Every PANCE is different, but the same conditions show up over and over. After enough exams and enough student debriefs, a list emerges — roughly one hundred diagnoses that you cannot afford to miss. Knowing these cold doesn't guarantee a passing score, but not knowing them guarantees a fail.
This list is organized by NCCPA blueprint category, in descending order of exam weight. Each entry has a one-line pearl — the single highest-yield fact, distinction, or clinical clue that the question writers most often hinge on. It's not a substitute for full content review. It's a checklist. If you can read each entry and instantly recall the diagnostic criteria, workup, and first-line treatment, that condition is solid. If you can't, that's a flag — go back to your primary review source and rebuild it.
Use this list as a final-week gut check, as a daily warm-up during weeks four and five, or as a self-test by covering the pearl and quizzing yourself from the name.
One more note before the list: percentages next to each section reflect the NCCPA's published blueprint weight for that content category. They are not the percentage of this list devoted to that category — the categories with the most reliable, repeated questions get more entries than their raw weight would suggest. Cardiovascular gets thirteen entries, not thirteen percent of one hundred entries, because cardiology has more distinct high-yield diagnoses than any other system.
Cardiovascular (1–13)
The largest single category — 13% of the exam
Cardiovascular is the system where the highest number of test points are won and lost. The thirteen conditions below cover the bulk of cardio questions you'll see. If you can move through this list without slowing, you've handled roughly one in eight exam questions before walking in.
1. Essential hypertension — Diagnosis = average BP ≥130/80 on two separate visits; first-line is thiazide, ACEI/ARB, or CCB depending on patient profile.
2. Stable angina — Substernal chest pain with exertion, relieved by rest or nitroglycerin; stress test is the diagnostic move when EKG is non-diagnostic.
3. Acute coronary syndrome (STEMI/NSTEMI/unstable angina) — STEMI = ST elevation in two contiguous leads → cath within 90 minutes; NSTEMI = positive troponin without ST elevation.
4. Heart failure — Reduced (HFrEF) vs. preserved (HFpEF) by ejection fraction <40% vs. ≥50%; the four pillars for HFrEF are ARNI/ACEI/ARB, beta-blocker, MRA, SGLT2 inhibitor.
5. Atrial fibrillation — Irregularly irregular rhythm with no P waves; rate control plus anticoagulation by CHA₂DS₂-VASc.
6. Aortic stenosis — Crescendo-decrescendo systolic murmur radiating to carotids; classic triad is angina, syncope, heart failure → valve replacement.
7. Mitral regurgitation — Holosystolic murmur radiating to axilla; often post-MI from papillary muscle dysfunction.
8. Mitral valve prolapse — Mid-systolic click followed by late systolic murmur; usually benign in young patients.
9. Infective endocarditis — Duke criteria; Staph aureus is the most common organism overall and the only one to think of in IV drug users.
10. Acute pericarditis — Pleuritic chest pain that improves leaning forward; diffuse ST elevation with PR depression.
11. Cardiac tamponade — Beck's triad: hypotension, muffled heart sounds, distended neck veins; pulsus paradoxus.
12. Abdominal aortic aneurysm — Pulsatile abdominal mass with back/flank pain; rupture = surgical emergency, screen male smokers 65–75 once with ultrasound.
13. Peripheral arterial disease — Claudication, decreased pulses, ABI <0.9; treat with cilostazol, smoking cessation, supervised exercise.
Pulmonary (14–23)
Second largest category — 10% of the exam
Pulmonary questions reward two skills: pattern recognition on PFTs and a clean diagnostic algorithm for acute dyspnea. Get those two down and the rest of the category falls into place. The most common error here is mistreating COPD as asthma — different pharmacology, different staging, different prognosis.
14. Asthma — Reversible airway obstruction; stepwise therapy starting with ICS, add LABA, then biologics.
15. COPD — Irreversible obstruction with FEV1/FVC <0.7; GOLD staging guides therapy; smoking cessation is the only intervention that alters disease course.
16. Community-acquired pneumonia — Outpatient: amoxicillin or doxycycline; inpatient: beta-lactam plus macrolide; ICU adds atypical and Pseudomonas coverage if risk factors.
