Physician Assistant Exam Review

By Brian Wallace PA-C

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Robin
 Jan 7, 2019
I am studying for my PANRE. These podcasts are the greatest! I listen to a topic and then it makes perfect sense when I go to read about it. Thanks Brian you are the best!

Description

We review core medical knowledge on a continuous basis for the physician assistant preparing for the PANRE.

Episode Date
EP 099 Infectious Disease Part 2 & When It isn’t Easy
19:33

Gonococcal Infections Neisseria gonorrhoeae – Gram negative intracellular diplococci Infects the mucous membranes of the reproductive tract, including the cervix, uterus, and fallopian tubes in women, and the urethra in women and men Can also infect the mucous membranes of the mouth, throat, eyes, and anus secondary to direct inoculation. Systemic gonococcal infection or disseminated […]

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Jun 28, 2022
E 098 Bacterial Infection Part
30:37

Botulism Clostridium botulinum – anaerobic organism Toxin inhibits the release of acetylcholine at the neuromuscular junction Infant botulism Between the ages of 2 and 6 months Floppy baby Caused by ingesting spores – No honey during first one year of life Adult botulism Caused by ingesting spore Canned food Wound botulism Medical emergency, can be […]

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Jun 15, 2022
Dominate Medicine 008
15:48

Three topics today Reflection and repetition for success It’s vs Its What if you LOVED it?

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Jun 07, 2022
33 Days to Pass Your PANCE June Cohort – Part 2
30:18

this is part two of the live event for 33 Days to Pass the PANCE

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May 17, 2022
33 Days to Pass Your PANCE June Cohort – Part 1
27:58

The 33 Days program is designed to get you the best possible score you can get on the PANCE. That’s my goal. The first ever cohort was completed in April and that group is doing fantastic.  I’ll be hosting another cohort beginning on June 1st. If your exam is coming up in July, August or […]

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May 17, 2022
S2 E097 Genitourinary Neoplasms and a small hack to help you through school
23:23

Bladder carcinoma   Bladder cancer is 3x as likely in men than women Transitional cell carcinoma is > 90% of bladder cancers. Risk Factors Smoking!! Chronic irritation Clinical Presentation –  Bloody urine is the most common presenting symptom Pyuria Dysuria Labs, Studies and Physical Exam Findings   Urinalysis shows hematuria   U/S, CT, MRI   […]

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Apr 19, 2022
S2 E096 Infectious Disorders of the Urinary Tract
16:41

Urinary Tract Infection Risk Factors Females are more prone than males Diabetes Obesity Sexual Activity Clinical Presentation Burning with urination Frequency May present with strangely in elderly Diagnosis Symptoms alone may be enough U/A Cultures Treatment – Several different options for antibiotic treatment Cephalexin (Keflex) Fluoroquinolones Bactrim is becoming less effective due to resistant organisms […]

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Apr 05, 2022
DoM 007 Rotations and feeling down
25:11

This week we tackle a listener question about a surgical rotation, and a new framework for handling the down days. You go this. We’ll tackle it together.

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Mar 29, 2022
S2 E095 Urology Problems & how to beat the PANCE
25:45

Cryptorchidism One or both of the testes absent from the scrotum   Risk factors   Premature birth   Low birth weight Clinical Presentation   Routine pediatric exam Labs, Studies and Physical Exam Findings –  Provider is unable to palpate one or both testicles –  U/S   MRI Treatment Initially watchful waiting. The majority will descend […]

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Mar 22, 2022
Dominate Medicine 006
17:19

We cover three topics today to help you navigate your way through school. How long do you scrub at the scrub sink? A slight twist on setting goals that will help your brain get it done And some advice from my kids pitching coach about trying harder You’re going to get a lot out of […]

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Mar 15, 2022
S2 E094 Male genitalia, Studying for test questions and understanding the PANCE
43:02

Not on GU? Listen to this one anyway. There’s so much to unpack here. One of the best episodes I’ve ever recorded. It doesn’t matter if your on GU or not. Give it a listen. Erectile dysfunction Clinical Presentation   Usually a routine physical exam and direct questioning Labs, Studies and Physical Exam Findings   […]

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Mar 08, 2022
Dominate Medicine 005 Rotations and the 2% rule
13:29

The number one question I’ve gotten over the past two weeks and a lesson on statistics from my PA school genetics professor that you might enjoy.

