the cardiac catheterization laboratory.

This patient has an acute inferior STEMI. Give aspirin promptly and pursue emergent PCI when it can be performed within the appropriate treatment window. IV fibrinolysis is considered when timely PCI is not available, but a 35-minute transport time supports activating the PCI pathway rather than delaying for additional diagnostic testing. CT angiography and stress testing are inappropriate in a patient with diagnostic ECG findings and active ischemic symptoms. Warfarin has no role in immediate STEMI reperfusion.

When reviewing questions like this, focus on the decisive clinical information: ischemic symptoms, diagnostic ECG changes, and the time-to-reperfusion decision.

Author and Clinical Educator

Jeremy Boroff, MPAS, PA-C

Jeremy Boroff is a physician assistant with 24 years of emergency medicine experience. He is an author, educator, and founder of CME Review Courses. His review materials are written for physician assistants and emphasize practical clinical reasoning, board-style questions, current references, and efficient preparation for certification and recertification exams.

Frequently Asked Questions

Can I use the same study materials for PANRE and PANRE-LA?

Yes. Both assessments use the same NCCPA Blueprint and evaluate core medical knowledge. The format differs, so traditional PANRE candidates should add full-length timed practice exams, while PANRE-LA candidates should emphasize consistent quarterly review and explanation-based learning.

Is PANRE-LA easier because it is open-book?

Not necessarily. Open-book access allows you to verify information, but you still need to interpret clinical vignettes efficiently. The assessment also requires consistent participation over multiple quarters.

When should I start studying?

Start early enough to identify knowledge gaps before your testing window. Candidates for traditional PANRE should build a scheduled review plan before years 9–10. PANRE-LA participants should maintain regular study habits beginning before the first quarterly assessment in year 7.

Are PANCE prep courses useful for PANRE?

Some pance prep courses cover overlapping core medical content, but PANRE preparation should use resources designed for the recertification exam and its broader expectations for practicing PAs. PA students can explore PAtopia’s web-based review library for PANCE, PACKRAT, EOC, and EOR preparation.

Start Your Review Plan

For practicing PAs, the decision is between a concentrated, proctored exam and a structured longitudinal assessment. Review the official NCCPA PANRE and PANRE-LA requirements, confirm your certification-cycle timeline, and select the format that matches your strengths and schedule.

Then build a preparation routine that includes practice questions, system-based review, and repeated analysis of incorrect answers.

• Explore the PANRE Review Course and 100 AAPA Category 1 CME credits
• Visit CME Review Courses
• Use PAtopia on the web
• Download PAtopia for iOS
• Download PAtopia for Android

Base price: $499.99
Access: 30 months
CME: Up to 100 Category 1 AAPA CME credits through the PANRE Clinical Review Module
Practice content: 2,500+ board-style questions, including five 240-question full-length practice exams

If you are responsible for completing a substantial amount of CME, your budget should support both your certification requirements and your ongoing professional needs. A well-selected PANRE review course can help you prepare for recertification while earning a large number of Category 1 AAPA credits.

CME Review Courses also offers optional cme gift cards from Amazon and Apple. These are paid add-ons, not free gifts. You select the gift card amount at checkout, and that amount is added to the total price of the CME package.

The result is a single CME purchase that combines structured clinical education, PANRE preparation, and a gift card option that may help you use your employer-provided CME allowance more efficiently.

1. Start with the CME requirement, not the gift card

The primary value of this package is the educational activity and the associated CME credit.

The PANRE Review Course with Gift Card includes the PANRE Clinical Review Module, an enduring online activity designated for up to 100 AAPA Category 1 CME credits. To earn credit, you must complete the course content, pass the post-test with a score of at least 70%, and complete the activity evaluation. You may retake missed questions as permitted by the course.

The current activity is listed with approval valid from August 26, 2026, through August 26, 2027, under AAPA reference number CME-2016187. Claim only the credit commensurate with your participation and completion.

The 100 Category 1 AAPA credits apply to the PANRE Clinical Review Module. They should not be attributed to the separate Pharmacology CME Review Course, which carries its own credit designation.

For many PAs, completing a single comprehensive activity can simplify CME planning. It also allows your study time to serve two purposes: reviewing clinical medicine and preparing for the PANRE or PANRE-LA.

2. Confirm what the PANRE review course delivers

A course should be evaluated by its measurable deliverables. The PANRE Review Course includes:

• Five full-length practice examinations
• 240 board-style questions per examination
• 1,200 questions across the five full-length exams
• More than 2,500 interactive board-style questions overall
• Question modules covering the 15 organ-system areas of the current NCCPA Blueprint
• Detailed answer rationales and cited sources
• A complete PANRE study library
• Online, self-paced access for 30 months

This structure allows you to use the course in more than one way. You can complete a full-length examination to establish a baseline, work through individual organ-system modules, or return to difficult topics during the months leading up to your exam.

The longer access period is also relevant when you are managing a clinical schedule. You do not need to finish the course during a single weekend or conference period. You can distribute your study and CME work across the access period.

Review the full PANRE Review Course with Gift Card details before purchasing.

3. Understand how the Amazon and Apple gift card add-ons work

The gift card option is straightforward, but it should be described accurately.

You begin with the $499.99 course price. At checkout, you may select an optional Amazon or Apple gift card add-on in amounts ranging from $100 to $1,500. The selected gift card amount is added to the package price.

For example:

• Course alone: $499.99
• Course plus $100 gift card add-on: $599.99 before applicable taxes
• Course plus $500 gift card add-on: $999.99 before applicable taxes
• Course plus $1,500 gift card add-on: $1,999.99 before applicable taxes

The gift card is not included at no cost. It is a purchased add-on, and the entire transaction should be reviewed against your employer’s CME reimbursement policy before checkout. Some organizations restrict how CME funds may be used or require prior approval for specific package structures.

Amazon and Apple gift cards are processed by email within approximately two to three business days. Gift card packages are nonrefundable after the gift card has been issued. CME Review Courses is not affiliated with or sponsored by Amazon or Apple.

You can compare the available Amazon gift card CME options and Apple gift card CME options.

4. Match the course to your professional role

The PANRE Review Course is designed primarily for physician assistants preparing for PANRE or PANRE-LA while completing CME requirements.

Nurse practitioners may find the clinical content useful, but acceptance of AAPA Category 1 credit for NP licensure or certification maintenance varies by state, employer, and certifying organization. NPs should verify eligibility with their state board of nursing and applicable credentialing organization before purchasing.

Physicians may also find value in the clinical review material. However, AAPA Category 1 credit does not automatically satisfy a physician’s Category 1 CME requirement. Physicians should confirm whether the activity may be reported under their applicable CME rules, including whether it qualifies as Category 2 credit.

The practical approach is to confirm three items before purchase:

1. How many CME hours you still need
2. Whether your employer or board accepts this credit
3. Whether your CME allowance permits a package with a paid gift card add-on

5. Use the right resource for your exam stage

The PANRE Review Course is intended for practicing PAs and recertification preparation. PA students looking for pance prep courses may need a different resource.

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

PAtopia is available through:

• PAtopia on the web
• PAtopia for iPhone and iPad on the App Store
• PAtopia for Android on Google Play

PAtopia is an exam-preparation resource. The 100 Category 1 AAPA credits discussed in this article belong to the PANRE Clinical Review Module, not to the standard PANCE review content in PAtopia.

Clinical practice question: pulmonary embolism

Vignette

Your patient is a 63-year-old man who is two days postoperative from total knee arthroplasty. He reports sudden-onset 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. He has unilateral left calf swelling and tenderness. He has no history of contrast allergy or renal disease.

Which is the most appropriate next diagnostic step?

A. D-dimer assay
B. CT pulmonary angiography
C. Bilateral lower-extremity venous ultrasound only
D. Repeat examination in four hours
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 hemodynamically stable and has no contraindication to iodinated contrast, making CT pulmonary angiography the appropriate diagnostic study.

A is incorrect because D-dimer is most useful when the pretest probability is low or intermediate. In a postoperative patient with a high clinical suspicion, a positive result is expected and does not efficiently establish the diagnosis.

C is incorrect because lower-extremity ultrasound may identify DVT but does not directly evaluate the pulmonary vasculature. It may be useful when CT contrast is contraindicated, but it is not the preferred next test here.

D is incorrect because delaying evaluation risks progression of an untreated PE.

E is incorrect because stress testing does not evaluate the suspected acute thromboembolic process.

This type of question reflects the practical decision-making required for PANRE preparation: establish pretest probability, select the appropriate test, and account for contraindications, cost, and unnecessary radiation exposure.

Make the purchase serve a defined purpose

A CME package with a gift card add-on is not automatically the right choice for every clinician. It is most useful when the course meets your educational needs, the credit is accepted for your professional requirements, and the total purchase fits your employer’s policy.

