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    Alert Medical Series: USMLE Alert I, II, III
    Alert Medical Series: USMLE Alert I, II, III
    Alert Medical Series: USMLE Alert I, II, III
    Ebook232 pages2 hours

    Alert Medical Series: USMLE Alert I, II, III

    By Ala Sarraj, MD

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    About this ebook

    Alert Med Series 

     

    Medical students, residents, physician assistants, nurse practitioners and physicians: shorten your knowledge acquisition, test prep, and study time by months with this series of medical study guides. Choose from USMLE I, II, III; Internal Medicine I, II, III; and Emergency Medicine I, II, III.

     

    Simulating flash cards, this series is full of well thought out laser-sharp, updated, and edited comprehensive notes by Ala Sarraj, MD. 

    Over the years, Dr. Sarraj has developed a unique study style for quickly and successfully gaining and retaining medical knowledge.

     

    Supplement your notebooks or smart phones with this study series. The Alert Med Series offers a concise, straightforward, and efficient approach and a high yield.

    LanguageEnglish
    PublisherOutskirts Press
    Release dateNov 21, 2023
    ISBN9781977268112
    Alert Medical Series: USMLE Alert I, II, III
    Author

    Ala Sarraj, MD

    The Author:  Ala Sarraj, MD, American board certified in Emergency Medicine and Internal Medicine. He graduated from Damascus Univ. Med. School / Syria. Trained at Georgetown Univ. Dept. of Medicine / DC General hospital, Washington, DC, and Rush Univ. Med. center / Chicago. Dr. Sarraj is a full time emergency medicine physician in Chicago metropolitan area since 1991. The Editor:  The series was reviewed and edited by Maggy Shamekh, MD. A graduate, residency trained and holding masters degree of family medicine from Cairo Univ. Med. School / Egypt. Performed collaboration research work between Cairo Univ. cancer institute and MD Anderson cancer center, Houston / Texas. Worked for the WHO for the eradication of polio in the Middle East. Dr. Shamekh is a diplomat in health care quality management from the American Univ. / Cairo.

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      Book preview

      Alert Medical Series - Ala Sarraj, MD

      Alert Medical Series

      USMLE Alert I, II, III

      All Rights Reserved.

      Copyright © 2024 Ala Sarraj, MD

      v2.0

      The opinions expressed in this manuscript are solely the opinions of the author and do not represent the opinions or thoughts of the publisher. The author has represented and warranted full ownership and/or legal right to publish all the materials in this book.

      This book may not be reproduced, transmitted, or stored in whole or in part by any means, including graphic, electronic, or mechanical without the express written consent of the publisher except in the case of brief quotations embodied in critical articles and reviews.

      Outskirts Press, Inc.

      http://www.outskirtspress.com

      Cover Photo © 2024 www.gettyimages.com. All rights reserved - used with permission.

      Outskirts Press and the OP logo are trademarks belonging to Outskirts Press, Inc.

      PRINTED IN THE UNITED STATES OF AMERICA

      PREFACE

      Alert Medical Series is a compilation of powerful random high yield notes and comparisons that will guarantee comprehensive and effective knowledge base and high score passing rates in the fields of USMLE (US Medical Licensing Exam), INTERNAL MEDICINE and EMERGENCY MEDICINE boards alike.

      It reflects years of revision and update that will save medical students, residents and physicians measurable time of test prep and knowledge acquisition.

      Alert Medical Series will serve you like multitude of pixels creating very high resolution and sharp picture.

      The USMLE series notes (basic and clinical) were put in a random manner mixing basic and clinical notes to simulate real life knowledge building and to reflect the future trend in USMLE testing to combine clinical science and the clinically based basic science.

      Table of Contents

      Dedication

      Preface

      Alert Medical Series USMLE Alert I

      Alert Medical Series references:

      Abbreviations

      Alert Medical Series USMLE Alert II

      Alert Medical Series references:

      Abbreviations

      Alert Medical Series USMLE Alert III

      Alert Medical Series references:

      Abbreviations

      Alert Medical Series

      USMLE

      Alert I

      Reye’s syndrome: typical findings:

      In brain: high voltage, slow wave.

      In liver: microvesicular steatosis.

      Stages:

      Stage 1: lethargy, vomiting.

      Stage 2: hyperventilation, delirium.

      Stage 3: decorticate posture.

      Stage 4: decerebrate posture.

      Stage 5: seizures, flaccidity, respiratory arrest.

      Celiac sprue:

      Increased 5 HIAA (5 Hydroxyindoleacetic acid) in the urine.

      Abnormal D- Xylose absorption.

      Biopsy is diagnostic.

      Tenia versicolor:

      Recurrence is common because MF (Malassezia Furfur) is part of the normal flora.

      Pinpoint pupils OOPS :

      Opiate overdose.

      Organophosphate poisoning.

      Pontine hemorrhage.

      Sarin gas exposure.

      Phrenic nerve is resistant to hyperbaric spinal anesthesia (no respiratory paralysis).

      Tendency to tetany increases when the following ratio increases:

      HCo3 x HPo4 / ca x Mg x H

      All in ionic form.

      Teratomas are cystic whereas hamartomas are cartilage like.

      No dissecting aneurysm in calcific medial sclerosis (Monckeberg’s disease).

      Prevalence is useful in chronic diseases.

      Birth rate: incidence.

      Birth defect rate: prevalence.

      Sensitivity and specificity:

      Sensitivity = a/a + c

      Specificity = d/b +d.

      The same results with repeating test:

      Reliability (precision).

      Validity = accuracy.

