Medicine MCQ Test Series 1
This Medicine MCQ Test Series contains 20 questions which can be attempted over 40 seconds each. After submission, answers and discussion will be displayed. Medicine MCQ Test Series 1 Time limit: 0 Quiz-summary 0 of 20 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Information ...
Source: Cardiophile MD - January 27, 2019 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Medicine MCQ - CVS Source Type: blogs

Funtabulously Frivolous Friday Five 261
Just when you thought your brain could unwind on a Friday! Time to GUESS THE DISEASE challenge for Funtabulously Frivolous Friday Five 261 The post Funtabulously Frivolous Friday Five 261 appeared first on Life in the Fast Lane. (Source: Life in the Fast Lane)
Source: Life in the Fast Lane - November 30, 2018 Category: Emergency Medicine Authors: Neil Long Tags: FFFF antiphospholipid syndrome APS Benjamin Sacks Catastrophic APS Cyclophosphamide Emanuel Libman endocarditis Glucocorticoids IVIG Libman-Sacks endocarditis Livedo reticularis plasma exchange Salmonella shrinking lung syndrom Source Type: blogs

Thoughts on a 23-year-old athlete dying from the Lemierre Syndrome
K-State football team to honor rower Samantha Scott, who died of Lemierre’s Syndrome  Every time I read such a story my heart breaks, a small piece each time. More physicians have become aware of the Lemierre syndrome. We must also educate patients and families that sore throats in adolescents and young adults can become life threatening. Why did she die?  The article does not have enough detail to develop a firm conclusion.  I can speculate on several reasons from multiple discussions with both survivors and families of adolescents who died.  We also have some unpublished survey data that informs...
Source: DB's Medical Rants - November 3, 2018 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

Is cardiac valves really (a)vascular structures ?
Though heart is known primarily as a pump, it is the four cardiac valves that ensures the critical , non-stop unidirectional flow that sustain the circulation . It is to be recalled these valves originate in the very early days of cardiac development when the primitive heart tube loops , even as the chambers expand from primitive ventricle. Mesenchymal differentiation controlled by various genes that cleaves the valve from myocardial tissue. While heart by itself is the supreme vascular organ ,  its surprising  few structures inside the heart , like the valves are quiet avascular ( or is it really so ?)...
Source: Dr.S.Venkatesan MD - October 18, 2018 Category: Cardiology Authors: dr s venkatesan Tags: cardiac embryology Embryology : Heart valve development Infective endocarditis : Pathology valvular heart disease blood supply to heart valves hematogenous spread of infective endocarditis how bacteria reach mitral valve in infective endocardi Source Type: blogs

Music is creating beauty in the most surprising of places
“Good morning, Mr. S! How are you feeling today?” I ask as I step into his hospital room. Yesterday, Mr. S was admitted for infective endocarditis and has been tolerating antibiotic treatment well. I am a medical student on my acute cardiology rotation taking care of him. “I’m feeling fine,” he says, and I proceed to ask about how he slept, if he’s experiencing any chest pain, palpitations, shortness of breath, abdominal pain, or problems going to the bathroom. He seems to have all these answers memorized, saying no to my questions. I perform a physical exam and decide that he is doing a...
Source: Kevin, M.D. - Medical Weblog - September 11, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/glenna-wong" rel="tag" > Glenna Wong < /a > Tags: Education Cardiology Hospital-Based Medicine Source Type: blogs

It ’s time for hospitalists to be engaged with opioid use disorders
Alvin is a 42-year-old man who was never really given a chance. His parents both had severe alcohol use disorder. At age 12, his parents encouraged him to skip school to sell marijuana in order to fund their drinking. As his parents began using various illicit drugs, Alvin started selling larger amounts of marijuana to foot their bill. Eventually, marijuana was not profitable enough. Alvin, then 16 years old, turned to crack cocaine. A year later, he was arrested with enough drugs in his possession to justify a criminal charge for dealing. Alvin spent the next 20 years in and out of prison. He had never been in a physical ...
Source: Kevin, M.D. - Medical Weblog - September 5, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/rich-bottner" rel="tag" > Rich Bottner, PA-C < /a > Tags: Conditions Hospital-Based Medicine Hospitalist Source Type: blogs

