Hepatic signs – MCQ
Hepatic signs – MCQ Pick out the wrong statement: a) Hepatomegaly in chronic heart failure can be non tender b) Presystolic hepatic pulsations are noted in tricuspid regurgitation c) Pulsatile hepatomegaly can be seen in constrictive pericarditis d) Abdominojugular reflux (earlier called “hepatojugular reflux”) can be noted in right heart failure Post your answer as a comment below (Source: Cardiophile MD)
Source: Cardiophile MD - March 26, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Medicine MCQ - CVS Source Type: blogs

A Troublesome Cup of Tea
A 45-year-old woman presented to the emergency department with nausea and vomiting. Her symptoms had started seven days earlier and steadily worsened. She reported generalized abdominal pain and distention and that her eyes appeared yellow.The patient had no past medical history, took no medications, and said she did not drink or use drugs. Her history showed that she had been drinking an herbal preparation every day for the past five months to ameliorate her heavy menstrual periods.The patient had mild right upper quadrant tenderness but no distention, rebound, or guarding. Her lungs were clear, and her heart rate and rhy...
Source: The Tox Cave - July 1, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

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

Tropical Travel Trouble 009 Humongous HIV Extravaganza
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 009 The diagnosis of HIV is no longer fatal and the term AIDS is becoming less frequent. In many countries, people with HIV are living longer than those with diabetes. This post will hopefully teach the basics of a complex disease and demystify some of the potential diseases you need to consider in those who are severely immunosuppressed. While trying to be comprehensive this post can not be exhaustive (as you can imagine any patient with ...
Source: Life in the Fast Lane - July 7, 2018 Category: Emergency Medicine Authors: Amanda McConnell Tags: Clinical Cases Tropical Medicine AIDS art cryptococcoma cryptococcus HIV HIV1 HIV2 PEP PrEP TB toxoplasma tuberculoma Source Type: blogs

Tropical Travel Trouble 005 RUQ Pain and Jaundice
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 005 Guest Post: Dr Branden Skarpiak – Global Health Fellow, Department of Emergency Medicine. UT Health San Antonio A 35 year old male presents to your emergency room for right upper quadrant pain that has gotten worse over the last 2-3 days. He also describes associated nausea, vomiting, and fevers. He denies other abdominal pain, or change in his bowel or bladder habits. His wife notes that he has started to “look more yellow...
Source: Life in the Fast Lane - March 19, 2018 Category: Emergency Medicine Authors: Neil Long Tags: Clinical Cases Tropical Medicine amebic amoeba amoebiasis amoebic dysentery amoebic liver abscess bloody diarrhoea e.dispar e.histolytica entamoeba histolytica Source Type: blogs

Learn pulmonary hypertension with a Medcomic
Pulmonary hypertension (PH) refers to increased pressure in the pulmonary circulation. It develops when pulmonary vessels become constricted and/or obstructed, which can occur in a wide variety of conditions. The increase in pressure is measured by right catheterization, and is defined as a mean pulmonary arterial pressure ≥ 25 mm Hg at rest. PH leads to right ventricular hypertrophy and enlargement as the ventricle pumps against increased resistance. Right-sided heart failure (cor pulmonale) can eventually develop. Signs and symptoms of PH include dyspnea on exertion, fatigue, substernal chest pain, syncope, hepatomega...
Source: Kevin, M.D. - Medical Weblog - December 30, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/jorge-muniz" rel="tag" > Jorge Muniz, PA-C < /a > Tags: Conditions Pulmonology Source Type: blogs

Naturopaths: Able to turn even Epsom salt potentially deadly
Naturopathy and naturopaths are a fairly frequent topic on this blog —and for very good reason. If there is an example of a pseudomedical " discipline " that has been gaining undeserved " respectability, " it's naturopathy. It's licensed in all too many states, and physicians who have fallen under the spell of so-called " integrative medicine, " a specialty that rebrands science-based lifestyle medical interventions as somehow " alternative " or " integrative " and uses them as a vessel to " integrate " quackery into medicine, seem to have a special affinity...
Source: Respectful Insolence - October 6, 2017 Category: Surgery Authors: oracknows Source Type: blogs

MKSAP: 68-year-old man with new-onset ascites
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old man is evaluated for new-onset ascites with lower-extremity edema. Symptoms have increased gradually over the past 4 weeks. He has consumed three alcoholic beverages per day for many years. His medical history is notable for coronary artery bypass graft surgery 8 months ago and dyslipidemia. His medications are low-dose aspirin, atorvastatin, and metoprolol. On physical examination, temperature is 36.8 °C (98.2 °F), blood pressure is 122/84 mm Hg, pulse rate is 64/min, and respirati...
Source: Kevin, M.D. - Medical Weblog - April 22, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions GI Source Type: blogs

MKSAP: 28-year-old man with elevated liver chemistry test result
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old man is evaluated in follow-up for elevated liver chemistry test results, which were performed to assess a 3-month history of fatigue. He has no history of liver disease and has not had abdominal pain or fever. His medical history is significant for a 3-year history of diarrhea. Following a physical exam, lab results, and abdominal CT, what is the most appropriate next step in management? On physical examination, vital signs are normal; BMI is 24. Spider angiomata and jaundice are absent. Ab...
Source: Kevin, M.D. - Medical Weblog - March 18, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions GI Source Type: blogs