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Mar 01, 2022
S2 E093 The Bladder & how to make your work better
33:21

Genitourinary system (Male and Female) When the say Reproductive System (Male and Female) – they mean Female genitals and reproduction. We cover the female breast, pregnancy, the cervix, mensuration the ovary and uterine and vaginal problems. When they say Genitourinary system (Male and Female) they mean urinary system and male genitals. We cover the bladder, […]

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Feb 23, 2022
Dominate Medicine 004
14:53

Everyone else talks about what to learn. Here we talk about how to learn. An Important lesson I learned from my college physicis professor about learning and one of the best ways to solidify what you’ve learned.

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Feb 15, 2022
S2 E092 Hernias, Diarrhea and Study Tips
32:40

Hernias   The movement of an organ through the wall which normally contains it   Reducible hernia – the hernia sac may be pushed back into place   Incarcerated hernia – the hernia sac may not be pushed back into place   Strangulated hernia – a hernia whose blood supply has been cut off   […]

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Feb 08, 2022
Dominate Medicine 003
20:49

What your schools do for you and what they don’t do for you. WW II general known for winning at all costs gives his ideas on how to win.

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Feb 01, 2022
S2 E091 Food issues & A Path to Growth
31:07

Food Allergies Gluten intolerance Gluten – a protein found in some grains like wheat, barley and rye Celiac disease occurs in 1-2% – https://www.physicianassistantexamreview.com/e85-small-bowel-and-a-job-hunt-tip/ Gluten sensitivity or intolerance 0.5-13% Gluten intolerance does create an immune response, but it does not obviously damage the vili in the small intestine. Clinical Presentation Bloating Gas Abdominal pain Diarrhea […]

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Jan 25, 2022
Things you’ve already got

We’re covering the things you can work with and how to use them to your advantage.

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Jan 18, 2022
S2 E090 Metabolic Disorders and a new format

G6PD Deficiency X- linked recessive More commonly found in Males African Americans Asians Patients of Mediterranean or Middle Eastern decent Increases RBC susceptibility to breakdown Specific triggers lead to cellular breakdown Bacterial or viral infection Fava beans which may be found in flour Drugs Aspirin Antimalarials Sulfonamides Methylene blue Diabetic ketoacidosis Clinical Presentation & Physical […]

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Jan 11, 2022
New Year New Show
14:57

I’ve been thinking for a while about changing the format of the PAER Podcast. I want to give you what you want, but also make sure I cover what’s going to help you the most. I explain everything in today’s episode. Take a listen here or wherever you listen to the show.

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Jan 04, 2022
S2 E089 Liver Cirrhosis and Studying in December
23:40

Cirrhosis (End Stage Liver Disease) Cirrhosis is a fibrosis or scaring of the liver. Normally functioning liver tissue is replaced with non functioning scar tissue over time. Typically an insidious onset over months or years Portal hypertension and decreased liver function cause most of the symptoms of cirrhosis Risk Factors/Causes Chronic hepatitis Chronic alcohol abuse […]

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Dec 10, 2021
S2 E088 Hepatitis & the Valley
44:53

Hepatitis An inflammation of the liver Acute hepatitis is less than six months. Chronic is greater than six months Causes Viruses Hep A Hep B Hep C Hep D Hep E And several others including CMV & Epstein Barr Alcohol Drugs Non alcoholic fatty liver disease Autoimmune disease Symptoms Jaundice Nausea Poor appetite Right upper […]

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Nov 17, 2021
S2 E087 Colon & Rectum & 3 Words That Might Change Everything
23:17

Polyps An abnormal growth of soft tissue projecting from a mucous membrane They may be flat, sessile or pedunculated 95% of adenocarcinoma of the colon are thought to come from polyps Clinical Presentation Surveillance According to the American Cancer society all patients of average risk should begin screening at age 45 with Fecal occult blood […]

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Oct 19, 2021
S2 E086 The Colon & Getting to the Right Answer
33:11

Important Definitions Abscess – a painful collection of pus, usually caused by a bacterial infectionFistula – An abnormal connection between two body partStricture – A narrowing Study tip for today. Differentiate diagnosis and disease stats Alright now on the large intestine. Diverticular disease Having diverticula or pockets in the colon Diverticulitis is an inflammation of […]

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Oct 05, 2021
S2 E085 Small Bowel and a Job Hunt Tip
28:28

Appendicitis Inflamed appendix Clinical Presentation Abdominal pain Beginning periumbilical and moving toward the RLQ Increasing in severity Pain with any movement Nausea and vomiting Fever Physical Exam Findings Abdominal tenderness even to light palpation Rebound tenderness Tenderness over McBurney’s point – located on the right side of the abdomen one third of the way from […]

