[Post a line you added to First Aid]

[perilou]

I thought it would be neat to see what other people are adding to their FA. I add something when I miss a question on USMLEWorld, or find it in another book and think it's important.

Open up to a random page and write down what you've added.

I'll start:

Vitamin A is of benefit to unvaccinated children w/ Rubeola (measles) virus.

---

Members don't see this ad.

 

[ACE Stimulator]

I thought it would be neat to see what other people are adding to their FA. I add something when I miss a question on USMLEWorld, or find it in another book and think it's important.

Open up to a random page and write down what you've added.

I'll start:

Vitamin A is of benefit to unvaccinated children w/ Rubeola (measles) virus.

Great Idea Perilou!!!!!
would you also include the pg. number and FA version. e.g. p368(2008).

I added:

Gerstman's Syndrome - damage the visual association cortex (angular gyrus)

• Inability to distinguish Left and Right
• Inability to identify fingers
• Writing disability (agraphia)
• Acalulia (lack of arithmatic knowledge)

 

[Cliff Huxtable]

I thought it would be neat to see what other people are adding to their FA. I add something when I miss a question on USMLEWorld, or find it in another book and think it's important.

Open up to a random page and write down what you've added.

I'll start:

Vitamin A is of benefit to unvaccinated children w/ Rubeola (measles) virus.

For less obvious notes like ths one, could you explain why?

 

[usmletoo]

tender loving care for nancy
pdh
alpha KG DH
branched chain ketoacid dh
transketolase- gives a sense of the degree of def

 

[perilou]

For less obvious notes like ths one, could you explain why?

Honestly I have no idea why. I was doing a question bank (an obscure one, not USMLEWorld) and this was the answer. Boy moves from Russia (ie. no vaccinations) and he develops a rash. What vitamin supplementation would be of benefit?

I thought it was pretty obscure, but I'll remember it. I put it on whatever page the info for Measles is.

 

[perilou]

tender loving care for nancy
pdh
alpha KG DH
branched chain ketoacid dh
transketolase- gives a sense of the degree of def

Hmm... Yeah okay we should post some sort of explanation if we wrote out short-hand notes. I can't decipher this

 

[MAK]

P 379 of 2008 FA

Cataracts: lens opacification caused be denaturation of lens protien, presence of white opacification, problem driving at night

why: bc i coudlnt find anywhere in FA where they talked about cataracts

P 381 of 2008 FA

So the nasal visual field or the temporal hemiretina does NOT cross at the optic chiasm, the only thing that crosses is the nasal hemiretina (or temporal visual field)

why: bc they didnt explain the physio behind the visual field defects

 

[Cliff Huxtable]

Microwaving foods causes a deacrease in B12 in them.

 

[igottaquestion]

Honestly I have no idea why. I was doing a question bank (an obscure one, not USMLEWorld) and this was the answer. Boy moves from Russia (ie. no vaccinations) and he develops a rash. What vitamin supplementation would be of benefit?

I thought it was pretty obscure, but I'll remember it. I put it on whatever page the info for Measles is.

Haha. Same scenario/answer in uworld question.

Microcards does indicate giving vit. A to severe cases in infants.

 

[fruitloops]

I'm proud that I made this one up myself and it was easy to remember during the test:

17-alpha-hydroxylase deficiency --> make salt
21-beta-hydroxylase deficiency --> make sex
11-beta-hydroxylase deficiency --> make sex and weak salt

Basically, I thought of the numbers as ages; the 17 year-old can only make salt; the 21 year-old adult can make sex hormone; the 11 year-old is spoiled and can make both weak salt and sex hormone without causing too much trouble. Of course, none of the three can make the cortisol.

 

[Svidrillion]

pg 264 (2009)

'lupus anticoagulants': antiphospholipids; these are only anticoagulant in vitro, but prothrombotic in vivo

 

[perilou]

p205 FA 2009

Prolonged TPN --> Lack of food through GI tract --> decreased cholecystokinin --> lack of gallbladder contractions --> gallstones (cholelithiasis)

 

[Cliff Huxtable]

p205 FA 2009

Prolonged TPN --> Lack of food through GI tract --> decreased cholecystokinin --> lack of gallbladder contractions --> gallstones (cholelithiasis)

I think you meant p.305

 

[Svidrillion]

pg 360(2009)

Sources of bone mets: prostate, breast, lung, kidney, GI, thyroid
Bone mets more common than primary tumors
Can be osteolytic (most common) or osteoblastic (prostate)

 

[perilou]

p358 FA2009

-Osteoclast differentiation - goverened by RANK-Ligand and M-CSF (both secreted from osteoblasts
-Osteoblasts also secrete OsteoProTegrin, a decoy molecule which binds Rank-Ligand

 

[nectarine]

p. 189 under protease inhibitors in HIV therapy

toxicity - PIs can cause fat redistribution to neck, abdomen, breasts. "buffalo hump".

 

[perilou]

p. 189 under protease inhibitors in HIV therapy

toxicity - PIs can cause fat redistribution to neck, abdomen, breasts. "buffalo hump".

