| Course | PA 526 Comprehensive Clinical Module Gastroenterology |
|---|---|
| Week | 7 |
| Paper type | Endoscopy indication write-up |
| Length | About 660 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 526 Week 7
Endoscopy Indication Write-Up: An Upper Endoscopy Requested to Answer Where N.R.'s Bleeding Starts and What Narrows the Lower Esophagus, Written So That a Normal Result Also Means Something
Student Name
Chamberlain University
PA 526: Comprehensive Clinical Module Gastroenterology
Instructor Name
Month Day, Year
Endoscopy Indication Write-Up: An Upper Endoscopy Requested to Answer Where N.R.'s Bleeding Starts and What Narrows the Lower Esophagus, Written So That a Normal Result Also Means Something
The Question
Is there a lesion in the esophagus, stomach or duodenum that explains both N.R.'s black stools and the solid-food dysphagia, and if so, is it a benign ulcer or stricture that can be treated during the procedure, or a cancer that needs tissue? A positive finding would identify the source and possibly treat it. A normal examination of all three would also mean something: it would move the bleeding source below the ligament of Treitz and make a motility disorder more likely as the cause of the dysphagia.
Where Along the Tube the Question Sits
Both suspected problems lie within reach of an upper endoscope: the narrowing low in the esophagus, near the junction with the stomach, and the probable bleeding ulcer in the stomach or duodenum. The instrument travels from the mouth to the second part of the duodenum, which covers everything above the ligament of Treitz. No part of the question requires a colonoscope or a capsule.
Why It Is Indicated
The bleeding guideline recommends endoscopy within 24 hours of presentation for patients admitted with upper gastrointestinal bleeding, after resuscitation (Laine et al., 2021). The reflux guideline recommends endoscopy for patients with alarm symptoms, including dysphagia and weight loss, rather than further trials of acid suppression (Katz et al., 2022). N.R. meets both.
The Cost the Request Has to Own
Upper endoscopy carries small but real risks: reactions to sedation, especially in a patient who is volume depleted; aspiration; bleeding from biopsies or dilation; and, rarely, perforation, which is more likely if a tight stricture is dilated during an active bleed. It also costs a day of N.R.'s work and requires someone to drive N.R. home. The request owns these by asking that dilation, if a stricture is found, be deferred until bleeding has settled and biopsies are back, unless food impaction makes it necessary.
Comparing the Alternative Honestly
A barium swallow would show the shape and length of a narrowing without sedation and might help plan dilation. It cannot take a biopsy, cannot treat bleeding and would leave barium in the gut that interferes with endoscopy for several days. For the bleeding, there is no reasonable alternative to endoscopy. For the dysphagia alone, a barium study could come first in some settings, but here the bleeding has made endoscopy necessary anyway, and one procedure can answer both questions.
Preparation
Nothing by mouth from midnight. Hemoglobin above 7 g/dL before sedation. Proton pump inhibitor continued. Naproxen stopped and listed as an adverse reaction. Consent discussion to include biopsy and possible treatment of a bleeding vessel.
What Happens With Each Result
If an ulcer with a visible vessel or active bleeding is found, it will be treated during the procedure, and N.R. will stay on a high-dose proton pump inhibitor. If a clean-based ulcer is found, N.R. can eat and go home sooner. If the lower esophageal narrowing looks benign, biopsies will be taken and dilation planned for after healing. If it looks malignant, biopsies will be taken and staging arranged. If the examination is normal, a capsule study or colonoscopy will be considered for the bleeding, and an esophageal pressure study for the swallowing.
Real Reports Stay Where They Are
The endoscopy report will be filed by the endoscopist and is not copied here. This write-up records only the indication. When the report arrives, the gallbladder plan will also need to be revisited, since the surgeon will want the bleeding source treated before an operation.
References
Katz, P. O., Dunbar, K. B., Schnoll-Sussman, F. H., Greer, K. B., Yadlapati, R., & Spechler, S. J. (2022). ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. American Journal of Gastroenterology, 117(1), 27-56. https://doi.org/10.14309/ajg.0000000000001538
Laine, L., Barkun, A. N., Saltzman, J. R., Martel, M., & Leontiadis, G. I. (2021). ACG clinical guideline: Upper gastrointestinal and ulcer bleeding. American Journal of Gastroenterology, 116(5), 899-917. https://doi.org/10.14309/ajg.0000000000001245
What the PA 526 Week 7 assignment asks for
Week seven asks for a short write-up justifying an endoscopy. Open with the question, not the patient, and write it so both a positive and a negative result would change what happens next. State where along the gut the suspected problem sits and whether the chosen instrument reaches it. Give the indications with guideline support. Acknowledge the costs and risks the request carries, and explain how the request reduces them. Compare the most reasonable alternative test honestly, including what it would and would not answer. Note the preparation needed. Map each likely result to its next step. Keep any actual procedure report out of the write-up; it belongs to the endoscopist. Some sections want a note format instead of a short paper, so check yours.