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Sep 21, 2021
S2 E084 Stomach, Pancreas and Anxiety
29:19

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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Aug 31, 2021
S2 E083 The Esophagus and a little anxiety management
26:04

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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Aug 17, 2021
S2 E082 Hyper-coagulability
33:08

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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Aug 03, 2021
S2 E081 Coagulation Disorders
18:35

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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Jul 20, 2021
S2 E080 Clotting overview
33:31

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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Jul 08, 2021
S2 E079 Lymphoma and an important tactic for the PANCE
28:09

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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Jun 22, 2021
S2 E078 Leukemia
32:56

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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Jun 09, 2021
S2 E077 Hemolytic Anemias
24:20

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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May 25, 2021
S2 E076 Macrocytic Anemia
20:53

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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May 11, 2021
S2 E075 Microcytic Anemia and a Better Way to Remember
40:21

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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Apr 28, 2021
S2 E074 Red Blood Cells
24:48

Red Blood Cells Priming Questions What are the four polypeptide chains that make up hemoglobin? Define polycythemia What does MCV stand for and what does it mean? Define hemolysis. Red Blood Cells Simplified The specific shape of a RBC gives it an increased surface area for better gas exchange and flexibility for fitting into tiny […]

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Apr 13, 2021
S2 E073 Hematology Overview
14:53

Red Blood cells, White blood cells, Platelets Our Three Basic Problems We either have to many We don’t have enough What’s being made isn’t working correctly Cytoses Polycythemia – to many RBC’s Thrombocytosis -to many Platelets Cytopenias Anemia – low RBC Leukopenia  -low WBC Coagulation disorders Clotting factor disorders – messed up clotting factors  Thrombocytopenias […]

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Mar 30, 2021
S2 E072 Wrapping up EENT
18:00

Parotitis/Sialadentitis Painful swelling of the parotid one or both parotid glands Cause Viral infection Historically the number one cause was the mumps Parainfluenza and Epstein barr are the most common HIV Bacterial infection Staph Aureus is the most common bacteria Autoimmune disease Sjogrens Blockage Stone Mucus plug Dehydration Clinical Presentation Facial swelling Facial pain Difficulty […]

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Jun 16, 2020
S2 E071 Throat and Mouth Infections and Inflammation
31:08

Oropharyngeal Infections/Inflammatory disorders Aphthous ulcers (Canker sore) Round ulcer on oral mucosa Unknown etiology Clinical Presentation Small open sore in the mouth The sore is yellow or white Labs, Studies and Physical Exam Findings Clinical diagnosis Treatment Self limiting ½ hydrogen peroxide or chlorhexidine mouthwash Corticosteroids Oral candidiasis (Thrush) Yeast infection of the mouth 50% […]

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Jun 02, 2020
S2 E70 The Nose and Sinuses
24:52

Acute/chronic sinusitis An inflammation/infection of the sinuses Typically secondary to an upper respiratory infection or seasonal allergies Most common pathogens Strep pneumoniae Haemophilus Influenzae Moraxella catarrhalis Staph aureus Predisposing Factors Anything that obstructs drainage from the sinuses Smoking – (decreases movement of cilia) Deviated septum Cystic fibrosis Large adenoids Clinical Presentation I’ve had a cold […]

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May 19, 2020
S2 E069 Inner Ear and Hearing Loss
27:05

<< Click here to get 23 ENT questions straight from my book, The Final Step >> Acoustic Neuroma (Vestibular Schwannoma) Slow growing benign tumor of the vestibulocochlear nerve, CN VIII Occurs in males and females equally Most often found in those between the ages of 50 and 60. The are the most common intracranial tumor […]

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May 05, 2020
S2 E068 External and Inner Ear from the PANCE Blue Print
23:45

<< Click here to get 23 ENT questions straight from my book, The Final Step >> External Ear Cerumen Impaction Ear wax built up in the external ear canal Cerumen can be impacted by the patients use of a cotton swab Clinical Presentation Routine office visit Progressive hearing loss Labs, Studies and Physical Exam Findings […]

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Apr 21, 2020
S2 E067 Failing PA School
43:53

This week I’m bringing you an amazing person and an amazing interview. The interview with Alana in Episode 061 about her first failing and then passing her PANCE was so good I decided to put together another interview. This week, for the second ever interview on the PAER podcast, I have an amazing member of […]

