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Eye Disorders
eye disorders
- related: Medicine
Eye disorders
- Blepharospasm
- orbital cellulitis
- optic neuritis
- eye problems
- uveitis conjunctivitis keratitis
- choroidal melanomas
- glaucoma
Hordeolum
Hordeolum (stye) is a bacterial infection of the sebaceous glands in the eyelid. Patients have tenderness, redness, and swelling at the eye
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ACL
ACL
ACL
Injuries to the anterior cruciate ligament (ACL) are common in young athletes, especially women who participate in noncontact sports requiring rapid direction changes or pivots on the lower extremity (eg, soccer, basketball, tennis). ACL tears can also occur in high-conta
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Allergy and Immunology
Allergy and Immunology
- Keywords: Medicine
Immune deficiencies
Soft tissue problems
Allergic Reactions
Lupus
Myopathy
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Antibodies
Antibodies
- related: Medicine
- tags: #note
GI
primary biliary cholangitis
autoimmune hepatitis
Celiac disease.
Rheum
Limited scleroderma (CREST syndrome).
- patient: adolescent male athletes. Early adolescence (typically ages 13-14 for affected males, and ages 10-11 for affected females)
- pathogenesis: This condition is caused by chronic/repetitive strain at the insertion of the patellar tendon on the tibial tubercle and is seen in pre-adolescent and adolescent patients undergoing rap
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Pain Meds
Pain Meds
- Figure out opioid hx and what is used in the past
- opioid naive: start morphine IV 2mg q4, then go up to 4, 6
- total dose in a day 1st then convert to others. Divide long and short into 1/2
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Symptoms
This patient with symmetric swelling and pain of the hands and feet in the setting of known sickle cell disease (SCD) has dactylitis (hand-foot syndrome). Dactylitis, resulting
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Step 1
Step 1
Subjects
- step 1 Antimicrobials
- step 1 Behavior Science
- step 1 Biochemistry
- step 1 Cardiology
- step 1 Cell
- step 1 Endocrinology
- step 1 Genetics
- step 1 GI
- step 1 Heme
- step 1 Immunology
- step 1 Infectious Disease
- step 1 Microbes
- step 1 MSK
- step 1 Neurology
- step 1 Pharm
- step 1 Pharmacology
- step 1 Pulmonary
- step 1 Renal
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Valvular Diseases
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Acute Pancreatitis
acute pancreatitis
acute pancreatitis
Causes
Acute pancreatitis is an inflammatory condition, which results in severe abdominal pain along with elevated pancreatic enzymes. Though the exact pathogenesis is not well known, there are several etiologies that have been linked to acute attacks.
Biliary tract disease (i.e. gallstones) and chronic alcohol use are the two most common causes of acute p
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Carbon Monoxide Poisoning
carbon monoxide poisoning
CO Poisoning
Cause
Carbon monoxide, a colorless and odorless gas, can be potentially fatal after exposure if not properly diagnosed and treated. Carbon monoxide poisoning is associated with:
- Automobile exhaust
- Inadequately ventilated heaters (hence most commonly occurring in the winter)
- Methylene chloride ingestion (converts to CO hepatically)
Pathophysiology
Ca
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Cyanide Poisonings
cyanide poisonings
Cyanide
Cause
- Cause: house fire, smoke inhalation injury, nitroprusside use in hypertensive emergency
- Sx:
- early: neurologic and cardiorespiratory stimulation, and patients develop headache, vertigo, dizziness, hyperventilation, tachycardia, nausea, and vomiting.