Fever with polyarthralgia – Medicine MCQ – CVS – Answer
Fever with polyarthralgia – Medicine MCQ – CVS – Answer Medicine MCQs – CVS: on Amazon Kindle Store Person presents with fever of 2 weeks and polyarthralgia. Which of the following findings will you specifically look for in the hands: Correct answer: c) Splinter hemorrhages From the point of view of cardiovascular system, prolonged fever with polyarthralgia could be a manifestation of infective endocarditis. Rheumatic fever seldom presents as prolonged fever. Striking manifestation is usually polyarthritis in rheumatic fever. Heberden’s nodes are seen in osteoarthritis. Cyanosis has...
Source: Cardiophile MD - September 4, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Uncategorized Source Type: blogs

LITFL Review 342
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 342nd LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. Readers can subscribe to LITFL review RSS or LITFL review EMAIL subscription The Most Fair Dinkum Ripper Beauts of the Week A wonderf...
Source: Life in the Fast Lane - July 29, 2018 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: LITFL review LITFL R/V Source Type: blogs

Tropical Travel Trouble 011 Tonsillitis and the Bull
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 011 Peer Reviewers: Dr Jennifer Ho, ID physician QLD, Australia and Dr Mark Little, ED physician QLD, Australia. You are working in far North Queensland and encounter a 20 year old Indigenous man with tonsillitis on your ED short stay ward round. He has been receiving IV penicillin and metronidazole overnight but is deteriorating and now cannot open his mouth beyond 1.5cm, and has a swollen neck (some might say ‘Bull neck&r...
Source: Life in the Fast Lane - July 25, 2018 Category: Emergency Medicine Authors: Amanda McConnell Tags: Clinical Cases Tropical Medicine antitoxin bull neck c. diphtheriae c.ulcerans DAT pseudomembrane vaccine Source Type: blogs

Tropical Travel Trouble 011 Tonsillitis and the Bull
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 011 Peer Reviewers: Dr Jennifer Ho, ID physician QLD, Australia and Dr Mark Little, ED physician QLD, Australia. You are working in far North Queensland and encounter a 20 year old Indigenous man with tonsillitis on your ED short stay ward round. He has been receiving IV penicillin and metronidazole overnight but is deteriorating and now cannot open his mouth beyond 1.5cm, and has a swollen neck (some might say ‘Bull neck&r...
Source: Life in the Fast Lane - July 25, 2018 Category: Emergency Medicine Authors: Amanda McConnell Tags: Clinical Cases Tropical Medicine antitoxin bull neck c. diphtheriae c.ulcerans DAT pseudomembrane vaccine Source Type: blogs

Acute severe AR – Cardiology MCQ – Answer
Most common cause of acute severe aortic regurgitation: Correct answer: b) Infective endocarditis Though acute rheumatic fever can produce aortic regurgitation, usually mitral regurgitation is the dominant lesion in acute rheumatic carditis. Aortic dissection can cause acute aortic regurgitation if the dissection flap reaches the level of the aortic valve. Myocardial infarction can cause acute mitral regurgitation if a papillary muscle is severely ischemic or ruptures, but not aortic regurgitation. Most common cause of chronic aortic regurgitation in the Western world is degenerative disease of bicuspid or trileaflet ...
Source: Cardiophile MD - June 14, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Acute severe AR – Cardiology MCQ
Most common cause of acute severe aortic regurgitation: a) Aortic dissection b) Infective endocarditis c) Rheumatic fever d) Myocardial infarction Please post your answer as a comment below. Correct answer will be published on: Jun 14, 2018 @ 13:32 (Source: Cardiophile MD)
Source: Cardiophile MD - June 12, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

Loeffler endocarditis
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - June 10, 2018 Category: Internal Medicine Tags: cardiovascular Source Type: blogs

What are the sites of vegetations in VSD with endocarditis?
Locations of vegetations in endocarditis depends on direction of the blood flow jet which causes jet lesions at the site which it impinges, causing damage to the endothelium. It is at this region that small thrombi can form and become a nidus for vegetations. In ventricular septal defect (VSD), there is a left to right jet from the left ventricle to right ventricle. The smaller the size of the VSD, higher the pressure gradient between the two ventricles and greater the velocity of the jet and chance for jet lesion. For the same reason, endocarditis is more common in small VSD and rare in large VSD. When there is a jet, th...
Source: Cardiophile MD - May 25, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs

Etiological types of prosthetic valve dysfunction
Prosthetic valve thrombosis Pannus formation – growth of fibrotic tissue from the annulus region into the prosthetic valve, hindering proper movement of the valve leaflets Degeneration of the bioprosthetic valve Prosthetic valve endocarditis formation of vegetation which hinder proper valve function The post Etiological types of prosthetic valve dysfunction appeared first on Cardiophile MD. (Source: Cardiophile MD)
Source: Cardiophile MD - May 24, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs