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Apr 07, 2020
S2 E066 COVID-19 and the Eyeball
28:43

Vascular disorders Retinal Artery Occlusion Causes & Predisposing Factors Clot Sclerosis HTN DM Atrial Fibrillation Temporal arteritis Clinical Presentation ACUTE vision loss Partial Complete NO PAIN Labs, Studies and Physical Exam Findings Fundal exam Optic atrophy Pale disc Cherry red spot – its actually that the rest of the retina is pale Boxcarring- narrowing of […]

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Mar 24, 2020
S2 E065 Eye and Trauma and Subconscious Study Cues
16:13

<< Click here to get 23 ENT questions straight from my book, The Final Step >> Blowout Fracture A fracture of the orbit Clinical Presentation “I got my face smashed in!” Ecchymosis Difficulty with vertical eye movement Diplopia Infraorbital anesthesia secondary to trauma to the infraorbital nerve Swelling Subconjunctival hemorrhage Labs, Studies and Physical Exam […]

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Mar 10, 2020
S2 E064 Nystagmus and Retinal issues for the PANCE
25:25

Neuro-Ophthalmologic Disorders << Click here to get 23 ENT questions straight from my book, The Final Step >> Nystagmus An involuntary rhythmic eye movement Patient is usually unaware that it’s happening, but may have blurred vision Causes Congenital neurological problem Trauma Stroke Multiple Sclerosis Inner ear inflammation Alcohol Sudden head movements Looking out a train […]

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Feb 25, 2020
S2 E063 The Eyeball Part 2 for the PANCE
18:31

<< Click here to get 23 ENT questions straight from my book, The Final Step >> Blepharitis An infection of the eyelid Acute blepharitis is most commonly caused by Staph May be viral Seborrheic dermatitis or acne rosacea can also cause blepharitis Clinical Presentation Eyelid Loss of eyelashes Red Itchy Burning Scaly Swollen Labs and […]

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Feb 11, 2020
S2 E062 The Eyeball Part 1
19:36

We start the eyeball today with conjunctivitis

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Jan 28, 2020
S2 EP 061 What to do When You Fail The PANCE
1:02:26

I discuss with Alana what happens after you fail your PANCE.

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Jan 14, 2020
S2 E060 Pulmonology – ARDS and more for the PANCE
16:44

<< Click here to get 40 Pulmonology questions straight from my book The Final Step >> Other Pulmonary Disease Acute Respiratory Distress Syndrome (ARDS) Severe inflammation of the lung tissue which impairs gas exchange secondary to acute injury secondary to pulmonary edema Without treatment 90% of patients will die Things associated with the onset of […]

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Dec 17, 2019
S2 E059 Pulm Neoplastic Disease
23:07

<< Click here to get 40 Pulmonology questions straight from my book The Final Step >> Lung Cancer #1 cause of cancer related deaths 85% of cases are associated with smoking Multiple exposure and exposure to other toxins increases risk Five year survival rate is 15% Small Cell and Non Small Cell Complications SVC syndrome […]

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Dec 03, 2019
S2 E058 Pulm Infections part 2
30:35

<< Click here to get 40 Pulmonology questions straight from my book The Final Step >> Influenza Influenza is an orthomyxovirus Most commonly seen during the fall and winter Incubation period of 18-72 hours Secondary diseases are a major concern Pneumonia Reye’s syndrome Children under 18 Biggest risk factors are having the Flu or Varicella […]

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Nov 19, 2019
S2 E057 Pulmonary infections Part 1
17:32

<< Click here to get 40 Pulmonology questions straight from my book The Final Step >> Acute bronchitis Infection of the large bronchi Most often caused by a virus RSV Rhinovirus Influenza 5-10% are bacterial Usually follows a URI Clinical Presentation Shortness of breath Cough can last for more than three weeks Wheezing Fever Labs, […]

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Nov 05, 2019
S2 E056 Pneumonia
22:57

<< Click here to get 40 Pulmonology questions straight from my book The Final Step >> Pneumonia Community Acquired Pneumonia From oxford dictionary – Lung inflammation caused by bacterial or viral infection, in which the air sacs fill with pus and may become solid. Inflammation may affect both lungs ( double pneumonia ), one lung […]

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Oct 22, 2019
S2 E055 Pulmonary Circ and PA WEEK!
20:28

PA WEEK! and pulmonary HTN, PE and more

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Oct 01, 2019
S2 E054 Pleural disease for the PANCE
25:09

Pneumothorax with a touch of decreasing your stress level

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Sep 17, 2019
S2 E053 Restrictive Lung Diseases and what to avoid on your breaks.
18:06

<< Click here to get 40 Pulmonology questions straight from my book The Final Step >> Restrictive Pulmonary Disease Idiopathic pulmonary fibrosis The development of scar tissue within the lungs Clinical presentation Dyspnea Dry cough Chest discomfort Labs, Studies and Physical Exam Findings Fine crackles at the bases may be present FEV1 is reduced FVC […]

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Sep 03, 2019
S2 E052 CF & why key terms aren’t enough
20:28

Knowing your key terms might not be enough??