- late: **coma, seizures, bradycardia, hypotension, and ca
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Delayed Growth
delayed growth
Delayed Growth
Puberty is considered delayed if no secondary sexual characteristics (typically testicular enlargement [>4 mL] or breast development) are present by age 14 in boys or age 12 in girls. This patient with short stature but normal growth velocity (4-6 cm/yr) most
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Delayed Puberty
delayed puberty
Delayed puberty in boys
Causes
- Primary hypogonadism
- Klinefelter syndrome
- Secondary hypogonadism
- Constitutional, chronic illness, malnutrition
- Hypothyroidism, hyperprolactinemia
- Kallmann syndrome
- Craniopharyngioma
- Clinical features
- Absent testicular enlargement by age 14
- Delayed growth spurt
- **Initial w
- Primary hypogonadism
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Heart Failure 9-2 Lecture
heart failure 9-2 lecture
- related: Medicine, Cardiology, heart failure
Definition
- HFrEF: <EF < 40%
- HFpEF: EF > 50%,
- Intermediate: HF with intermediate ejection 40-50%
- EF normal does not mean CO is normal. Can have preserved EF but low CO
Classifications
- NYHA: functional classification
- 1: no sx
- 2: sx with normal activity
- 3: sx with reduced activity
- 4: sx at rest
- ACC/AHA staging: more structural elements
- A: high risk o
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Heart Murmurs
heart murmurs
- Keywords:: Step 3, Medicine
- Related: 22 Heart Murmurs
Heart Murmurs
- General rules
- Most murmurs increase in sound with increase preload
- Forward murmurs (stenosis) decrease with increase afterload
- Backward murmurs (regurge, VSD) increase with increase afterload
- MVP, HCM decrease with increase preload or afterload
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Hypoparathyroidism
hypoparathyroidism
- Keywords: Step 3, Medicine, Endocrine, Parathyroid
Hypoparathyroidism
- primary: low PTH, surgery, radiation, autoimmune, congenital (Digeorge, APS-1)
- pseudohypoparathyroidism: abnormal sensor to PTH in kidney and bone
- lab looks like secondary hyperparathyroidism
- high PTH, low Ca, high phos
- Albright's Hereditary Osteodys
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Methemoglobinemia
methemoglobinemia
Methemoglobinemia
Methemoglobinemia is most commonly acquired after excessive exposure to an oxidizing agent (eg, dapsone, nitrites, local/topical anesthetics such as benzocaine/lidocaine (surgical patients)). Methemoglobin is a form of hemoglobin in whi -
Multifocal Atrial Tachycardia
Multifocal Atrial Tachycardia
- related: Medicine, Cardiology, tachycardia
- tag: #note
Multifocal atrial tachycardia (MAT) is an irregularly-irregular supraventricular tachycardia (SVT) characterized by the presence of 3 or more ectopic atrial pacemaking foci.
MAT occurs more commonly in patients with COPD, hypoxemia, and underlying pulmonary dysfunction. Other
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Organophosphate
organophosphate
This patient has signs and symptoms of cholinergic toxicity after playing outside, which is suggestive of organophosphate poisoning. Organophosphates have historically been used in bioterrorism as nerve agents but are also used in insecticides and pesticides. Intoxication occurs after absorption via contact, inhalation, or ingest
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Otitis Externa
otitis externa
This patient has acute otitis externa (OE), likely from swimming. The most common organisms causing OE are Pseudomonas and Staphylococcus species. Initial treatment includes thoroughly cleaning the ear canal to remove cerumen and other debris and nonsteroidal anti-inflammatory drugs for pain control. An otos
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Palliative Care
palliative care
- related: Psychiatry, Medicine
- tags: #note
Palliative care is a model of treatment that involves managing symptoms, providing psychosocial support, coordinating care, and assisting with decision making to relieve suffering and improve quality of life for patients and families facing s
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Patellofemoral Pain
patellofemoral pain
- Patient population: common cause of knee pain in young athletes and predominantly affects women.
- Pathogenesis: chronic overuse or malalignment (eg, angular deformities, weakness of hip abductors) but can also be seen acutely following trauma.
- Sx:
- aching sensation and worsened by activities such as squatting or climbing stairs. Also
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Pes Anserine Bursitis
pes anserine bursitis
Pes Anserine Bursitis
- aka anserine pain
- patient:
- pathogenesis: PAPS can be caused by an abnormal gait, overuse, or trauma.
- Sx: pain and tenderness at the anterior medial knee distal to the joint line, often exacerbated by pressure from the opposite knee while lying on the side.
