Ace Your PANCE Prep Pearls: 3rd Ed. (2019) Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Physician Assistant (PA) Students
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PANCE Prep Pearls: 3rd Ed. (2019) | Physician Assistant (PA) School Study Aid
Cholecystitis Causes
- Gallbladder Inflammation
- 6 Fs
- Female
- Fair (Caucasian)
- Fat (Obese)
- Fertile (Pregnant)
- Forty (Advanced Age Over 40)
- Flatulence
2 mins
Cholecystitis Assessment
- RUQ Pain
- Referred Shoulder Pain
- Clay Colored Stools
- Jaundice
- Nausea and Vomiting
- Dyspepsia (Indigestion)
- Fever
- Considerations
- Increased WBCs
- Fatty or Spicy Foods
- Ultrasound
2 mins
Cholecystitis Interventions
- Supportive Therapy
- Antibiotics
- Low Fat Diet
- NG Tube
- Analgesics
- Lithotripsy
- Cholecystectomy
- T Tube
2 mins
Acute Cholangitis Characteristics and Clinical Features
- Characteristics
- Biliary Tract Infection
- Biliary Tract Obstruction
- Clinical Features
- Charcot's Triad
- Fever
- Jaundice
- Abdominal Pain
- Reynold's Pentad
- + Hypotension
- + Altered Mental Status
2 mins
Ascending Cholangitis Diagnosis and Treatment
- Imaging
- ERCP
- CT Scan
- Ultrasound
- Biliary Duct Dilation and/or Stones
- Labs
- Hyperbilirubinemia
- Elevated Alkaline Phosphatase
- Elevated GGT
- Treatment
- Broad Spectrum Antibiotics
- Biliary Drainage
4 mins
Gallstones (Part 1/2)
- Characteristics
- Cholelithiasis
- Pathophysiology
- Increased Bilirubin
- Increased Cholesterol
- Stasis
- Decreased Bile Salts
- Risk Factors
- Cholesterol Stones are the Most Common Type
- Fat, Female, Fertile, Forty, Fair Complexion
- Crohn's Disease
- Rapid Weight Loss
- Estrogen Therapy
- Native American
- Diagnosis
- Ultrasound
- Treatment
- Cholecystectomy
3 mins
Gallstones (Part 2/2)
- Cholesterol Stones
- Cholesterol Stones are the Most Common Type
- Radiolucent
- Pigmented Stones
- Black Pigment Stones
- Hemolysis
- Brown Pigment Stones
- Infection
- Radiopaque
2 mins
Jaundice
- General
- Due To Elevated Conjugated Or Unconjugated Bilirubin
- Unconjugated
- Hemolysis
- Crigler-Najjar Or Gilbert's Syndrome
- Physiologic Jaundice Of Newborn
- Conjugated
- Biliary Obstruction From Stone Or Mass
- Cholangitis
- Dubin-Johnson And Rotor Syndrome
- Mixed
- Cirrhosis
- Hepatitis
5 mins
Hyperbilirubinemia
- Cause/Mechanism
- Increased Unconjugated Bilirubin
- Assessment
- Jaundice
- Kernicterus
- Interventions
- Early Feedings
- Heme Oxygenase Inhibitors
- Phototherapy
- Protect Eyes
- Monitor for Dehydration
- Considerations
- Monitor Bilirubin Levels
3 mins
Bilirubin Lab Value
- 0.2-1.2 mg/dL
- Increased Bilirubin Causes Jaundice
54 secs
Crigler-Najjar Syndrome Type 1
- Pathophysiology
- Autosomal Recessive
- Absent UDP-glucuronosyltransferase
- Symptoms
- Neonatal Jaundice
- Kernicterus
- Diagnosis
- Normal Liver Function Tests
- Elevated Unconjugated Bilirubin
- Treatment
- Phototherapy
- Plasmapheresis
- Calcium Phosphate and Orlistat
- Death often by Age 2
- Considerations
- No Response to Phenobarbital
3 mins
Gilbert's Syndrome
- Pathophysiology