17. Tuberculosis — Positive PPD/IGRA → CXR; treat latent with INH; treat active with RIPE for 6 months.
18. Pulmonary embolism — Wells score → D-dimer (low) or CTA (intermediate/high); treat with anticoagulation, thrombolysis if massive.
19. Pleural effusion — Light's criteria distinguish exudate from transudate; thoracentesis for diagnosis and symptom relief.
20. Pneumothorax — Tension = tracheal deviation, hypotension, distended neck veins → needle decompression before imaging.
21. Lung cancer — Small cell (central, paraneoplastic syndromes) vs. non-small cell (peripheral); low-dose CT screening for high-risk smokers 50–80.
22. Sarcoidosis — Bilateral hilar lymphadenopathy on CXR; non-caseating granulomas on biopsy; treat symptomatic cases with steroids.
23. Obstructive sleep apnea — Polysomnography is diagnostic; treat with CPAP; weight loss is curative if achievable.
Gastrointestinal (24–32)
Plus nutritional — 9% of the exam
GI is dominated by acute abdominal pain stems and chronic liver disease management. The look-alike trap most students fall into is confusing epigastric stems — PUD, gastritis, pancreatitis, biliary disease, and inferior MI can all present similarly. Treat every epigastric stem as cardiac until the labs prove otherwise.
24. GERD — Heartburn, regurgitation; PPI trial is both diagnostic and therapeutic; endoscopy for alarm features.
25. Peptic ulcer disease — H. pylori is the most common cause; triple therapy is PPI + clarithromycin + amoxicillin.
26. Acute viral hepatitis — A and E = fecal-oral, no chronic carriers; B, C, D = bloodborne, can become chronic.
27. Cirrhosis — Complications: ascites, varices, hepatic encephalopathy, hepatorenal, hepatocellular carcinoma; MELD score guides transplant priority.
28. Acute pancreatitis — Epigastric pain radiating to back + lipase ≥3× upper limit; gallstones and alcohol cause 80%.
29. Cholecystitis/cholelithiasis — Murphy sign; RUQ ultrasound is the test of choice; cholecystectomy within 72 hours for acute.
30. Diverticulitis — LLQ pain + fever; CT is diagnostic; outpatient antibiotics for uncomplicated, IV antibiotics and bowel rest for complicated.
31. Inflammatory bowel disease — Crohn = transmural, anywhere mouth-to-anus, skip lesions, fistulas; UC = mucosal, continuous, rectum upward, bloody diarrhea.
32. Colorectal cancer — Screen average-risk adults age 45–75; FOBT, FIT, or colonoscopy; iron deficiency anemia in an older adult = colon cancer until proven otherwise.
Musculoskeletal (33–40)
Heavy on pattern recognition — 8% of the exam
MSK questions reward visual and physical-exam pattern recognition more than any other category. Joint distribution, morning stiffness duration, age, sex, and the presence or absence of systemic features will usually solve the differential before you read the lab values. Fracture eponyms and pediatric ortho red flags are reliable points.
33. Osteoarthritis — DIP and PIP involvement, morning stiffness <30 minutes, no systemic symptoms; treat with acetaminophen, NSAIDs, weight loss.
34. Rheumatoid arthritis — MCP/PIP/wrist symmetric, morning stiffness >1 hour, RF and anti-CCP positive; methotrexate is first-line DMARD.
35. Gout — Monosodium urate crystals (negatively birefringent, needle-shaped); acute = NSAIDs/colchicine/steroids; chronic = allopurinol.
36. Low back pain — Red flags: trauma, age >50, weight loss, fever, neurologic deficit, IV drug use, history of cancer; otherwise conservative for 6 weeks.
37. Rotator cuff tear — Drop-arm test, weakness with external rotation or empty can; MRI is the imaging test of choice.
38. Carpal tunnel syndrome — Median nerve numbness/tingling, Tinel and Phalen signs; nerve conduction studies confirm; splinting first, surgery if persistent.
39. Common fractures — Colles = distal radius dorsal angulation; scaphoid = snuffbox tenderness (high risk of AVN, splint even if X-ray negative); hip fracture in elderly = surgery.
40. Osteoporosis — DEXA T-score ≤−2.5; bisphosphonates are first-line; screen all women age 65 and over.
Endocrine (41–47)
Diabetes dominates the category — 7% of the exam
Roughly half of endocrine questions are diabetes — diagnosis, complications, and pharmacology. The other half cluster around thyroid, adrenal, and calcium. Lab interpretation matters more here than in any other category: TSH plus free T4, calcium plus PTH, cortisol plus ACTH. Always read both values, not one.
