PA Study Sesh

Appendicitis #1 cause=fecalith Age 10-30. Think adolescents Symptoms (PROM) Periumbilical pain followed by RLQ pain McBurney’s point tenderness: 1/3 distance for ASIS & navel Physical Exam: Rebound tenderness Rovsing Sign: RLQ pain with LLQ palpation Obturator Sign: RLQ pain with internal & external hip rotation with flexed knee Psoas Sign: RLQ pain with right hip … Continue reading Small & Large Intestine Part II: Immune Disorders, Ischemia, Infection →

Small Bowel Obstruction Etiology Post-surgical adhesions #1 Symptoms Abdominal pain (progressively worsens) Vomiting Obstipation (inability to pass gas) Physical Exam Distension Hyperactive bowel sounds in early obstruction High-pitched tinkles on auscultation & visible peristalsis Late bowel obstruction=hypoactive bowel sounds Diagnosis Abdominal X-ray Air-fluid levels in step ladder pattern Dilated bowel loops Treatment Non-strangulated NPO IV … Continue reading Small & Large Intestine Part 1: Obstruction →

Gastritis/Peptic Ulcer Disease Etiology #1 H. Pylori Infection #2 NSAIDs Consider Zollinger-Ellison Syndrome or Cancer in non-healing gastric ulcers Discussed Below Symptoms Gastritis alone, typically asymptomatic Dyspepsia (epigastric pain) GI Bleed PUD #1 cause of UGI bleed Located in stomach or duodenum Duodenum most common Pain worse before meals or 2-5 hr after meals Pain … Continue reading Disorders of the Stomach →

GERD Relaxation of lower esophageal sphincter allows for reflux=mucosal injury Symptoms: Heartburn! Often 30-60 minutes postprandial Worse when lying down (increases pressure on LES) Cough Diagnosis: Clinical Endoscopy (aka EGD esophagogastroduodenoscopy) if persistent or concerned about complications 24 hour ambulatory pH monitoring: gold standard Invasive Management: Lifestyle Modifications: Small meals Avoid being supine for 3 … Continue reading Disorders of the Esophagus →

So you’re procrastinating studying for the PANCE by scrolling through your Facebook Feed and there it is, another “Happy to announce that I’ll be working for ______ as a PA!” post. As graduation inches closer, it seems to be all there is. You want to be happy for your classmates, but what you’re really thinking … Continue reading Am I the Only One Without a Contract? A New Grad PA’s Perspective on the Job Hunt →

Acute Pericarditis Inflammation of the pericardium Peri=around Layer AROUND the heart #1 cause = viral Dressler syndrome=Post-MI pericarditis Symptoms Sharp Pleuritic (worse with inspiration) May radiate to back Improved with leaning forward Physical Exam Pericardial friction rub Best heard at end expiration while upright and leaning forward Diagnosis EKG Diffuse ST elevations Echo Used to … Continue reading Cardio Conglomeration →

Disclaimer: new guidelines as of late 2017 Unlikely to be reflected on PANCE yet. New BP Guidelines: Elevated: 120-129/< 80 Stage 1: 130-139/80-89 Stage 2: 140+/90+ Hypertensive crisis: 180+/120+ with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage. Medication … Continue reading Hypertension & Hyperlipidemia →

This episode is less about boards, more about being thorough and thinking about how to process an EKG systemically in order to not miss something. For boards, it’s ok to jump to what is glaring at you. No questions or take away points associated with this podcast. As promised, here is my EKG Cheatsheet! Evidence of a … Continue reading Back to Basics: EKG Interpretation →

On this week’s episode, we will be attacking heart failure and finishing off cardiomyopathies. Check out the congenital heart disease episode for information regarding hypertrophic cardiomyopathy here. Heart Failure Systolic vs diastolic Systolic #1 Heart isn’t strong enough to pump blood Decreased ejection fraction (aka HFrEF) Thin ventricular walls Dilated ventricles + S3 (passive ventricular … Continue reading Heart Failure →

On this week’s episode, we’ll be discussing vascular disorders. Please note that we’ll be discussing arteriovenous malformations in the neurology chapter. Peripheral artery disease PAD Picmonic Here! Pain in lower extremities increased with exercise, relieved with rest Called claudication Imagine angina for the legs Most commonly in the calf Physical exam Decreased pulses Decreased cap … Continue reading Vascular Disorders →

