Physician Assistant Exam Review

Disorders of the Stomach Peptic Ulcer Disease Defined as a break in the mucosal lining of the stomach or the duodenum. An ulcer is four to five times more likely to be found in the duodenum than in the stomach. PUD is the most common cause of a GI bleed Risk factors Helicobacter pylori is […]

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Esophagitis An inflammation of the esophagus Causes GERD Medications NSAIDS Antibiotics Bisphosphonates Many others Excessive alcohol consumption Infectious causes are related to an immunocompromised patient. Candida Herpes Cytomegalovirus (CMV) Clinical Presentation Dysphagia (diffic ulty swallowing) Odynophagia (painful swallowing) Heartburn Nausea Cough Labs and Studies Endoscopy with biopsy Herpes – Multiple shallow ulcers throughout the esophagus […]

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Hypercoagulable states (Thrombophilia) Where is the problem? Clotting Factors Too many Too active Platelets Too many Too active Vascular injury Surgery Trauma Stasis Virchow’s triad Stasis Hypercoagulable state Vascular injury German doctor and scientist who first described the mechanism for a pulmonary embolism. The name Virchow’s triad was not used until well after his death. […]

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Coagulation Factor Disorders von Willebrand Disease A spectrum of low production to production of poorly functioning von Willebrand’s Factor. von Willebrand’s factor (vWF) has two major functions. vWF helps platelets to stick together in the subendothelial collagen vWF binds to and maintains Factor VIII in circulation. Factor VIII breaks down very quickly in the bloodstream […]

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Our two main players in coagulation are platelets and clotting factors.  To help make things clear we can split up these two agents into separate categories even though the work in concert. Primary hemostasis When a blood vessel is damaged, the subendothelium spaces are exposed to blood.  This triggers a number of events designed to […]

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Lymphoma A group of malignancies that develop from lymphocytes There are over 80 types of lymphoma. Unlike leukemia lymphoma is a solid tumor Generally speaking (this is by no means 100% true) lymphoma develops in the lymphatic system Think lymph nodes and spleen Leukemia develops in the bone marrow The two main classifications of lymphoma […]

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Leukemia Leukemia is a disease characterized by the overproduction of a particular type of blood cell. This process often inhibits the production of normal blood cells These leukemia cells do not function as proper cells Leukemia does not form a solid tumor. Rather it produces blood cells which may infiltrate tissue. Leukemic cells have unusually […]

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Sickle Cell Anemia Genetic Pattern Autosomal recessive Homozygote inheritance of Hemoglobin S (HbS) Predominantly seen in the African American population Oxygenated HbS does not dissolve well and forms a gel that distorts the shape of the RBC into a sickle. This makes the cells “sticky” and less flexible leading to clogging of small blood vessels. […]

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Macrocytic Anemia Macrocytic anemias produce strange dysfunctional blood cells. This will result in some hemolysis and progress to splenic dysfunction as the spleen becomes overloaded. Howell-Jolly bodies are DNA remnants seen with a macrocytic anemia or a damaged spleen. You will find them in B12 deficiency anemia, folate deficient anemia, sickle cell anemia and celiac […]

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Anemia Anemia means low RBC or Hgb count. A patient could be bleeding out and have a low Hgb or they could have a dietary deficiency. Anemia is a starting place. As we get more detailed and more specific we can get a more clear diagnosis and treatment plan. One of the easiest places to […]

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