- Dx: Examination shows a well-defined area of tenderness ov
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Pharmacology
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Pituitary Adenoma
pituitary adenoma
- Keywords:: Step 3, Medicine, Endocrine
- Related: 07 Pituitary Secretions
Gonadotrophs adnenoma
This patient has amenorrhea and hypogonadism with suppressed luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels but increased α-subunits. This is strongly suggestive of a nonfunctioning pituitary adenoma, which usually arises from the gonadotropin-secreting cells (gonadotrophs) in the pituitary gland. Normal
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Temporal Arteritis
temporal arteritis
- Keywords:: Step 3, Allergy and Immunology, Medicine
Temporal Arteritis
Temporal (giant cell) arteritis is a chronic vasculitis that affects **medium- and large-sized arteries **with a proclivity for the cranial branches of the arteries that originate from the aortic arch.
It is characterized pathologically by the presence of subacute granulomatous inflammation.
The inflammation is segmental
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Uveitis Conjunctivitis Keratitis
uveitis conjunctivitis keratitis
- Keywords:: Step 3, Medicine, eye disorders, conjunctivitis
Anterior uveitis (iritis) is characterized by pain, redness, variable visual loss, and a constricted and irregular pupil.
Most cases are due to an underlying infection (eg, AIDS) or systemic inflammatory disease. Manifestations typically include:
- Erythema at the limbus (junction of cornea and sclera)
- A constricted p
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Pain Management
pain management
1. Assess Pain
- Using functional status as a guide
- 30% improvement as function
Types of pain:
- acute vs chronic
- malignant vs non-malignant pain
- Somatic
- tissue damage, muscle, bone
- aching, deep, dull, sharp, stabbing
- localized
- Visceral
- gallbladder, intestines, liver
- crampy, pressure, bloating, nausea, vomiting, sweating
- referred
- Neuropathic
- cause: somatic/visceral coexisting, injury
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Emergency Medicine
emergency medicine
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Goals of Care
goals of care
- related: Medicine, palliative care, MOST form
- tags: #note
Quick Overview
- Introduction
- Always introduce yourself and the team before big family discussions
- Make sure burning questions to be answered
- Keep at top level, don't jump to answer specific questions in the beginning
- Assess emotion at each level. Don't proceed if you sense resistance or unnamed emotions
- Start with emotion, build rapport
- We can't imagine how h
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Medicare Medicaid
medicare medicaid
Medicare
Part A
- Qualification
- Pay into it with income for 10 years or spouse of
- 65 year and older
- ESRD
- Disabled
- Blind
- Benefit
- no premium
- inpatient stay
- home health
- SNF for 100 days max
- hospice
Part B
- Qualification: Part A
- Benefit
- outpatient visits
- cancer screening: labs, xray
- DME
- pays doctors no matter where
Part D
- Qualification
- premium, co pa
- Qualification
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Perioperative
Perioperative
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related: Medicine
Preoperative Laboratory Testing
Perioperative Medication Management
Perioperative medication management begins with eliciting a complete preoperative medication history, including her
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Treat End of Life Depression with Methylphenidate
treat end of life depression with methylphenidate
- related: Medicine, Psychiatry
Treat depression at the end of life with methylphenidate.
Methylphenidate is a rapid-acting psychostimulant that is well tolerated and effective in the treatment of depression at the end of life; results can be seen as quickly as 24 to 48 hours after initiation.
