2020 PANRE and Pilot Alternative to PANRE Interactive Content Blueprint

Content Blueprint for the Physician Assistant National Recertifying Examination (PANRE) and the Pilot Alternative to PANRE

Organized by Content Category

The diseases and disorders that may be covered on PANRE and the Pilot Alternative to PANRE are provided below. Also provided is the level at which each disease and disorder will be assessed. The levels are defined as follows:

• Level 1: Recognize most likely diagnosis using signs, symptoms, and risks; refer appropriately.
• Level 2: Make appropriate diagnosis by recognizing signs, symptoms, risks and/or interpreting results of diagnostic studies, and have knowledge of first-line treatment.
• Level 3: Make appropriate diagnosis by recognizing signs, symptoms, risks and/or interpreting the results of diagnostic studies and have knowledge of first-line treatment. In addition, have the knowledge required to manage well- known comorbid conditions, contraindications, and complications.

Information on how the blueprint was developed may be accessed on the NCCPA website.

Content Area	Percent Allocation*
Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants
Cardiovascular System	13%
Dermatologic System	6%
Endocrine System	6%
Eyes, Ears, Nose, and Throat	8%
Gastrointestinal System/Nutrition	11%
Genitourinary System	5%
Hematologic System	4%
Infectious Diseases	6%
Musculoskeletal System	9%
Neurologic System	7%
Psychiatry/Behavioral Science	5%
Pulmonary System	10%
Renal System	3%
Reproductive System	7%

Content Category

Cardiovascular System: 13%*
Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants
Diseases and Disorders	Level 1	Level 2	Level 3
Abdominal aortic aneurysm	•
Acute myocardial infarction: non–ST-segment elevation myocardial infarction (NSTEMI)	•	•
Acute myocardial infarction: ST-segment elevation myocardial infarction (STEMI)	•	•
Acute pericarditis	•	•
Acute/subacute bacterial endocarditis	•
Angina pectoris (stable angina)	•	•	•
Aortic dissection	•	•
Aortic stenosis	•
Arterial embolism/thrombosis	•	•
Atrial fibrillation	•	•	•
Atrial flutter	•	•
Atrioventricular block­	•
Bundle branch block	•
Cardiac tamponade	•	•
Cardiogenic shock	•
Coronary artery disease	•	•	•
Deep venous thrombosis	•	•	•
Diastolic heart failure	•
Dilated cardiomyopathy	•
Essential hypertension (in adults)	•	•	•
Hypercholesterolemia	•	•	•
Hypertensive emergency	•	•
Hypertriglyceridemia	•	•	•
Hypertrophic cardiomyopathy	•
Iliac artery occlusion	•
Mitral regurgitation	•
Mitral valve prolapse	•
Orthostatic hypotension	•	•
Paroxysmal supraventricular tachycardia	•	•
Pericardial effusion	•
Peripheral artery disease	•	•
Phlebitis/thrombophlebitis	•	•
Premature atrial/ventricular contractions	•	•
Prinzmetal variant angina	•
Secondary hypertension	•	•
Sick sinus syndrome	•
Systolic heart failure	•	•
Temporal arteritis	•	•
Thoracic aortic aneurysm	•
Torsades de pointes	•	•
Unstable angina	•	•
Varicose veins	•	•
Venous insufficiency	•	•
Ventricular fibrillation	•	•
Ventricular tachycardia	•	•
Cardiology Exam	Take Exam

Dermatologic System: 6%*
Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants
Diseases and Disorders	Level 1	Level 2	Level 3
Acne vulgaris	•	•
Actinic keratosis	•	•
Acute urticaria, Drug eruptions	•	•
Atopic dermatitis	•	•
Basal cell carcinoma	•
Burns	•	•
Cellulitis, Erysipelas	•	•	•
Contact dermatitis	•	•
Erythema multiforme	•
Herpes simplex virus	•	•
Hidradenitis suppurativa	•	•
Impetigo	•	•
Lipomas/epidermal inclusion cysts	•	•
Melanoma	•
Molluscum contagiosum	•	•
Onychomycosis, Dermatophyte infections	•	•
Paronychia	•	•
Pilonidal disease	•	•
Pityriasis rosea	•	•
Pressure ulcers	•	•
Psoriasis	•	•
Rosacea	•	•
Scabies, Lice infestation	•	•
Seborrheic dermatitis	•	•
Spider bites	•	•
Squamous cell carcinoma	•
Toxic epidermal necrolysis, Stevens-Johnson syndrome	•
Dermatology Exam	Take Exam

Endocrine System: 6%*
Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants
Diseases and Disorders	Level 1	Level 2	Level 3
Benign thyroid nodules	•
Cushing syndrome	•
Diabetes insipidus	•
Hyperparathyroidism	•
Hyperthyroidism/thyrotoxicosis	•	•
Hypoparathyroidism	•
Hypothyroidism	•	•	•
Metabolic syndrome and obesity	•	•	•
Osteoporosis	•	•	•
Primary adrenal insufficiency	•
Thyroid cancer	•
Thyroiditis	•	•
Type 1 diabetes mellitus	•	•	•
Type 2 diabetes mellitus	•	•	•
Endocrine System Exam	Take Exam