41. Diabetes mellitus type 2 — A1c ≥6.5%, fasting glucose ≥126, or random ≥200 with symptoms; metformin is first-line.
42. Diabetic ketoacidosis — Hyperglycemia, anion gap acidosis, ketonemia; IV fluids → insulin drip → potassium replacement before correcting glucose.
43. Hyperthyroidism (Graves) — Suppressed TSH, elevated T4; TSI antibodies, diffuse uptake on radioiodine scan; methimazole or radioactive iodine.
44. Hypothyroidism (Hashimoto) — Elevated TSH, low T4; anti-TPO antibodies; levothyroxine titrated by TSH.
45. Adrenal insufficiency (Addison) — Fatigue, hyperpigmentation, hyponatremia, hyperkalemia; ACTH stimulation test for diagnosis; replace glucocorticoid and mineralocorticoid.
46. Cushing syndrome — Central obesity, moon facies, striae, easy bruising; screen with 24-hour urinary cortisol, late-night salivary cortisol, or low-dose dexamethasone.
47. Primary hyperparathyroidism — Hypercalcemia + elevated PTH; "stones, bones, abdominal groans, psychiatric overtones"; parathyroidectomy if symptomatic or end-organ effects.
EENT (48–54)
Eye emergencies are heavily tested — 7% of the exam
Half the EENT category is the red eye differential. Knowing which red eye is an emergency (acute angle-closure, iritis, keratitis, hyphema) and which is benign (allergic, viral, bacterial conjunctivitis) is the most reliable EENT skill you can build. Otitis and pharyngitis questions are easy points if you've reviewed the antibiotic algorithms.
48. Acute angle-closure glaucoma — Severe eye pain, fixed mid-dilated pupil, halos around lights, nausea/vomiting; emergency — IOP-lowering drops and urgent ophthalmology.
49. Open-angle glaucoma — Asymptomatic until late, cupping on fundoscopy, elevated IOP; first-line prostaglandin analog drops.
50. Bacterial conjunctivitis — Purulent discharge, lids stuck shut; topical antibiotics; contact lens wearer requires Pseudomonas coverage.
51. Otitis media — Bulging, erythematous TM with effusion; amoxicillin first-line if treating; watchful waiting often appropriate.
52. Otitis externa — Pain with tragal manipulation; ear canal edema; topical ciprofloxacin/dexamethasone drops.
53. Strep pharyngitis — Centor criteria; rapid antigen test then culture if negative; penicillin or amoxicillin × 10 days.
54. Acute sinusitis — Mostly viral; bacterial if symptoms >10 days, severe, or worsening after improvement; amoxicillin-clavulanate first-line for bacterial.
Neurologic (55–61)
Stroke is the highest-yield single topic — 7% of the exam
Neurology questions live or die by localization. A clean mental map of vascular territories, motor and sensory pathways, and cranial nerves will solve more questions than memorizing disease lists. The most important time-sensitive call in the entire exam — tPA eligibility for ischemic stroke — comes from this category.
55. Ischemic stroke — Sudden focal neurologic deficit; non-contrast CT to rule out bleed; tPA within 4.5 hours if eligible, thrombectomy up to 24 hours for large vessel.
56. Hemorrhagic stroke/SAH — Thunderclap headache → CT, then LP if CT negative; SAH = subarachnoid blood, usually aneurysmal.
57. Seizures and epilepsy — Status epilepticus = seizure >5 minutes or recurrent without recovery; benzo → levetiracetam/phenytoin → general anesthesia.
58. Primary headaches — Migraine = unilateral throbbing with nausea/photophobia, ± aura; cluster = unilateral orbital with autonomic features; tension = bilateral band-like.
59. Alzheimer dementia — Insidious memory loss progressing to executive dysfunction; cholinesterase inhibitors (donepezil) and memantine slow progression but don't cure.
60. Parkinson disease — TRAP: tremor (resting, pill-rolling), rigidity, akinesia/bradykinesia, postural instability; levodopa-carbidopa is most effective.
61. Bell palsy — Acute unilateral lower motor neuron facial palsy involving the forehead; prednisone within 72 hours improves recovery.
