Cardiovascular System
12%of exam
Pulmonary System
10%of exam
Gastrointestinal Nutrition
10%of exam
Endocrine System
8%of exam
DiabetesThyroidAdrenalBoneEndocrine Picker
Eyes Ears Nose Throat
8%of exam
OtitisSinusitisRed EyeVisionEENT Picker
Musculoskeletal System
8%of exam
FracturesArthritisSeptic JointBack PainMSK Picker
Infectious Diseases
7%of exam
SepsisSTIHIVTBID Picker
Psych Behavioral
7%of exam
DepressionAnxietyBipolarSuicidePsych Picker
Dermatologic System
5%of exam
RashesSkin CancerCellulitisBurnsDerm Picker
Genitourinary System
5%of exam
UTIBPHStonesTorsionGU Picker
Neurologic System
5%of exam
StrokeSeizureHeadacheDementiaNeuro Picker
Reproductive System
5%of exam
PregnancyPIDAUBContraceptionRepro Picker
Hematologic System
4%of exam
AnemiaCoagulationVTELeukemiaHeme Picker
Renal System
4%of exam
AKICKDElectrolytesPyeloRenal Picker
Emergent Topics
2%of exam
EthicsLegalDEISafetyDocumentation
Quick Facts
- Exam
- PANRE
- Owner
- NCCPA
- Format
- Pearson VUE
- Questions
- 240 MCQ
- Blocks
- 4 x 60
- Testing
- 4 hours
- Pass
- 379 scaled
- Fee
- $350
- Cycle
- Years 9-10
Top PANRE Weight
Cardio, pulm, GI drive one-third.
Cardio 12%Pulm 10%GI 10%
STEMI vs NSTEMI
STEMI
- ST elevation
- Immediate PCI
- Do not wait
NSTEMI
- Troponin rise
- Risk stratify
- Early invasive
ECG drives urgency
Cardio Picker
- ST elevation→Cath lab(STEMI)
- High-risk NSTEMI→Early cath
- Unstable bradycardia→Atropine pacing
- Wide VT unstable→Cardioversion
- HFrEF stable→ARNI beta MRA SGLT2
- Massive PE→Thrombolysis
Cardiovascular
- STEMI
- PCI now
- NSTEMI
- Risk stratify
- HFrEF
- Quadruple therapy
- AFib
- Rate plus anticoag
- DVT/PE
- Anticoagulate
- Dissection
- Tear emergency
Asthma vs COPD
Asthma
- Variable obstruction
- ICS foundation
- Triggers common
COPD
- Fixed obstruction
- LAMA/LABA foundation
- Smoking history
Reversibility separates
Pulmonary Picker
- Persistent asthma→ICS
- COPD exacerbation→SABA steroid
- Stable COPD→LAMA/LABA
- CAP outpatient→Amoxicillin doxy
- PE likely→CTPA
- OSA likely→Sleep test
Pulmonary
- Asthma
- ICS controller
- COPD
- LAMA/LABA
- CAP
- Empiric antibiotics
- PE
- CTPA or anticoag
- Pneumothorax
- Size decides
- OSA
- Sleep testing
Crohn vs UC
Crohn
- Skip lesions
- Transmural
- Mouth to anus
UC
- Continuous
- Mucosal
- Starts rectum
Skip vs continuous
GI Picker
- GERD no alarms→PPI trial
- GI bleed unstable→Resuscitate
- Pancreatitis→LR fluids
- Symptomatic stones→Cholecystectomy
- Appendicitis→Surgery
- IBD flare→Steroids
GI Nutrition
- GERD
- PPI trial
- PUD
- H pylori
- Pancreatitis
- LR fluids
- Cholecystitis
- Surgery
- IBD
- Inflammatory diarrhea
- GI bleed
- Stabilize first
DKA vs HHS
DKA
- Ketones
- Acidosis
- Type 1 common
HHS
- Severe glucose
- Osmolality high
- Minimal ketones
Acidosis vs osmolality
Endocrine
- T1DM DKA
- Fluids insulin K
- T2DM
- Metformin first
- HHS
- Profound dehydration
- Hypothyroid
- Levothyroxine
- Thyrotoxicosis
- Beta blocker
- Osteoporosis
- DEXA plus bisphosphonate
EENT
- AOM
- Bulging TM
- Otitis externa
- Topical drops
- Sinusitis
- Ten days
- Glaucoma
- Painful pressure
- Retinal detachment
- Curtain vision
- Peritonsillar abscess
- Uvula deviation
Musculoskeletal
- Fracture
- Immobilize image
- Compartment
- Pain passive stretch
- Septic joint
- Aspirate urgently
- Gout
- Crystals NSAID
- RA
- Symmetric inflammatory
- Cauda equina
- Surgical emergency
Infectious Diseases
- Sepsis
- Cultures antibiotics fluids
- HIV
- ART for all
- TB
- Airborne isolation
- Influenza
- Oseltamivir early
- Syphilis
- Penicillin preferred
- Lyme
- Doxycycline typical
Psych Behavioral
- MDD
- SSRI or therapy
- GAD
- SSRI CBT
- Bipolar
- Mood stabilizer
- Psychosis
- Antipsychotic
- SUD
- Withdrawal risk
- Suicide
- Safety assessment
Melanoma ABCDE
Asymmetric borders colors diameter evolving.