For a PA preparing for PANRE or PANRE-LA, the combination is direct:

• Up to 100 Category 1 AAPA CME credits
• 2,500+ board-style questions
• Five full-length practice exams
• 30 months of access
• An optional paid Amazon or Apple gift card add-on from $100 to $1,500

Explore the complete CME Review Courses catalog or review the PANRE Review Course with Gift Card before using your CME budget.

About the author

Jeremy Boroff, MPAS, PA-C, is a practicing emergency medicine physician assistant with 24 years of clinical experience and more than 20 years of experience as an APC director of an emergency department. He is the sole faculty member for the PANRE Clinical Review Module and has authored multiple PA exam-review resources. His content focuses on practical clinical reasoning, board-style assessment, and evidence-based explanations for physician assistants.

This article is for educational and planning purposes. Verify current CME requirements with AAPA, NCCPA, your state licensing board, certifying organization, and employer before claiming credit or using CME funds.

Course price: $499.99 for the PANRE Review Course
Access: 30 months from purchase
CME deliverable: Up to 100 hours of AAPA Category 1 CME through the PANRE Clinical Review Module
Study deliverables: More than 2,500 board-style questions, five full-length 240-question practice exams, a PANRE Study Library, cited explanations, and downloadable slides
Gift card options: Paid Amazon and Apple add-ons from $100 to $1,500

A CME budget is most useful when it supports both your professional requirements and your actual study plan. For PAs preparing for recertification, the PANRE Review Course with Gift Card combines exam preparation with up to 100 hours of AAPA Category 1 CME.

The Amazon and Apple gift cards are optional paid add-ons. They are not free gifts, discounts, rebates, or complimentary items. The selected gift card amount is added to the course price and included in the total package cost. Confirm that your employer allows this type of bundled CME purchase before selecting an add-on.

Start with the CME and PANRE requirement

The most efficient approach is to choose the educational product first. The gift card should help you use an eligible remaining CME allowance; it should not determine whether the course is clinically appropriate for you.

The PANRE Review Course with Gift Card is designed for practicing PAs preparing for the PANRE or PANRE-LA. The course reviews the organ systems and task areas covered by the NCCPA Blueprint and uses board-style multiple-choice questions with five answer choices.

The 100 AAPA Category 1 CME hours apply specifically to the PANRE Review Course. They are earned by completing the required course content, passing the post-test with a score of at least 70%, and completing the evaluation. You should claim only the number of credits that corresponds to your actual participation.

The listed approval period for this activity is August 26, 2026, through August 26, 2027, under AAPA reference number CME-2016187. Verify your current NCCPA and employer requirements before purchasing.

Calculate the remaining CME allowance

Before selecting an add-on, determine three numbers:

1. How much CME funding remains in your current cycle?
2. How many Category 1 credits do you still need?
3. What types of educational purchases does your employer reimburse?

The base course is $499.99. Paid gift card add-ons range from $100 to $1,500, depending on the brand and amount selected. The total package price is the course price plus the selected gift card amount.

Examples:

• Course only: $499.99
• Course plus $100 Amazon or Apple gift card: $599.99
• Course plus $500 Amazon or Apple gift card: $999.99
• Course plus $1,500 Amazon or Apple gift card: $1,999.99

These calculations make it easier to match the purchase to a defined CME budget. Do not select an add-on that exceeds your allowance or violates your organization’s reimbursement policy.

Confirm your employer’s policy before checkout

CME policies differ by employer, health system, and practice. Some organizations cover online review courses and board-preparation materials. Others restrict reimbursement to specific categories or require prior authorization.

Ask whether your policy permits:

• Online CME review courses
• PANRE or recertification preparation
• Bundled CME purchases with a paid Amazon or Apple gift card add-on
• Reimbursement for the full package price
• Gift card amounts within the $100-to-$1,500 range

The gift card is a paid component of the purchase. It does not create additional CME credit, and it does not change the number of credits assigned to the PANRE Review Course.

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

Use the course deliverables as your study plan

The financial value of the course depends on whether you use the educational content. The PANRE Review Course includes:

• More than 2,500 PANRE practice questions
• Five full-length practice examinations
• 240 questions per full-length exam
• Five-answer multiple-choice formatting
• Detailed rationales and cited sources
• System-based question modules
• A complete PANRE Study Library
• A readiness dashboard with performance tracking and question flagging
• Mobile-friendly access for 30 months

A practical schedule is to complete one system-based module at a time, review missed questions, and then use the full-length exams to assess pacing and endurance. Your score should identify where additional review is needed; it should not be treated as a substitute for completing the CME activity requirements.

A full-length examination also helps identify a common problem: recognizing a diagnosis but missing the next best step in management. The following vignette illustrates that distinction.

PANRE Practice Question

A 62-year-old woman presents to the emergency department with acute dyspnea and right-sided pleuritic chest pain that began two hours ago. She underwent total knee arthroplasty 10 days ago. HR is 112/min, BP is 128/76 mm Hg, RR is 24/min, and SaO₂ is 92% on room air. Her right calf is swollen and tender compared with the left. She is alert and has no hemoptysis. ECG shows sinus tachycardia without ST-segment elevation.

Which is the most appropriate next diagnostic step?

A. D-dimer assay
B. Lower-extremity venous ultrasound only
C. CT pulmonary angiography
D. Transthoracic echocardiography
E. Immediate systemic thrombolysis

Correct answer: C. CT pulmonary angiography.

This patient has a high pretest probability for pulmonary embolism based on recent surgery, tachycardia, hypoxemia, pleuritic chest pain, and unilateral calf findings. In a hemodynamically stable patient without a major contraindication to iodinated contrast, CT pulmonary angiography is the preferred diagnostic test.

A D-dimer is not useful when the pretest probability is high and is frequently elevated after surgery. Lower-extremity ultrasound may identify DVT but does not directly evaluate the pulmonary vasculature. Echocardiography is useful when assessing right-heart strain or an unstable patient but is not the preferred initial confirmatory study in this stable presentation. Thrombolysis is reserved for selected patients with hemodynamic compromise or other high-risk features. If contrast exposure or radiation is a significant concern, a V/Q scan may be considered when the chest radiograph and clinical context are appropriate.

This is the type of management distinction that repeated practice can reinforce: identify the syndrome, assess stability, and select the test that provides the most useful information with appropriate attention to cost, radiation exposure, renal function, and availability.

Match the product to your career stage

The PANRE Review Course is intended for practicing PAs who need recertification preparation and Category 1 CME. PAs earlier in training may need a different type of question bank.

For students preparing for the PANCE, PACKRAT, EOR, or End of Curriculum examination, the PAtopia All-Access Pass includes 11,325 practice questions, 60 full-length exams, and 27 months of access. It covers PANCE, all seven EOR examinations, PACKRAT, and the End of Curriculum exam.

PAtopia is also available through mobile apps:

• PAtopia on the iOS App Store
• PAtopia on Google Play

The PAtopia products are PANCE prep courses and are separate from the PANRE Review Course’s AAPA Category 1 CME designation.

Author and Clinical Review

Jeremy Boroff, MPAS, PA-C
Jeremy Boroff is a physician assistant with 24 years of emergency medicine experience. He is an author, educator, and founder of CME Review Courses. His clinical and educational work focuses on practical board preparation, evidence-informed decision-making, and efficient CME for practicing PAs.

Final CME budget checklist

Before purchasing a CME package with a gift card add-on:

• Confirm your remaining CME allowance.
• Check how many Category 1 credits you still need.
• Verify that PANRE preparation is an eligible expense.
• Obtain employer approval for the full bundled purchase when required.
• Remember that Amazon and Apple gift cards are paid add-ons, not free gifts.
• Select an add-on amount that fits your approved budget.
• Complete the PANRE Review Course requirements before claiming CME.
• Claim only the AAPA Category 1 credit supported by your participation.

To review the current course options, visit CME Review Courses. For the primary PANRE and CME package, see the PANRE Review Course with Gift Card.

Course price: $499.99
Access: 30 months
CME: Up to 100 AAPA Category 1 CME credits
Included study material: 2,500+ PANRE practice questions, five 240-question mock exams, 15 organ-system modules, and a complete PANRE Study Library

If you are a PA planning for recertification, the type of CME you earn matters. A course may be clinically useful but still fail to provide the Category 1 credit needed for NCCPA certification maintenance.

The following five facts can help you select valid CME, avoid counting errors, and use your CME budget efficiently.

Fact 1: Category 1 CME is structured professional education that supports patient care

AAPA Category 1 CME consists of clinical and professional educational activities designed to maintain, develop, or increase the knowledge, skills, and professional performance used in patient care.

This is different from simply reading a medical article or attending an informal educational session. Category 1 activities are reviewed against established criteria and formally designated for a specific amount and type of CME credit.

For PAs, Category 1 CME is important because NCCPA certification maintenance requires:

• 100 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
• A recertification examination every 10 years, such as PANRE or an applicable PANRE-LA pathway

Review the current requirements directly through NCCPA Continuing Medical Education and the AAPA CME FAQs.

