andersenpa

Too generous, E! Last time I did the Kaplan test bank and looked up the stuff I got wrong Honestly I'm thinking about ignoring peds and taking that section cold I'm so out of the loop on recert (given how irrelevant it is to real life practice), I figured some young sharp PAs here would know the latest resources on the interwebs. But I will take your advice to heart.... M

Hello all, Recert time again. Lots more online reviews/Q banks etc available. Any recommendations? Medchallenger, myCME, Rosh....help me out here folks. -A

PAs do not need the tether of a state-endorsed supervisory relationship. It is a top-down mandate that has no evidence basis and is not being clamored for the any group other than the state medical commissions/physician groups. Oh, and OK plenty of backward-thinking PAs. If you as a PA aren't willing to accept professional responsibility for your malpractice-covered actions, then maybe you shouldn't be in medicine. I wouldn't link the need for professional stewardship with financial reward. I understand your point but it is easy to accuse that argument of being ONLY financially based, which invalidates ANY of the principle PAs are endorsing with a goal of striking out "supervision"

Easy. Get rid of supervision. Independent license. Let all scope determinations be made at the level of the practice.

10 demerits for using the word "betwixt"

I may be out of the loop here but did anyone see this? https://www.aapa.org/workarea/downloadasset.aspx?id=548 http://www.nxtbook.com/nxtbooks/aapa/paprofessional_201508/#/9 AAPA model legislation document endorsing collaboration as the descriptive term (that's the old news), but also that 1) PAs are not required to document their collaborating physician with the state and 2) states develop an independent PA board which can be exclusively PA led? This is a pretty progressive document and seems to mirror NP practice acts for all the big things PAs have been asking for. Pasted summary below: The updated model state legislation proposes an administrative process in which a PA presents his or her credentials to a state regulatory agency and receives a license in return. The license is renewable, based on meeting state requirements. The model legislation does not propose that the regulatory authority approve or register collaborating physicians. Any licensed physician or group of physicians (MD or DO) may collaborate with a PA unless the physician’s ability to collaborate has been limited by disciplinary action. The scope of PA practice under the model legislation is determined by what is within the PA’s skills, education and experience. Language describing PA scope of practice being determined by physician delegation has been deleted. The model legislation authorizes PA prescriptive authority, including controlled substances in Schedules II through V, as well as limited dispensing authority. In modernizing the model legislation language, requiring the collaborating physician to assume responsibility for care provided by the PA was removed. Rather, the PA is responsible for their professional actions. The new model also removes the concept that a PA should be considered the “agent” of a physician. In the past, rather than amending health law outside the PA practice act, PAs sought to be able to perform specific regulated medical and surgical tasks as the “agent” of a physician. Current advocacy efforts seek to have PAs specifically named in all relevant health law, removing the need for “agency” language. It is stated quite clearly in the model legislation that a physician need not be physically present as long as the PA and physician can contact one another easily. The details of collaboration are left to the PA physician team. Augmenting previous language that removed the requirement that PAs practice with physician collaboration when responding to a disaster situation, the new model state legislation extends the same authorization to PAs who are participating in volunteer activities. The new model legislation presents a list of options for regulatory models, with the preferred option being a separate and independent PA board. Because the revisions to the AAPA model legislation were adopted in May 2015, they are not yet extensively reflected in current state laws and regulations. Advocacy projects to adopt the modernized model law are underway across the country.

rule #1- don't read the machine's interpretation on the printout.

thebesian (coronary sinus) eustachian (IVC) although a snarky CTS PA would say the 2 bioprosthetic valve replacements at the aortic and mitral position!

I love the photo of him too Basically sitting there saying "Yeah, that's right....."

Great story. Looking fwd to sharing it with the rest of my surgical group!

