PANCE Content

The Physician Assistant National Certifying Examination (PANCE) is developed and managed by the National Commission on Certification of Physician Assistants (NCCPA). Every couple of years, the PANCE undergoes content updates published in a revised NCCPA blueprint. The most recent PANCE blueprint went into effect in January 2019, reflecting feedback on current PA practices from certified physician assistants.

What Are the PANCE Blueprint Categories?

The PANCE blueprint breaks down the exam into medical content and task categories defined as follows:

  • Medical Content Categories: Knowledge of the diseases and disorders physician assistants encounter.
  • Task Categories: Knowledge and skills related to tasks physician assistants perform when treating patients.

Because the medical field is constantly changing to address improved practices and technologies, the NCCPA leans on certified PAs to provide industry information through profession-wide practice analysis studies. Certified PAs are also involved in updating the exam by reviewing the results of the practice analyses, creating new questions, critiquing the exam prior to it being administered, reviewing exam-question performance data, and offering suggestions for the passing standard. While PANCE blueprint updates do not occur annually, certified PAs continuously work with the NCCPA to ensure the PANCE is relevant.

PANCE medical content categories

As defined above, the medical content categories on the PANCE assess candidates’ knowledge of the diseases and disorders PAs encounter. Below are the contents of each category and how each category is allocated on the exam:

Categories % Allocation


  • Dilated
  • Hypertrophic
  • Restrictive

Conduction disorders/dysrhythmias

  • Atrial fibrillation/flutter
  • Atrioventricular block
  • Bundle branch block
  • Paroxysmal supraventricular tachycardia
  • Premature beats
  • Sick sinus syndrome
  • Sinus arrhythmia
  • Torsades de pointes
  • Ventricular fibrillation
  • Ventricular tachycardia

Congenital heart disease

  • Atrial septal defect
  • Coarctation of aorta
  • Patent ductus arteriosus
  • Tetralogy of Fallot
  • Ventricular septal defect

Coronary artery disease

  • Acute myocardial infarction
    • Non–ST-segment elevation
    • ST-segment elevation
  • Angina pectoris
    • Prinzmetal variant
    • Stable
    • Unstable

Heart failure


  • Essential hypertension
  • Hypertensive emergencies
  • Secondary hypertension


  • Cardiogenic shock
  • Orthostatic hypotension
  • Vasovagal hypotension

Lipid disorders

  • Hypercholesterolemia
  • Hypertriglyceridemia

Traumatic, infectious, and inflammatory heart conditions

  • Acute and subacute bacterial endocarditis
  • Acute pericarditis
  • Cardiac tamponade
  • Pericardial effusion

Valvular disorders

  • Aortic
  • Mitral
  • Pulmonary
  • Tricuspid

Vascular disease

  • Aortic aneurysm/dissection
  • Arterial embolism/thrombosis
  • Arteriovenous malformation
  • Giant cell arteritis
  • Peripheral artery disease
  • Phlebitis/thrombophlebitis
  • Varicose veins
  • Venous insufficiency
  • Venous thrombosis

Acneiform eruptions

  • Acne vulgaris
  • Folliculitis
  • Rosacea


  • Erythema multiforme
  • Stevens-Johnson syndrome
  • Toxic epidermal necrolysis

Diseases/disorders of the hair and nails

  • Alopecia
  • Onychomycosis
  • Paronychia

Envenomations and arthropod bite reactions


  • Erythema infectiosum (fifth disease)
  • Hand-foot-and-mouth disease
  • Measles

Infectious diseases

  • Bacterial
    • Cellulitis
    • Erysipelas
    • Impetigo
  • Fungal
    • Candidiasis
    • Dermatophyte infections
  • Parasitic
    • Lice
    • Scabies
  • Viral
    • Condyloma acuminatum
    • Herpes simplex
    • Molluscum contagiosum
    • Varicella-zoster virus infections
    • Verrucae

Keratotic disorders

  • Actinic keratosis
  • Seborrheic keratosis


  • Benign
  • Malignant
  • Premalignant

Papulosquamous disorders

  • Contact dermatitis
  • Drug eruptions
  • Eczema
  • Lichen planus
  • Pityriasis rosea
  • Psoriasis

