UTHSC PA Program Podcast

In this episode, we review Hirschsprung disease, a congenital disorder caused by the absence of enteric ganglion cells in the distal colon, leading to functional obstruction and chronic constipation. We break down the embryologic failure of neural crest cell migration, classic neonatal findings such as delayed passage of meconium and bilious emesis, and the hallmark "squirt sign" on exam. The disc...

In this episode, we review nonalcoholic fatty liver disease (NAFLD), a common and often silent condition driven primarily by insulin resistance and metabolic dysfunction. We break down the distinction between simple steatosis (NAFL) and nonalcoholic steatohepatitis (NASH), highlighting key pathophysiologic differences such as hepatocellular ballooning and fibrosis. The discussion covers risk facto...

In this episode, we review gastroparesis, a chronic disorder of delayed gastric emptying without mechanical obstruction. We break down normal gastric motility, the role of the vagus nerve and interstitial cells of Cajal, and how dysfunction leads to impaired antral contraction and pyloric relaxation. The discussion highlights key risk factors—including diabetes, postsurgical vagal injury, and medi...

In this episode, we review ileus, a functional inhibition of gastrointestinal motility without mechanical obstruction, most commonly seen after surgery. We break down the neurogenic and inflammatory phases that suppress peristalsis, along with key risk factors such as opioid use, intra-abdominal infection, and electrolyte imbalances. The discussion highlights how to distinguish ileus from small bo...

In this episode, we review acute appendicitis, a common yet time-sensitive surgical emergency. We break down the pathophysiology of luminal obstruction—most often from a fecalith—leading to infection, ischemia, and potential perforation within 24–48 hours if untreated. The discussion covers classic symptom progression from periumbilical pain to right lower quadrant tenderness, key physical exam ma...

In this episode, we review abdominal and groin hernias, including inguinal (direct and indirect), femoral, umbilical, and incisional types. We break down the pathophysiology of fascial defects leading to organ protrusion, key risk factors such as heavy lifting and prior surgery, and the clinical distinction between reducible, incarcerated, and strangulated hernias. The discussion highlights hallma...

In this episode, we review gastritis, an inflammatory condition of the gastric mucosa commonly triggered by H. pylori infection, NSAID use, alcohol, or physiologic stress. We break down the pathophysiology of mucosal inflammation, key differences between acute and chronic gastritis, and the clinical features of epigastric pain, nausea, and possible GI bleeding. The discussion highlights appropriat...

In this episode, we review esophageal varices, a life-threatening complication of portal hypertension most commonly seen in patients with cirrhosis. We break down the pathophysiology of increased portal venous pressure leading to fragile, dilated submucosal veins at high risk of rupture. The discussion highlights the dramatic presentation of upper GI bleeding, the critical role of emergent endosco...

In this episode, we review ischemic bowel disease, a life-threatening condition caused by insufficient blood flow to the intestines. We break down the spectrum of disease—including ischemic colitis, acute mesenteric ischemia, and chronic mesenteric ischemia—and discuss key risk factors such as vascular disease and atrial fibrillation. The episode highlights the classic presentation of severe abdom...

In this episode, we review systemic sclerosis (scleroderma) , a rare connective tissue disease characterized by autoimmune endothelial injury and progressive fibrosis of the skin and internal organs. We break down hallmark features such as Raynaud phenomenon, skin tightening, GERD, and dyspnea, along with key physical exam findings like sclerodactyly and telangiectasias. The discussion highlights...

In this episode, we review polymyositis, a rare autoimmune inflammatory myopathy characterized by symmetric proximal muscle weakness. We break down the T-cell–mediated pathophysiology, key clinical features such as difficulty climbing stairs or lifting arms, and important distinctions from dermatomyositis. The discussion highlights diagnostic strategies—including elevated creatine kinase levels, a...

In this episode, we review osteomyelitis, a serious infection of bone that can progress to necrosis and chronic sequestrum formation if not treated promptly. We break down the pathophysiology of bone infection, common risk factors such as diabetes and IV drug use, and key differences between acute and chronic disease. The discussion highlights diagnostic strategies—including why MRI is the most se...

n this episode, we review lumbar disc herniation, a common cause of radicular back pain in adults ages 30–50. We break down the pathophysiology of nucleus pulposus herniation leading to nerve root compression, along with classic symptoms such as radiating leg pain, numbness, and weakness. The discussion highlights key exam findings like a positive straight leg raise, appropriate use of MRI, and ev...