That's a good one. I was surprised that lipid redistribution wasn't in there.

 

[nectarine]

That's a good one. I was surprised that lipid redistribution wasn't in there.

yeah, I remembered learning it from class and was surprised FA didn't have it, and seeing it again in Lippincott made me add it.

although there's a bunch of things I think aren't in FA and then I find them 2 days later in some random place. so who knows.

good thread idea

 

[Svidrillion]

although there's a bunch of things I think aren't in FA and then I find them 2 days later in some random place. so who knows.

That's a whole other thread: Lines that I added to my FA but than later found on another page. They should really cross-reference it at the bottom of the pages.

 

[joeylux]

That's a whole other thread: Lines that I added to my FA but than later found on another page. They should really cross-reference it at the bottom of the pages.

I found the first entry for that thread

pg 360(2009)

Sources of bone mets: prostate, breast, lung, kidney, GI, thyroid
Bone mets more common than primary tumors
Can be osteolytic (most common) or osteoblastic (prostate)

Page 219 (2009): Metastasis to bone

P.T. Barnum Loves Kids
Prostate, Thyroid, Breast, Lung, Kidney.

We'll have to incorporate GI into that somehow. P.T. Barnum Loves Good Kids (?)

 

[rahulb]

how about 'P.T Barnum loves groping kids'

 

[Slide]

FA2009 Pg. 449: Citrate: Can be used to chelate Calcium ion in urine. Decreased citrate may lead to kidney stones.

 

[igottaquestion]

how about 'P.T Barnum loves groping kids'

Well, now it can't get unstuck from my head . . .

 

[perilou]

p427 FA2009

troilism - engaging in sex in the presence of a 3rd person (type of paraphilia)

 

[hateroftheyear]

That's a good one. I was surprised that lipid redistribution wasn't in there.

In the 2009 edition, "lipodystropy" is listed as a PI side effect.

What they don't include to my knowledge, is that Ritonavir is a PI used in HAART not for its stated protease inhibition activity but because it also serves as a P450 inhibitor, thus amplifying the effects of the other drugs in the regimen.

Also, indications for HAART:
CD4<500/mm^3 or high viral load

And specific drug-toxicity relationships:
Didanosine (NRTI, ddI) -- Pancreatitis
Nevirapine -- Stevens Johnson (FA only says "Rash-NNRTIs")

Mnemonic for NNRTIs: They say "Never Ever Deliver Nucleosides" for Nevirapine, Efavirenz, Delavirdine, I prefer:

NEVada and DELaware are my FAVorite states.

Also made a note to myself about Efavirenz vs. Enfurvitide (sound similar, easy to confuse, the above mnemonic is also helpful in disambiguating).

 

[hateroftheyear]

2009 pg. 207

SargraMostim (GM-CSF) has worse side effects than Filgrastim (G-CSF) including first dose hypotnesion, muscle pain, dyspnea, syncope...

Filgrastim is most commonly bone pain and alopecia.

I don't want to ruin anyone's practice exam by including this tidbit, but believe me, you'll be surprised if/when you come across the question demanding it.

 

[hateroftheyear]

interatrial septum, right side, inferoposterior near the ostium of the coronary sinus

SA Node: also right atrium, but near SVC entrance in wall of right atrium

Conduction speeds:

AV node slowest overall (to allow proper ventricle filling)
Purkinje fastest
Atrial>ventricular in terms of conduction velocity

There is a chart with the shape and speed of each of the action potentials in the heart by cell type, but I don't think the latter point was appropriately emphasized and I got a question wrong in World as a result.

 

[ENThopeful]

That's a good one. I was surprised that lipid redistribution wasn't in there.

it is, "lipodystrophy"

 

[joeylux]

On page 288 my trick for remembering de Quervain's subacute thyroiditis vs. lymphocytic is "Vain's Grains of Pain."

De Quervain's is the painful variation and it also forms granulomas (grains).

 

[hateroftheyear]

Under Onc Pharm:

Cladribine is an adenosine deaminase mimic that inhibits purine synthesis through mimicry, treatment for HAIRY CELL LEUKEMIA.

Under COX stuff:
COX-2 inhibitors have recently been shown to possibly have some efficacy in prevention of colon cancer (wtf?)

Under cardiac pharm:
Nimodipine is a dihydropyridine type calcium channel blocker that is NOT used for typical dihydropyridine indications (to review, nifedipine: primary indications Raynaud's and Prinzmetal's Angina, also an alt to beta blocker + nitrate for stable angina, can be used for HTN most commonly in elderly blacks, also used off-label to delay labor rather than B2 agonists such as ritodrine, magnesium sulfate, or indomethacin)

Rather, Nimodipine is used to prevent vasospasm after subarachnoid hemorrhage, a life-threatening complication.