Pigment disorders

  • Melasma
  • Vitiligo

Skin integrity

  • Burns
  • Lacerations
  • Pressure ulcers
  • Stasis dermatitis

Vascular abnormalities

  • Cherry angioma
  • Telangiectasia

Vesiculobullous disease

  • Pemphigoid
  • Pemphigus

Other dermatologic disorders

  • Acanthosis nigricans
  • Hidradenitis suppurativa
  • Lipomas/epidermal inclusion cysts
  • Photosensitivity reactions
  • Pilonidal disease
  • Urticaria

Adrenal disorders

  • Primary adrenal insufficiency
  • Cushing syndrome

Diabetes mellitus

  • Type 1
  • Type 2



  • Multiple endocrine neoplasia
  • Neoplastic syndrome
  • Primary endocrine malignancy
  • Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Parathyroid disorders

  • Hyperparathyroidism
  • Hypoparathyroidism

Pituitary disorders

  • Acromegaly/gigantism
  • Diabetes insipidus
  • Dwarfism
  • Pituitary adenoma

Thyroid disorders

  • Hyperthyroidism
  • Hypothyroidism
  • Thyroiditis

Eye disorders

  • Conjunctival disorders
    • Conjunctivitis
  • Corneal disorders
    • Cataract
    • Corneal ulcer
    • Infectious
    • Keratitis
    • Pterygium
  • Lacrimal disorders
    • Dacryocystitis
  • Lid disorders
    • Blepharitis
    • Chalazion
    • Ectropion
    • Entropion
    • Hordeolum
  • Neuro-ophthalmologic disorders
    • Nystagmus
    • Optic neuritis
    • Papilledema
  • Orbital disorders
    • Orbital cellulitis
  • Retinal disorders
    • Macular degeneration
    • Retinal detachment
    • Retinopathy
  • Traumatic disorders
    • Blowout fracture
    • Corneal abrasion
    • Globe rupture
    • Hyphema
  • Vascular disorders
    • Retinal vascular occlusion
  • Vision abnormalities
    • Amaurosis fugax
    • Amblyopia
    • Glaucoma
    • Scleritis
    • Strabismus

Ear disorders

  • External ear
    • Cerumen impaction
    • Otitis externa
    • Trauma

Inner ear

  • Acoustic neuroma
  • Barotrauma
  • Dysfunction of eustachian tube
  • Labyrinthitis
  • Vertigo

Middle ear

  • Cholesteatoma
  • Otitis media
  • Tympanic membrane perforation

Hearing impairment

Other abnormalities of the ear

  • Mastoiditis
  • Meniere disease
  • Tinnitus

Foreign bodies


  • Benign
  • Malignant

Nose/sinus disorders

  • Epistaxis
  • Nasal polyps
  • Rhinitis
  • Sinusitis
  • Trauma

Oropharyngeal disorders

  • Diseases of the teeth/gums
  • Infectious/inflammatory disorders
    • Aphthous ulcers
    • Candidiasis
    • Deep neck infection
    • Epiglottitis
    • Herpes simplex
    • Laryngitis
    • Peritonsillar abscess
    • Pharyngitis
  • Salivary disorders
    • Sialadenitis
    • Parotitis
  • Trauma
  • Other oropharyngeal disorders
    • Leukoplakia

Biliary disorders

  • Acute/chronic cholecystitis
  • Cholangitis
  • Cholelithiasis

Colorectal disorders

  • Abscess/fistula
  • Anal fissure
  • Constipation
  • Diverticulitis
  • Fecal impaction
  • Hemorrhoids
  • Inflammatory bowel disease
  • Irritable bowel syndrome
  • Ischemic bowel disease
  • Obstruction
  • Polyps
  • Toxic megacolon

Esophageal disorders

  • Esophagitis
  • Gastroesophageal reflux disease
  • Mallory-Weiss tear
  • Motility disorders
  • Strictures
  • Varices