The most appropriate treatment for this patient's depression is methylphenidate. Patients with a serious, life-threateni
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OBGYN
date: 2020-09-07
OBGYN
OB
OB:
- Normal pregnancy
- Folic acid in pregnancy
- HPV and pregnancy
- Labor in Pregnancy
- Postpartum thyroiditis
- Infertility
- Infections in Pregnancy
- Choriocarcinoma
- Cervical insufficiency
- Abortions
- excercise in prenancy
- Peripartum Cardiomyopathy
- Seizure in pregnancy
- Rh Autoimmunization
- Thyroid in pregnancy
- [[Ectop
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Urology
Urology
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related: Medicine
This patient is most likely to have pain relief with testicular elevation (Prehn sign). His history and examination findings (erythema and swelling of the hemiscrotum; fever; tenderness to palpation near the epididymis; and lack of worsening symptoms, nausea, vomiting, and
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Bowel Regimens
bowel regimens
Strategy
- Start with Miralax and senna-docusate once a day each
- Avoid lactulose if bowel is in colon as they will just sit there, absorb water, expand, and cause perforation
- Use manual disimpaction if bowel in rectum
- Can use dulcolax or lactulose suppository
- Use suppository next
- Use enema last
- Lactulose enema does not cause perforation
- Avoid electrolyte enema in renal patients: milk of ma
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Sinus Tachycardia
sinus tachycardia
- related: Medicine, Cardiology, tachycardia
- tag: #note
Causes
- sepsis
- fever
- usually persistent
- volume
- Anemia
- Dehydration
- usually persistent
- stress
- Pain
- Anxiety
- ACS
- HF
- others
- Withdrawal
- Intoxication
- TSH
Inappropriate sinus tachycardia
- IST
- pt: women in 30s-40s
- elevated resting heart rate
- exaggerated increase with light activity
- decreased rate with sleep
- treatment:
- remova
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Ebm
ebm
- related: Medicine
- tag: #ebm
- ARRIVE: ASA doesn't work for primary prevention
- REDUCE-it: icosapent ethyl decreases mortality for pts on statin and has DM and ASCVD
Cardiology
- Empagliflozin in Heart Failure with a Preserved Ejection Fraction: empagliflozin reduces CV risk and hospitalization for heart failure patients with EF > 40 % with or without diabetes
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Enteral Feeding
enteral feeding
- related: Medicine, ICU
- tags: #note
- source: https://www.uptodate.com/contents/enteral-feeding-gastric-versus-post-pyloric
Types
- nasogastric: most preferred
- nasoduodenal
- nasojejunal
- PEG: percutaneous endoscopic gastrostomy. Consider if needed more than 4-5 weeks
- PEJ: jejunostomy
Types of feeding
- Bolus: patient in stable condition
- Continuous: less stable patient
Timing
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ICU
ICU
- related: vasopressors, Medicine
Medications
Physiology
ICU ID
Airway
- capnography
- The Walls Manual of Emergency Airway Management
- design features of modern mechanical ventilators
- [[ventilation strategies for ARDS includes low tidal volum
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Dermatology
date: 2020-09-07
Dermatology
- related: Medicine
MKSAP
- Approach to the Patient with Dermatologic Disease
- Therapeutic Principles in Dermatology
- Common Rashes
- Disorders of Pigmentation
- Drug Reactions
- Acneiform Eruptions
- Common Skin Infections
- Infestations
- Bites and Stings
- Cuts, Scrapes, and Burns
- Common Neoplasms
- Pruritus
- Urticaria
- Autoimmune Bullous Diseases
- [[Cutaneo
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Rheumatology
date: 2021-08-29
Rheumatology
- related: Medicine
- Approach to the Patient with Rheumatologic Disease
- Principles of Therapeutics
- Rheumatoid Arthritis
- Osteoarthritis
- Fibromyalgia
- Spondyloarthritis
- Systemic Lupus Erythematosus
- Sjogren Syndrome
- Inflammatory Myopathies
- Systemic Sclerosis
- Mixed Connective Tissue Disease
- Crystal Arthropathies
- Infectious Arthritis
- [[Systemic Vasculiti
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Dry Mouth Can Be Treated with Cevimeline or Other Muscarinics
dry mouth can be treated with cevimeline or other muscarinics
- related: Medicine
- tags: #note
Xerostomia (dry mouth) occurs in approximately 80% of patients undergoing radiotherapy for head and neck cancer. Most cases are transient but permanent damage can occur with large radiation doses, especially if no parotid glands are spared (the parotid glands account for >75% of saliva production). Complications include oral pain, dental carries, oral infections,
