If you are studying for the PANRE, whether it’s the high-risk exam or the pilot program, you have to study differently. What we want to cover in this blog are those diseases that are considered Level 1 diseases. Remember, these are the diseases you need to diagnose and then get help for. The NCCPA’s criteria says we must recognize the most likely diagnosis using signs, symptoms and risk factors, and refer appropriately. We’re going to go through each field of medicine and identify the Level 1, or Red, diseases and disorders.
Cardiology is now 13% of your boards. It used to be 16%. The diseases that are considered Level 1 are valvular heart disease, including mitral insufficiency, aortic stenosis and mitral valve prolapse. Note that the valves you need to understand are the left sided heart valves. You don’t have to worry about the tricuspid and the pulmonic valve under cardiology. We need to know that heart blocks, bundle branch blocks and sick sinus syndrome fall under the category of Level 1. Know iliac artery occlusion, pericardial effusion, Prinzmetal angina, aneurysms of the aorta (either thoracic or abdominal), endocarditis, cardiogenic shock, diastolic heart failure, or hypertrophic obstructive cardiomyopathy.
The next biggest topic on the boards will be gastrointestinal, which is 11%. The diseases that are Level 1 are caustic ingestions, intussusception, large bowel obstructions, ischemic bowel disease, toxic megacolon, esophageal varices, Mallory-Weiss tear, pyloric stenosis, hepatitis, anal abscesses and fistulas, celiac disease, cholangitis, sorosis and colon cancer.
For pulmonary, the Level 1 information is just lung masses. That’s it. Lung cancers and lung modules.
Musculoskeletal has a number of Level 1 diseases. Of the back, it’s cauda equina syndrome, kyphosis and scoliosis and spinal disc herniation, slipped capital femoral epiphysis, systemic lupus erythematosus, osteomyelitis, avascular necrosis, compartment syndrome. Of the shoulder, it’s rotator cuff tear. There are also multiple fractures and dislocations of the knee, patella, ankle, foot, forearm, wrist, hand, shoulder, hip and spine.
EENT is worth 8% of your study investment. For the eye, there are cataracts, corneal ulcers, glaucoma, papilledema, nystagmus hyphema, retinal detachment and a blowout fracture. Of the mouth, it’s oral leukoplakia and proctitis. Of the ear, it’s tinnitus, hearing loss and labyrinthitis.
Neuro, which is 7% of your boards, is multiple sclerosis, Parkinson’s, seizure disorders, intercranial hemorrhage, delirium, encephalitis, Guillain-Barre syndrome and the major cognitive dementia-like disorders.
For the reproductive, which is 7%, ovarian cysts, placenta previa or abruptio placentae, postpartum hemorrhage, premature rupture of membranes, prenatal diagnosis and care, Rh incapability, sexual abuse, amenorrhea, cancer of both the breast and cervix, dysfunctional uterine bleeding, endometriosis, gestational diabetes and Heparin-induced thrombocytopenia.
For dermatology, it’s cancer (such as melanoma, squamous cell carcinoma and toxic epidermal necrolysis), Stevens-Johnson syndrome, endocrine thyroid masses, Addison’s, Cushing’s syndrome, diabetes insipidus and parathyroid disease.
Infectious disease went from 3% up to 6% of your PANRE questions. There are also infectious diseases that do not fall into this category. Meningitis, for example, falls under neurology and is therefore not considered under the 6% of infectious disease. Infectious disease is going to be probably closer to 10% in total. The diseases listed under Level 1 of infectious disease are HIV, rabies and tetanus.
Gastrointestinal’s Red diseases are prostate cancer, testicular cancer, bladder cancer, phimosis and paraphimosis, thecal incontinence and a hydrocele varicocele.
For psych, it’s addictive disorders, posttraumatic stress disorder, substance use disorders, eating disorders, ADHD, bipolar and abuse.
For hematology, it’s lymphoma, anemia such as sickle-cell anemia and hemolytic anemia, TTP, which is thrombocytopenic purpura, leukemias, anemia chronic disease and hypercoagulability.
Renal, which is 3%, only includes acid based disorders and acute renal failure. With renal making up 3% of your boards, you really need to know your acid base.
Studying for the new PANRE really has changed. You need to know the levels and understand that the criteria on the boards is going to be a much narrower spectrum. It’s a good time to be a physician assistant.