Food allergies and food sensitivities

  • Gluten intolerance
  • Lactose intolerance
  • Nut allergies

Gastric disorders

  • Gastritis
  • Peptic ulcer disease
  • Pyloric stenosis

Hepatic disorders

  • Acute/chronic hepatitis
  • Cirrhosis


Infectious diarrhea

Ingestion of toxic substances or foreign bodies

Metabolic disorders

  • G6PD deficiency
  • Paget disease
  • Phenylketonuria
  • Rickets


  • Benign
  • Malignant

Nutritional and vitamin disorders

  • Hypervitaminosis/hypovitaminosis
  • Obesity

Pancreatic disorders

  • Acute/chronic pancreatitis

Small intestine disorders

  • Appendicitis
  • Celiac disease
  • Intussusception
  • Obstruction
  • Polyps

Bladder disorders

  • Incontinence
  • Overactive bladder
  • Prolapse

Congenital and acquired abnormalities

  • Cryptorchidism
  • Peyronie disease
  • Trauma
  • Vesicoureteral reflux

Human sexuality

Infectious disorders

  • Cystitis
  • Epididymitis
  • Orchitis
  • Prostatitis
  • Pyelonephritis
  • Urethritis


  • Bladder cancer
  • Penile cancer
  • Prostate cancer
  • Testicular cancer


Penile disorders

  • Erectile dysfunction
  • Hypospadias/epispadias
  • Paraphimosis/phimosis

Prostate disorders

  • Benign prostatic hyperplasia

Testicular disorders

  • Hydrocele/varicocele
  • Testicular torsion

Urethral disorders

  • Prolapse
  • Stricture

Autoimmune disorders

Coagulation disorders

  • Clotting factor disorders
  • Thrombocytopenias


  • Anemia
  • Leukopenia


  • Polycythemia
  • Thrombocytosis


  • Hemochromatosis
  • Sickle cell disease
  • Thalassemia

Immunologic disorders

  • Transfusion reaction

Neoplasms, premalignancies, and malignancies

  • Acute/chronic lymphocytic leukemia
  • Acute/chronic myelogenous leukemia
  • Lymphoma
  • Multiple myeloma
  • Myelodysplasia

Bacterial diseases

  • Botulism
  • Campylobacter jejuni infection
  • Chlamydia
  • Cholera
  • Diphtheria
  • Gonococcal infections
  • Gonorrhea
  • Methicillin-resistant Staphylococcus aureus infection
  • Rheumatic fever
  • Rocky Mountain spotted fever
  • Salmonellosis
  • Shigellosis
  • Tetanus

Fungal diseases

  • Candidiasis
  • Cryptococcosis
  • Histoplasmosis
  • Pneumocystis

Mycobacterial diseases

  • Atypical mycobacterial disease
  • Tuberculosis

Parasitic diseases

  • Helminth infestations
  • Malaria
  • Pinworms
  • Toxoplasmosis
  • Trichomoniasis

Prenatal transmission of disorders

  • Congenital varicella
  • Herpes simplex virus
  • Human papillomavirus
  • Zika virus

Sepsis/systemic inflammatory response syndrome

Spirochetal diseases

  • Lyme disease
  • Syphilis

Viral diseases

  • Cytomegalovirus infections
  • Epstein-Barr virus infections
  • Erythema infectiosum
  • Herpes simplex virus infections
  • HIV infection
  • Human papillomavirus infections
  • Influenza
  • Measles
  • Mumps
  • Rabies
  • Roseola
  • Rubella
  • Varicella-zoster virus infections

Chest/rib disorders

  • Deformities
  • Fractures

Compartment syndrome

Degenerative diseases

  • Osteoarthritis

Infectious diseases

  • Osteomyelitis
  • Septic arthritis

Lower extremity disorders

  • Avascular necrosis
  • Developmental dysplasia
  • Fractures/dislocations
  • Osgood-Schlatter disease
  • Slipped capital femoral epiphysis
  • Soft-tissue injuries