The PANRE Review Course with Gift Card is designed to combine exam preparation with CME completion. The course offers up to 100 AAPA Category 1 CME credits when you complete the required content, post-test, and evaluation. Claim only the credit amount supported by your actual participation and completion.

Fact 2: AAPA Category 1 credit is accepted by NCCPA for the CME requirement

NCCPA accepts AAPA Category 1 CME toward the 100-credit certification maintenance requirement. This makes AAPA Category 1 credit directly relevant to PAs preparing for PANRE and managing their two-year CME cycle.

The practical distinction is important: PANRE is the recertification examination, while CME is part of the ongoing certification maintenance process. Completing CME does not replace the examination requirement when an exam is due. However, earning appropriate Category 1 CME helps you satisfy the CME component of maintaining national certification.

The PANRE Review Course provides:

• 100 AAPA Category 1 CME credits
• More than 2,500 board-style PANRE questions
• Five full-length mock exams with 240 questions each
• 1,200 total questions across the five mock exams
• Questions covering the organ systems and task areas represented in the NCCPA PANRE Blueprint
• Detailed answer explanations and cited sources
• Online access for 30 months

A single completed course can provide enough credit to satisfy the total 100-credit requirement for a two-year NCCPA cycle, including the minimum 50 Category 1 credits. You should still review your NCCPA account and current certification cycle before deciding how much CME you need.

Some Category 1 activities are designated specifically as self-assessment or performance improvement CME. NCCPA may apply additional weighting to eligible self-assessment and PI-CME activities. Do not assume that every Category 1 course receives this weighting. Log the credit type and amount exactly as stated by the provider.

Fact 3: Category 1 and Category 2 are not interchangeable

Category 1 CME is formally reviewed and designated by an accepted CME sponsor or accreditor. Examples include:

• AAPA Category 1 CME
• AAPA Category 1 Self-Assessment CME
• AAPA Category 1 Performance Improvement CME
• AMA PRA Category 1 Credit from an appropriately accredited provider
• AOA Category 1-A credit
• Other credit types recognized by NCCPA

Category 2 CME includes educational activities related to medicine, patient care, or the PA profession that have not been designated for Category 1 credit. Examples may include independent reading, certain professional meetings, clinical research, or other eligible self-directed education.

Category 2 can be useful, but it does not replace the minimum Category 1 requirement. If you complete 100 hours of Category 2 education, you may still have a Category 1 deficiency for NCCPA certification maintenance.

This is why the product description, accreditation statement, and final certificate matter. The PANRE Review Course is specifically designated for 100 AAPA Category 1 CME credits. The separate Pharmacology Review Course provides its own stated amount of Category 1 AAPA credit; do not combine or transfer credit between products unless the provider documentation supports it.

Fact 4: You should verify the accreditation statement before purchasing

Do not rely on the words “CME,” “board review,” or “continuing education” alone. Before counting a course as AAPA Category 1 CME, verify the following:

1. Look for explicit language.
   The course should state the exact credit designation, such as “AAPA Category 1 CME” or “AAPA Category 1 Self-Assessment CME.”

2. Confirm the number of credits.
   The provider should identify the maximum credit amount and explain whether credit is based on completing specific modules, passing a post-test, or completing an evaluation.

3. Check the sponsor and reference information.
   The current PANRE Review Course accreditation statement identifies review by the AAPA Review Panel, an approval period of August 26, 2026, through August 26, 2027, and AAPA reference number CME-2016187.

4. Review the completion requirements.
   For this course, you must review the content, complete the post-test with a score of at least 70%, and complete the evaluation before receiving a certificate.

5. Confirm the timing.
   CME must fall within your applicable NCCPA earning window. A valid course completed outside the relevant cycle may not satisfy the cycle you are trying to complete.

6. Keep the provider documentation.
   Your certificate should identify your name, activity title, completion date, credit amount, and credit designation. NCCPA may audit Category 1 submissions.

You can also compare available activities through the AAPA CME Catalog and review NCCPA’s guidance on acceptable CME sponsors and activity types.

Fact 5: A large Category 1 course can protect both your schedule and your budget

Many PAs postpone CME until the end of the cycle and then search for disconnected activities. That approach can create unnecessary administrative work and make it harder to ensure that enough of the completed education qualifies as Category 1.

The PANRE Review Course offers a more consolidated option: exam preparation and up to 100 hours of AAPA Category 1 CME in one activity. You can work through the material over 30 months while preparing for PANRE or PANRE-LA.

The course is also available with paid Amazon or Apple Gift Card add-ons from $100 to $1,500. These are optional paid add-ons, not free gifts or credits included at no cost. The selected gift card amount is added to the purchase price, and the card is delivered by email according to the product terms. Review your employer’s CME spending policy before purchasing.

Explore the PANRE Review Course with Gift Card or visit the CME Review Courses website to review available CME packages.

Clinical Practice: PANRE-Style Questions

Question 1

Your patient is a 64-year-old man with substernal chest pressure for 45 minutes. He is diaphoretic and nauseated. HR is 104/min, BP is 158/92 mm Hg, and SaO₂ is 96% on room air. ECG shows 2-mm ST-segment elevations in leads II, III, and aVF. Which intervention is most appropriate?

A. Administer IV alteplase immediately
B. Obtain outpatient stress testing
C. Activate the cardiac catheterization laboratory
D. Administer a nonsteroidal anti-inflammatory drug
E. Observe for serial troponins only

Correct answer: C. Activate the cardiac catheterization laboratory.

This patient has an acute inferior STEMI requiring immediate reperfusion, preferably primary PCI when promptly available. Fibrinolysis is considered when PCI cannot be delivered within the appropriate timeframe. Outpatient stress testing, NSAIDs, and observation alone delay definitive treatment.

Question 2

Your patient is a 27-year-old woman with polyuria, vomiting, and abdominal pain. HR is 122/min, BP is 96/60 mm Hg, and respirations are 30/min. Serum glucose is 480 mg/dL, bicarbonate is 10 mEq/L, and potassium is 4.8 mEq/L. What is the first step in management?

A. Begin an IV insulin infusion
B. Administer IV isotonic crystalloid
C. Give IV sodium bicarbonate
D. Administer potassium replacement immediately
E. Give subcutaneous long-acting insulin

Correct answer: B. Administer IV isotonic crystalloid.

This patient has DKA with significant volume depletion. Initial treatment is IV isotonic fluid resuscitation, followed by insulin and electrolyte management. Insulin should not be started before assessing potassium, and bicarbonate is reserved for severe acidemia. Potassium replacement depends on the measured serum potassium and total-body deficit.

Question 3

Your patient is a 71-year-old man with new unilateral weakness and aphasia beginning 70 minutes ago. HR is 88/min, BP is 176/98 mm Hg, and glucose is 112 mg/dL. Noncontrast head CT shows no hemorrhage. Which treatment should be considered next?

A. IV thrombolytic therapy after confirming eligibility
B. Immediate anticoagulation with IV heparin
C. Aspirin only because the blood pressure is elevated
D. Lumbar puncture
E. Discharge with outpatient neurology follow-up

Correct answer: A. IV thrombolytic therapy after confirming eligibility.

The presentation is consistent with acute ischemic stroke within the treatment window. After hemorrhage is excluded and contraindications are reviewed, IV thrombolytic therapy should be considered. IV heparin is not routine acute treatment, and aspirin alone is inadequate when the patient is otherwise eligible for reperfusion therapy.

Use Your CME Budget Deliberately

Before purchasing any CME product, confirm the credit type, approval status, completion requirements, access period, and total price. For PAs, the PANRE Review Course with 100 hours of AAPA Category 1 CME can consolidate certification maintenance education with structured PANRE preparation.

If you are a PA student or preparing for the PANCE, explore PAtopia on the web, the PAtopia iOS app, or PAtopia on Android. PAtopia provides PANCE prep courses, EOR review, PACKRAT preparation, and EOC practice in one platform.

About the Author

Jeremy Boroff, MPAS, PA-C, is a physician assistant with 24 years of Emergency Medicine experience. He is an author and educator who develops clinical review materials for physician assistants, including PANRE preparation, PANCE prep courses, and continuing medical education. His work emphasizes practical clinical reasoning, board-style assessment, and efficient preparation for certification and recertification exams.

Ready to combine PANRE preparation with Category 1 CME? Visit the PANRE Review Course with Gift Card to review the 100-hour AAPA Category 1 CME option and available paid Amazon and Apple gift card add-ons.

If you are planning recertification, the first decision is not which review resource to buy. It is identifying which NCCPA pathway fits your certification cycle, clinical schedule, and study habits.