MKSAP: 68-year-old woman with progressive abdominal distention
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old woman is evaluated for a 3-month history of gradually progressive abdominal distention. Her medical history is notable for a 20-year history of obesity, type 2 diabetes mellitus, hyperlipidemia, and hypertension. She also has had a 10-year history of elevation of serum aminotransferase levels, which was attributed to nonalcoholic fatty liver disease. She does not consume alcohol. Her medications are metformin, lisinopril, low-dose aspirin, and simvastatin. On physical examination, vital sig...
Source: Kevin, M.D. - Medical Weblog - December 24, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions GI Source Type: blogs

MKSAP: 68-year-old woman with gradually progressive abdominal distention
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old woman is evaluated for a 3-month history of gradually progressive abdominal distention. Her medical history is notable for a 20-year history of obesity, type 2 diabetes mellitus, hyperlipidemia, and hypertension. She also has had a 10-year history of elevation of serum aminotransferase levels, which was attributed to nonalcoholic fatty liver disease. She does not consume alcohol. Her medications are metformin, lisinopril, low-dose aspirin, and simvastatin. On physical examination, vital sig...
Source: Kevin, M.D. - Medical Weblog - September 24, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions GI Source Type: blogs

The core of the scientific process is how we ultimately serve our patients
A few weekends ago, I saw a patient with bloated shins at our school’s free clinic, and I marked in my notes that she exhibited “peripheral edema,” an esoteric phrase that means little to those outside of the medical community. That experience only highlighted the tendency in medicine to inflate common bodily functions into opaque medical jargon. Its use can be frustrating for patients who are trying to understand their illness — and at times even for the uninformed medical student who is trying to learn about his patient. It doesn’t help that the list of jargon is endless. Itchiness becomes p...
Source: Kevin, M.D. - Medical Weblog - October 20, 2015 Category: Journals (General) Authors: Tags: Education Medical school Source Type: blogs

Test your medicine knowledge: 55-year-old man with elevated liver enzymes
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 55-year-old man is evaluated during a routine examination. He feels well other than mild knee pain. He drinks six to eight cans of beer per night. He has no personal history of liver disease, but his older brother was recently diagnosed with hereditary hemochromatosis. On physical examination, vital signs are normal; BMI is 24. He is tanned on sun-exposed body surfaces. Cardiac examination is normal. Abdominal examination reveals hepatomegaly. Bilateral bony hypertrophy of the knees is noted. Laborator...
Source: Kevin, M.D. - Medical Weblog - October 10, 2015 Category: Journals (General) Authors: Tags: Conditions GI Source Type: blogs

Chronic Lymphocytic Leukemia
Chronic lymphocytic leukemia is a neoplatic disease Pathophysiology 1) chronic lymphocytic leukemia is a neoplastic disorder with clonal proliferation of lymphocytes 2) 95% of cases are B cell in origin 3) primary site of involvement is the bone marrow (eventually bone marrow becomes completely replaced) with release into bloodstream of neoplastic lymphocytes 4) spleen, liver, and lymph nodes may become enlarged 5) 10 % of patients convert to prolymphocytic leukemia (most with more aggressive course) 6) 5% of patients with chronic lymphocytic leukemia convert to Richter’s syndrome Signs and Symptoms of Chronic Lymph...
Source: Inside Surgery - November 18, 2013 Category: Surgeons Authors: Editor Tags: Oncology chronic lymphocytic leukemia CLL prolymphocytic Richter's smudge cell Source Type: blogs

MKSAP: 32-year-old woman with progressive jaundice
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 32-year-old woman is evaluated for a 10-day history of malaise, right upper quadrant discomfort, and progressive jaundice. She has had no recent travel outside of the United States, does not drink alcohol, and has no recent ingestions of drugs, including acetaminophen or herbal remedies. Up until this time, she has been healthy. She has a history of type 1 diabetes mellitus for which she takes insulin glargine and insulin detemir. She has no other medical problems. On physical examination, temperature is 37...
Source: Kevin, M.D. - Medical Weblog - November 9, 2013 Category: Family Physicians Tags: Conditions GI Infectious disease Source Type: blogs

Pulmonary Hypertension
Pathophysiology 1) increased arterial pressure in lungs 2) primary or idiopathic form occurs in absence of known precipitating causes 3) secondary form caused by – mitral stenosis, pulmonary venous occlusive disease, extreme obesity (Pickwickian syndrome), chronic hypoxemia, recurrent pulmonary embolism, kyphosis, infiltrative lung disease, chronic bronchitis, long periods at high altitude Signs and Symptoms 1) insidious onset of dyspnea idiopathic form 2) right heart failure with venous distention of neck 3) peripheral cyanosis late in disease 4) palpable right ventricular heave (owing to cor pulmonale) 5) fatigue ...
Source: Inside Surgery - January 23, 2013 Category: Surgeons Authors: Editor Tags: Pulmonology arterial pressure cyanosis dyspnea high altitude lungs obesity right heart failure Source Type: blogs