The unscientific lure of antibiotics
Although my father did not discover penicillin, he helped do the research showing its effectiveness in curing infective endocarditis. As an internist, he then became enamored with the role antibiotics could play in treating infections. Growing up, my siblings and I can attest to his unbridled enthusiasm, as every time we contracted a cold, we would get a shot of the wonder mold in our butts. The fact that colds were caused by viruses and not bacteria did little to dissuade him from the utility of the treatment. When I finally developed a rash after another shot, I celebrated the fact that the painful solution would never e...
Source: Kevin, M.D. - Medical Weblog - May 22, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/david-mokotoff" rel="tag" > David Mokotoff, MD < /a > Tags: Physician Infectious Disease Primary Care Source Type: blogs

Stop shaming those with addiction
He was younger than I was — still in his twenties — but the patient had already had his chest opened twice. Deadly bloodstream infections contracted from sharing needles had destroyed his heart valves on two separate occasions. And now six months out from his most recent operation, he was back with fever and chills: ominous signs of another infection. That was years ago. The opioid epidemic hadn’t yet been declared a public health emergency. I had just begun my training in cardiology, and he was the first such patient that I had ever taken care of. In the ensuing years, there would be many more like him: ...
Source: Kevin, M.D. - Medical Weblog - May 19, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/akshay-pendyal" rel="tag" > Akshay Pendyal, MD < /a > Tags: Physician Emergency Medicine Primary Care Source Type: blogs

Lake Louise criteria – Cardiology MCQ
Lake Louise criteria is for the diagnosis of: a) Myocardial infarction on echocardiography b) Endocarditis on blood culture c) Myocarditis on cardiac magnetic resonance imaging d) None of the above Please post your answer as a comment below. Correct answer will be published on: May 19, 2018 @ 18:18 The post Lake Louise criteria – Cardiology MCQ appeared first on Cardiophile MD. (Source: Cardiophile MD)
Source: Cardiophile MD - May 17, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs

LITFL Review 331
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 331st LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. Readers can subscribe to LITFL review RSS or LITFL review EMAIL subscription The Most Fair Dinkum Ripper Beauts of the Week One of th...
Source: Life in the Fast Lane - May 13, 2018 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: LITFL review LITFL R/V Source Type: blogs

LITFL Review 315
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 315th LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum Ripper Beauts of the Week Rob Macsweeney of Critical Care Reviews posts the 2 hour livestream of the ADRENAL...
Source: Life in the Fast Lane - January 21, 2018 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

Risk factors which can affect the outcome of CABG
(Coronary Artery Bypass Grafting) Age and gender: advanced age and female gender have less favourable outcome. Previous cardiovascular events: prior cardiovascular surgery, interventions, myocardial infarction, stroke or transient ischemic attacks. Cardiovascular variables: left ventricular function, hypertension, cardiac arrhythmias. Diabetes mellitus, chronic renal disease, chronic obstructive pulmonary disease. Complexity of disease: number of vessels involved, severity of associated valvular stenosis or regurgitation and endocarditis if any. Hemodynamic status and urgency of surgery. Pulmonary hypertensi...
Source: Cardiophile MD - January 6, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiac Surgery Source Type: blogs

The challenge of “ evidence based ” sore throat guidelines
In 2007, Matthys and colleagues published a classic article: Differences Among International Pharyngitis Guidelines: Not Just Academic Jan Matthys, Marc De Meyere, Mieke L. van Driel, An De Sutter Ann Fam Med. 2007 Sep; 5(5): 436–443. doi: 10.1370/afm.741 PMCID: PMC2000301 RESULTS We included 4 North American and 6 European guidelines. Recommendations differ with regard to the use of a rapid antigen test and throat culture and with the indication for antibiotics. The North American, French, and Finnish guidelines consider diagnosis of group A streptococcus essential, and prevention o...
Source: DB's Medical Rants - October 23, 2017 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

LITFL Review 302
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Welcome to the 302nd LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chunk of FOAM. The Most Fair Dinkum Ripper Beauts of the Week The ALIEM AIR Series delivers another amazing collation of the best resources in FO...
Source: Life in the Fast Lane - October 15, 2017 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

