Deep Vein Thrombosis Risk Factors

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By Joe Savarese

Deep Vein Thrombosis Risk FactorsThe other day, while I was procrastinating from studying the intricacies of congestive heart failure, I pulled out my phone to browse social media and news outlets for something exciting (don’t judge, we all are pros at this). I came across an article about famous NBA Miami Heat basketball player, Chris Bosh, who recently suffered a blood clot that travelled to his lungs. While much has not been released about the origin of his blood clots, we know he likely experienced a deep vein thrombosis (DVT) that travelled to his lungs causing a pulmonary embolism (PE). Like a good medical student, this brought me back on track to challenge myself regarding the major risk factors of DVTs, as well as common clinical presentation and appropriate work-up.

Let’s start with the risk factors. You may already be familiar with Virchow’s triad (endothelial injury, venous stasis, and hypercoagulability), which serves as the mechanism that puts patients at an increased risk for DVTs. Here is a mnemonic to summarize the key risk factors, appropriately titled CHRIS BOSH. A more detailed list of other risk factors can be found on Medscape’s website (DVT Etiology and Risk Factors). (more…)

Deliberate Practice: Optimizing Your Studying

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By Mark Ard

Consider two students during their month of dedicated Step 1 study time.

Student A wakes up at 8 a.m. after two hours of snoozing (no one wakes up at six if they don’t have to). He eats, gets ready, and starts working at 8:30 a.m. He reclines on the couch and starts reading where he left off in First Aid, highlighting all the bold topics. When he doesn’t understand something, he checks Wikipedia. He isn’t really learning anything, so he stops at 9:30 a.m. (it’s been getting progressively sooner). He watches a show, checks Facebook, falls asleep. Ok it’s noon. “I’ve worked for four hours.” He eats. Opens a Q-bank in tutor mode. If he gets a question wrong, it’s a stupid question. If he gets it right, he pats himself on the back. Ouch, 40% block. “They’re just testing minutiae.” He then does another block while watching TV (30%, but it’s ok, he was distracted). Then reads First Aid while watching more TV. Goes to bed at 10 p.m., so he can wake up at 6 a.m.

Student B wakes up at 8 a.m.. She gets ready, eats, and starts working at 9 a.m.. She checks her calendar. Flash cards first, a fan of the Leitner system. At 9:30 a.m., she checks her reading plan. First Aid, with supplemental images/explanations from her course textbooks. She hates reading, so she only reads for 25 minutes, then goes outside for five minutes. A follower of the Pomodoro technique. She carries on this way until noon, eats, and starts a Qbank block at 1 p.m. It takes 2.5 hours to go through the block and review each answer, right or wrong. She annotates key points into First Aid. She makes flashcards for need-to-know facts she struggles with. She finishes at 6 p.m.. She goes to the gym and exercises for a bit, then eats and meets with a friend at 7:30 p.m. They watch some review videos together, phones off and away, pausing when they seem distracted. She finishes at 9 p.m. She goes home, showers, and then looks over her Qbank results to plan what to focus on for her “catch up” day. She looks over her plan for the next day, organizes her stuff, cleans up a bit, then sits down to watch some TV. Bright lights off at 11 p.m. Sleep by midnight. (more…)

“Reading First Aid is the Perfect First Date” – MCG 2017 – Med School Lifestyle (Study)

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We love this video from:

Medical College of Georgia Class of 2017

Got a video you’d like us to feature? Let us know by emailing a link to submissions@usmle-rx.com

USMLE-Rx Step 2 Qmax Challenge #21516

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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 2 Qmax Challenge #21516A 32-year-old G1P1 woman presents to an outpatient gynecology clinic with a complaint of stale, white vaginal discharge for the past 4 days. She is sexually active with a monogamous partner of 8 years. She denies vaginal spotting, genital pruritus, or dysuria. A vaginal speculum examination reveals a copious amount of malodorous, grey-white discharge. A sample is obtained, and on potassium hydroxide preparation a strong fishy odor is detected. A photomicrograph is shown in the image.

Which of the following is the optimal treatment for this patient?

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
D. Treat her with oral fluconazole and test for other sexually transmitted diseases
E. Treat her with oral metronidazole
F. Treat her with oral metronidazole and test for other sexually transmitted diseases

———————–

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.

How to Succeed on the Pediatric Clerkship

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By Mark Ard

I spent hours searching the internet, combing blogs, and harassing 4th years to figure out how to tackle my first rotation. Below is what worked for me to honor the course.

Apply these tips as you will…

  • Get a decent-sized review book. Something like First Aid for the Wards is great for the big picture, but when you’re on a specific rotation, you want something a bit beefier. First Aid for the Pediatric Clerkship at 600 pages on an eight-week rotation was tough, but that’s the length I’d suggest. Boards and Wards, Toronto notes, Kaplan Lecture Notes… There are a ton of rotation-specific review books.
  • Find a comprehensive source. Ask your attending/resident what they use. We are talking 1,000+ page range. Harriet Lane Pediatrics was what I used, but check your library or online access list to see if you get any for free. Also, use the one in your clinic, on the ward, or at the library. Basically never carry it more than 10 feet.
  • Get quality digital references. UpToDate, Epocrates, Medscape, etc. Download them to a tablet. Use a tablet, not a phone. People think you’re texting on a phone, but you must be learning on a tablet.
  • Use journals. Ask your attending/resident. Never pay for access. Use what your school offers. We had Pediatrics In Review, and it was a great resource. See the post I wrote about using Evernote on the wards.
  • Get multiple-choice questions. There are plenty of Q&A books and online banks like USMLERx, Kaplan, UWorld.
  • Get a casebook. You want your prototypical patient who presents classically. Some schools subscribe to case programs like Med-U that are awesome but can be time consuming.

(more…)

Mnemonic Monday: The Krebs Cycle

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By Haley Masterson

Mnemonic courtesy of First Aid for the USMLE: Step 1

USMLE-Rx Step 2 Qmax Challenge #21515

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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 2 Qmax Challenge #21515A 42-year-old G2P2 obese woman is seen at an outpatient gynecology clinic with a 2-day history of thick, curd-like white discharge with intense vaginal swelling, burning, and itching. She has required treatment for similar symptoms four times in the past 2 years. A speculum examination reveals thick, white cottage cheese-like vaginal discharge and erythematous vaginal mucosa. Gram stain of a sample of the discharge is shown in the image.

Which of the following would predispose the patient to recurrence of these symptoms?

A. Cervical neoplasia
B. Diabetes
C. Herpes simplex virus infection
D. Hypercholesterolemia
E. Multiple sexual partners
F. Unknown HIV infection

———————–

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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