  • Benign
  • Malignant

Rheumatologic disorders

  • Fibromyalgia
  • Gout/pseudogout
  • Juvenile rheumatoid arthritis
  • Osteoporosis
  • Polyarteritis nodosa
  • Polymyalgia rheumatica
  • Polymyositis
  • Reactive arthritis
  • Rheumatoid arthritis
  • Sjögren syndrome
  • Systemic lupus erythematosus
  • Systemic sclerosis (Scleroderma)

Spinal disorders

  • Ankylosing spondylitis
  • Cauda equina syndrome
  • Herniated nucleus pulposus
  • Kyphosis
  • Scoliosis
  • Spinal stenosis
  • Sprain/strain
  • Thoracic outlet syndrome
  • Torticollis
  • Trauma

Upper extremity disorders

  • Fractures/dislocations
  • Soft-tissue injuries

Closed head injuries

  • Concussion
  • Postconcussion syndrome
  • Traumatic brain injury

Cranial nerve palsies

Encephalopathic disorders


  • Cluster headache
  • Migraine
  • Tension headache

Infectious disorders

  • Encephalitis
  • Meningitis

Movement disorders

  • Essential tremor
  • Huntington disease
  • Parkinson disease
  • Tourette disorder


  • Benign
  • Malignant

Neurocognitive disorders

  • Delirium
  • Major/mild neurocognitive disorders

Neuromuscular disorders

  • Cerebral palsy
  • Multiple sclerosis
  • Myasthenia gravis

Peripheral nerve disorders

  • Carpal tunnel syndrome
  • Complex regional pain syndrome
  • Guillain-Barré syndrome
  • Peripheral neuropathy

Seizure disorders

  • Focal seizures
  • Generalized seizures
  • Status epilepticus

Vascular disorders

  • Arteriovenous malformation
  • Cerebral aneurysm
  • Intracranial hemorrhage
  • Stroke
  • Syncope
  • Transient ischemic attack

Abuse and neglect

  • Child abuse
  • Domestic violence
  • Elder abuse
  • Sexual abuse

Anxiety disorders

  • Generalized anxiety disorder
  • Panic disorder
  • Phobias

Bipolar and related disorders

Depressive disorders

  • Major depressive disorder
  • Persistent depressive disorder (dysthymia)
  • Premenstrual dysphoric disorder
  • Suicidal/homicidal behaviors

Disruptive, impulse-control, and conduct disorders

  • Conduct disorder

Dissociative disorders

Feeding and eating disorders

Human sexuality

Obsessive-compulsive and related disorders

Neurodevelopmental disorders

  • Attention-deficit/hyperactivity disorder
  • Autism spectrum disorder

Personality disorders

Schizophrenia spectrum and other psychotic disorders

Sleep-wake disorders

  • Narcolepsy
  • Parasomnias

Somatic symptom and related disorders

Substance-related and addictive disorders

Trauma- and stressor-related disorders

  • Adjustment disorders
  • Post-traumatic stress disorder

Chronic obstructive pulmonary diseases

  • Chronic bronchitis
  • Emphysema

Infectious disorders

  • Acute bronchiolitis
  • Acute bronchitis
  • Acute epiglottitis
  • Croup
  • Influenza
  • Pertussis
  • Pneumonias
    • Bacterial
    • Fungal
    • HIV-related
    • Viral
  • Respiratory syncytial virus infection
  • Tuberculosis


  • Carcinoid tumors
  • Lung cancer
  • Pulmonary nodules

Pleural diseases

  • Pleural effusion
  • Pneumothorax

Pulmonary circulation

  • Cor pulmonale
  • Pulmonary embolism
  • Pulmonary hypertension

Restrictive pulmonary diseases

  • Idiopathic pulmonary fibrosis
  • Pneumoconiosis
  • Sarcoidosis

Sleep apnea/Obesity hypoventilation syndrome

Other pulmonary disorders

  • Acute respiratory distress syndrome
  • Asthma
  • Cystic fibrosis
  • Foreign body aspiration
  • Hyaline membrane disease

Acute disorders

  • Glomerulonephritis
  • Nephrotic syndrome
  • Pyelonephritis

Acute kidney injury (acute renal failure)

Chronic kidney disease

Congenital or structural renal disorders

  • Horseshoe kidney
  • Hydronephrosis
  • Polycystic kidney disease
  • Renal vascular disease