Funtabulously Frivolous Friday Five 204
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF…introducing Funtabulously Frivolous Friday Five 204. Question 1 Richard Doll published an epidemiology paper in 1950. What had he discovered? + Reveal the Funtabulous Answer expand(document.getElementById('ddet1398470481'));expand(document.getElementById('ddetlink1398470481')) The link between smoking a...
Source: Life in the Fast Lane - September 7, 2017 Category: Emergency Medicine Authors: Neil Long Tags: Frivolous Friday Five addison's disease bubo bubonic plague cancer endocarditis JF Kennedy Libman Sacks moritz roth richard doll roth spots SLE smoking Source Type: blogs

7 ways to combat compassion fatigue
This is the patient’s eight admission over the course of two weeks. The patient is a heroin abuser and has bacteremia and endocarditis. Their heart valve is failing and they are in and out of congestive heart failure. Every day, dozens of medical professionals converge on the patient to give treatment and advice. And every day after hearing that advice, the patient leaves the hospital against medical advice and goes to use IV drugs. They wind up back in the hospital out of fear or panic, or they are brought back in after overdosing by the police. The cycle continues. In this common daily scenario, it is very easy as ...
Source: Kevin, M.D. - Medical Weblog - August 17, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/jenny-hartsock" rel="tag" > Jenny Hartsock, MD < /a > Tags: Physician Cardiology Hospital-Based Medicine Infectious Disease Primary Care Source Type: blogs

What it ’s like to be a doctor in the heroin capitol of the U.S.
I am a practicing hospitalist physician in Dayton, Ohio. Dayton has emerged in the last year as the city with the highest per capita death rate from opioid overdoses. When we measure the number of deaths here we talk about how many there are per day, not per week or month. We have been inundated with heroin and other products laced with fentanyl or carfentanil. Every other drug, including marijuana, is laced with an opiate in this city. Dealers stand on street corners and throw baggies of heroin into passing cars who have the windows open — free of charge — to get new customers hooked. A routine dose of Narcan ...
Source: Kevin, M.D. - Medical Weblog - July 19, 2017 Category: General Medicine Authors: < a href="http://www.kevinmd.com/blog/post-author/jenny-hartsock" rel="tag" > Jenny Hartsock, MD < /a > Tags: Physician Medications Source Type: blogs

Hours out of the OR for valve replacement surgery: patient with paced rhythm becomes hemodynamically unstable
Conclusions: ACO in VPR is an uncommon condition. The MSC showed good Sens for diagnosis of ACO in the presence of VPR, especially among patients with high peak cTn, and Spec was excellent. These methods and results are consistent with studies that have used the MSC to diagnose ACO in LBBB. (Source: Dr. Smith's ECG Blog)
Source: Dr. Smith's ECG Blog - May 19, 2017 Category: Cardiology Authors: Steve Smith Source Type: blogs

Small muscular ventricular septal defect – echocardiogram
Echocardiogram in apical 5 chamber view shows the mosaic colour jet of a small ventricular septal defect (VSD) near the apex. The cardiac chambers are not dilated. The small defect is difficult to see on two dimensional echocardiography, though it is easily detected clinically with a pan systolic murmur and Doppler echo documents the high velocity jet across the VSD. LV: Left ventricle; RV: right ventricle; Ao: Aorta; LA: Left ventricle; Pulm vein: Pulmonary vein. Continuous wave (CW) Doppler interrogation shows the inter-ventricular pressure gradient as 81 mm Hg, which is consistent with a restrictive VSD. Small muscular...
Source: Cardiophile MD - December 10, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology Echocardiogram Library Echocardiography Source Type: blogs

MKSAP: 47-year-old man with a bicuspid aortic valve
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 47-year-old man is evaluated during a routine examination. He has no symptoms. Medical history is significant for a bicuspid aortic valve. He is not taking any medications. On physical examination, he is afebrile, blood pressure is 130/70 mm Hg, pulse rate is 56/min, and respiration rate is 15/min. Cardiac examination reveals a grade 1/6 diastolic murmur at the left lower sternal border. Echocardiogram shows a bicuspid aortic valve with moderate aortic regurgitation, normal left ventricular systolic fu...
Source: Kevin, M.D. - Medical Weblog - December 3, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Heart Source Type: blogs