At a Glance: PANRE Review Course Details

• Price: $499.99 for the PANRE Review Course
• Access: 30 months from purchase
• CME: Up to 100 hours of AAPA Category 1 CME through the PANRE Clinical Review Module
• Practice questions: 2,500+ board-style questions, including five full-length 240-question practice examinations
• Gift card add-ons: Optional Amazon or Apple Gift Cards from $100 to $1,500
• Gift card terms: Gift cards are paid add-ons, not free gifts. Their cost is added to the course purchase total. They are emailed within approximately 2–3 business days, and gift card packages are nonrefundable.

Review the PANRE Review Course with Gift Card for current pricing, access, accreditation, and available add-ons.

The course is designed for practicing PAs preparing for either the traditional PANRE or PANRE-LA. The 100 AAPA Category 1 credits apply to the PANRE Clinical Review Module specifically. They do not automatically apply to every other CME or pharmacology product.

PANRE-LA vs Traditional PANRE: The Core Difference

The traditional PANRE is a proctored examination completed during the ninth or tenth year of your certification cycle. PANRE-LA is a longitudinal assessment that distributes questions across multiple quarters and years.

Both pathways use the same general NCCPA content blueprint and question format. The primary difference is how and when you demonstrate competency.

According to NCCPA information on PANRE-LA and PANRE:

• PANRE-LA: Apply during Year 6 and begin the assessment in Year 7.
• Traditional PANRE: Take the proctored examination during Year 9 or Year 10.
• PANRE-LA: Complete 25 questions each quarter, with five minutes available for each question.
• Traditional PANRE: Complete a single, proctored examination consisting of 240 questions.
• PANRE-LA: Online and print references may be used while answering questions.
• Traditional PANRE: Closed-book, proctored testing-center environment.
• PANRE-LA: Immediate feedback and explanations are provided after questions.
• Traditional PANRE: Results reflect performance on the examination as a whole.

You must confirm your eligibility and application window through your NCCPA portal. PAs seeking to regain certification after expiration or revocation are generally required to use the traditional PANRE rather than PANRE-LA.

Who May Prefer PANRE-LA?

PANRE-LA may fit your practice if you perform better with spaced repetition and regular feedback rather than one high-stakes testing date.

The format can be practical for a PA who:

• Has a demanding clinical schedule
• Wants to study in smaller sessions
• Prefers using references to confirm clinical reasoning
• Benefits from immediate explanations after each question
• Wants performance feedback over time
• Is comfortable maintaining a consistent quarterly schedule

The longitudinal model does not eliminate the need for preparation. You still need broad knowledge across cardiovascular, pulmonary, GI, infectious disease, neurologic, psychiatric, reproductive, renal, endocrine, musculoskeletal, dermatologic, hematologic, EENT, genitourinary, and professional practice topics.

A common mistake is treating PANRE-LA as an open-book replacement for studying. References can help you verify a difficult point, but they do not replace pattern recognition, diagnostic prioritization, or familiarity with first-line management.

The PANRE/PANRE-LA Review Exams Bundle can help you practice the same five-answer multiple-choice structure used in the examination environment. It includes three full-length practice examinations and 720 total questions.

Who May Prefer Traditional PANRE?

Traditional PANRE may be a better fit if you prefer to prepare intensively, schedule a defined examination date, and finish the testing requirement in one concentrated period.

This format may fit your practice if you:

• Prefer a clear deadline
• Have difficulty maintaining quarterly study habits
• Perform well during structured examinations
• Want to complete recertification testing in one sitting
• Need the traditional PANRE to regain certification
• Prefer a testing-center environment without access to outside references

The traditional PANRE requires stamina and pacing. A 240-question examination demands more than recognition of isolated facts. You must move efficiently through vignettes, identify the key clinical problem, eliminate distractors, and reserve time for difficult questions.

A useful preparation plan includes:

1. Complete a baseline practice examination.
2. Identify weak organ systems and task areas.
3. Review explanations rather than only recording correct answers.
4. Repeat missed questions after a delay.
5. Complete at least one timed, full-length simulation.
6. Review test-center requirements and NCCPA policies before examination day.

How Your CME Budget Fits Into the Decision

The exam pathway and your CME strategy are related but separate decisions.

The PANRE Review Course costs $499.99 and provides 30 months of access. After completing the module requirements: including the content, post-test, and evaluation: you may claim up to 100 AAPA Category 1 CME credits for the PANRE Clinical Review Module.

For NCCPA certification maintenance, self-assessment CME may receive additional weighting under NCCPA policies. You should log credit according to the instructions provided by NCCPA and claim only the amount commensurate with your participation.

The course includes:

• 2,500+ interactive PANRE review questions
• Five 240-question full-length practice exams
• Explanations and cited sources
• Review modules covering all major NCCPA content areas
• A performance dashboard for tracking attempted and correct questions
• Downloadable review materials
• 30 months of online access

If your employer provides a CME allowance, you may be able to use that budget for the course. Employer rules differ, so verify that exam preparation materials and optional add-ons are eligible before purchasing.

CME Gift Cards: What the Add-On Actually Means

CME Review Courses offers optional Amazon and Apple gift card add-ons in amounts from $100 to $1,500.

The gift card is not included at no cost. You select the gift card brand and amount at checkout, and that amount is added to the purchase total. For example, selecting a $500 Amazon Gift Card creates a $500 additional charge beyond the base course price.

The practical value is budget flexibility. If you have unused CME funds, the purchase can combine a clinically relevant review course with an optional paid gift card add-on in one transaction, subject to your employer’s CME policy.

Amazon and Apple are not affiliated with or sponsors of CME Review Courses. Gift card packages are nonrefundable after delivery.

Clinical Practice Question

Vignette

Your patient is a 68-year-old man with COPD who presents with fever, productive cough, and dyspnea. He is confused. Vital signs are BP 86/50 mm Hg, HR 118/min, RR 30/min, and SaO₂ 88% on room air. Chest radiography demonstrates a right lower-lobe infiltrate. After receiving 30 mL/kg of IV crystalloid, his BP remains 84/48 mm Hg. Which of the following is the most appropriate next step?

A. Administer IV furosemide
B. Begin a norepinephrine infusion
C. Start oral prednisone and discharge
D. Order an outpatient CT chest
E. Administer IV propranolol for tachycardia

Correct answer: B. Begin a norepinephrine infusion

This patient has presumed septic shock from community-acquired pneumonia with persistent hypotension after an appropriate initial crystalloid bolus. Norepinephrine is the first-line vasopressor when hypotension persists despite fluid resuscitation.

Furosemide may worsen intravascular depletion. Prednisone and discharge are inappropriate in a patient with shock and altered mental status. CT chest delays resuscitation and does not change the immediate management priority. Propranolol can worsen hypotension and is not indicated for compensatory tachycardia.

This is the type of management-focused reasoning tested across PANRE and PANRE-LA content areas. Practice should include both diagnosis and the next best step, with attention to hemodynamics, medication effects, contraindications, and resource utilization.

Where PANCE Prep Courses Fit

PANCE prep courses are primarily designed for PA students, while PANRE review is intended for certified PAs preparing for recertification. However, the underlying clinical reasoning skills overlap.

For PA students, PAtopia All-Access includes 11,325 questions, 60 full-length exams, and review tracks for the PANCE, PACKRAT, all seven EOR exams, and the EOC exam.

PAtopia is available through:

• PAtopia web access
• PAtopia on the Apple App Store
• PAtopia on Google Play

Use PAtopia for PA school examination preparation. Use the PANRE Review Course for recertification preparation and the associated 100 hours of AAPA Category 1 CME.

A Practical Decision Rule

Choose PANRE-LA if you are eligible, prefer distributed assessment, and will consistently complete quarterly questions.

Choose traditional PANRE if you prefer a concentrated testing experience, need to regain certification, or do not want a multiyear assessment schedule.

Regardless of pathway, begin with the same steps:

1. Check your NCCPA certification cycle and eligibility.
2. Confirm your PANRE-LA application window, if applicable.
3. Select a preparation resource aligned with the NCCPA content blueprint.
4. Use timed practice questions to measure readiness.
5. Apply your CME budget to a course that supports both clinical review and certification maintenance.
6. Verify employer rules before selecting any CME gift card add-on.

Prepare With CME Review Courses

The PANRE Review Course combines recertification preparation with up to 100 hours of AAPA Category 1 CME, 2,500+ practice questions, five full-length practice examinations, and 30 months of access.

You can also review the CME Review Courses website for additional PANRE, pharmacology, emergency medicine, internal medicine, cardiology, orthopedics, dermatology, psychiatry, neurology, and family medicine resources.

Author Box : Jeremy Boroff, MPAS, PA-C
Jeremy Boroff is a physician assistant with 24 years of experience in emergency medicine. He holds a Master of Physician Assistant Studies and is the author and faculty member behind CME Review Courses’ PANRE and clinical review content. His materials are written for practicing PAs and emphasize board-style clinical reasoning, efficient management decisions, and practical application across common medical specialties.

Educational content is not a substitute for NCCPA policies, clinical judgment, or individualized medical advice. CME eligibility and acceptance may vary for physicians, nurse practitioners, and other professionals. Nurse practitioners should verify AAPA Category 1 credit acceptance with their state board and certifying organization before purchase.