In this episode, we review cauda equina syndrome, a rare but time-sensitive neurologic emergency caused by compression of the lumbosacral nerve roots. We break down the underlying pathophysiology, high-risk causes such as herniated disc or spinal tumor, and the classic red flag symptoms including saddle anesthesia, urinary retention, and bilateral leg weakness. The discussion emphasizes urgent MRI...

In this episode, we review small bowel obstruction (SBO)—a common surgical emergency that can rapidly progress to ischemia, perforation, and sepsis if not recognized early. We break down the pathophysiology of mechanical obstruction, classic risk factors such as prior abdominal surgery and adhesions, and the key clinical findings that distinguish partial from complete obstruction. The discussion h...

In this episode, we review peritonitis, a medical and surgical emergency characterized by acute inflammation of the peritoneum with high risk of sepsis and shock. We break down the different types—spontaneous bacterial peritonitis (SBP), secondary peritonitis, peritoneal dialysis–related infection, and tertiary peritonitis—along with their distinct mechanisms and management strategies. The discuss...

In this episode, we review percutaneous endoscopic gastrostomy (PEG) tube placement, a commonly performed procedure for long-term enteral access. We discuss indications such as chronic dysphagia and upper GI obstruction, key contraindications, and the relevant anatomy required for safe placement. The episode walks through the pull technique step-by-step, emphasizing site selection, infection preve...

In this episode, we break down acute pancreatitis, a common and potentially life-threatening cause of acute abdominal pain. We review the pathophysiology of premature enzyme activation leading to pancreatic autodigestion and systemic inflammation, along with key risk factors including gallstones, alcohol use, and hypertriglyceridemia. The discussion highlights diagnostic criteria, appropriate imag...

In this episode, we provide a practical, evidence-based review of abdominal drains—when to use them, how to place them safely, and how to manage them postoperatively. We discuss indications, contraindications, drain selection (passive vs. closed-suction systems), and key procedural steps to optimize positioning and minimize complications. The episode also covers postoperative monitoring, biochemic...

In this episode, we review intussusception, a common pediatric abdominal emergency most often seen in children 6–36 months old. We break down the pathophysiology of telescoping bowel leading to venous congestion, ischemia, and potential perforation, along with the classic presentation of intermittent severe abdominal pain, vomiting, and the late finding of currant jelly stools. The discussion high...

In this episode, we break down portal hypertension with a clear, clinically focused approach. We review the hemodynamic basis of elevated portal pressure, the development of portosystemic collateral circulation, and the classic signs such as splenomegaly, ascites, and varices. The discussion highlights diagnostic strategies, including Doppler ultrasound and endoscopic screening, and emphasizes evi...

In this episode, we break down cirrhosis using a clinically focused, high-yield framework. We review the pathophysiology of chronic liver injury leading to fibrosis, portal hypertension, and synthetic dysfunction, along with classic history and physical exam findings. The discussion highlights key laboratory and imaging clues, severity scoring with Child-Pugh and MELD, and essential management str...

In this episode, we tackle toxic megacolon, a life-threatening complication of severe colonic inflammation most commonly associated with ulcerative colitis and Clostridioides difficile infection. We review the pathophysiology of nitric oxide–mediated colonic paralysis, hallmark clinical features of systemic toxicity, and the critical imaging findings of colonic dilation ≥6 cm. The discussion empha...

In this episode, we break down chronic cholecystitis using a practical, clinically focused framework. We review the pathophysiology of recurrent gallstone obstruction leading to chronic inflammation and fibrosis, along with hallmark history and exam findings such as postprandial right upper quadrant pain with typically normal labs. The discussion highlights first-line imaging, including ultrasound...

In this episode, we review pyloric stenosis, a classic pediatric surgical condition every clinician should recognize. We cover the underlying pathophysiology of gastric outlet obstruction, hallmark clinical features such as projectile non-bilious vomiting, and key physical exam findings. The discussion highlights diagnostic imaging, electrolyte abnormalities, and evidence-based management, includi...