End-stage renal disease

Fluid and electrolyte disorders

  • Acid-base disorders
  • Dehydration
  • Hyperkalemia/hypokalemia
  • Hypervolemia
  • Hyponatremia


  • Renal cell carcinoma
  • Wilms tumor

Breast disorders

  • Abscess
  • Fibroadenoma
  • Fibrocystic changes
  • Galactorrhea
  • Gynecomastia
  • Mastitis

Cervical disorders

  • Cervicitis
  • Dysplasia

Complicated pregnancy

  • Abortion
  • Abruptio placentae
  • Breech presentation
  • Cesarean delivery
  • Cord prolapse
  • Dystocia
  • Ectopic pregnancy
  • Fetal distress
  • Gestational diabetes
  • Gestational trophoblastic disease
  • Hypertension disorders in pregnancy
  • Incompetent cervix
  • Multiple gestation
  • Placenta previa
  • Postpartum hemorrhage
  • Premature rupture of membranes
  • Rh incompatibility
  • Shoulder dystocia

Contraceptive methods

Human sexuality



Menstrual disorders

Neoplasms of the breast and reproductive tract

  • Benign
  • Malignant

Ovarian disorders

  • Cysts
  • Polycystic ovarian syndrome
  • Torsion

Sexually transmitted infections/Pelvic inflammatory disease


  • Physical assault
  • Sexual assault
  • Trauma in pregnancy

Uncomplicated pregnancy

  • Normal labor/delivery
  • Postnatal/postpartum care
  • Preconception/prenatal care

Uterine disorders

  • Endometriosis
  • Leiomyoma
  • Prolapse

Vaginal/vulvar disorders

  • Cystocele
  • Prolapse
  • Rectocele
  • Vaginitis

PANCE task categories

The task categories on the PANCE assess candidates’ knowledge and skills related to tasks PAs perform when treating patients. Below are the contents of each category and how each category is allocated on the exam:

Categories % Allocation

Knowledge of:

  • General physical examination components and techniques
  • Pertinent historical information
  • Risk factors for development of significant medical conditions
  • Significant physical examination findings
  • Signs and symptoms of significant medical conditions

Skill in:

  • Conducting comprehensive and/or problem-based interviews and physical examinations
  • Eliciting patient information from other sources
  • Identifying conditions requiring referral to or consultation with specialists
  • Identifying pertinent patient and family historical information from patients and caregivers
  • Identifying pertinent physical examination information
  • Triaging of patients based on recognition of abnormal vital signs, examination findings, and/or general observations

Knowledge of:

  • Appropriate patient education relating to diagnostic and laboratory studies
  • Indications for initial and subsequent diagnostic and laboratory studies
  • Indications for preventive screening tests
  • Risks associated with diagnostic and laboratory studies

Skill in:

  • Collecting diagnostic and laboratory specimens
  • Communicating risks, benefits, and results effectively to other members of the healthcare team
  • Communicating risks, benefits, and results effectively to patients, families, and caregivers
  • Reviewing and interpreting results of diagnostic and laboratory studies, and correlating the results with history and physical examination findings
  • Selecting appropriate diagnostic and/or laboratory studies
  • Using diagnostic equipment safely and appropriately

Knowledge of:

  • Significance of diagnostic and laboratory studies as they relate to diagnosis
  • Significance of history as it relates to the differential diagnosis
  • Significance of physical examination findings as they relate to diagnosis

Skill in:

  • Developing multiple differential diagnoses for complicated and/or multisystem cases
  • Formulating most likely differential diagnoses
  • Incorporating history, physical examination findings, and diagnostic data into medical decision-making
  • Recognizing the need for referral to a specialist
  • Selecting the most likely diagnosis in light of presented data

Knowledge of:

  • Appropriate patient education regarding preventable conditions and lifestyle modifications
  • Early detection and prevention of medical conditions
  • Effects of aging and changing family roles
  • Genetic testing and counseling
  • Human growth and development
  • Human sexuality and gender identity, gender transition, and associated medical issues
  • Immunization schedules and recommendations for infants, children, adults, and foreign travelers/adoptions
  • Impact of patient demographics on risks for medical conditions
  • Prevention of communicable diseases
  • Preventive screening recommendations
  • Psychosocial effects of illness, stress, and injury as well as related healthy coping strategies
  • Signs of abuse and neglect