Price: $499.99 for the PANRE Review Course
Access: 30 months from purchase
Deliverables: 100 hours of AAPA Category 1 CME, 2,500+ board-style questions, five full-length 240-question practice examinations, and a comprehensive PANRE Study Library

Preparing for the PANRE requires more than reviewing the conditions you see every day. The exam evaluates broad clinical knowledge across multiple organ systems and task areas. A focused strategy helps you identify knowledge gaps, practice clinical reasoning, and use your CME budget efficiently.

The PANRE Review Course from CME Review Courses is designed for practicing PAs preparing for the traditional PANRE or PANRE-LA. Completion of the PANRE Clinical Review Module provides up to 100 AAPA Category 1 CME credits, subject to completion requirements and credit claimed commensurate with participation.

The following five mistakes can cost you study time, CME value, or both.

Mistake 1: Studying Only the Specialty You Practice

Your clinical experience is valuable, but it does not replace generalist exam preparation.

If you work primarily in emergency medicine, orthopedics, cardiology, or dermatology, you may be highly efficient in your daily practice area while becoming less familiar with topics outside that setting. The PANRE requires you to move across systems and presentations. Your preparation must do the same.

A common example is a PA who reviews chest pain, fractures, and sepsis extensively but gives minimal attention to reproductive health, psychiatry, dermatology, or endocrine disorders. Those lower-frequency topics can become avoidable missed questions.

Use the NCCPA PANRE/PANRE-LA Content Blueprint as the organizing framework for your review. Then use question performance to determine where additional study is needed.

Practical correction: Start with a broad diagnostic assessment. Do not assume that years of practice automatically identify your weak areas. Let performance data show you where to focus.

Mistake 2: Treating Every Topic as Equally Important

You have limited study time. Spending the same number of hours on every diagnosis is inefficient.

The NCCPA Blueprint assigns different emphasis to clinical content areas. Your study plan should reflect that weighting while still covering the full exam. High-volume areas deserve consistent question practice, but smaller sections should not be ignored entirely.

A better approach is to divide your preparation into three phases:

1. Initial assessment: Complete mixed questions to establish a baseline.
2. Targeted review: Study the systems and task areas with the lowest performance.
3. Exam simulation: Complete timed, mixed practice examinations to evaluate readiness.

Avoid spending an entire week rereading one familiar section because it feels productive. Review should be based on exam relevance and demonstrated weakness, not comfort level.

Practical correction: Track your percentage correct by organ system. Revisit missed questions after a delay rather than immediately memorizing the answer.

Mistake 3: Using Too Many Disconnected Resources

Collecting multiple books, apps, question banks, and short courses can create the appearance of preparation without producing an efficient workflow.

Every new resource requires time to learn its format, organize notes, and determine whether its content overlaps with what you already reviewed. Fragmented preparation also makes it harder to measure progress.

Choose a primary resource that combines:

• Broad content coverage
• Board-style questions
• Explanations and references
• Full-length practice examinations
• Performance tracking
• Sufficient access time to support your schedule

The CME Review Courses PANRE package includes five full-length practice examinations with 240 questions each, or 1,200 examination questions, in addition to system-based question modules and the Study Library. This allows you to use one structured platform for learning, assessment, and review.

This principle also applies when comparing pance prep courses with PANRE resources. PANCE and PANRE preparation overlap in clinical content, but you should select a course that specifically addresses your certification or recertification objective.

Practical correction: Select one primary review course and a limited number of supplemental references. Use additional sources only when a specific question requires clarification.

Mistake 4: Failing to Plan for Your CME Requirement

A review course that does not provide usable CME may leave you with two separate problems: preparing for the exam and completing your Category 1 requirement.

For PAs, the PANRE Review Course provides up to 100 hours of AAPA Category 1 CME through the PANRE Clinical Review Module. This credit applies to the PANRE Review Course. It should not be attributed to the separate Pharmacology Review Course, which has its own Category 1 designation and credit amount.

To earn the PANRE course credit, you must review the activity content, complete the post-test with a passing score, and complete the evaluation. Confirm your individual NCCPA requirements before relying on any activity for certification maintenance.

The course also offers Amazon and Apple gift card add-ons from $100 to $1,500. These are optional, paid add-ons. They are not free gifts, rebates, or additional CME. The selected gift card amount is added to the total purchase price.

For example, a $499.99 PANRE course with a $300 Amazon gift card add-on has a total package price of $799.99. The $300 is the cost of the add-on, while the course provides the educational content and eligible CME.

These cme gift cards may help some PAs use an employer-provided CME allowance for educational technology, books, or other permitted professional resources. Employer policies differ, so verify that your organization allows this type of purchase before ordering.

Practical correction: Review your CME balance and employer policy early. Decide whether you need the course alone or whether a paid add-on fits your remaining allowance.

Learn more about the PANRE Review Course with Amazon and Apple gift card options.

Mistake 5: Waiting Until the End to Practice Questions

Reading alone does not show whether you can apply information under exam conditions.

PANRE-style questions require you to identify the key clinical finding, prioritize the differential diagnosis, and select the best next step. You should begin question practice early enough to use missed questions as a study guide.

Do not wait until the final week to complete a full-length examination. Timed practice helps identify pacing problems, knowledge gaps, and fatigue-related errors. After each examination, review both incorrect answers and correct answers reached through guessing.

PANRE/EOR-Style Clinical Practice Question

Your patient is a 62-year-old man with hypertension and tobacco use who presents with abrupt, severe chest pain radiating to the back. His BP is 190/110 mm Hg in the right arm and 160/90 mm Hg in the left arm. HR is 108/min, and SaO₂ is 96% on room air. Chest radiography demonstrates a widened mediastinum. Which diagnostic study is most appropriate in a hemodynamically stable patient?

A. Transthoracic echocardiography
B. Exercise stress testing
C. CT angiography of the chest
D. Serum troponin level
E. Coronary artery calcium scoring

Answer: C. CT angiography of the chest

This presentation is concerning for acute aortic dissection. Abrupt tearing chest pain radiating to the back, pulse or BP differential, and widened mediastinum are classic findings. In a hemodynamically stable patient, CT angiography is an appropriate definitive diagnostic study because it rapidly evaluates the aorta and is widely available.

Transthoracic echocardiography may miss portions of the thoracic aorta. Troponin testing can evaluate myocardial injury but does not diagnose dissection. Stress testing and coronary calcium scoring are inappropriate in an unstable acute chest-pain presentation.

A More Efficient PANRE Review Strategy

To protect your time, use a repeatable daily process:

• Complete a defined number of mixed or system-based questions.
• Record missed concepts by organ system.
• Review the explanation and cited source.
• Reattempt flagged questions after a delay.
• Schedule regular timed examinations.
• Adjust your study plan according to performance rather than preference.

The goal is not to complete the largest number of resources. The goal is to use a structured panre review course that combines comprehensive content, practice questions, performance feedback, and eligible CME in one plan.

Additional PA Exam Preparation With PAtopia

If you are also preparing for the PANCE, EOR examinations, PACKRAT, or EOC, PAtopia provides browser-based review resources for PA students. The platform includes exam-specific practice questions, study libraries, and performance analytics.

You can:

• Access PAtopia on the web
• Download PAtopia for iOS
• Download PAtopia for Android

Use the platform that matches your current training or certification goal. The PANRE Review Course is intended for recertification preparation and provides the specific 100-hour AAPA Category 1 CME opportunity described above.

Final Daily CME Tip

Avoiding PANRE review mistakes is largely a matter of planning. Cover the full NCCPA Blueprint, use questions to find weak areas, limit resource overload, account for CME requirements, and begin timed practice before the final weeks.

The PANRE Review Course is $499.99 with 30 months of access and up to 100 hours of AAPA Category 1 CME. Optional Amazon and Apple gift card add-ons from $100 to $1,500 are paid additions to the purchase and may help eligible customers use their CME budget more efficiently.

Review the CME Review Courses catalog to compare available options.

About the Author

Jeremy Boroff, MPAS, PA-C, is an emergency medicine physician assistant with 24 years of Emergency Medicine experience. He is an author, educator, CME developer, and founder of CME Review Courses. Jeremy creates PANRE, PANCE, EOR, and specialty review materials for physician assistants and other healthcare professionals.

Major announcement: The complete CME Review Courses catalog is now approved for AAPA Category 1 CME. The full program includes 14 clinical and exam-preparation modules, AAPA Category 1 CME credit for every module, and access to focused review content for practicing PAs and NPs.

The program is accredited as a single enduring activity:

Comprehensive Clinical Review for Practicing PAs, 2026–27
AAPA reference number: CME-2016187
Approval period: August 26, 2026, through August 26, 2027

One clarification is important: the accreditation covers the entire 14-module program, not the credit amount for one individual purchase. Each course awards the credits assigned to that specific module.