Eyes, Ears, Nose, and Throat: 8%*
Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants
Diseases and Disorders	Level 1	Level 2	Level 3
Acute epiglottitis	•	•
Acute pharyngitis	•	•	•
Acute/chronic otitis media	•	•	•
Acute/chronic sinusitis­	•	•
Allergic rhinitis	•	•
Aphthous ulcers	•	•
Blepharitis	•	•
Cataract	•
Chalazion	•	•
Conjunctivitis	•	•
Corneal abrasion	•	•
Corneal ulcer	•
Epistaxis	•	•
Eustachian tube dysfunction	•	•
Foreign body in ear	•	•
Foreign body in eye	•	•
Foreign body in nose	•	•
Glaucoma	•
Hearing loss	•
Hordeolum	•	•
Hyphema	•
Labyrinthitis	•
Laryngitis	•	•
Mastoiditis	•	•
Meniere disease	•	•
Nystagmus	•
Oral candidiasis	•	•	•
Oral leukoplakia	•
Orbital blowout fracture	•
Orbital cellulitis	•	•
Otitis externa	•	•
Papilledema	•
Parotitis	•
Peritonsillar abscess	•	•
Retinal detachment	•
Tinnitus	•
Tympanic membrane perforation	•	•
Vertigo	•	•
Eyes, Ears, Nose, and Throat Exam	Take Exam

Gastrointestinal System/Nutrition: 11%*
Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants
Diseases and Disorders	Level 1	Level 2	Level 3
Acute hepatitis	•
Acute/chronic cholecystitis	•	•
Acute/chronic pancreatitis	•	•
Anal abscess/fistula	•
Anal fissure	•	•
Appendicitis	•	•	•
Celiac disease	•
Cholangitis	•
Cholelithiasis	•	•
Chronic hepatitis	•
Cirrhosis	•
Colon cancer	•
Constipation	•	•	•
Diverticulitis/diverticulosis	•	•
Esophageal varices	•
Esophagitis	•	•
Fecal impaction	•	•
Food allergies	•	•
Foreign body ingestion	•	•
Gastritis	•	•
Gastroesophageal reflux disease	•	•	•
Hemorrhoids	•	•
Hernias	•	•
Infectious diarrhea	•	•
Inflammatory bowel disease	•	•
Ingestion of caustic substance	•
Intentional overdose of medication	•	•
Intussusception	•
Irritable bowel syndrome	•	•
Ischemic bowel disease	•
Large-bowel obstruction	•
Mallory-Weiss tear	•
Noninfectious diarrhea	•	•
Peptic ulcer disease	•	•
Pyloric stenosis	•
Small-bowel obstruction	•	•
Toxic megacolon	•
GI and Nutrition Exam	Take Exam

Genitourinary System: 5%*
Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants
Diseases and Disorders	Level 1	Level 2	Level 3
Acute prostatitis	•	•
Bacterial cystitis	•	•
Benign prostatic hyperplasia	•	•
Bladder cancer	•
Chronic prostatitis	•	•
Epididymitis	•	•
Erectile dysfunction	•	•
Fecal incontinence	•
Hydrocele/varicocele	•
Nephrolithiasis/urolithiasis	•	•
Orchitis	•	•
Paraphimosis/phimosis	•
Prostate cancer	•
Testicular cancer	•
Testicular torsion	•	•
Urethritis	•	•
Urinary incontinence	•	•
Genitourinary System Exam	Take Exam

Hematologic System: 4%*
Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants
Diseases and Disorders	Level 1	Level 2	Level 3
Acute/chronic lymphocytic leukemia	•
Anemia of chronic disease	•
Factor V Leiden hypercoagulability	•
Folate deficiency anemia	•	•
Hemolytic anemia	•
Hodgkin lymphoma	•
Hypocoagulable states	•
Iron deficiency anemia	•	•
Non-Hodgkin lymphoma	•
Sickle cell anemia	•
Thrombotic thrombocytopenic purpura	•
Vitamin B12 deficiency anemia	•	•
Hematologic System Exam	Take Exam

Infectious Diseases: 6%*
Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants
Diseases and Disorders	Level 1	Level 2	Level 3
Acute rheumatic fever	•	•
Chickenpox/herpes zoster	•	•	•
Chlamydial infections	•	•
Epstein-Barr virus infections	•	•
Gonococcal infections	•	•
HIV infection	•
Human papillomavirus infections	•	•
Influenza	•	•	•
Lyme disease	•	•
Measles	•	•
Mumps	•	•
Pinworm infestation	•	•
Rabies	•
Rocky Mountain spotted fever	•	•
Roseola	•	•
Rubella	•	•
Syphilis	•	•
Tetanus	•
Tuberculosis	•	•
Vaginal candidiasis	•	•