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Aug 13, 2019
S2 E051 COPD & Asthma (and my best advice for struggling)
32:15

<< Click here to get 40 Pulmonology questions straight from my book The Final Step >> Obstructive Lung Diseases Spirometry The most used pulmonary function test. It measures volume and speed of exhalation and inspiration. Total lung capacity (TLC) The volume of the lungs at maximal inflation Tidal volume The volume of air moved into […]

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Jul 30, 2019
S2 E050 Derm Misc for the PANCE/PANRE
16:41

<< Click here to get 26 Derm questions straight from my book, The Final Step >> Acanthosis Nigricans Typically occurs in African Americans Causes May be inherited May appear in a healthy individual May be directly related to an underlying health issue which is usually an endocrine disorder Insulin resistant disorders are most common DM […]

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Jul 16, 2019
S2 E049 Derm: Skin Cancer for the PANRE and PANCE
23:51

<< Click here to get 26 Derm questions straight from my book, The Final Step >> Kaposi’s Sarcoma A systemic disease caused by herpes virus 8 Most often have lesions on the skin surface. Typically a very slow developing illness, but in conjunction with the AIDS virus it progresses very quickly. These lesions became linked […]

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Jul 02, 2019
S2 E048 Vascular and blistering issues for the PANCE/PANRE
22:38

Little red spots and gross blisters

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Jun 18, 2019
S2 E047 SJS/TEN for the PANCE or PANRE
17:10

demystifying TEN and SJS

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Jun 04, 2019
S2 E046 Derm integrity for the PANCE/PANRE
30:54

PANCE/PANRE review of Derm including burns and ulcers

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May 21, 2019
S2 E045 Derm viruses
20:14

Derm viruses - chicken pox, herpes, warts and more

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May 07, 2019
S2 E044 Childhood Exanthem
21:56

the six childhood exanthema

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Mar 05, 2019
S2 E043 Bacterial skin infections
16:57

Erysipelas, Impetigo, Cellulitis

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Feb 19, 2019
S2 EO42 Spiders, Bugs and Fungal Infections (Yuck!)
25:34

Derm Part 5 Moving right along

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Feb 05, 2019
S2 E041 Hair, Nails & Pigment Disorders
18:42
Jan 22, 2019
S2 E040 Derm Part 3
16:05

<< Click here to get 26 Derm questions straight from my book, The Final Step >> Acne Vulgaris Obstruction and inflammation of hair follicles and sebaceous glands The most common skin disease affecting 80% of the US population Sebum is an oily secretion from the sebaceous glands How it happens Follicles get clogged with sebum […]

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Jan 08, 2019
S2 E039 Dermatology part 2
18:55

Papulosquamous disorders Conditions which present with both papule and scales Lichen simplex chronicus (not on 2019 blueprint) A skin disorder characterized by repetitive itching and scratching. This may be secondary to eczema, psoriasis, bug bites, psych disorders etc. Clinical Presentation & Physical Exam findings Itching Lichenified (leathery) skin with well defined borders Labs, Studies and […]

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Dec 11, 2018
S2 E038 Dermatology Part 1
22:20

Dermatology: The beginning vocab and what not

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Nov 13, 2018
S2 E037 Lipids
15:57

<< Click here to get 25 Endocrinology questions straight from my book, The Final Step >> Dyslipidemia Low-density lipoprotein (LDL) (lousy) Increased LDL correlates with an increased risk of heart disease. High-density lipoprotein (HDL) (happy) Increased HDL correlates with a decreased risk of heart disease. Triglycerides An increase in triglycerides is correlated to a an […]

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Oct 30, 2018
S2 E036 DM2
25:46

Covering Diabetes Type 2

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Oct 16, 2018
S2 E035 Diabetes Type 1
28:04

Diabetes type 1 and an important thing you can stop worrying about.

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Oct 02, 2018