What changed for PAs

Previously, only selected CME Review Courses products carried AAPA Category 1 credit. The full library has now been reviewed and approved by the American Academy of Physician Associates Review Panel.

That means you can select education based on your certification or clinical needs without automatically limiting yourself to Category 2 content. Choose a focused specialty course, complete the PANRE or PANRE-LA review module, or combine multiple modules across your CME cycle.

Every course includes online enduring material, a post-test, an activity evaluation, and a certificate stating the precise amount of credit earned.

The 14-course AAPA Category 1 catalog

Specialty CME packages

Each specialty module includes 200 cited, board-style questions and lecture video. Each specialty course is $499.99 with 30 months of access.

• Emergency Medicine CME Package : up to 25 AAPA Category 1 CME credits
• Family Medicine CME Package : up to 25 credits
• Pediatrics Review CME Package : up to 25 credits
• Internal Medicine/Hospitalist CME Package : up to 24.5 credits
• Urgent Care CME Review Package : up to 24.5 credits
• Cardiology CME Review Package : up to 23 credits
• Psychiatry CME Package : up to 22.5 credits
• OB/GYN CME Review Package : up to 22 credits
• Dermatology CME Package Review Course : up to 21.75 credits
• Neurology CME Package : up to 21.5 credits
• Orthopedics CME Package : up to 21.5 credits

These 11 specialty modules total 256.25 AAPA Category 1 CME credits.

Pharmacology CME Review Package

The Pharmacology CME Review Package includes:

• 12.5 AAPA Category 1 CME credits
• 120 pharmacology questions
• Lecture-based review organized around medication classes and clinical application
• $499.99 price with 30 months of access

Pharmacology is useful as a focused review course or as a supplement to broader PANRE preparation. It addresses the medication knowledge required in nearly every clinical setting, including anticoagulants, antimicrobials, antihypertensives, diabetes medications, psychotropics, analgesics, and adverse-effect recognition.

PANRE Review Course

The PANRE Review Course with Gift Card is designated for up to 100 AAPA Category 1 CME credits.

Course details:

• $499.99
• 30 months of access
• 1,200 total board-style questions
• Five practice examinations with 240 questions each
• Complete PANRE Study Library
• Content aligned with the NCCPA Blueprint
• Online, self-paced delivery

This course is designed for PAs preparing for the traditional PANRE while also completing a substantial portion of their CME requirement. It provides structured exam review rather than isolated question repetition.

PANRE-LA Review Course

The PANRE-LA Review Course is also designated for up to 100 AAPA Category 1 CME credits.

It includes the same core question volume: 1,200 total questions across five 240-question exams, along with the Study Library. The material supports PAs who are completing the NCCPA Longitudinal Assessment pathway and need consistent review across the assessment period.

The PANRE and PANRE-LA modules each account for 100 credits within the program. Purchasing one does not award the credits assigned to the other.

Add Amazon or Apple gift cards to any order

CME Review Courses also offers cme gift cards as paid add-ons. You can add an Amazon or Apple gift card from $100 to $1,500 to any eligible course order.

These are paid add-ons, not free gifts. The gift card amount is added to the purchase total. Confirm that your employer or organization permits this type of CME expense before ordering.

Amazon and Apple are the only gift card options currently offered. Best Buy and Lowe’s gift cards are no longer available.

The add-on option can be useful when you have an employer-sponsored CME budget that must be used during a defined benefit period. Select the course that supports your clinical or certification goals, then choose the gift card amount that fits your approved budget.

Gift cards are processed and delivered by email according to the product-page terms. CME completion is separate: you must complete the required educational activity, pass the post-test, and submit the evaluation to earn credit.

How you earn AAPA Category 1 CME

The process is consistent across the accredited modules:

1. Review the course content.
2. Complete the module post-test.
3. Earn a score of 70% or higher.
4. Complete the activity evaluation.
5. Download the certificate stating the precise credit earned.

You may retake missed questions as permitted by the course. Claim only the credit that corresponds to your actual participation and successful completion.

PAs should log the credit according to NCCPA requirements and their certification-maintenance schedule. NPs may find the content valuable, but acceptance of AAPA Category 1 CME for NP licensure or certification varies by state, employer, and certifying organization. NPs should verify requirements with their state board of nursing before purchase.

Physicians may also find the clinical content useful. Physicians generally claim this activity as Category 2 CME, not Category 1 CME.

Practice question

Your patient is a 64-year-old man who develops sudden pleuritic chest pain and dyspnea 5 days after total knee arthroplasty. HR is 118/min, BP is 132/78 mm Hg, RR is 26/min, and SaO₂ is 89% on room air. He is alert and has no active bleeding. What is the most appropriate next diagnostic step?

A. D-dimer assay
B. CT pulmonary angiography
C. Screening lower-extremity ultrasound only
D. Electrocardiography
E. Noncontrast chest CT

Answer: B. CT pulmonary angiography

CT pulmonary angiography is the appropriate next diagnostic test because this patient has a high pretest probability for acute PE: recent major orthopedic surgery, abrupt dyspnea, pleuritic chest pain, tachycardia, and hypoxemia.

A D-dimer is not useful when clinical suspicion is high and is frequently elevated after surgery. Lower-extremity ultrasound may identify DVT but does not directly evaluate the pulmonary vasculature. ECG can support the evaluation but cannot exclude PE. A routine noncontrast chest CT is not the appropriate study.

If iodinated contrast is contraindicated or renal function prevents CT angiography, a V/Q scan may be considered. In practice, the diagnostic choice should account for pretest probability, renal function, contrast allergy, radiation exposure, and local availability.

This type of question reflects the purpose of the CME Review Courses catalog: combine practical clinical reasoning, cited explanations, and structured preparation for certification examinations.

Accreditation statement

This activity has been reviewed by the American Academy of Physician Associates Review Panel and is compliant with AAPA CME Criteria. The activity is designated for AAPA Category 1 CME credits across the complete 14-module program.

Approval is valid from 8/26/2026 to 8/26/2027.
AAPA reference number: CME-2016187.

PAs should only claim credit commensurate with the extent of their participation. Each individual course awards the credits assigned to that module.

Target audience: Practicing PAs and NPs
Faculty: Jeremy Boroff, MPAS, PA-C

Choose your next course

If you are preparing for recertification, begin with the PANRE Review Course with Gift Card or the PANRE-LA Review Course.

If you need focused clinical education, select the specialty module that matches your practice or the area where you need the most review. These courses are intended for practicing clinicians; PAs seeking initial certification should review dedicated PANCE prep courses instead.

Read the full accreditation announcement and browse all 14 AAPA Category 1 CME courses →

About the author

Jeremy Boroff, MPAS, PA-C is an emergency medicine physician assistant with 24 years of clinical experience as a PA-C and an additional seven years of experience as a registered respiratory therapist. He is a PA educator, author, and CME developer who created the PANRE, PANCE, EOR, pharmacology, and specialty review courses at CME Review Courses.

Course price: $499.99

Access: 30 months

CME: 100 hours of AAPA Category 1 Self-Assessment CME through the PANRE Review Course

Deliverables: 2,500+ PANRE practice questions, 3 full-length 240-question mock exams, detailed explanations, NCCPA Blueprint-mapped review content, readiness tracking, and downloadable slides

Gift card options: Optional Amazon or Apple Gift Card add-ons from $100 to $1,500. These are paid add-ons added to the purchase price and are not free gifts.

Choosing between PANRE-LA and the traditional PANRE depends on how you prefer to prepare, test, and manage your recertification timeline. Both options assess the same core medical knowledge and both require you to maintain your CME obligations.

The important point is that your exam choice does not eliminate the need for CME. The PANRE Review Course can help you prepare for either path while earning 100 hours of Category 1 AAPA credit through the PANRE course itself.

PANRE-LA vs Traditional PANRE: The Main Differences

Feature	Traditional PANRE	PANRE-LA
Testing format	Proctored exam at a Pearson VUE testing center	Online longitudinal assessment
Timing	Available during years 9 or 10	Apply in year 6; assessment begins in year 7
Question volume	240 questions in one examination	25 questions per quarter
Testing schedule	Four 60-question blocks	Complete each quarterly set by the deadline
References	Closed book	Printed and online references permitted
Scoring	Single exam result	Final score based on the best 8 of 12 quarters
Feedback	Results typically available within two weeks	Immediate feedback after each question
CME	Does not replace regular CME requirements	Two Category 1 Self-Assessment credits per completed quarter, with NCCPA weighting applied according to current policy

The NCCPA certification maintenance page confirms that both pathways use the same core content and that PAs must continue meeting their CME requirements while participating in PANRE-LA.

Budget note: The Amazon and Apple Gift Card add-ons remain optional paid additions of $100 to $1,500. They are added to the purchase price and are not free gifts, regardless of which exam pathway you choose.