Reproductive (62–68)
OB and gyn together — 7% of the exam
The defining habit in reproductive: any reproductive-age woman with abdominal pain gets an hCG before anything else, mentally and on the question. Ectopic must be ruled out. The other heavy-hitters here are preeclampsia (delivery is treatment when severe), STIs (empiric treatment matters), and contraception (most stems hinge on a contraindication).
62. Pregnancy — Naegele's rule for due date; first-trimester ultrasound for dating; quad screen at 15–20 weeks; glucose tolerance at 24–28 weeks.
63. Preeclampsia/eclampsia — New hypertension + proteinuria after 20 weeks; severe features → magnesium for seizure prophylaxis, delivery is definitive.
64. Ectopic pregnancy — Positive hCG without intrauterine pregnancy on transvaginal ultrasound; methotrexate if stable, surgery if ruptured or unstable.
65. Pelvic inflammatory disease — Cervical motion tenderness, adnexal tenderness, uterine tenderness; ceftriaxone + doxycycline ± metronidazole.
66. STIs (gonorrhea/chlamydia/syphilis) — Empirically treat both GC and chlamydia (ceftriaxone + doxycycline); syphilis = benzathine penicillin G, dose by stage.
67. PCOS — Rotterdam criteria (2 of 3): oligo/anovulation, hyperandrogenism, polycystic ovaries; metformin and combined OCPs.
68. Breast cancer — Screen with mammography starting at 40 or 50 depending on guideline; BRCA mutations dramatically raise lifetime risk.
Psychiatry and Behavioral (69–74)
DSM-5 criteria are heavily tested — 6% of the exam
Psych questions hinge on diagnostic criteria — specific symptom counts, duration thresholds, and onset patterns. Memorize the time cutoffs (two weeks for major depression, six months for GAD and schizophrenia, one week for mania) and the SIGECAPS and DIGFAST mnemonics. Medication side-effect profiles are the second most-tested topic.
69. Major depressive disorder — ≥5 SIGECAPS symptoms for ≥2 weeks; SSRIs first-line; suicide risk assessment on every patient.
70. Bipolar disorder — Manic episode = ≥1 week of elevated mood with DIGFAST symptoms; never treat with SSRI alone — mood stabilizer first (lithium, valproate, antipsychotic).
71. Generalized anxiety disorder — Excessive worry most days for ≥6 months; SSRI/SNRI first-line; benzos only short-term.
72. Schizophrenia — ≥2 positive/negative symptoms for ≥6 months; atypical antipsychotics first-line; watch for metabolic syndrome and EPS.
73. Substance use disorders — Alcohol withdrawal = benzos; opioid overdose = naloxone; long-term opioid use disorder = buprenorphine or methadone.
74. ADHD — Inattention and/or hyperactivity onset before age 12, present in ≥2 settings; stimulants are first-line (methylphenidate, amphetamines).
Infectious Disease (75–80)
Sepsis and HIV are perennial questions — 6% of the exam
Two anchors: sepsis recognition (qSOFA criteria, antibiotics within one hour) and HIV opportunistic infections by CD4 count. Beyond those, expect questions on tick-borne illness, the pediatric and adult vaccine schedules, and common bacterial pneumonia pathogens. Antibiotic selection questions punish anyone who hasn't reviewed coverage spectra.
75. Sepsis — Suspected infection + organ dysfunction (qSOFA: RR ≥22, altered mentation, SBP ≤100); fluids, broad-spectrum antibiotics within 1 hour, source control.
76. HIV/AIDS — Initial 4th-gen Ag/Ab test then confirmatory; ART for all; PCP prophylaxis at CD4 <200, MAC at <50.
77. Influenza — Oseltamivir within 48 hours of symptom onset; vaccinate annually; high-risk = young, old, pregnant, immunocompromised, chronic disease.
78. Lyme disease — Erythema migrans → doxycycline; later stages can cause arthritis, carditis, neurologic disease.
79. Mononucleosis — Fatigue, pharyngitis, posterior cervical lymphadenopathy, splenomegaly; monospot positive; avoid contact sports for 3–4 weeks.
80. C. difficile colitis — Recent antibiotics + watery diarrhea; PCR or toxin assay; oral vancomycin or fidaxomicin (no longer metronidazole first-line).