Oh boy.... A list I made yrs ago (maybe 10!), but hopefully is still up to date. Includes "Most Commons" as well as the Buzzwords associated w/ certain conditions Please feel free to post corrections as most of this list is not my field! Long list, let's see if it posts: Bouchard’s Nodes (PIP), Heberdeen’s nodes (DIP)- OA Swan Neck, Boutionneire deformity, ulnar deviation, claw toes, hallux valgus- RA Koebner phenomenon (rash provoked by scratching) – JRA Sausage finger (flexor tendon tenosynovitis), “Cup and saucer” proximal phalanx- psoriatic arthritis Bamboo spine – Ankylosing spondylitis Tinel’s sign – tapping Median N. – paresthesias in median n. distribution Gottron’s sign (violaceous inflammation on knuckles), Heliotrope rash – Dermatomyositis Vasculitis associated with Hepatitis B, C – Polyarteritis Nodosa Xerostomia & Xeroderma, Schirmer’s Tear Test – Sjogren’s syndrome Esophageal web, dysphagia, Iron Deficiency Anemia – Plummer Vinson Syndrome IBS & Mitral Valve Prolapse – Fibromyalgia association Housemaid’s Knee – Pre/Suprapatellar bursitis Weaver’s Bottom – Ischial Bursitis Pump Bump – Achilles Bursitis Sickle Cell Osteomyelitis – Salmonella Boxer’s Fracture – Distal Fifth Metacarpal Greenstick Fracture – bowing, one sided Torus fracture – buckling fracture; compression Nursemaid’s Elbow – radial head subluxation Dinner Fork Deformity (on radiograph) - Colles’ Fracture (transverse distal radius metaphysic w/ dorsal distal fragment displacement) Falling on outstretched hand – scaphoid or Colles’ Rotator Cuff muscles Supraspinatus Infraspinatus Teres Minor Subscapularis Drop Arm Test – Rotator Cuff injury Lachman Test - ACL Bankart Lesion – tear of glenoid labrum Kocher Maneuver – shoulder reduction Apprehension Test – anterior shoulder dislocation Jerk Test – posterior shoulder dislocation “Separated Shoulder” – AC separation Neer Classification – humeral head fracture Nerve Injury in Humeral Shaft fracture – Radial N. Claw Hand deformity - Volkmann’s Contracture – ischemic flexion contracture resulting from fracture, compartment syn., cast or tourniquet application Keinbock’s disease – lunate osteonecrosis Gamekeeper’s Thumb – tear/sprain UCL thumb Lateral Epicondylitis – Tennis Elbow Medial Epicondylitis – Golfer’s/Baseball Elbow Finkelstein’s Test - DeQuervain’s Tenosynovitis (stenosing tenosynovitis of abductor pollicus longus extensor pollicus brevis) Sellick’s Maneuver – cricoid pressure Scheuermann's disease – Juvenile kyphosis Culprit crnal nerve in ptosis - III McMurray Test – Meniscal Tear Legg-Calve-Perthes Disease – avascular necrosis of femoral head Feeling of sitting on a ball – uterine prolapse Clue cells – Gardnerella (BV) First step in infertility w/u – semen analysis Nagelel’s Rule- Date of LMP – 3 mo + 7 d Sack of grapes/Snow Storm U/S – molar/hydatidiform pregnancy Bloody Show- passage of blood tinged mucous cap from cervical os during early labor Vaginal discharge: Malodorous frothy green-yellow – Chlamydia Fishy – BV (Gardnerella) Todd’s Paralysis – transient postictal limb paralysis Lhermitte’s sign/”Barber Chair Phenomenon” – passive neck flexion causing sensation of electricity down back; classic in Multiple Sclerosis Brain bx revealing Tangles and Plaques – Alzheimer’s Band like HA – tension Stocking Glove neuropathy – DM Tyramine free diet – MAOIs Magical thinking – schizophrenia Condyloma- HPV of abraded skin Erythema marginatum – rheumatic fever Erythema migrans - Lyme Erythema toxicum neonatorum Erythema mulitforme – drug lesions, infectious Erythema “Sunburn with goosebumps” – scarlet fever “Dewdrop on a rose petal” – varicella zoster Rice water stool – cholera Box shaped rods in chains – anthrax Infectious Trismus - tetanus Pea Soup diarrhea – salmonella (typhoid) Pharyngeal gray membrane – diphtheria Bulls-Eye Lesion – erythemia migrans Herald patch, Christmas Tree Pattern rash – pityriasis rosea Koplik spots- measles Wickhams striae – lichen planus Auspitz’s sign – capillary bleeding after peeling away scale; Psoriasis Tapioca lesions – dyshidrosis Hot tub folliculitis – Pseudomonas Target lesions – erythema multiforme Spaghetti & meatballs on microscopy – pityriasis versicolor (Malassezia furfur) Rash sparing skin overlying joints – SLE Farmer’s/Sailor’s skin – dermatoheliosis Pearly white domes papule – BCC Microcytosis out of proportion to anemia – thalassemia Prussian blue staining – sideroblastic anemia Basophilic stippling – lead toxicity Heinz Bodies – hemolytic anemia Howell-Jolley Bodies Auer Rods - AML Glossitis in anemia – Folate (beefy