When Traditional PANRE May Fit Better

Traditional PANRE is appropriate if you prefer a defined preparation period followed by one examination. It is administered at a Pearson VUE testing center during the ninth or tenth year of your certification maintenance cycle.

The exam includes:

• Four blocks of 60 questions
• 60 minutes for each block
• A total of 240 questions
• Approximately five hours for testing, tutorial, and breaks
• Up to four total attempts, subject to NCCPA rules and timing restrictions

This format rewards concentrated preparation, timed practice, and the ability to sustain attention during a long testing session. The PANRE Review Course includes three full-length 240-question mock exams so you can practice pacing and identify whether your performance declines during the final blocks.

A traditional PANRE study plan should include:

1. A baseline full-length exam.
2. Review of missed questions by organ system.
3. Targeted study of high-weight systems such as cardiovascular, gastrointestinal, and pulmonary medicine.
4. Additional timed question blocks.
5. At least two more full-length simulations before test day.

PANCE prep courses may provide useful general medical review, but they are not automatically designed for the needs of an experienced PA preparing for recertification. Your clinical practice may be narrow, while the PANRE evaluates core knowledge across multiple specialties.

Budget note: If you purchase the PANRE Review Course for traditional PANRE preparation, any Amazon or Apple Gift Card amount from $100 to $1,500 is a paid add-on added to the course price: not a free gift.

When PANRE-LA May Fit Better

PANRE-LA is designed for PAs who prefer smaller assessments distributed over time. According to NCCPA, you apply during the sixth year of your certification maintenance cycle and begin the assessment in the seventh year.

Each quarter includes 25 questions, and you have five minutes to answer each question. You may use printed or online references, but you may not consult other people. The assessment provides immediate feedback, including the correct answer, explanation, and references.

The final score is based on your best eight quarters out of 12. You may skip up to four quarters, but you must participate in at least one quarter during years seven and eight. If you do not successfully complete PANRE-LA, NCCPA provides opportunities to take the traditional PANRE during year 10.

PANRE-LA may be a better fit if you:

• Prefer open-book testing.
• Learn effectively from immediate feedback.
• Want to distribute preparation across several years.
• Prefer studying in shorter sessions.
• Can maintain consistent engagement with quarterly deadlines.

The main disadvantage is that PANRE-LA requires long-term organization. Delaying every quarter until the deadline creates unnecessary pressure and reduces the educational value of the feedback. Use the assessment as a recurring learning activity rather than treating each quarter as an isolated test.

The PANRE Review Course can function as a searchable reference while you prepare. Its 100 hours of Category 1 AAPA credit apply to the PANRE Review Course, not to a separate pharmacology course.

Budget note: The optional Amazon and Apple Gift Card add-ons are available from $100 to $1,500, but the selected amount is added to the purchase price and is not a free gift.

CME Implications: Both Paths Still Require Planning

NCCPA certification maintenance is divided into five two-year CME cycles within the 10-year certification period. During each two-year cycle, you must earn and log 100 CME credits and meet the applicable Category 1 requirements.

PANRE-LA can produce additional Category 1 Self-Assessment CME for completed quarters. However, PANRE-LA does not replace your regular CME requirements. You must continue completing and logging CME while participating.

The PANRE Review Course is designed to combine exam preparation with CME fulfillment:

• 100 hours of AAPA Category 1 Self-Assessment CME
• 2,500+ practice questions
• Three 240-question mock exams
• Coverage of all major systems in the current NCCPA PANRE/PANRE-LA Content Blueprint
• 30 months of access
• Self-paced online study

NCCPA may apply its 50% weighting policy to eligible Self-Assessment CME when credits are logged for certification maintenance. Confirm current requirements in your NCCPA account and claim only the credit commensurate with your participation.

Budget note: The course is $499.99, while the optional Amazon or Apple Gift Card add-on is separately priced from $100 to $1,500. The add-on is not free and increases the total purchase price.

Maximize Your CME Budget With Paid Gift Card Add-ons

Many PAs receive an annual employer CME allowance. If funds expire at the end of the fiscal year, a course that supports both exam preparation and CME can be a more efficient purchase than buying disconnected resources.

The PANRE Review Course with Gift Card allows you to select an Amazon or Apple Gift Card add-on when you check out. The selected amount is added to the total price and processed as part of the order. Gift cards are generally delivered by email within two to three business days.

Use these steps before purchasing:

1. Confirm your employer’s CME reimbursement policy.
2. Verify whether bundled purchases and gift-card add-ons are permitted.
3. Select an amount that fits your available CME balance.
4. Confirm that the course’s CME designation meets your professional requirements.
5. Track your course completion and CME documentation separately from the gift card.

The add-on can help you use an approved CME allowance for a professional education purchase, but it should not be treated as a discount, rebate, or free promotional item. Amazon and Apple Gift Card add-ons from $100 to $1,500 are paid additions to the course price and are not free gifts.

Common PANRE Review Mistakes

1. Relying only on PANCE prep courses

PANCE prep courses are usually designed for students and new graduates. PANRE preparation should address the broad core knowledge expected of practicing PA-Cs and should be organized around the current NCCPA Blueprint.

2. Studying passively

Reading slides without answering questions does not adequately test clinical reasoning. Use active recall. For each missed question, identify the diagnosis, the management principle, and why the distractors are incorrect.

3. Avoiding full-length simulations

Short quizzes do not test endurance or pacing. Complete full-length 240-question exams under timed conditions before your actual PANRE.

4. Studying every topic equally

Use your baseline performance and the NCCPA content percentages to prioritize. Cardiovascular content represents approximately 12% of the examination, while gastrointestinal and pulmonary content each represent approximately 10%. Weak performance in these areas should receive focused attention.

5. Separating CME from exam preparation

Buying one resource for PANRE preparation and another for Category 1 credit can increase cost and administrative work. The PANRE Review Course provides 100 hours of Category 1 AAPA credit while you review for recertification.

Budget note: Any Amazon or Apple Gift Card add-on selected with the course costs an additional $100 to $1,500, is added to the purchase price, and is not a free gift.

PANRE Practice Question

Your patient is a 72-year-old woman with atrial fibrillation who presents with sudden severe abdominal pain that began two hours ago. The pain appears disproportionate to the mild abdominal tenderness on examination. She is restless and diaphoretic. Vital signs are BP 156/92 mmHg, HR 118/min and irregular, RR 24/min, and SaO2 97% on room air. Serum lactate is elevated.

Which of the following is the most appropriate diagnostic study?

A. Abdominal ultrasound

B. CT angiography of the abdomen and pelvis

C. Colonoscopy

D. Plain abdominal radiography

E. Upper endoscopy

Correct answer: B. CT angiography of the abdomen and pelvis

CT angiography is the preferred initial diagnostic study for suspected acute mesenteric ischemia in a hemodynamically stable patient. This patient has atrial fibrillation, abrupt severe abdominal pain, pain out of proportion to the examination, and an elevated lactate, suggesting an arterial embolic event involving the mesenteric circulation.

Abdominal ultrasound is limited by bowel gas and operator dependence. Colonoscopy and upper endoscopy do not evaluate the full mesenteric arterial circulation and may delay definitive management. Plain radiography has poor sensitivity for early mesenteric ischemia.

Immediate surgical and vascular consultation is also appropriate. Avoid delaying imaging when the patient is stable enough for CT, because bowel infarction carries substantial morbidity and mortality.

Make Your Daily CME Plan More Efficient

Whether you select PANRE-LA or traditional PANRE, use a study system that combines broad medical review, question practice, and CME planning.

The PANRE Review Course provides:

• $499.99 purchase price
• 30 months of access
• 100 hours of Category 1 AAPA Self-Assessment CME
• 2,500+ practice questions
• Three full-length mock exams
• NCCPA Blueprint-mapped content and explanations

Optional cme gift cards from Amazon or Apple are available from $100 to $1,500. They are paid add-ons added to the purchase price, not free gifts. Review your employer’s policy before selecting an add-on.

For additional PA exam preparation, use the PAtopia web version, or download the PAtopia iOS app or PAtopia Android app. PAtopia is designed primarily for PANCE preparation, while the PANRE Review Course is the relevant CME and recertification resource for practicing PA-Cs.

Review the PANRE Review Course with optional CME gift card add-ons

Important: AAPA Category 1 credit acceptance for nurse practitioners varies by state and employer. Physicians may find the clinical content useful, but the activity generally counts as Category 2 CME for physicians. Verify requirements with your licensing board or credentialing organization.

About the Author

Jeremy Boroff, MPAS, PA-C, is a practicing Emergency Medicine physician assistant with 24 years of clinical experience as a PA-C, along with seven years of prior experience as a Registered Respiratory Therapist. He is a PA educator, CME developer, author, and founder of CME Review Courses. Jeremy creates PANRE, PANCE, EOR, pharmacology, and specialty review content focused on clinical reasoning, practical management, and efficient exam preparation.