Skill in:

  • Adapting health maintenance to an individual patient’s context
  • Communicating effectively with and educating patients, family members, and caregivers regarding medical conditions
  • Conducting education on modifiable risk factors with an emphasis on primary and secondary prevention
  • Using counseling techniques

Knowledge of:

  • Clinical procedures and their indications, contraindications, complications, risks, benefits, and techniques
  • Conditions that constitute medical emergencies
  • Criteria for admission to or discharge from the hospital or other facilities
  • Management, treatment, and follow-up of medical conditions
  • Palliative care and end-of-life issues
  • Roles of other health professionals
  • Sterile technique
  • Therapeutic regimens
  • Universal precautions and special isolation conditions

Skill in:

  • Demonstrating technical expertise related to performing specific procedures
  • Evaluating patient response to treatment/intervention
  • Facilitating patient/caregiver adherence to and active participation in treatment
  • Formulating and implementing treatment plans in accordance with applicable practice guidelines
  • Interfacing in multidisciplinary teams, including education of other health care professionals
  • Making appropriate dispositions
  • Monitoring and managing nutritional status
  • Prioritizing tasks
  • Recognizing and initiating treatment for life-threatening conditions
  • Using community resources to meet the needs of patients/caregivers

Knowledge of:

  • Adverse effects, reactions, and toxicities
  • Common alternative/complementary therapies and their interactions and toxicities
  • Contraindications
  • Drug interactions, including presentation and treatment
  • Indications for use
  • Mechanism of action
  • Methods to reduce medication errors
  • Monitoring and follow-up of pharmacologic regimens
  • Presentation and treatment of allergic reactions
  • Regulation of controlled substances
  • Special populations requiring drug/dose modification
  • Substances of abuse

Skill in:

  • Assessing patient adherence to drug regimens
  • Drafting a prescription
  • Evaluating, treating, and reporting adverse drug reactions and/or adverse effects
  • Identifying and managing medication misuse
  • Interacting with pharmacists to address medication issues
  • Maintaining knowledge of relevant pharmacologic agents
  • Monitoring pharmacologic regimens and adjusting as appropriate
  • Prescribing controlled substances appropriately
  • Selecting appropriate pharmacologic therapy and dosing

Knowledge of:

  • Basic biochemistry
  • Basic genetics
  • Human anatomy and physiology
  • Microbiology
  • Pathophysiology and immunology

Skill in:

  • Evaluating emerging medical trends critically as they relate to patient care
  • Maintaining awareness of trends in infectious disease
  • Relating pathophysiologic principles to specific disease processes

Legal/medical ethics

Knowledge of:

  • Cultural and religious beliefs related to health care
  • Informed consent and refusal process
  • Living will, advance directives, organ donation, code status, do not resuscitate, do not
    intubate, medical power of attorney, etc.
  • Medicolegal issues
  • Patient/provider rights and responsibilities
  • Privacy, security, and responsibility related to medical record documentation and management

Skill in:

  • Caring for patients with cognitive impairment

Medical informatics

Knowledge of:

  • Billing/coding to maintain accuracy and completeness for reimbursement and administrative

Skill in:

  • Demonstrating appropriate medical record documentation
  • Using appropriate medical informatics sources

Patient care and communication (individual patients)

Knowledge of:

  • Affordable and effective health care that is patient specific
  • Cultural and religious diversity
  • Stewardship of patient and community resources

Skill in:

  • Acknowledging and applying patient/provider rights and responsibilities
  • Ensuring patient satisfaction
  • Providing patient advice and education regarding the informed consent and refusal process
  • Providing patient advice and education related to end-of-life decisions

Physician/PA relationship

Knowledge of:

  • Professional and clinical limitations, scope of practice, etc.
  • Supervision parameters: malpractice, mandated reporting, conflict of interest, impaired
    provider, ethical principles

