(138 comments, 249 posts)
This user hasn't shared any profile information
Posts by FirstAid-RStigall
A 70-year-old man presents to the emergency department complaining of increased shortness of breath with minimal exercise, cough, and fatigue. These symptoms began 2 weeks ago and have progressed gradually. He reports he used to feel this way “all the time” years ago, but that this has not happened much since he began using his inhalers and his “water pill.” He also has a history of chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), coronary artery disease (CAD), diabetes mellitus, hypertension, and 30-pack-years of smoking. He denies swelling of the extremities, fever or chills, productive cough, chest pain, or palpitations. He cannot remember the names of his medications, but says he has not missed any doses. When asked about his diet, he says he has been eating more hot soup since the weather has gotten colder. His temperature is 37.5°C (99.5°F), blood pressure is 135/90 mm Hg, heart rate is 90/min, respiratory rate is 18/min, and oxygen saturation is 94% on room air. Examination of the neck reveals mild jugular venous distension. Examination of the lungs reveals loud crackles throughout the lung fields bilaterally. Examination of the heart reveals a laterally displaced point of maximum impulse with no murmurs, rubs, or gallops. There is mild clubbing of the extremities, as well as pitting edema of the lower extremities to the knee, bilaterally. His plasma brain natriuretic peptide level on rapid bedside assay is 500 pg/mL, and an x-ray of the chest reveals perivascular haziness, interstitial edema, and an enlarged cardiac silhouette.
The Electronic Residency Application Service (ERAS) is opening up the MyERAS website for residency applicant registration on July 1, 2012. This will mark the beginning of the ERAS 2013 cycle. You should receive an electronic token from your designated Dean’s Office in order to register on the MyERAS website. The following are important dates for ERAS (note: some of these have changed for the 2013 season):
The internal medicine shelf exam is the most important exam for medical students because it tests your knowledge of the most common medical concepts encountered on rotations such as cardiology, gastroenterology, hematology/oncology, rheumatology, pulmonology, neurology, nephrology, infectious diseases, endocrinology, and primary care medicine. These subjects obviously form a majority of questions and answers on shelf exams, but it’s important to develop core strengths in subjects most interesting to you by devoting extra effort and time to details that could increase scores. While it’s nearly impossible to predict what combination of questions your shelf exam will include, implementing the following study methods may help you get started, and with enough review, prepare you for the shelf exam.
By Haley Masterson
All Physicians Take Money
(Aortic, Pulmonic, Tricuspid, Mitral)
From left to right across your chest: A is the right upper sternal border (the second right interspace), P is the left upper sternal border (the second left interspace), T is the left lower sternal border, and M is the apex.
Congratulations! You’ve just taken Step 1. Or maybe you’re reading this post in advance of taking Step 1… Regardless, this is the attitude you should embody during the post-test waiting period. You’ve worked really hard to get to this point, so you should celebrate. Take some vacation time, if your schedule allows it. Even if it’s just a weekend getaway, you should reward yourself for all of your hard work by getting away from the places you associate with board study and maybe visit the friends and/or family you’ve probably been neglecting a little over the past several weeks. A little social time and relaxation can go a long way toward recharging your work ethic for your first clinical rotation, which most of you will likely begin before receiving your scores. Average reporting time is 3-4 weeks, tending more toward longer reporting times during the summer months (May – July). Keep an eye on the USMLE website for announcements regarding reporting delays, so you won’t worry about your score. We’ll try to post any announcements we see from the NBME on our website, as well.