Wards Survival Series – Approach to the Septic Patient

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By Michael Spinner

Sepsis is a commonly encountered problem in hospitalized patients that may progress to multi-organ failure, shock, and death if not recognized and treated promptly. In an effort to reduce sepsis-related mortality, the Surviving Sepsis Campaign was initiated in 2002 to establish annual evidence-based guidelines to assist in the early diagnosis and treatment of sepsis. This post reviews six of the most important diagnostic tests and therapeutic interventions recommended by the Surviving Sepsis Campaign when approaching the septic patient: (more…)

USMLE-Rx Step 1 Qmax Challenge #3408

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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).

USMLE-Rx Step 1 Qmax Challenge #3408A patient undergoing lung transplantation because of pulmonary fibrosis had his pressure-volume curves monitored throughout the operation. The following events took place in the operating room: (1) his right lung was resected, (2) the new right lung was transplanted, and (3) positive end-expiratory pressure (PEEP) was added to prevent pulmonary edema.

Which pressure-volume loop most likely represents the patient’s pulmonary function when the patient was being ventilated on one lung prior to the new lung being transplanted?

A. Loop A
B. Loop B
C. Loop C
D. Loop D

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Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 1 test bank. For more USMLE Step 1 prep, subscribe to our Flash Facts and Step 1 Express video series. Score the best deal on all three products with a Step 1 Triple Play Bundle.

First Aid / USMLE-Rx Fall Special

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Let’s Crash Course the Ebola Virus: Medical Student Edition

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By Joe Savarese

Lets Crash Course the Ebola Virus - Medical Student EditionUnless you truly have been living in a hole studying for exams, you have probably noticed that the media has run daily headlines about Ebola scares and fears of future epidemics. So I thought, as a medical student, what should I know about Ebola if a friend, relative, or patient asked for information? (or what if it showed on an USMLE exam?)

Here’s the crash course..

The Ebola Virus is part of the Filoviridae family, meaning it’s a helical single-stranded negative-sense RNA strand. (Remember a negative-stranded virus must carry with it a RNA-dependent RNA polymerase for infectivity).

Marburg virus is in the same class and is very similar to Ebola since both present as fatal hemorrhagic fevers. The Marburg virus has a natural reservoir in monkeys, while unknown in the Ebola virus, it is believed to be in bats. Most outbreaks of Ebola thus far have occurred in Sub-Saharan Africa such as Uganda and the Democratic Republic of the Congo. (more…)

Final Details for Your ERAS® Application as an IMG

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By Edison Cano

The ERAS® application is another crucial milestone of the journey that you started so long ago. In many of our home countries, we are not familiar with application processes, and some terms vary from our unique education systems. In this post, I want to highlight some details that could you may find useful.

Overall, the application process is very clear and well structured. If you have your ERAS® Token and you are finishing your application on the Electronic Residency Application Service (ERAS), the second website you’ll be using is the On-line Applicant Status and Information System (OASIS), where you will upload letters of recommendation (LORs), postgraduate training authorization letters (PTALs), transcripts, and medical student performance evaluations (MSPE).

Let’s highlight some features of the ERAS® website. There are several resources in the AAMC website for IMGs including the IMG application checklist and MyERAS® Residency User Guide. (more…)

USMLE-Rx Step 3 Qmax Challenge #31003

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Check out this Step 3 Qmax Question Challenge.

Know the answer? Post it in the comments 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).

USMLE-Rx Step 3 Qmax Challenge #31003An 88-year-old woman with mild dementia, hypertension, gastroesophageal reflux disease, hypothyroidism, and osteoarthritis presents to her primary care physician for evaluation of an unsteady gait. She and her family have noticed gradual worsening of her gait over the past year. She denies dizziness or lightheadedness and she has no pain. She says that she is not interested in cooking any more and mostly eats toast with jam and drinks tea or coffee. Her medications include hydrochlorothiazide, levothyroxine, acetaminophen, aspirin, and pantoprazole. Her vital signs are unremarkable. Her examination is most notable for mild conjunctival pallor, decreased proprioception in the toes, and a positive Romberg’s sign. Laboratory tests reveal a hematocrit of 29% and mean corpuscular volume of 108 fL. A peripheral blood smear is shown in the image.

Which of her medications is most likely exacerbating her anemia?

A. Acetaminophen
B. Aspirin
C. Hydrochlorothiazide
D. Levothyroxine
E. Pantoprazole

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Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 3 test bank. Get more Step 3 study help at USMLE-Rx.com.

USMLE-Rx Step 2 Qmax Challenge #21202

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Check out today’s Step 2 CK Qmax Question Challenge.

Know the answer? Post it in the comments 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).

USMLE-Rx Step 2 Qmax Challenge #21202A 32-year-old man with trisomy 21 presents with fatigue and swollen, bleeding gums for the past 5 days. He lives in a group home, and was formerly employed in a factory manufacturing hair products. He has smoked 1 pack of cigarettes per day for the past 15 years. He denies use of alcohol or illicit drugs. Physical examination reveals pallor, diffuse petechiae, oozing oral mucosa, and splenomegaly. Bone marrow aspirate reveals the type of cell shown in the image.

Which of the following risk factors contributed most to the development of the patient’s condition?

A. Age <40 years
B. Down’s syndrome (trisomy 21)
C. Exposure to Epstein-Barr virus in his home
D. History of smoking
E. Prior lead exposure

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Want to know the ‘bottom line?’ Purchase a USMLE-Rx Subscription and get many more features, more questions, and passages from First Aid, including images, references, and other facts relevant to this question.

This practice question is an actual question from the USMLE-Rx Step 2 CK test bank. Get more Step 2 CK study help at USMLE-Rx.com.

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