How this PA 526 Week 7 example is built
The write-up opens with a two-part question, whether an upper lesion explains both the melena and the solid-food dysphagia and whether it is benign or malignant, and shows what a normal examination would imply. A section places the narrowing and the probable ulcer within the instrument's reach. Indications cite the 24-hour endoscopy recommendation for upper bleeding and the reflux guideline's call for endoscopy with alarm symptoms. A costs section names sedation, aspiration, biopsy bleeding and perforation risk, and defers dilation during active bleeding. A barium swallow is compared fairly and set aside. Preparation lists fasting, a hemoglobin threshold and consent for treatment. A results section maps each possible finding to its next step, and a closing section keeps the report with the endoscopist.
Reading the PA 526 Week 7 grading rubric
The rubric rewards a request built around a question. A write-up that opens with the patient and never states what the procedure should answer loses the most. Faculty then check whether both positive and negative results are given meaning. Credit goes to placing the suspected problem along the gut and confirming the instrument reaches it. The costs section is weighted heavily: a request that lists benefits only, or ignores risks specific to the patient's state, is marked down. The alternative test must be compared honestly. Mapping results to next steps earns marks for showing the request was fully planned. Copying a procedure report into the write-up is a deduction. Guideline support should be cited for each indication.
PA 526 Week 7 help from the desk
Endoscopy requests often lose marks by describing the patient at length without stating what the procedure must answer. Tell us the clinical problem and the procedure proposed, and your version would open with a question designed so that any result is useful, place the problem along the gut and cite the guidelines that support the indication. Risks are stated plainly with how the request reduces them. The most reasonable alternative is compared fairly. Preparation and a map of results to next steps are included. If your section requires a note format, the content is arranged to match. Check the timing and thresholds against the guidelines your course assigns before relying on them.
Get a PA-526 Week 7 example written to your instructions
Send the case and the rubric and a custom PA-526 Week 7 write-up comes back inside 24-48h, the first one free, built in whichever format your section grades. One boundary worth stating: a report from a site you rotate through stays where it was written, and every finding described in a sample is composed for the case rather than copied from anyone.
More PA 526 papers and MPAS samples
- PA 526 Week 1: Abdominal Region Discussion Post
- PA 526 Week 2: Abdominal Quadrant Brief
- PA 526 Week 3: GI Alarm Feature Checklist
- PA 526 Week 4: Dysphagia and Reflux Case
- PA 526 Week 5: Liver Panel Interpretation
- PA 526 Week 6: GI Bleeding Source Triage
- PA 526 Week 8: Hepatobiliary Case Paper
- PA 524 Week 7: Urinary Obstruction Brief
- PA 522 Week 7: Adrenal Incidentaloma Workup
- PA 520 Week 7: 6-Minute Walk Test Report
- PA 518 Week 7: Stroke Risk Scoring Memo
PA 526 Week 7 questions, answered
Does the write-up have to compare imaging?
Most rubrics on this module reward it even where the wording does not demand it, because the comparison is what shows the choice was reasoned. The example gives the alternative a fair two or three sentences, including what it would show that the instrument could not. If your section explicitly limits the scope, send that line and the sample stays inside it.
My section wants a consent paragraph included.
Then it goes in, written as what the conversation would cover rather than as a signed form, which is the version a coursework rubric can mark. The example keeps it brief and tied to the specific request, since a generic paragraph adds length without earning anything. Send the rubric row and the paragraph is written against its wording.
Can it be written as a note rather than a paper?
Yes, and several sections require exactly that. A note compresses the same six moves into headed fragments, which is harder rather than easier because each fragment still has to carry a claim. Send the note template your classroom supplies and the sample is built into it, with the citations placed wherever that format allows them.
Where can I find a free PA 526 Week 7 sample paper?
This page carries the full PA 526 Week 7 endoscopy indication, written so that both a positive and a normal result would change the plan.
Why does the PA 526 Week 7 sample defer dilation?
Dilating a tight stricture during an active bleed raises the risk of perforation, so dilation waits until bleeding settles and biopsies return, unless food impaction forces it.