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Aortic Stenosis: 
Narrowing the Differential

aortic stenosis

One of my favorite things to do with students, is to look at my patient schedule for the day, and consider differential diagnoses for certain chief complaints. A great deal can be gained from thinking outside the box with a simple chief complaint. For example, have you considered all of the diagnoses or conditions that could present with sore throat?...

Bell’s Palsy (Facial Nerve Paralysis)

Bell's Palsy

Bell’s palsy is an acute peripheral nerve palsy of cranial nerve VII.  This nerve innervates the muscles that allow facial expression.  It also carries parasympathetic fibers to the lacrimal and salivary glands, as well as sensory fibers that contribute to taste on the anterior 2/3 of the tongue. The annual incidence of Bell’s palsy is 15 to 30 persons per...

Clostridium Difficile 
Infection: A Clinical Review

Clostridium Difficile Clinical Pearls

Clostridium difficile is a gram positive, spore and toxin producing, anaerobic bacillus that is a very common and clinically important; it is a cause of acute diarrhea in long term care facilities such as nursing homes, hospitals, and personal care homes. Due to the possibility of fulminant colitis, leading to perforation and death, as well as the transmissibility of...

Surviving PA School

Today’s topic will be a little different from previous articles. It will be directed more for those that are currently in PA school. In this article, I will discuss tips that worked well for myself, during that time. Bear in mind, everyone is different, and what might work for one person, might not work for someone else. I attended Southern Illinois...

Diverticulitis (Case Study)

My routine, when entering exam rooms, has remained the same since I was a student: 1. Walk in 2. Introduce myself 3. Lather up some liquid soap between my hands for hygiene 4. Quickly answer a single question in my mind: “Is this patient sick or not sick?” The above question is important to keep in mind, regardless of specialty or setting, because inevitably,...

Achilles Tendon Rupture

achilles tendon rupture

Multiple athletes, and famous individuals, have injured their achilles tendon; including Kobe Bryant, The Rock, David Beckham, Al Gore, George Clooney, and Brad Pitt.  However, many regular Joe’s, like you and I, have also injured this same tendon which was named after the Greek warrior, Achilles. An Achilles tendon tear most often results from: 1. Stress on the tendon 2. Natural degeneration of...

Applying to PA School – what not to do

applying to pa school

Sitting in an airport terminal, almost 1,000 miles away from home, I felt like a total failure... I had just completed my first physician assistant school interview, and to say it went poorly, is a massive understatement. I had eagerly started prepping for the process over summer, with applications to 16 physician assistant schools. It was now fall of 2013 and my...

Hypogonadism: Testosterone Replacement

Testosterone is becoming an increasing treatment modality in the United States, particularly by primary care providers.  However, there is conflicting evidence on the benefit of this therapy for an age-related decline in testosterone. Like with most things in life, testosterone therapy included, there are bad things that come along with the perceived good. Today, we will review the signs and symptoms,...

Approaching Acute Testicular Pain

Among the conditions to impact males, disorders of the testicles represent a set of conditions, varying from benign in nature to true emergencies, that can be seen frequently in the outpatient setting, urgent care, and emergency department. An important understanding of clinical male anatomy, as well as how conditions manifest, is important to providing good care. Conditions impacting the testicles...

Shingrix vs Zostavax

The FDA has recently approved a new vaccine for Varicella Zoster Virus named Shingrix for all those 50 years and older. Since 2006, all that's been available is the Zostavax, which was only recommended in adults 60 years and older. I will first start off with a little about Herpes Zoster.  You can review my colleague Daniel Champigny’s article on Herpes...