Course price: $499.99
Access: 30 months
Deliverables: 100 hours of AAPA Category 1 CME through the PANRE Review Course, 2,500+ practice questions, and three 240-question mock exams

If you are a PA approaching an NCCPA certification maintenance deadline, the type of CME you purchase matters. A course may provide clinical education, but that does not automatically mean it qualifies as AAPA Category 1 CME.

The key distinction is whether the activity has been formally reviewed and designated for Category 1 credit by an accepted accrediting organization. For PAs, AAPA Category 1 CME can help satisfy the Category 1 portion of the NCCPA requirement while also providing structured exam preparation.

The PANRE Review Course with Gift Card is designed to combine both objectives: prepare for the PANRE or PANRE-LA and provide 100 hours of AAPA Category 1 CME in one course purchase.

What Is AAPA Category 1 CME?

AAPA Category 1 CME consists of planned educational activities designed to maintain, improve, or expand the clinical knowledge and professional skills used in PA practice.

The activity must meet established educational standards. In practical terms, that generally means the course has:

• Defined learning objectives
• Clinically relevant content
• A structured educational format
• An evaluation or assessment process
• Formal accreditation or designation
• Documentation showing the type and amount of credit awarded

The important point is that Category 1 CME is not simply any medical information you read or review. The activity must be formally designated for that credit type.

The AAPA CME FAQs explain that Category 1 CME includes approved clinical and professional education used to maintain knowledge, skills, and professional performance.

How Category 1 Differs From Category 2 CME

For NCCPA certification maintenance, PAs must earn 100 CME credits every two years, including at least 50 Category 1 CME credits. The remaining 50 credits may be Category 1, Category 2, or a combination of both.

Category 1 CME

Category 1 CME is formally reviewed and designated by an accepted accreditor or sponsor. Examples include:

• AAPA Category 1 CME
• AMA PRA Category 1 Credit™ from an eligible provider
• AOA Category 1-A credit
• AAFP Prescribed Credit
• Certain other recognized credit systems accepted by NCCPA

The activity typically involves an organized course, conference, self-assessment, or performance improvement program.

Category 2 CME

Category 2 CME is elective education related to medicine, patient care, or the PA profession that has not been formally designated for Category 1 credit.

Examples may include:

• Reading medical journals or textbooks
• Reviewing clinical research
• Participating in certain professional meetings
• Precepting students
• Completing other practice-related educational activities that do not carry Category 1 designation

Category 2 credit can be useful, but it does not replace the minimum Category 1 requirement for NCCPA certification maintenance.

The NCCPA CME requirements provide the current details on Category 1, Category 2, self-assessment, and performance improvement CME.

Who Can Claim AAPA Category 1 Credit?

Physician Assistants

PAs are the primary audience for AAPA Category 1 CME. If you complete an activity designated for AAPA Category 1 credit, you can generally claim the awarded credit toward NCCPA certification maintenance, provided the activity falls within your current CME earning window.

For the PANRE Review Course, participants must complete the course requirements and electronic evaluation before claiming the credit. You should claim only the amount of credit that corresponds to your participation.

Nurse Practitioners

NPs may find the clinical content useful, but acceptance of AAPA Category 1 CME varies by state, employer, and credentialing organization.

Some state boards and employers accept AAPA Category 1 credit for NP continuing education. Others require credit approved through nursing-specific organizations. NPs should verify acceptance with their state board of nursing and credentialing body before purchasing.

Physicians

Physicians may also use the clinical content for professional education. However, this activity is not Category 1 CME for physicians. Physicians should generally claim it as Category 2 CME, subject to their state medical board and employer requirements.

This distinction is important when comparing a course’s educational value with its credit value. The same clinical material may count differently depending on your profession and licensing requirements.

How the PANRE Review Course’s 100 AAPA Category 1 Hours Work

The 100 hours of AAPA Category 1 credit apply specifically to the PANRE Review Course. They do not apply to the Pharmacology Course.

The PANRE course is designated for 100 AAPA Category 1 Self-Assessment CME credits, with AAPA reference number CME-203981. The course covers major clinical areas tested on the current NCCPA Blueprint and is structured around board-style questions, explanations, and review materials.

The course includes:

• More than 2,500 board-style practice questions
• Three full-length mock exams
• 720 mock-exam questions total
• Interactive quizzes with explanations
• Organ-system review modules
• A performance dashboard
• Unlimited question attempts
• 30 months of online access

This makes the course useful for both certification maintenance and PANRE preparation. You are not completing a disconnected CME activity solely to collect credit. You are reviewing the clinical content you may need for the recertification exam while working toward the CME requirements attached to your certification cycle.

The NCCPA gives a 50% additional weighting to eligible self-assessment CME when logged for NCCPA certification maintenance. This weighting applies to NCCPA certification maintenance only. It does not change the number of hours awarded on the course documentation, and state licensing boards may require you to report the actual awarded amount without additional weighting.

The PANRE Review Course with Gift Card includes the complete course details, accreditation statement, and available purchase options.

Do Not Confuse the PANRE Course With the Pharmacology Course

CME Review Courses offers a separate Pharmacology CME Review Course.

That course provides 12 hours of AAPA Category 1 Self-Assessment CME in pharmacology. It is intended for clinicians who need focused pharmacology education, including prescribing principles, drug safety, contraindications, and medication management.

It does not provide the 100 Category 1 hours associated with the PANRE Review Course.

If your primary goal is to complete a large portion or all of your NCCPA CME requirement while preparing for recertification, the PANRE course is the relevant product. If you need additional pharmacology-specific education, the Pharmacology Course can be considered separately.

Paid CME Gift Card Add-Ons: What the Purchase Includes

The PANRE Review Course can be purchased with optional Amazon or Apple Gift Card add-ons ranging from $100 to $1,500.

These are paid add-ons, not free gifts. The selected gift card amount is added to the total purchase price. For example, choosing a $500 Amazon Gift Card add-on increases the package total by $500.

The add-on structure may help clinicians use an employer-sponsored CME allowance for a substantial educational purchase while also obtaining funds for additional professional resources. Depending on your employer’s policy, the gift card may be used for items such as:

• Medical textbooks
• Clinical reference tools
• Computer or tablet equipment
• Educational subscriptions
• Other approved professional-development expenses

Before purchasing, confirm that your employer permits this type of CME package and add-on structure. Amazon and Apple are independent companies and are not affiliated with or sponsors of CME Review Courses. Gift cards are processed separately and typically delivered by email within two to three business days.

Practice Clinical Vignette

Your patient is a 67-year-old man with hypertension and hyperlipidemia who presents with sudden, severe chest pain radiating to the interscapular region. His BP is 204/112 mmHg in the right arm and 178/96 mmHg in the left arm. HR is 118/min. Chest radiography shows a widened mediastinum.

Which medication should be administered first to reduce aortic wall shear stress?

A. IV nitroprusside
B. IV labetalol
C. Oral amlodipine
D. IV heparin
E. Sublingual nitroglycerin

Correct answer: B. IV labetalol.

In suspected acute aortic dissection, initiate rapid beta-blockade to reduce HR and ventricular contractility before adding a vasodilator. IV labetalol decreases shear stress through beta blockade with additional alpha blockade. Nitroprusside may be added after beta blockade if hypertension persists, but using it first can produce reflex tachycardia. Heparin is inappropriate when dissection is suspected because of hemorrhage risk. Oral therapy is too slow for this hypertensive emergency.

One Course Purchase, 100 Category 1 Hours

For a PA, the value of the PANRE Review Course is the combination of exam preparation and CME fulfillment.

You receive:

• A course designed for PANRE and PANRE-LA preparation
• 100 hours of AAPA Category 1 CME from the PANRE Review Course
• More than 2,500 practice questions
• Three 240-question mock exams
• 30 months of access
• Optional paid Amazon or Apple Gift Card add-ons from $100 to $1,500

Always confirm your personal NCCPA earning window, state licensing requirements, and employer reimbursement rules before enrolling. For most PAs who need both recertification preparation and a substantial amount of Category 1 CME, completing one comprehensive course can be more efficient than assembling credits from multiple unrelated activities.

Continue Studying With PAtopia

If you are still in PA school or preparing for the PANCE, PAtopia’s web version provides PANCE, PACKRAT, EOC, and EOR review resources. PAtopia is an exam-preparation platform and is separate from the AAPA-accredited PANRE CME activity.

You can also study on mobile:

• Download PAtopia for iOS on the App Store
• Download PAtopia for Android on Google Play

PAtopia includes board-style practice questions and study libraries for clinicians seeking pance prep courses and PA school exam preparation.

About the Author

Jeremy Boroff, PA-C is an emergency medicine physician assistant with more than two decades of clinical experience. He has served as an advanced practice clinician director, written PA board-review materials, and developed PANRE, PANCE, EOR, and specialty CME courses for physician assistants. His educational content focuses on practical clinical reasoning, exam-relevant decision-making, and evidence-based patient care.