red), Fe (pale) Anemia w/ neuro symptoms – B12 > 1g Hgb drop/week = hemolysis or loss Pruritis w/ bathing – polycythemia vera Pancytopenia w/ circulating blasts – acute leukemia Monoclonal spike on electrophoresis – Multiple Myeloma Ashigenaza Jews – Factor XI deficiency Russel Viper Venom Time – Lupus Anticoagulant Bird’s Beak sign – achalasia Virchow’s Node- Left Supraclavicular Lymphadenopathy- Gastric CA Sister Mary Joseph Nodule – Periumbilical nodule – Gastric CA String Sign – pyloric stenosis Cushing Disease- primary pituitary ACTH overproduction w/ cortical adrenal hyperplasia and glucocorticoid excess Cushing Syndrome- manifestions of glucocorticoid excess from any cause Cushingoid Features – Buffalo Hump, Moon Facies, Supraclavicular Fat Pad ENT disorder seen in dwarfism – recurrent OM Hypercalcemia seen in patients on bed rest – Paget’s disease of bone Eruptive/Tendinous xanthomas – hyperlipidemia Drugs causing hyperlipidemia Beta Blockers Thiazides Estrogen Cortisol Foamy Urine – nephrotic syndrome GU complication of mumps - orchitis Rust colored sputum – strep pneumo Currant jelly sputum – Klebsiella Susceptible populations: Wool workers, farmhands - anthrax Fish handlers – erysipeloid Purpura, Arthritis, Abdominal Pain – Henoch Schonlein Purpura Can’t Pee Can’t See Can’t Dance with me – Reiter’s Stndrome Lichen Planus 5 Ps Purple Planar Polygonal Papular Pruritic Chronic Pancreatitis Pancreatic Calcification Steatorrhea DM Necrotizing Fasciitis Fever Diffuse Crepitus Shock Hypercalcemia/Hyperparathyroidism- “Bones, Stones, Groans, Moans, Psychic Overtones” Bone Turnover Cholelithiasis Cholecystitis Constipation/N/V Delerium/fatigue/lethargy Horner’s Syndrome- Ptosis, Miosis, Anhidrosis Pancoast Syndrome – Horner’s + Neuritic Arm Pain, Arm muscle atrophy “SPHERE” of lung CA complications SVC Syndrome Pancoast Syndrome Horner’s Syndrome Effusions Recurrent Laryngeal Nerve Injury Endocrine (paraneoplastic) Gross hematuria, flank pain, palpable mass – Renal Cell Carcinoma Diarrhea, Dermatitis, Dementia – pellagra Poor wound Healing, Petechiae, Bleeding Gums – Scurvy Tumor Markers CA125 Ovarian CEA Colon AFP PSA Prostate Most Common…. Benign Primary Hand Bone Tumor – Ecchondroma Facial pain – TMJ Neck Pain – Cervical spondylosis Fracture in children and adolescents – clavicle Neuropathy – median n. (CTS) Elbow overuse injury – lateral epicondylitis Shoulder dislocation – anterior Hip Dislocation – posterior LBP – prolapsed intervertebral disk Spinal Deformity – idiopathic adolescent scoliosis Deformity of MTP – Hallux Valgus (Bunion) Curvature in scoliosis – R T7-8 Secondary Ammenorrhea – pregnancy Presentation of fibroids – vaginal bleeding GYN malignancy – Endometrial CA Ovarian growth – cyst Benign breast diases – fibrocystic (#2 Fibroadenoma) Breast CA – ductal Site Breast CA – upper outer RF for preeclmapsia – nulliparity 3rd Trim bleeding – abruption Infectious infertility - chalmydia Primary intracranial neoplasm – glioma Dementia – Alzheimers HA – Tension Side for Bell’s Palsy – Right Cause of Movement disorder in children – Cerebral Palsy Viral meningitis – coxsackie Source of brain mets – Lung, Breast, renal, GI Form of schizophrenia – Paranoid Antipsychotic causing agranulocytosis – Clozapine Mental disorder – Phobia Vector borne disease - Lyme Skin Condition – acne Cutaneous malignancy – BCC Anemia – IDA Cause IDA – GI blood loss Hypochrmoic microcytic anemia - IDA Normochromic normocytic anemia – Chronic disease B12 def iency – pernicious anemia Leukemia – CLL Coagulopathy – thrombocytopenia Acquired coagulaopathy – Vit K deficiency Congenital coagulaopathy – Von Willebrand Disease Acquired platelet dysfunction – NSAIDs/ASA Extranodal site of NHL – stomach Cancer deaths Lung Skin Colon Pancreatitis – ETOH Acute Hepatitis – Viral Cause of hyperthyroidism- Grave’s Cause of hypothyroidism- Iodine Deficiency Thyroid CA – papillary Site of cystic bone lesions in hyperparathyroidism – mandible Blindness in patients > 60 yrs – DM retinopathy Compication DM – neuropathy Addison’s disease – autoimmune cortex destruction Acromegaly – pituitary adenoma Neuro finding in Paget’s disease of bone- deafness Renal stone – Ca Electrolyte disorder in hospitalized patients – hyponatremia Atypical pneumonia – mycoplasma Solitary pulmonary nodule – healed granuloma Interstitial lung disease – idiopathic fibrosing interstitial pneumonia (formerly idiopathic pulmonary fibrosis) PUD – H pylori Finding in Gastric CA – IDA Jaundice + Palpable GB – Pancreatic CA Death in US Heart Disease CA CVA