Coronary Artery Disease Atherosclerosis #1 cause Fatty streak formation: lipid deposition in white blood cells=1ststep Risk Factors: Diabetes Smoking Hyperlipidemia HTN Male Age (>45 men >55 women) Family Hx Stable Angina Check out the Stable Angina Picmonic! Chest pain Substernal Poorly localized Exertional Radiation to arm, teeth, lower jaw Typically 1-5 minutes, but less than … Continue reading Coronary Heart Disease →

Heart murmurs continue with congenital heart diseases. A Picmonic is available for EVERY topic in today’s episode. Start by checking out our first topic here. Ventricular Septal Defect #1 type of congenital heart disease Loud, high-pitched harsh, holosystolic murmur at LLSB Typically a left to right shunt (restrictive) May switch to right to left 2/2 pulmonary … Continue reading Congenital Heart Disease →

During this week’s episode, we’ll be discussing valvular disorders, in essence, heart murmurs. There are LOADS of Picmonics available for heart murmurs. A couple of my favorites Mitral Regurgitation and Aortic Stenosis. Systole=ventricles contracting Diastole=ventricles relaxing & refilling S1=beginning of systole. AV valves (mitral & tricuspid) are closing. “lub” S2=end of systole. Semilunar valves closing (aortic & pulmonic) … Continue reading Valvular Disorders →

This week on PA Study Sesh we are starting the cardio chapter and discussing conduction disorders. Sinus Arrhythmia Appears as normal sinus rhythm, but rhythm is irregular Normal variant INcreases during INspiration Sinus Bradycardia 100BPM Tx: Vagal maneuvers, adenosine, bblockers, CCB, Digoxin (ABCDs) … Continue reading Conduction Disorders →

This week on PA Study Sesh, we’ll learn about Rheumatology. A note about ANA, RF, ESR, CRP ANA: Antinuclear antibodies Shows antibodies against self Can be positive in healthy people Also induced by certain drugs & cancers NONSPECIFIC CRP: C-reactive protein Produced in the early stages of inflammatory process. NONSPECIFIC ESR: erythrocyte sedimentation rate “sed … Continue reading Rheumatology →

This week on PA Study Sesh, we will talk disorders of the hip as well as a hodgepodge of other orthopedic topics. Pelvic Fx: High impact or osteoporotic CT scan= gold standard Tx: pelvic binder & specialist consult Hip Fx: Osteoporotic women common Externally rotated, Abducted,(first 2 are opposite a dislocation) shortened limb: BREAKS Groin … Continue reading Hip Disorders & Ortho Hodgepodge →

This week on PA Study Sesh, we’ll be covering disorders of the spine and demystifying the dermatomes. Cauda Equina SURGICAL EMERGENCY Symptoms Urinary/bowel retention/incontinence Saddle anesthesia Decreased anal sphincter tone (no anal wink) Tx: steroids (decrease inflammation) and emergent surgery Spinal stenosis (pseudoclaudication) Narrowing of spinal canal > 60 y.o. (but can be congenital) low … Continue reading Spine →

This week on PA Study Sesh we will be discussing disorders of the foot and ankle, bone tumors, and compartment syndrome. Ankle Dislocation Most commonly posteriorly (calcaneus goes posterior) Risk to peroneal n Sx: foot drop Tx: closed reduction & posterior splint Ankle Sprain MOI: inversion Anterior talofibular ligament (ATFL) #1 Eversion injury = deltoid … Continue reading Foot & Ankle; Compartment Syndrome; Neoplastic Disease →

This week on PA Study Sesh, we will be covering disorders of the knee and proximal tibia. Medial and lateral collateral ligament injuries (MCL & LCL) MCL=valgus stress LCL= varus stress MCL more common than LCL injury Grade I & II (sprain & incomplete tear)= conservative Grade III (complete) = surgical ACL (anterior cruciate ligament) … Continue reading Knee Disorders →

This week on PA Study Sesh, we will be finishing the upper extremity. Supracondylar fx MOI: FOOSH with hyperextended elbow Kids 5-10 X-Ray: Normal: anterior humeral line must intersect capitulum (lateral view) May still be in alignment with fx Fat Pad sign=refer Anterior to humerus = sometimes normal Posterior to humerus = always abnormal Darkness=blood … Continue reading Elbow to Phalanges →

Welcome to PA Study Sesh! We will be kicking off with orthopedics, starting with disorders of the shoulder and upper arm. Shoulder Dislocation Anterior #1 Presents abducted, externally rotated. “Squared off” shoulder Opposite of a hip Light SABER Posterior: adducted internally rotated Usually associated with seizures or ECT Sulcus sign: sulcus near the acromion. May … Continue reading Clavicle to Humeral Shaft →

What to expect from PA Study Sesh.