Dermatologic (81–85)
Image recognition matters — 5% of the exam
Dermatology questions are sneakily high-yield because the morphology vocabulary is small (macule, papule, plaque, vesicle, bulla, pustule) and the classic location patterns are nearly diagnostic. Pediatric exanthems and skin cancer recognition (ABCDE for melanoma) appear on essentially every exam.
81. Atopic/contact dermatitis — Atopic = chronic, flexural in adults; contact = sharply demarcated to exposure pattern; topical steroids.
82. Psoriasis — Well-demarcated erythematous plaques with silvery scale on extensor surfaces; topical steroids and vitamin D analogs; biologics for severe.
83. Cellulitis — Erythema, warmth, swelling without distinct border; cephalexin or clindamycin for non-purulent; cover MRSA if purulent or risk factors.
84. Skin cancers — Basal cell = pearly papule with telangiectasias; squamous cell = scaly, can ulcerate; melanoma = ABCDE.
85. Tinea infections — Annular scaly patch with central clearing; KOH prep; topical antifungal except tinea capitis (oral) and tinea unguium (oral terbinafine).
Genitourinary (Male) (86–90)
Don't miss torsion — 5% of the exam
Small category by weight, but testicular torsion is one of the highest-stakes diagnoses on the entire exam — get the differential of acute scrotal pain absolutely right. The rest of the category is BPH pharmacology and prostate cancer screening. UTI in a male is, by definition, complicated; workup differs from females.
86. Benign prostatic hyperplasia — Obstructive urinary symptoms; treat with alpha-blockers (tamsulosin) ± 5-alpha-reductase inhibitor (finasteride).
87. Prostate cancer — Most common cancer in men; PSA + DRE for screening (controversial); Gleason score grades aggressiveness.
88. Prostatitis — Acute = fever, pelvic pain, tender boggy prostate (do NOT massage); fluoroquinolone × 4–6 weeks.
89. Testicular torsion — Acute scrotal pain, high-riding testis, absent cremasteric reflex; emergency surgical detorsion within 6 hours.
90. Erectile dysfunction — PDE5 inhibitors (sildenafil) first-line; contraindicated with nitrates.
Renal (91–95)
Electrolytes show up in every system — 5% of the exam
Renal looks small at five percent, but electrolyte questions bleed into every other category — endocrine, cardio, neuro, GI. Master AKI categorization, hyperkalemia management order, sodium disorders by volume status, and acid-base interpretation. The five conditions below are the named diagnoses; the underlying skills are tested everywhere.
91. Acute kidney injury — Pre-renal (FeNa <1%), intrinsic (FeNa >2%), post-renal (obstruction on ultrasound); treat the cause.
92. Chronic kidney disease — GFR <60 for ≥3 months; staging by GFR; ACE/ARB slow progression; dialysis at stage 5 or symptomatic.
93. Nephrolithiasis — Flank pain radiating to groin, hematuria; non-contrast CT is the imaging test of choice; calcium oxalate most common.
94. UTI/pyelonephritis — UTI: nitrofurantoin or TMP-SMX; pyelonephritis: outpatient fluoroquinolone if stable, IV antibiotics if not.
95. Glomerulonephritis (nephritic vs. nephrotic) — Nephritic = hematuria, hypertension, RBC casts; nephrotic = >3.5 g/day proteinuria, edema, hyperlipidemia.
Hematologic (96–100)
Smear questions and anticoagulation — 5% of the exam
Heme questions are about pattern matching on three things: MCV plus iron studies for anemias, peripheral smear morphology, and coagulation cascade interpretation. Anticoagulation choice questions sneak in here too — know the indications for warfarin, the DOACs, LMWH, and the new factor Xa and direct thrombin inhibitors.
96. Iron deficiency anemia — Microcytic, hypochromic; low ferritin is most specific; oral iron and find the source of loss.
97. B12/folate deficiency — Macrocytic with hypersegmented neutrophils; B12 deficiency adds neurologic symptoms — always check B12 before replacing folate alone.
98. Sickle cell disease — Sickled cells on smear; vaso-occlusive crisis = pain control, hydration, oxygen; hydroxyurea reduces crisis frequency.
99. Deep vein thrombosis — Calf swelling, pain, warmth; ultrasound is the test; treat with anticoagulation (DOAC, LMWH, or warfarin).
