A Question to All Medical Geeks

Did somebody figure out how to use the online version usmleworld question bank simultaneously with other programs or webpages. What I mean is, that usmleworld use java script and during the time it is running nothing else can be opened. So, every time you want to check something online or to look up your pdf books, you have to close usmleworld and than you will be able to see what you want. It’s a waste of time. Any ideas?

PS: I use a laptop and desktop at home, but when I go to the library I can’t bring the desktop, obviously.

 

Phreno and The Medical Students on Low Budget

I stumbled upon this website 1 week ago and I was like, “Wow, this guy phreno is the king of medwarez”. Very good stuff on one place. And the website is kind of great too, not like some of the others I’ve seen around. You can tell, Phreno is doing excellent job. The whole this downloading thing is also very convenient. You just go online and download whichever book you need.

There is only one problem: the information overflow. I always say to myself,”It’s not that important how many books you have on the shelf, but how much knowledge you got in your head”. I know people who constantly buy new medical books and finally end up confused which one is good and which one to use for the exams. For step 1, I picked very carefully the books I really need for this particular exam and use only them, nothing else.

I don’t usually present warez on USMLEMD. This phrenorrhagetx is the only one exception. Enjoy!

 

Usmle Step 2 Ck Preparation, How to get a good score

There are thousands of “How to get 99″, “How to ace on USMLE”. For step 2 CK I particularly like this one, which is the closest to my understanding of the preparation for step 2 CK. I found it on ayubians.com, written by ReZ. Here it is:

My preparation for USMLE Step 2 CK was somewhat less dramatic, less intense and less varied than step 1. However if you sit for the preparation after giving step 1 it is still tiring. The first thing is that there are not a lot of good books as options for studying step 2. Almost everyone studies the Kaplan series with some additions. The books I used were:

 

Do You Like Coffee and If the Answer is Yes, How Many Do You Have Per Day

I love coffee!

I cannot imagine myself studying without coffee. Fortunately, in Gerstein library bringing coffee inside the library is allowed, not like in some other places.

My favorite brands starting with the most favorite are:

1. Starbucks-unbeatable. The best coffee!

2. Second cup-only good if Starbucks is not available.

3. Dokidok’s coffee-this is the coffee I make at home. I bought a cheap coffee maker for $11 from Walmart. That was 4 years ago and I am still using it. The coffee is not that great, but it is better than Tim Hortons. In terms of price, Dokidok’s coffee has the best price. I usualy use Nabob coffee, which costs about $5.

4. Tim Hortons-don’t like it. It is too watery for my taste.  They call it coffee for suburban people and construction workers (no offence here). I buy it very rarely, if there is no other choice.

I try not to drink more than one coffee a day. If I really feel like having a second one, I usually drink decaffeinated. OK, I just finished with one block of the UW Q-bank and now I am going downstairs to get my Second cup coffee. Starbucks is too far.

 

Workforce Experts Share Their Perspectives on Physician Shortage Crisis

Edward Salsberg, M.P.A., Associate Vice President, Association of American Medical Colleges (AAMC), and Jean Moore, M.S.N., Director of the Center for Health Workforce Studies (CHWS) at SUNY Albany, addressed conference participants regarding the national and state physician shortages.

Mr. Salsberg talked about the fact that the physician population is aging and retiring at a time when the baby boomers will need more health care. AAMC has recommended a 30% increase in the number of physicians by 2015 by not only increasing the number of slots at medical schools but also increasing graduate medical education (GME) to accommodate the increase. Diversity in medicine and geographic distribution are important in the growth of the physician population. He indicated that primary care as well as other specialty positions are in demand. He spoke about our country’s strong reliance on international medical school graduates (IMGs) as a vital source in a period of international uncertainty. He also cited a decrease in the number of U.S. physicians who are specializing in family medicine, internal medicine, OB/GYN, and pediatrics with the opposite being true of IMGs. Read the rest of this article>>>

[hanys]

 

Lung Sounds

It has always been difficult for me to distinguish the different types of lung sounds. So, I started collectiong information and soon I will try to update this post. Until that time I want to present two websites where you can listen and get the idea of the lung sounds. Click on the pictures below:

 

Blue-Gray Centrofacial Hyperpigmentation

A 68-year-old man presented to a university dermatology department with an asymptomatic blue-gray discoloration of the centrofacial region. Physical examination revealed a blue-gray hyperpigmentation of the forehead, cheeks, nose, malar regions and chin (see the accompanying figure). The medical history revealed that the patient was diagnosed with ischemic dilated cardiomyopathy two years previously and was resuscitated from a syncopal episode associated with sustained ventricular tachycardia that was refractory to quinidine, disopyramide phosphate and procainamide. Results of routine laboratory tests were normal. A 3-mm punch biopsy specimen showed normal epidermis and a perivascular deposition of yellow-brown pigment within microphages in the dermis.

Question
Which one of the following is the correct diagnosis, given the patient’s history, the physical and skin biopsy findings?

A. Actinic lichen planus.

B. Hemochromatosis.

C. Amiodarone-induced hyperpigmentation.

D. Ashy dermatosis (erythema dyschromicum perstans).

For the answer visit ffap.

Actually I have seen a patient with this hyperpigmentation and it is very distinguishing feature of the disease. If you see it once, you can’t forget it.

 

How to Beat the Breath Test

 

Osler Nodes vs. Janeway Lesions

The differences between these two cutaneous presentations of Infectious endocarditis have always been a bit tricky for me. Finally I decided to solve that problem and here it is:

Osler nodes: Osler’s nodes (painful, palpable, erythematous lesions most often involving the pads of the fingers and toes). Caused by immune complexes (they want you to know that for Step 2). Infectious endocarditis and Roth spots are also due to immune complexes–>immune vasculitis.

Janeway lesions (nontender, macular lesions most commonly involving the palms and soles). Janeway lesions occur more frequently in endocarditis caused by Staphylococcus aureus. Janeway lesions are caused by septic emboli. Subcutaneous abscesses are found on histologic examination.

We can add to the picture and splinter hemorrhages aka fingernail hemorrhage: narrow, red to reddish-brown lines of blood beneath the nails. They run in the direction of nail growth and are named splinter hemorrhages because they look like a splinter beneath the fingernail. The hemorrhages may be caused by tiny clots that damage the small capillaries under the nails or by vessel damage from swelling of the blood vessels (vasculitis). [medlineplus]

The most common cause for splinter hemorrhages is trauma to the nail. [umm]

PICTURE (Credit Children’s Hospital Boston): The lesions in Figures A-C were tender and represent Osler’s nodes, while the lesion in Figure D was nontender and represents a Janeway lesion.

For more pictures showing the differences between Osler Nodes and Janeway Lesions visit er119test.

 

Endovascular Aortic Aneurysm Repair

Yesterday I had a patient in the CVICU who had this procedure done, and that’s why I decided to post it in the category medical video of the week.