Source: UWorld Pharm and wikipedia (My gut instinct says this has a very low possibility of showing up on my exam, but there were entire questions devoted to it, so what the hell)

 

[hateroftheyear]

to aortic insufficiency, add:
Best heard sometimes if patient leans forward sitting up with breath held at end-expiration at the left lower sternal border

(and I think it's worth emphasizing on the diagram that the "Aortic Area" only corresponds to Aortic STENOSIS, whereas aortic and pulmonic regurg are best heard at the left steranl border near the 2nd ICS, as is the murmur of hypertrophic cardiomyopathy (FA2009 pg 245).

Also associated with pre-systolic "Austin Flint" murmur.

to mitral stenosis, add:
Best heard in left lateral decubitus position with bell of stethoscope (since it is a low-pitched, rumbling 'r' murmur).

To S3/S4, add:

S3 - Ken-tuck-y (lub dub-dee), occurs shortly after S2 (S1, S2-S3)
S4 - Ten-nes-see (dee-lub dub), occurs shortly before S1 (S4-S1, S2)
S3 and S4 - Gallop Rhythm (dee-lub dub-dee) (S4-S1, S2-S3)

To Mitral Valve prolapse, add Goljan's Favorite:
Increase Preload --> Click murmur occurs closer to S2 (more blood = more ejection time = more time for events of systole to occur before the prolapse occurs)
Decrease Preload --> Click murmur occurs closer to S1. Examples, standing up or increasing Heart Rate. Less Blood, Click happens earlier in systole.

 

[inspire316]

This is a great thread! Please keep them coming. I've annotated the crap out of my FA so I will add more in the coming days. . .

Pg. 360(2009): Osteoid osteoma - common finding on x-ray: radiolucent nidus surrounded by sclerotic bone. clinical finding: nocturnal pain alleviated by NSAIDs

pg. 367: Psoriasis: unregulated prolif. of keratinocytes.
Auspitz sign: extension of papillary dermis close to surface epithelium

 

[hateroftheyear]

"Porcelain" Gallbladder: bluish marbled appearance from calcifications, seen most commonly in overweight middle-aged or elderly females with history of gallstones, prophylactic cholecystectomy is recommended due to association with poor-prognosis gallbladder CA. This association is uncertain.

 

[perilou]

Small blue tumor under the nailbed = melanoma (S100 positive) or globangioma (tumor surrounding a vessel)

 

[Deferoxamine]

Found this in my FA this morning:

Retrograde travel is utilized by viruses that PHaRT:

P olivirus
H erpes
a
R abies
T etanus

Can be inserted into your First Aid in a variety of different spots as needed.

You're welcome.

 

[future_dr_house]

#1 DR

COP1 and Dynein are for Retrograde transport

if you know this then, you also know that COP2 and Kinesin are anterograde

 

[Guyton Killah]

I'm proud that I made this one up myself and it was easy to remember during the test:

17-alpha-hydroxylase deficiency --> make salt
21-beta-hydroxylase deficiency --> make sex
11-beta-hydroxylase deficiency --> make sex and weak salt

Basically, I thought of the numbers as ages; the 17 year-old can only make salt; the 21 year-old adult can make sex hormone; the 11 year-old is spoiled and can make both weak salt and sex hormone without causing too much trouble. Of course, none of the three can make the cortisol.

 

[kdburton]

"preggers chix at risk for hepatic ademoa --> maybe complicated by rupture"

 

[inspire316]

I'm proud that I made this one up myself and it was easy to remember during the test:

17-alpha-hydroxylase deficiency --> make salt
21-beta-hydroxylase deficiency --> make sex
11-beta-hydroxylase deficiency --> make sex and weak salt

Basically, I thought of the numbers as ages; the 17 year-old can only make salt; the 21 year-old adult can make sex hormone; the 11 year-old is spoiled and can make both weak salt and sex hormone without causing too much trouble. Of course, none of the three can make the cortisol.

this one is money seriously.

 

[satcool]

Pyrantel pamoate is useful as a secondary treatment for Enterobius, Ascaris, Necator. Pg. 160.

 

[llsprings]

this one is money seriously.

Although both 17alpha and 11beta both lead to hypertension, the causes are aldosterone, and 11-deoxycorticosterone, respectively.

 

[jeesapeesa]

FA 2009 p283

PTH --> osteoblast --> IL-1 --> osteoclast (resorption)

osteoporosis:
- estrogen keeps IL-1 in check but during menopause, decrease in estrogen cause increase in IL-1 --> increase in resorption

 

[HopefulDoc1984]

I found the first entry for that thread



Page 219 (2009): Metastasis to bone

P.T. Barnum Loves Kids
Prostate, Thyroid, Breast, Lung, Kidney.

We'll have to incorporate GI into that somehow. P.T. Barnum Loves Good Kids (?)

BLT with Ketchup and Pickle

 

[GotTheSikhness]

Hmm... Yeah okay we should post some sort of explanation if we wrote out short-hand notes. I can't decipher this

Tender Loving Care For Nancy = Thiamine, Lipoic Acid, CoA, FAD, NAD

Required cofactors for those enzymes