- Decreased UDP-Glucuronosyltransferase Activity
- Decreased Bilirubin Conjugation
- Signs and Symptoms
- Often Asymptomatic
- Jaundice (Mild)
- Fasting
- Stress
- Alcohol Intake
- Labs
- Increased Unconjugated Bilirubin
2 mins
Primary Biliary Cholangitis (Primary Biliary Cirrhosis)
- Mechanism
- Autoimmune Destruction of Bile Ducts
- Intrahepatic bile ducts
- Cholestasis
- Occurs in Middle-Aged Females
- Signs and Symptoms
- Fatigue
- Pruritus
- Skin Hyperpigmentation
- Hepatomegaly
3 mins
Primary Biliary Cholangitis (Primary Biliary Cirrhosis) Diagnosis and Treatment
- Diagnosis
- Positive Antimitochondrial Antibodies
- Increased Alkaline Phosphatase (ALK-P)
- Increased Cholesterol
- Treatment
- Ursodiol
- Liver Transplant
2 mins
Primary Sclerosing Cholangitis Mechanisms
- Mechanism
- Unknown Mechanism
- "Onion Skin" Fibrosis
- "Beading" of Bile Ducts
- Symptoms
- Pruritus
- Hepatosplenomegaly
- Jaundice
2 mins
Primary Sclerosing Cholangitis Labs and Treatment
- Labs
- Increased Conjugated Bilirubin
- Increased ALK-P
- Increased IgM
- Associated Pathologies
- Ulcerative Colitis
- Cholangiocarcinoma
- Secondary Biliary Cirrhosis
- Treatment
- Liver Transplant
- Stent
2 mins
Hepatitis A
- Characteristics
- Picornavirus
- 4 Week Incubation Period
- Fecal-oral
- Day Care Centers
- Travel to Developing Countries
- Signs and Symptoms
- Usually Asymptomatic
- Acute Disease
- Jaundice
- Fever
- Vomiting
2 mins
Hepatitis A (HAV) Assessment
- Transmission
- Fecal-Oral
- Ingestion of Contaminated Food or Water
- Incubation
- 4 Weeks
- Assessment
- Fever
- General Malaise
- Hepatomegaly
- Considerations
- Self-Limiting
- Proper Hand Washing
2 mins
Hepatitis B Virus Disease
- Can turn chronic
- < 10% of adults become chronic carriers
- 90% of newborns become chronic carriers
- Cirrhosis
- Hepatocellular carcinoma
- Membranous Glomerulonephritis
- Polyarteritis nodosa
- Serum sickness like syndrome
2 mins
Hepatitis B Virus Characteristics
- Hepadnavirus
- Enveloped
- Circular
- Partially Double-stranded DNA
- Has Reverse Transcriptase
- IV Drug Use
- Sex
- Maternal Fetal Routes
- 3 Month Incubation Period
2 mins
Hepatitis B (HBV) Assessment
- Transmission
- Bodily Fluids
- Blood Transmission
- People Who Use IV Drugs
- Incubation
- Variable 1-6 Months
- Assessment
- Fever
- Nausea and Vomiting
- Hepatomegaly
- Chronic Disease
- Cirrhosis
- Hepatocellular Carcinoma
- Considerations
- Vaccination
2 mins
Hepatitis C
- Characteristics
- Enveloped
- RNA Virus
- Flavivirus
- Icosahedral
- SS positive Linear
- Clinical Features
- Most Cases are Due to IV Drug Use
- Turns to Chronic Hepatitis in Over 70% of Cases
- Cirrhosis
- Hepatocellular Carcinoma
- Most Common Indication for Liver Transplantation
- Associated With Type I MPGN
- Porphyria Cutanea Tarda
2 mins
Hepatitis C (HCV) Assessment
- Transmission
- Blood Transmission
- High Risk Sex (rare)
- IV Drug Users
- Incubation
- 7 Weeks
- Chronic Disease
- Cirrhosis
- Considerations
- Barrier Protection
2 mins
Liver Enzyme Tests: AST and ALT
- AST/ALT Ratio
- AST: 8-20 U/L
- ALT: 8-20 U/L
1 min