Reviving your old post here E Aren't non-EM boarded docs a rarity now? Except for those grandfathered in I'm surprised if places are privileging non-BC EM docs.

I guess on an average you could arrive at some number, but for some things it's 100% for both and some PAs learn far less than 50% of what the MS does. But as we are getting at what matters is where the rubber meets the road and not the lofty cerebral heights of academia, no?

1.The "textbooks associated with medical school" are the same books used in PA school (Netter, Harrison, Cecil, Steadman, Bates, Guyton, Sabiston, etc....) We both have to learn the same clinical medicine. The differences are what time and depth our programs put into underlying basic science (histo, embryo, level of patho, etc) and the time we have in clinical rotations. 2. We both are practicing the same craft- medicine. They're the same, not "MD Medicine" and "PA Medicine"....

Not really since the more subspecialized you get, thje further you migrate from the generlaist PA model. Even residency trained PAs are not close to docs who do residency/fellow in that field. The training programs are just light yrs apart. But at the PCP level it's alot closer. Given that we have PCP PAs who carry their own pt panels, have great outcomes, no greater incidence of litigation relative to MDs, high satisfaction rates, etc, the applicable knowledge base (if you want to focus on that) is much higher than 50%. Case in point, ask a PA w/ 5 yrs experience and a freshman PCP MD what they want to say about the histology of the teeth and you'll get similar answers.