12 Percent of People Will Be Diagnosed With This Life-Threatening Heart Disease
The post below first appeared on HuffPost Healthy Living on April 20. Jen Hyde, a 30-year-old poet and artist living in Brooklyn, has a congenital heart defect. By the age of 25, Hyde had two open-heart surgeries, including a heart valve replacement. “I know that heart disease is the number one killer of women in America,” Hyde said. “I’m currently in great shape, but part of staying this way means building a strong relationship with my cardiologist so that the care I receive is preventative, not reactive.” Hyde is not alone in suffering from heart health issues — in the U.S., cardiova...
Source: Disruptive Women in Health Care - April 25, 2016 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Chronic Conditions Source Type: blogs

DM / DNB Cardiology Entrance Mock Test 22
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 22. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rat...
Source: Cardiophile MD - March 21, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs

DM / DNB Cardiology Entrance Mock Test 21
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 21. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rat...
Source: Cardiophile MD - March 8, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs

DM / DNB Cardiology Entrance Mock Test 20
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 20. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rat...
Source: Cardiophile MD - February 26, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs

The heroin epidemic – some thoughts
As a medical student and resident, I saw many heroin addicts.  We got used to managing right sided endocarditis and overdoses.  That epidemic diminished greatly until recently.  Susan Collins points out the likely source of the current epidemic – Susan Collins cites possible tie between hospital patient surveys, overprescription of opioids. “In the meantime, however, we are concerned that the current evaluation system may inappropriately penalize hospitals and pressure physicians who, in the exercise of medical judgment, opt to limit opioid pain relievers to certain patients and instead rewa...
Source: DB's Medical Rants - February 10, 2016 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

DM / DNB Cardiology Entrance Mock Test 14
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 14. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rat...
Source: Cardiophile MD - February 7, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs

DM / DNB Cardiology Entrance Mock Test 12
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 12. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rat...
Source: Cardiophile MD - February 4, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs

DM / DNB Cardiology Entrance Mock Test 11
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 11.You scored %%SCORE%% out of %%TOTAL%%.Your performance has been rated as %%...
Source: Cardiophile MD - February 3, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs

DM / DNB Cardiology Entrance Mock Test 9
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 9. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rate...
Source: Cardiophile MD - January 27, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs

DM / DNB Cardiology Entrance Mock Test 8
This study found that though it is often associated with coronary artery disease (CAD), it can also occur in those without significant CAD. It was not specifically associated with disease of right coronary artery disease. This cardioinhibitory response may be a manifestation of the Bezold-Jarisch reflex. Bezold-Jarisch reflex inhibits sympathetic activity (sympathetic withdrawal) and increases parasympathetic activity, resulting in bradycardia, which may be associated with vasodilatation, nausea and hypotension. Bezold-Jarisch has been described in the setting of inferior wall infarction and coronary angiography. Origin...
Source: Cardiophile MD - January 26, 2016 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ Cardiology X-ray Featured Source Type: blogs

Trans Esophageal Echocardiography (TEE)
Transesophageal echocardiography is a specialised form of echocardiographic study using an echo probe held at the tip of an endoscope like device.  As the esophagus is very close to the heart, higher quality images are obtained. Interference by air in the lungs, which is usual for transthoracic echocardiography (TTE) is also avoided. As the imaging is in the near field, higher frequency transducers can be used, providing better image resolution. TEE imaging frequency is of the order of 5 – 10 MHz. TEE is very useful for imaging the posterior structures of the heart like the left atrium. Clots in the left at...
Source: Cardiophile MD - December 6, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Echocardiography Intra operative TEE Intra operative trans esophageal echocardiography risk of TEE risk of trans esophageal echocardiography TEE for liver transplantation surgery TEE in those with esophageal varices Transesophageal echocardi Source Type: blogs

Prosthetic valve endocarditis: Indications for surgery
Brief Review Prosthetic valve endocarditis is a life threatening situation and often can be refractory to medical therapy, requiring surgical intervention. Indications for surgery in prosthetic valve endocarditis (PVE) include: Persistent bacteremia after 7-10 days Heart failure Early prosthetic valve endocarditis Fungal endocarditis Paravalvular leak Annular or aortic abscess True or false aneurysm Fistula formation New onset conduction disturbance Recurrent peripheral embolisation despite therapy A best evidence topic review suggested that unless patient is a poor surgical candidate, surgery is the treatment of ch...
Source: Cardiophile MD - November 10, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiac Surgery Early prosthetic valve endocarditis Fungal endocarditis PALSUSE score paravalvular leak Source Type: blogs