100. Acute vs. chronic leukemias — Acute = blasts on smear, rapid onset (AML adult/ALL pediatric); chronic = mature cells, indolent (CML with Philadelphia chromosome, CLL with smudge cells).
The Ten Conditions You Cannot Miss
Of the hundred, ten carry disproportionate weight on test day — either because they're heavily tested, frequently misdiagnosed, or both. If you have one weekend left and you want to maximize the marginal point return, these are the diagnoses to spend it on.
Acute coronary syndrome. Multiple questions per exam. Know the EKG patterns, the troponin timing, the antiplatelet and anticoagulation algorithm, and the cath versus medical management decision tree.
Heart failure. Reduced versus preserved ejection fraction, the four pharmacologic pillars for HFrEF, the diuretic strategy for acute decompensation, and the BNP interpretation.
Pulmonary embolism. Wells score, PERC rule, D-dimer cutoffs, CTA criteria, anticoagulation choice, and thrombolytic indications. PE shows up in pulmonary, cardio, and OB stems.
Diabetic ketoacidosis. Diagnostic triad, management sequence (fluids, insulin, potassium), and the trap of correcting glucose before replacing potassium.
Stroke (ischemic and hemorrhagic). Time windows for tPA and thrombectomy, NIHSS-driven decision points, blood pressure management differences between ischemic and hemorrhagic, and the SAH workup.
Acute angle-closure glaucoma. The single most heavily tested ophthalmologic emergency. Severe pain, fixed mid-dilated pupil, halos, nausea — refer immediately.
Testicular torsion. Six-hour viability window. Absent cremasteric reflex, high-riding testis, negative Prehn sign — surgery before imaging if the clinical picture is convincing.
Ectopic pregnancy. Any reproductive-age woman with abdominal pain. Positive hCG without intrauterine pregnancy on transvaginal ultrasound. Methotrexate if stable, surgery if unstable or ruptured.
Sepsis. Recognition criteria (qSOFA), the one-hour bundle, fluid resuscitation parameters, and broad-spectrum antibiotic selection. Time-to-antibiotic is the answer to most sepsis stems.
Major depression with suicidal ideation. Suicide risk assessment is the unspoken expectation behind any depression stem. Whatever else the question is testing, never choose an answer that fails to assess safety.
Memorize these ten cold. Drill them in week six, drill them again in week eight, and walk into the exam confident you can recognize each one from a one-line stem.
Common Patterns Across the 100
Reading through the list, several patterns emerge that aren't disease-specific but show up in nearly every PANCE category. Recognizing them shortens your time per question and reduces the rate of careless misses.
Time-sensitive emergencies have one-step answers. Torsion, tPA-eligible stroke, tension pneumothorax, sepsis, anaphylaxis, status epilepticus, acute angle-closure glaucoma. When the stem describes any of these, the correct answer is the intervention, not the workup. Imaging waits.
Screening guidelines are tested by age and risk factor. Mammography, colonoscopy, AAA ultrasound, lung-cancer low-dose CT, bone density. Know the starting age and frequency for the average-risk patient, and the modifier for the high-risk patient.
Antibiotic selection follows organ + patient profile. Otitis = amoxicillin; cellulitis = cephalexin (cover MRSA if purulent); pyelonephritis = fluoroquinolone outpatient; community pneumonia = setting-dependent. Memorize the first-line drug for each common infection by site and the modifier for special populations (pregnancy, pediatrics, renal disease).
Diagnostic tests have a preferred order. Suspected DVT → ultrasound. Suspected PE → CTA (or V/Q if contrast contraindicated). Suspected appendicitis → CT (or ultrasound in pediatrics and pregnancy). Suspected AAA → ultrasound (screening) or CT (symptomatic). The test rewards knowing the right first move.
How to Use This List
Don't try to memorize the list itself — memorize the underlying diagnoses. The pearls are exam-style anchors, not summaries. If you can read the pearl and immediately walk yourself through the workup, the differential, the treatment, and one or two distinguishing features that separate it from the look-alikes, that condition is exam-ready. If the pearl makes you pause, go back to the full content.
Knowing one hundred conditions cold will not by itself produce a passing score. Knowing one hundred conditions cold while having done two thousand practice questions and one full content pass through the blueprint almost certainly will.