Alert Medical Series: Internal Medicine Alert I

By Ala Sarraj, MD

This series is a compilation of powerful high yield random notes and comparisons that will guarantee laser-sharp comprehensive and effective knowledge acquisition and high score passing rates in the fields of USMLE (US Medical Licensing Exam), Internal Medicine and Emergency Medicine boards.

• Language: English
• Publisher: Outskirts Press
• Release date: Oct 15, 2016
• ISBN: 9781478769484

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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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.

Alert Medical Series: Internal Medicine Alert I

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Copyright © 2016 Ala Sarraj, MD

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To My Mother

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.

• PNH (Paroxysmal Nocturnal Hemoglobinuria):

Non-immune hemolysis.

Dark urine in the morning.

Thrombosis: liver (Budd Chiari syndrome), mesenteric vein, CNS site.

• NPH (Normal Pressure Hydrocephalus):

1.Urinary incontinence.

2.Slow movements (bradykinesia).

3.Confusion.

( Wet, Wacko, Wobbly ).

• ARDS (adult respiratory distress syndrome) most common causes:

Sepsis.

Gastric content aspiration.

Trauma, burns, overdoses.

• PEEP (positive end expiratory pressure) should not exceed 20 cm H2O.

• Intrinsic PEEP (auto PEEP):

End expiratory intra pulmonary pressure.

Causes: obstruction, aggressive bronchodilation therapy, increased expiration time.

Auto PEEP should be minimized.

• Keep insp. Plateau pressure < 35 cc H2O.

• NIF (neg. insp. Pressure) < - 20 (normal: -100):

Impending respiratory failure.

• AC (assist control): the vent. delivers set tidal volume for all breaths including the patient’s.

SIMV (synch. Intermittent mandatory vent): the vent delivers set tidal volume to the back up breaths only excluding the patient’s.

• Autoimmune chronic hepatitis: piecemeal necrosis.

• Serum H. Pylori antibody test:

Used for screening.

Not affected by antacids.

• Urea breath test: most accurate.

30% false negative with antacids.

Antacids should be stopped x 2 wks, and antibiotics should be stopped x 3 wks before testing.

• SV (stroke volume)= cardiac output / heart rate.

=