By Luke Murray
As I wrote about in my earlier posts, ‘The Avoidable Cycle of Self-Doubt’ and ‘Give Your Presentation Backwards’, I used to be confused about what I ‘should’ be doing on wards… presentation-wise. Most of the time, I tried to do what I thought they wanted or leaned towards what the textbook said to do, or I hedged my bets by giving more information instead of less, because I was concerned I’d leave something out. I used to read every lab value and every section of the H&P out loud because…that’s what it says in Bates.
The problem was: my presentations were painfully boring because 90+% of what I was saying didn’t matter. And I was spending so much effort and brainpower collecting and reporting every last bit of information that I didn’t have the time (and my team didn’t have the patience to help me) intelligently organize and share the most important part of the H&P – the Assessment and Plan.
None of the residents presented in the classic med student way. They just talked about their patient in a generally organized way. That’s it.
Now in my second year of residency, I’m doing the same. And it’s making me a better doctor.
For example, I had a patient come into the ED last night, he was tachypnic, had increased work of breathing, and I was working him up appropriately but starting to feel in over my head and stuck in a few places, so I called my attending.
This was my ‘presentation’: (more…)
Join us for a FREE Webinar on January 20th
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This high-yield talk from Dr. Tao Le, the series editor for First Aid, will cover the basics of the USMLE Step 1 including an overview of the boards, goal setting, high-yield topics in each subject area, study strategies, review
resources, and study schedules.
Stay with us after the webinar for a live, interactive Q & A session.
Title: First Aid for the USMLE Step 1 by Dr. Tao Le
Date: Tuesday, January 20, 2015
Time: 9:00 PM – 10:00 PM EST
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By Haley Masterson
Reading your first fetal heart tracing can be intimidating, but you will be a pro at interpreting accelerations, early decelerations, variable decelerations, and late decelerations once you read a few hundred of them. Until then, keep this mnemonic close at hand…
Love your First Aid book, but wish it was easier to use? We asked one of our blog authors, Luke Murray, to do a quick run-through of how to modify your First Aid book by unbinding, then rebinding, his own copy.
By Tim Durso
As someone who recently took Step 1, I can officially say that there is no way to properly emphasize how important it is to have a strategy in place for attacking questions with consistency. I DON’T EVEN THINK WRITING IN ALL CAPS IS ENOUGH!
In all seriousness, trust me when I say that developing a question taking strategy is a key component to success on test day. Now, I know what you might be thinking, “Tim, I’m in medical school. I can read. Questions have words. Mad reading skillz + words + medical knowledge = 280+ no problem.” My first reaction is… do you always read blog posts with this much internal monologue sass? My second reaction is to point out that, if that were true, then the Step 1 average would be higher than the 230 it currently is. What will follow is my general outline for approaching each and every question I come across, Step or otherwise. (more…)
By Mark Ard
“Napkin drawing” is a term that describes diagrams that literally look like they were drawn on a napkin, devoid of proper axis labeling and/or not entirely reflective of real observations. They serve to highlight a few key concepts without getting bogged down in the details.
Loops tend to make for good napkin drawings (see episode 1). Now technically these images have axes, but the key here is that the actual contours are basically freehanded, poorly. Their shape, however, tells a story about what’s going on in the lungs.
Let’s work our way counter-clockwise around a normal lung first. A patient begins at maximal exhalation, the rightward most point on the loop (Residual Volume, if you’re trying to memorize all the different lung volumes). They inhale to their Total Lung Capacity, the far left point. As they switch from inhalation to exhalation, they cross the zero flow line and start exhaling. To start, the patient is in the “effort dependent stage” as their expiratory rate increases to 8L/s. Then the force becomes “effort independent” as their flow rate decreases until they finally poop out. (more…)
Check out today’s Step 1 Qmax Question Challenge.
Know the answer? Post it below! Don’t forget to check back for an update with the correct answer and explanation (we’ll post it in the comments section below).
An 18-year-old college student presents to the student health clinic with a complaint of copious yellow vaginal discharge. She has been sexually active with a new partner for the past month, but she is unsure if her partner is monogamous. A speculum examination reveals petechiae in the upper vagina and malodorous, yellow-green discharge. A potassium hydroxide preparation reveals no organisms, and results of phase contrast wet mount microscopy are shown in the image.
Which of the following is the most appropriate treatment?
A. Treat her and her partner with oral fluconazole and test for other sexually transmitted diseases
B. Treat her and her partner with oral metronidazole and test for other sexually transmitted diseases
C. Treat her with oral fluconazole and test for other sexually transmitted diseases
D. Treat her with oral metronidazole and test for other sexually transmitted diseases
E. Treat her with vaginal fluconazole and test for other sexually transmitted diseases
F. Treat her with vaginal metronidazole and test for other sexually transmitted diseases
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