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good going guys....i agree workhard...i am also planning to do two cases daily from uw ccs software and 2 cases from the read cases in world.
Also CCs is the scoring part too...if you do extremely good on CCS...it can pull off average performance on questions... as per couple of my friends given step 3 recently..
keep going guys
I am doing uw obgyn today.
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Workhard as you requested I'm posting some points in Neurology.
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Bullet points in Neurology
* CT before LP—Altered consciousness, focal neurological deficit, papilloedema, Seizures, suspected intracranial bleed.
* Raised Lymphocytes in CSF—viral meningitis
* Meningitis in HIV positives—Cryptococcus or Listeria.
* Listeria-Add Ampicillin to the usual combination of Ceftriaxone and Vanco
* Thousands of neutrophils in CSF- bacterial meningitis
* Meningitis with petechial rash—Neisseria meningitides
* H/O camping/hiking, meningitis and rash—Lyme’s disease, RMSF
* Tb meningitis— High CSF protein level, PCR for accurate diagnosis.
* Gram negative,pleomorphic coccobacillary organism—Haemophilus, Gram positive bacilli—Listeria.
* Swimmers in fresh water—Amoebic meningitis
* Fever with altered mental status—Encephalitis, Herpes is most common—HSV PCR in CSF for accurate diagnosis.
* Wernicke-Korsakoff syndrome—Alcoholic, Ataxia, Occulomotor disturbance, encephalopathy
* Vertigo without hearing loss/tinnitus—BPPV/ Vestibular neuritis
* Vertigo with tinnitus, hearing loss- Labyrinthitis/Meniere’s—Can be differentiated by duration of symptoms
* Headache with Aura—Migraine
* Headache with redness, tearing eyes, rhinorrhea—Cluster Headache
* Headache with jaw claudication—Temporal Arteritis
* Headache with papilloedema—Pseudotumor cerebrum
* Sudural Haematoma—present shaped
* Epidural Haematoma—lens shaped
* SAH—Headache, stiff neck, photophobia
* Stroke/TIA—CT without contrast first
* Thrombolytics—within 3 hrs, if late—Aspirin, Add Dipyridamol or switch to clopidogrel if new seizure on Aspirin
* Broccas Aphasia—problem with naming and repetition
* Wernick’s Aphasia—word salad, fluent but devoid of meaning
* Anterior cerebral art infarct—contralateral lower extremity weakness, urinary incontinence, personality changes
* MCA— C/L upper extremity weakness, eyes deviated to the side of lesion.
* PICA—loss of pain and temp to ipsilateral face and contralateral body, vertigo, Horner’s syndrome, dysphagia
* Basilar Art—Bilateral motor, No sensory, eye involvement
* Status Epilepticus—Lorazepam—>Repeat—>fosphenytoin—>Phenobarbital—>GA
* Absence/Petit-mal—Ethosuximide
* Lamotrigine can cause skin reactions.
* Parkinsonism—Anticholinergic for tremor alone in < 60 yrs, Amantadine—tremor alone in >60 yrs.
* Moderte to severe symptoms—Premipexole, Ropinirole
* Add COMT inhibitor to extend effect of Levodopa/Carbidopa.
* MCC of Dementia— Alzheimer’s—Slowly progressive memory loss
* Frontotemporal Dementia—Personality/behavioral problems
* Chorea, dementia, personality changes—Huntington’s disease
* Creuzfeldt-Jakob disease—Dementia with Myoclonus.
* NPH—urinary incontinence, Dementia, Wide based gait
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Samp2016--Keep it up! Let me know if you have any issues in obgyn.
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Are you doing mapping before uw cases?
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Yes I'll do mapping before UW CCS.
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Toxicology points:
ANTIDOTES
Acute mental status of unclear ethology—Naloxone, thiamine, dextrose
Heparin—Protamine
Warfarin—Vit K, FFP
tPA,streptokinase—Aminocaproic acid
Lead—EDTA, Dimercaprol, Succimer
Arsenic, gold, mercury—BAL
Copper-Penicillamine
Cyanide—Nitrite
Acetaminophen—N-acetylcysteine
Aspirin—NaHCO3
TCAs—NaHCO3
Ethylene glycol—Ehanol/Fomepizole
Methanol—Ethanol/Fomepizole
NMS—Bromocriptin, Dantrolene
Organophosphates—Atropine, Pralidoxime
Amphetamine—NH4Cl
Iron—Deferoxamine
Presentation:
Acetaminophen—Nausea, vomiting, hepatic failure 10 gm—toxic
Aspirin—Hyperventilation, metabolic acidosis, renal insufficiency, Elevated PT, confusion, fever
Carbon monoxide—shortness of breath, headache, lightheadedness, metabolic acidosis
Digoxin—GI disturbances, yellow halos , blurred vision, arrhythmia, hyperkalemia, encephalopathy
Ethylene Glycol—Metabolic acidosis with anion gap, renal insufficiency, hypocalcemia, kidney stones
Methanol—Metabolic acidosis with anion gap, visual disturbances
Methaemoglobinemia—Cyanotic with normal pO2
NMS—Raised temp, hyperkalemia, arrhythmia, confusion, elevated CPK
Opiate Toxicity—Respiratory depression
Organophosphates—Salivation, Lacrimation, Urination, Diarrhea, wheezing.
TCAs—Dilated pupils, dry mouth, constipation, Urinary retention, seizure, arrhythmia
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Read Toxicology section in MTB. Now I'll be doing Questions.
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PCP intoxication—Aggression, violent behaviour, acute psychosis, ataxia, nystagmus, myoclonus, seizure, coma, fever, hypersalivation
Coccaine withdrawal—Headache, hypersomnolence, depression, sweating, nightmares
Marijuana withdrawal—Irritability, tremor, Nystagmus, sweating, Nausea, vomiting, diarrhea
Heroin withdrawal—Anxiety,restlessness, lacrimation, salivation, diarrhoea, mydriasis, hypertension
Heroin Intoxication—hypotension, constipation, respiratory depression.
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