AsymmetryBorderColorDiameterEvolution
Cellulitis vs Abscess
Cellulitis
- Diffuse erythema
- Antibiotics
- No fluctuance
Abscess
- Fluctuant pocket
- Drain first
- MRSA possible
Fluid needs drainage
Dermatology
- Cellulitis
- Nonpurulent strep
- Abscess
- Drainage first
- SJS/TEN
- Stop culprit
- Melanoma
- ABCDE
- Actinic keratosis
- SCC risk
- Scabies
- Permethrin contacts
Genitourinary
- Cystitis
- Dysuria frequency
- Pyelo
- Fever flank
- BPH
- Alpha blocker
- Stone
- Colicky hematuria
- Torsion
- Detorse surgery
- Prostatitis
- Fluoroquinolone often
Neuro Red Flags
FAST deficits need stroke clock.
FaceArmSpeechTime
Neurology
- Stroke
- Time window
- TIA
- Transient deficit
- Seizure
- Protect airway
- Migraine
- Triptan acute
- Meningitis
- Antibiotics now
- Parkinson
- Levodopa wearing-off
Reproductive
- Ectopic
- Pregnancy plus pain
- PID
- Ceftriaxone doxy
- AUB
- Rule pregnancy
- Pre-eclampsia
- HTN proteinuria
- Postpartum bleed
- Uterine atony
- PCOS
- OCP first
Hematology
- Iron deficiency
- Microcytic ferritin low
- B12 deficiency
- Neuro symptoms
- ITP
- Platelets low
- DVT
- Anticoagulate
- Leukemia
- Blasts cytopenias
- Sickle crisis
- Pain oxygen fluids
Dialysis AEIOU
Dialyze refractory AEIOU problems.
AcidosisElectrolytesIntoxicationOverloadUremia
Renal
- Prerenal AKI
- BUN/Cr high
- ATN
- Muddy casts
- CKD
- eGFR chronic
- Hyperkalemia
- Calcium first
- Pyelonephritis
- Systemic UTI
- Dialysis
- AEIOU
PANRE vs PANRE-LA
PANRE
- Proctored center
- 240 questions
- Closed book
PANRE-LA
- Quarterly online
- 25 per quarter
- Open book
Same blueprint
Exam Picker
- One-day exam→PANRE
- Quarterly format→PANRE-LA
- Need open-book→PANRE-LA
- Need retakes→PANRE
- Need CME credit→PANRE-LA
- Missed LA window→PANRE
Emergent Topics
- HIPAA
- Minimum necessary
- Consent
- Risks benefits alternatives
- Capacity
- Decision-specific
- Disclosure
- Tell harmful errors
- DEI
- Equitable care
- Documentation
- Timely accurate
Capacity vs Consent
Capacity
- Can decide
- Decision-specific
- Clinician assesses
Consent
- Informed agreement
- Risks reviewed
- Alternatives reviewed
Ability before agreement
Exam Logistics
- PANRE scale
- 200 to 800
- PANRE pass
- 379 or higher
- PANRE-LA pass
- 1150 or higher
- CME cycle
- 100 credits
- Category 1
- 50 minimum
- Retake gap
- 90 days
Common Traps
PANRE Timing
One minute each ≠ Not leisurely review
Blueprint Scope
Generalist medicine ≠ Not specialty habits
PANRE-LA Scoring
Best eight quarters ≠ Not every quarter
Small Domains
Easy points ≠ Not optional
Antibiotic Reflex
Drain abscess ≠ Do not only prescribe
Pregnancy First
Check pregnancy ≠ Before meds imaging
Ethics Items
Disclose errors ≠ Do not hide harm
Last Minute
- 1.PANRE pass = 379 scaled
- 2.PANRE-LA pass = 1150 scaled
- 3.Cardio is biggest domain
- 4.Top three = 32%
- 5.Treat unstable first
- 6.Rule pregnancy early
- 7.Drain abscess before antibiotics
- 8.Sepsis: cultures, antibiotics, fluids
- 9.Stroke clock drives therapy
- 10.CME: 100 credits per cycle
- 11.Category 1: 50 minimum
- 12.No penalty for guessing
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