Alert Medical Series: USMLE Alert I

Alla Sarraj

Description

This series is a compilation of powerful high yield random notes and comparisons that will guarantee laser-sharp comprehensive and effective knowledge acquisition and high score passing rates in the fields of USMLE (US Medical Licensing Exam), Internal Medicine and Emergency Medicine boards.

Sujets

• Médecine
• Spécialités médicales
• Médecine d'urgence
• Emergency Medicine
• Medical

Informations

• Publié par: Outskirts Press
• Date de parution: 10 octobre 2016
• Nombre de lectures: 0
• EAN13: 9781478769439
• Langue: English

Extrait

The opinions expressed in this manuscript are solely the opinions of the author and do not represent the opinions or thoughts of the publisher. The author has represented and warranted full ownership and/or legal right to publish all the materials in this book.

Alert Medical Series: USMLE Alert I
All Rights Reserved.
Copyright © 2016 Ala Sarraj, MD
v6.0 r1.0

Cover Photo © 2016 thinkstockphotos.com. All rights reserved - used with permission.

This book may not be reproduced, transmitted, or stored in whole or in part by any means, including graphic, electronic, or mechanical without the express written consent of the publisher except in the case of brief quotations embodied in critical articles and reviews.

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ISBN: 978-1-4787-6943-9

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PRINTED IN THE UNITED STATES OF AMERICA

Preface
Alert M edical Series is a compilation of powerful random high yield notes and comparisons that will guarantee comprehensive and effective knowledge base and high score passing rates in the fields of USMLE (US Medical Licensing Exam), INTERNAL MEDICINE and EMERGENCY MEDICINE boards alike.
It reflects years of revision and update that will save medical students, residents and physicians measurable time of test prep and knowledge acquisition.
Alert Medical Series will serve you like multitude of pixels creating very high resolution and sharp picture.
The USMLE series notes (basic and clinical) were put in a random manner mixing basic and clinical notes to simulate real life knowledge building and to reflect the future trend in USMLE testing to combine clinical science and the clinically based basic science.
• Reye’s syndrome: typical findings:
In brain: high voltage, slow wave.
In liver: microvesicular steatosis.
Stages :
Stage 1: lethargy, vomiting.
Stage 2: hyperventilation, delirium.
Stage 3: decorticate posture.
Stage 4: decerebrate posture.
Stage 5: seizures, flaccidity, respiratory arrest.
• Celiac sprue:
Increased 5 HIAA (5 Hydroxyindoleacetic acid) in the urine.
Abnormal D- Xylose absorption.
Biopsy is diagnostic.
• Tenia versicolor:
Recurrence is common because MF (Malassezia Furfur) is part of the normal flora.
• Pinpoint pupils “OOPS “:
Opiate overdose.
Organophosphate poisoning.
Pontine hemorrhage.
Sarin gas exposure.
• Phrenic nerve is resistant to hyperbaric spinal anesthesia (no respiratory paralysis).
• Tendency to tetany increases when the following ratio increases:
HCo3 x HPo4 / ca x Mg x H
All in ionic form.
• Teratomas are cystic whereas hamartomas are cartilage like.
• No dissecting aneurysm in calcific medial sclerosis (Monckeberg’s disease).
• Prevalence is useful in chronic diseases.
• Birth rate: incidence.
Birth defect rate: prevalence.
• Sensitivity and specificity:
Test / Patient
Disease
Healthy
+
a
b: false positive
_
c: false neg.
d

Sensitivity = a/a + c
Specificity = d/b +d.
• The same results with repeating test:
Reliability (precision).
Validity = accuracy.
• The basic characteristic of incidence type rates is TIME.
• Standard deviation measures and indicates dispersion.
• Highly sensitive = few false negative.
• Puberty is marked by:
Thelarche.
Adrenarche.
Menarche.
Growth spurt.
• Furosemide is of choice when GFR < 25 ml/ min.
• Hydralazine is usually avoided in coronary artery disease.
• The following parameters indicate the need for mechanical ventilation:
Respiratory rate > 25/ min.
Tidal volume < 5 ml/ kg.
Vital capacity < 1 liter.
• PEEP (positive end expiratory pressure) is most effective in ARDS (adult respiratory distress syndrome).
• In CO poisoning:
Arterial Po2 is usually normal.
• In angina pectoris: no syncope is reported yet.
• Empyema: toxicity after improvement is noted.
• SalicyLates interfere with carbohydrate metabolism, leading to ketosis.
It uncouples oxidative phosphorylation.
• Compare:
Calcium
Phosphorus
Alk.phos.
Rickets Hypovit.D
Decreased
Decreased
Normal
Osteoporosis
Normal
Normal
Normal
Paget’s dz
Normal
Normal
Increased
Hyper parathyroidism
Increased
Decreased
Normal
Hypo parathyroidism
Decreased
Increased
Normal
• Pellagra:
Dermatitis.
Diarrhea.
Dementia.
• Hepatitis B virus does NOT cross the placenta.
• Twin to twin transfusion: difference in hemoglobin more than 15%.
• Neonatal jaundice:
Day#
Serum level
Premature
5-7
8-12
Physiologic
2-3
5-6
Hypothyroid
Physiologic but
It persists
Erythroblastosis fetalis
24hrs
20
Sepsis
4-7
Elevated.
• Pyloric stenosis: can lead to jaundice (indirect hyperbilirubinemia).
• Bile related enteropathy (like resection, Crohn disease): leads to fat and calcium malabsorption, which leads to increased oxalate absorption and hence oxalate kidney stones.
• Ulcerative colitis involves the colon only.
• Cystic fibrosis: Salty taste when kissed!
Nasal polyps.
• Compare:
Heat stroke
Heat exhaustion
Water intoxication
Hypovolemia
Dry skin
Wet hot skin
No sweating
Sweating
• Meconium obstruction: leads to microcolon / disuse colon.
• External steroids: leads to decreased ACTH production, which leads to decreased blood flow to the adrenals then atrophy.