MRI is best to Dx suspected osteonecrosis (e.g., of hip). An individual who suffers severe traumatic injury should be given narcotics for pain relief regardless of addiction/abuse Hx. Tx of malignant otitis externa = intravenous anti-‐pseudomonals (e.g., ciprofloxacin) followed by oral therapy for 6-‐8 weeks of total Abx therapy. Echinacea causes anaphylaxis, especially high risk in asthmatics. Drugs that can cause HTN: ephedra (used for colds/flus and to increase energy), St John wort when with other serotonergic drugs (used for depression/anxiety and insomnia), and licorice (also causes hypokalaemia). Herbs associated with increased bleeding risk: Ginkgo biloba, ginsing, saw palmetto (likely platelet dysfunction), black cohosh, garlic, horse chestnut Ginkgo used for memory ginsing used for increased mental function saw palmetto used for BPH (also causes GI disturbance) black cohosh used for post-‐menopausal Sx horse chestnut used for venous stasis/insufficiency Herbs associated with hepatotoxicity: black cohosh, kava kava (used for anxiety/depression and insomnia). Apnea testing confirms brain death in individuals w/ absent cortical and brainstem reflexes. A monozygotic twin has a 50% chance of developing T1DM if his or her twin has it. A child has a 3% chance of acquiring T1DM if only his or her mom has T1DM, and 6% chance if the father has T1DM (difference not fully elucidated). A (+) ELISA on its own could mean persistent infection, cleared infection, or false (+). A patient with a (+) HepC antibody ELISA screen needs confirmatory testing for HCV RNA as the next best step. The abscess is in the sternocleidomastoid. Bezold abscess = neck abscess resulting from medial spread of mastoiditis. Verapamil, quinidine, amiodarone + spironolactone can all cause digoxin toxicity. Over the age of 30, mammogram and ultrasound is done. Ultrasound alone is done under the age of 30. Mammograms should be done every two years age 50-‐75.
Cephalohaematoma is associated with underlying skull fracture in 10-‐25%, there is no discolouration of the scalp, and it is not visible for several hours because of slow bleeding it self-‐resolves in two weeks to three months. Caput can be ecchymotic it presents soon after birth + self-‐resolves in weeks.
Caput succedaneum crosses suture lines cephalohaematoma does not. It is mandatory to report to patients only errors that have occurred. It is not mandatory to report near misses to patients. ‘Near-‐miss events,’ or medical errors caught before they reach the patient, must be reported to hospital administration. Reticulocyte count increases first, followed by Hb and Hct in one month. Do an FBC and give oral iron supplementation if anaemic. ‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐ Iron deficiency in an infant is often due to supplementing with cow/goat/soy milk under the age of 1, or exclusively breastfeeding after 6 months.
They are a random agglomeration of pearls that should serve as review and to fill in gaps for a student finishing medical school. These notes are not ‘bottom line statements’ nor are they meant to be unequivocally comprehensive in all subject areas. This document is a collection of HY notes from the USMLE World Step 3 question bank.