Prosthetic valve associated hemolysis
Brief Review Prosthetic valve associated hemolysis is more with paravalvular leak, endocarditis and structural failure in bioprosthetic valve. Prosthetic valve dehiscence is an important cause for prosthetic valve associated hemolysis [1]. Control of hypertension with beta blockers can reduce hemolysis as the shear stress reduced. One of the earlier studies used propranolol to reduce hemolysis in patients with aortic prosthetic valve [2]. Three of the five patients given propranolol in their study had a clear decrease in hemolysis. One of their patients developed congestive heart failure with propranolol therapy at 6 ...
Source: Cardiophile MD - November 10, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiac Surgery paravalvar leak Prosthetic valve dehiscence Source Type: blogs

Prosthetic valve endocarditis
Brief Review Prosthetic valve endocarditis is a serious disease with unfavourable outcome. Staph. aureus is the commonest organism in prosthetic valve endocarditis. More complications like paravalvar leak and abscess formation are more common with prosthetic valve endocarditis. Fortunately, the incidence of early prosthetic valve endocarditis has come down, due to better perioperative care and infection control. There is a difference between mechanical and bioprosthetic valves. The mechanical valves do not allow the adherence of the organism unless there is a thrombus. The infection is most often in the region of the annul...
Source: Cardiophile MD - November 10, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Bioprosthetic valves Prosthetic valve endocarditis staph aureus endocarditis Source Type: blogs

LITFL Review 201
Welcome to the 201st LITFL Review! Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM. The Most Fair Dinkum Ripper Beauts of the Week In his final talk at SMACC Chicago, the late Dr John Hinds shares More Cases From the Races. [MG] The Best of #FOAMed Emergency Medicine Should we be treating fever in the ED? HEFT EMCast discusses the HEAT trial and its relevance to EM practi...
Source: Life in the Fast Lane - October 12, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs

FDG-PET CT increases the diagnostic yield in prosthetic valve and intracardiac device related endocarditis
Prosthetic valve endocarditis and intracardiac device related endocarditis are difficult to diagnose and treat. Because of dense acoustic shadowing related to the components of prosthetic valves and cardiac implantable devices, role of echocardiography is often limited in the diagnosis of endocarditis in these situations. Of late Positron Emission Tomography Computed Tomography (PET CT) have been used more often in detecting foci of active inflammation / metabolism in infective endocarditis. Study by María N. Pizzi et al[1] has provided us with documentary evidence for adding PET CT to our diagnostic armamentarium i...
Source: Cardiophile MD - September 23, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: General Cardiology Source Type: blogs

Are we to blame for the heroin epidemic?
This article blames physicians for opiate addiction – Doctors Play A Role In The Opioid Addiction Epidemic, Study Finds. To begin to figure out how many, a team at the Mayo Clinic, led by pain specialist Dr. W. Michael Hooten, analyzed the medical records of 293 patients given a short-term prescription for opiates for the first time in 2009. These patients were being treated for acute pain — from traumas such as sprained ankles or major surgeries — so their doctors did not expect them to become long-term users of painkillers. Yet just over 1 in 4 of these patients went on to use opioid painkillers for lon...
Source: DB's Medical Rants - September 6, 2015 Category: Internal Medicine Authors: rcentor Tags: Medical Rants Source Type: blogs

Moving From Spaced Repitition to Spaced Learning
This article proposed a strategy that revolves around the cognitive technique known as spaced repetition. Spaced repetition takes advantage of time and reinforces one’s knowledge the moment before one forgets it. This technique involves reviewing material according to a schedule determined by a temporal relationship known as the “spacing effect”. Although beneficial, spaced repetition requires time and as a result, is not without its own limitations. Spaced repetition can help students remember what they learn, but it will not help students deepen their understanding or teach them things they don’t...
Source: The Health Care Blog - August 17, 2015 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Learning Medical Education Osmosis Picmonic Spaced Repitition Source Type: blogs

Moving From Spaced Repetition to Spaced Learning
This article proposed a strategy that revolves around the cognitive technique known as spaced repetition. Spaced repetition takes advantage of time and reinforces one’s knowledge the moment before one forgets it. This technique involves reviewing material according to a schedule determined by a temporal relationship known as the “spacing effect”. Although beneficial, spaced repetition requires time and as a result, is not without its own limitations. Spaced repetition can help students remember what they learn, but it will not help students deepen their understanding or teach them things they don’t...
Source: The Health Care Blog - August 17, 2015 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Learning Medical Education Osmosis Picmonic Spaced Repitition Source Type: blogs