      The basic characteristic of incidence type rates is TIME.

      Standard deviation measures and indicates dispersion.

      Highly sensitive = few false negative.

      Puberty is marked by:

      Thelarche.

      Adrenarche.

      Menarche.

      Growth spurt.

      Furosemide is of choice when GFR < 25 ml/ min.

      Hydralazine is usually avoided in coronary artery disease.

      The following parameters indicate the need for mechanical ventilation:

      Respiratory rate > 25/ min.

      Tidal volume < 5 ml/ kg.

      Vital capacity < 1 liter.

      PEEP (positive end expiratory pressure) is most effective in ARDS (adult respiratory distress syndrome).

      In CO poisoning:

      Arterial Po2 is usually normal.

      In angina pectoris: no syncope is reported yet.

      Empyema: toxicity after improvement is noted.

      SalicyLates interfere with carbohydrate metabolism, leading to ketosis.

      It uncouples oxidative phosphorylation.

      Compare:

      Pellagra:

      Dermatitis.

      Diarrhea.

      Dementia.

      Hepatitis B virus does NOT cross the placenta.

      Twin to twin transfusion: difference in hemoglobin more than 15%.

      Neonatal jaundice:

      Pyloric stenosis: can lead to jaundice (indirect hyperbilirubinemia).

      Bile related enteropathy (like resection, Crohn disease): leads to fat and calcium malabsorption, which leads to increased oxalate absorption and hence oxalate kidney stones.

      Ulcerative colitis involves the colon only.

      Cystic fibrosis: Salty taste when kissed!

      Nasal polyps.

      Compare:

      Meconium obstruction: leads to microcolon / disuse colon.

      External steroids: leads to decreased ACTH production, which leads to decreased blood flow to the adrenals then atrophy.

      With steroids withdrawal: increased ACTH but no steroid reserve in the atrophic gland.

      Korsakoff encephalopathy:

      Alcoholism + ophthalmoplegia + ataxia.

      Complete heart block, atrial flutter: regular rhythm.

      Click- murmur syndrome: mitral prolapse.

      Restrictive lung disease:

      Decreased Po2 / Pco2.

      Decreased lung volumes.

      Normal FEV1/FVC.

      Paget’s disease is the most common cause of an isolated increase in Alk.phos. level.

      Atrial septal defect does not need antibiotic prophylaxis.

      An individual’s erythrocytes express A antigen only (group A), B antigen only (group B), neither antigen (group O), or both A and B antigens (group AB).

      An individual’s plasma contains antibodies against the A or B antigen that are not present on one’s erythrocytes.

      Rh antigens are transmembrane proteins that are present on erythrocytes.

      One of these antigens, the Rh(D) antigen, is highly immunogenic and induces IgG anti-D antibody formation in most Rh(D)-negative individuals exposed either from pregnancy or the transfusion of Rh(D)-positive erythrocytes.

      Pre-transfusion compatibility testing begins with typing (ABO/Rh determination) and screening (detection of non-ABO antibodies).

      If a patient needs an emergency transfusion, group O erythrocyte units and group AB plasma units are used until the ABO/Rh type is determined.

      Group O erythrocytes can be transfused to anyone, because there are no A or B antigens on these cells to react with anti-A or anti-B hemagglutinins.

      Similarly, group AB plasma can be transfused to anyone because it contains no hemagglutinins to react with A or B antigens.

      Rh positive patients can safely receive either Rh(D) positive or Rh(D) negative blood.

      But Rh negative patients must receive Rh(D) blood to avoid alloimmunization.

      This is a concern in women of childbearing age to prevent formation of anti-D antibodies, leading to severe hemolytic disease of the newborn.

      Metabolic alkalosis widens anion gap esp. with dehydration which will increase the negative charged proteins.

      Multiple myeloma proteins are + charged, which leads to decreased anion gap.

      Severe hypoxia and respiratory alkalosis marks COPD with pulmonary embolism.

      Exercise induced asthma is caused by heat loss.

      Airway cooling can be prevented by Cromolyn Na.

      In renal failure:

      Ascites: on exam there is + fluid wave and shifting dullness.

      Pulsus paradoxus: a decrease in systolic pressure more than 10 mhg during inspiration.

      Normally it is less than 10 mhg.

      Salmonella is the most common cause of food poisoning.

      Causes of extroverted umbilicus:

      Ascites, mass, umbilical hernia.

      Compare:

      In diabetes the ileus results from visceral autonomic neuropathy.

      Increased bilirubin:

      In Gilbert: decreased hepatic uptake.

      In Crigler Najjar: decreased hepatic conjugation, similar to physiologic jaundice.

      Grey Turner sign (bruising of the flanks):

      Hemorrhagic pancreatitis.

      Mesenteric ischemia.

      Strangulated hernia.

      Phlegmasia alba dolens: painful white edema in DVT.

      Phlegmasia cerulea dolens: painful bluish edema of DVT.

      Childhood nephrosis: decreased excretion of free water leads to very concentrated urine.

      In SLE there are 5 types of nephritis:

      Mesangial.

      Focal proliferative.

      Diffuse proliferative.

      Membranous.

      Interstitial.

      Nephrotic edema: pitting and shifting with position.

      Proximal tubular acidosis: normal anion gap + hyperchloremia.

      Hemolytic uremic syndrome:

      Sporadic.

      Familial.

      The diagnosis of traumatic disruption of the pancreas would be confirmed by laparotomy.

      Tay Sachs disease: loss of Hexosaminidase activity in white blood cells.

      Asymmetric crying face: hypoplasia of triangularis

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