Skill in:

  • Communicating and consulting with the supervising physician and/or other specialists/consultants

Professional development

Knowledge of:

  • Continuing medical education resources

Skill in:

  • Critically analyzing evidence-based medicine
  • Identifying and interpreting data from medical informatics sources and identifying appropriate
    reference sources
  • Using epidemiologic techniques to evaluate the spread of disease

Public health (population/society)

Knowledge of:

  • Basic disaster preparedness
  • Infection control measures and response to outbreaks
  • Occupational health issues as they pertain to health care as well as non–health care workers
  • Population health, travel health, and epidemiology of disease states

Skill in:

  • Protecting vulnerable populations and recognizing disparities in provision of and access to

Risk management

Knowledge of:

  • Quality improvement and patient safety
  • Resource stewardship

Skill in:

  • Ensuring patient safety and avoiding medical errors
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How medical content and task categories are tested

As you might have noticed, the percent allocation on each table equals 100%. This is because the medical content questions are coded to task areas (with the exception of the “Professional Practice” task category, totaling 5% allocation). As a result, medical content makes up 95% of the exam. Additionally, up to 20% of tested content may be related to general surgical topics. This percent allocation varies by exam.

PANCE Practice Questions Based on the NCCPA Blueprint

The UWorld PA QBank is written by practicing physician assistants to put aspiring PAs on a path to success. Our PANCE sample questions and industry-leading rationales are based on the latest NCCPA blueprints to ensure you know everything you’re expected to know on exam day. To see how our active-learning methodology can help you achieve PANCE success, try our example problems below. Submit your answers to view our award-winning explanations.

A 1-month-old boy is brought to the office for a routine visit. His prenatal and birth histories are unremarkable. His vital signs and pulse oximetry are normal. Examination shows a harsh, 3/6 holosystolic murmur over the left lower sternal border. Palpation indicates no thrill over the precordial region. Brachial and femoral pulses are 2+ and equal. The skin is pink and well perfused. ECG is normal. Which of the following is the best next step in management of this patient?

  1. Digoxin and diuretic therapy
  2. Echocardiography
  3. Oxygen administration
  4. Prostaglandin E1 therapy
  5. Reassurance and no further workup

A 78-year-old resident of an extended care facility is brought to the emergency department due to lethargy, fevers, and poor oral intake for the last day. Temperature is 39 C (102 F), blood pressure is 70/40 mm Hg, and pulse is 120/min and regular. On examination, the patient is lethargic but arousable. His extremities are warm. A Foley catheter is inserted into the bladder and drains 500 mL of cloudy urine consistent with urinary tract infection. Five hours after admission, the patient begins to bleed from the nose and venipuncture sites, and the Foley catheter begins to drain blood-tinged urine. Which of the following laboratory findings would most likely to be seen in this patient?

  1. Increased fibrinogen
  2. Normal D-dimer
  3. Normal partial thromboplastin time
  4. Normal prothrombin time
  5. Thrombocytopenia

A 45-year-old woman comes to the emergency department for acute onset of low back pain radiating down her left leg after lifting heavy boxes at home. She has had no muscle weakness and has no concerns with bowel or bladder function. The back pain worsens with coughing or bearing down. Neurologic examination reveals 5/5 muscle strength in all 4 extremities with 2+ reflexes. Straight-leg raise sign is positive on the left. Sensory examination reveals reduced pinprick and temperature sensation along the posterolateral region of the left leg. X-ray of the lumbar spine reveals only degenerative changes. Which of the following is the best next step in management of this patient?

  1. Bone density testing
  2. Gabapentin and tramadol
  3. Light exercise and a nonsteroidal anti-inflammatory drug
  4. MRI of the lumbar
  5. Physical therapy
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Read More About the PANCE

Learn everything you need to know about the exam itself, as well as our tips for passing it on your first attempt.

Discover how the PANCE is scored, when you can see your score, and historical pass rates.

Understand PANCE eligibility requirements, how to register for the exam, and associated fees.

Explore our comprehensive study guide for the PANCE, including study strategies, plans, and schedules.
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