Musculoskeletal System: 9%*
Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants
Diseases and Disorders	Level 1	Level 2	Level 3
Acute/chronic osteomyelitis	•
Avascular necrosis	•
Back strain/sprain, Lower back injuries	•	•
Biceps tendinitis	•	•
Carpal tunnel syndrome	•	•
Cauda equina syndrome	•
Compartment syndrome	•
de Quervain tenosynovitis	•	•
Fibromyalgia	•	•
Fractures and dislocations: knee/patella, ankle/foot, forearm/wrist/hand, shoulder, hip, spine	•
Ganglion	•	•
Gout/pseudogout	•	•
Kyphosis	•
Lateral and medial epicondylitis	•	•
Osgood-Schlatter disease	•	•
Osteoarthritis	•	•
Rheumatoid arthritis	•	•
Rotator cuff tear	•
Scoliosis	•
Septic arthritis	•	•
Shoulder bursitis	•	•
Shoulder tendinitis	•	•
Slipped capital femoral epiphysis	•
Soft-tissue injuries of the knee, foot/ankle, forearm/wrist/hand	•	•
Spinal disk herniation	•
Spinal stenosis	•	•
Systemic lupus erythematosus	•
Musculoskeletal System Exam	Take Exam

Neurologic System: 7%*
Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants
Diseases and Disorders	Level 1	Level 2	Level 3
Cerebral aneurysm	•
Cluster headache	•	•
Concussion	•	•
Delirium	•
Encephalitis	•
Essential tremor	•	•
Guillain-Barré syndrome	•
Major neurocognitive disorder/dementia	•
Meningitis	•	•
Migraine	•	•	•
Multiple sclerosis	•
Parkinson disease	•
Peripheral neuropathy	•	•
Postconcussion syndrome	•	•
Radiculopathy	•	•
Seizure disorders	•
Spontaneous intracranial hemorrhage	•
Status epilepticus	•	•
Stroke/transient ischemic attack	•	•	•
Syncope	•	•
Tension headache	•	•	•
Traumatic intracranial hemorrhage	•
Neurologic System Exam	Take Exa2m

Psychiatry/Behavioral Science: 5%*
Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants
Diseases and Disorders	Level 1	Level 2	Level 3
Anorexia nervosa, Bulimia nervosa	•
Attention-deficit/hyperactivity disorder	•
Bereavement/grief reaction	•	•
Bipolar disorder	•
Child/elder abuse, Spouse/partner abuse	•
Generalized anxiety disorder	•	•
Major depressive disorder	•	•
Non–substance-related addictive disorders	•
Panic disorder	•	•
Post-traumatic stress disorder	•
Substance use disorders: illicit substances, prescription drugs, alcohol, tobacco	•
Suicide risk	•	•
Psychiatry and Behavioral Science Exam	Take Exam

Pulmonary System: 10%*
Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants
Diseases and Disorders	Level 1	Level 2	Level 3
Acute bronchiolitis	•	•
Acute bronchitis	•	•
Acute respiratory distress syndrome	•	•
Asthma	•	•	•
Bacterial pneumonia	•	•	•
Chronic bronchitis	•	•	•
Croup	•	•
Emphysema	•	•	•
Foreign body aspiration	•	•
Lung cancer	•
Pertussis	•	•
Pleural effusion	•	•
Pneumothorax	•	•
Pulmonary embolism	•	•	•
Pulmonary nodules	•
Respiratory syncytial virus infection	•	•
Sleep apnea	•	•
Viral pneumonia	•	•	•
Pulmonary System Exam	Take Exam

Renal System: 3%*
Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants
Diseases and Disorders	Level 1	Level 2	Level 3
Acid-base disorders	•
Acute kidney injury (acute renal failure)	•
Chronic kidney disease	•	•
Electrolyte disorders	•	•
Pyelonephritis	•	•

Reproductive System: 7%*
Smarty PANCE is not sponsored or endorsed by, or affiliated with, the National Commission on Certification of Physician Assistants
Diseases and Disorders	Level 1	Level 2	Level 3
Abruptio placentae	•
Amenorrhea	•
Breast abscess	•	•
Breast cancer	•
Cervical cancer	•
Cervicitis	•	•
Contraception	•	•
Dysfunctional uterine bleeding	•
Dysmenorrhea	•	•
Ectopic pregnancy	•	•
Endometriosis	•
Gestational diabetes	•
Hypertension disorders in pregnancy	•
Mastitis	•	•
Menopause	•	•
Ovarian cysts	•
Pelvic inflammatory disease	•	•
Placenta previa	•
Postpartum hemorrhage	•
Premature rupture of membranes	•
Premenstrual syndrome	•	•
Prenatal diagnosis and care/preconception counseling	•
Rh incompatibility	•
Sexual/physical abuse in pregnancy	•
Vaginitis	•	•
Reproductive System Exam	Take Exam