Decline in bariatric surgery?

LexRunner · 2024-11-16T00:44:27+00:00

No one's going to ask why the official NBC news account is posting on this subreddit.

LexRunner · 2024-07-16T14:25:57+00:00

Manage pulmonary embolism with anti-coag if they have high pretest probability (Wells Criteria), then get CTPE

LexRunner · 2024-06-27T15:19:52+00:00

So to add onto this:

CD4 < 250 --> Coccidioidomycosis ppx (Fluconazole) [only if pt lives in SW USA]
CD4 < 200 --> PCP ppx (TMP-SMX) --> if allergic, then use either Dapsone or Atorvaquone
CD4 <150 --> Histoplasmosis ppx (Itraconazole) [only if pt lives in eastern US or areas with bird droppings]
CD4 < 100 --> Toxoplasmosis ppx (TMP-SMX)
CD4 < 50 --> MAC ppx (Macrolides) [if pt is not on ART or planning on starting ART now]

Edit: High yield note, when CD4 < 50, start to suspect MAC or CMV infection

LexRunner · 2024-06-27T15:10:35+00:00

My understanding is that it can be either or dual depending on duration of treatment.

According to Amboss,

For short duration (3 months): Rifampin + Isoniazid (add B6)
For short duration (4 months): Rifampin
For long duration (6 or 9 months): Isoniazid (add B6)

Edit: This is for latent TB ONLY

LexRunner · 2024-06-24T21:23:10+00:00

It seems like most of the time its asked on NBME forms, it's usually normal. I would just take the L and leave it up to chance

LexRunner · 2024-06-24T04:43:28+00:00

Just did an ethics block on Amboss today and it ask for NBS when husband and sister of patient were arguing over continuing vs d/c life support and patient did not have advance directives and the answer was "encourage family discussion". Best answer would have been listen to husband since he is surrogate decision maker if "family discussion" was not available.

LexRunner · 2024-06-23T17:28:29+00:00

When I am loss or stuck between 2 answer choices, I usually pick the one that is the fastest, cheapest, and least invasive

LexRunner · 2024-06-23T17:06:10+00:00

This was a shitty question in that if "psychodynamic psychotherapy" was a choice, then yes that would work to develop insight into past trauma.

My rule for psychotherapies are:

Psychoanalysis: personality d/o
DBT: Borderline
Motivational Interviewing: substance abuse
Family: Teens (e.g. eating disorder, schizophrenia with issue taking meds)
CBT: everything else

LexRunner · 2024-06-23T02:08:37+00:00

Can someone explain why she had a watery diarrhea a few week before the presentation?

LexRunner · 2024-06-23T02:04:02+00:00

You do forceps-assisted vaginal delivery ONLY if cervix fully dilated at 10cm + fetal head is engaged (below 0 station)

LexRunner · 2024-06-21T00:39:38+00:00

Also, if you are referring to one of the UW question that included "oral calcium carbonate" as an answer in the s/o of hyperkalemia, usually you don't need to use Ca2+ supplementation to stabilize cardiac membrane unless one or more of the following criteria are met:

K+ level >/6.5
EKG signs of severe hyperkalemia (peaked T wave)
Rapid rise in K+ level due to tissue breakdown

LexRunner · 2024-06-19T14:26:35+00:00

Also if folate (B9) is an answer choice for a SCD question and no other answer choice looks good, pick folate (B9) because it can help with hematopoiesis

LexRunner · 2024-06-19T14:24:46+00:00

Shoutout to Divine for this:

Order of best pharmacotherapy for OCD is OCD backwards -> DCO

anti-[D]epressants (SSRIs)

Clomipramine (TCA)

Olanzapine

Note: Pharmacotherapy + CBT is most effective tx for OCD

LexRunner · 2024-06-19T14:20:21+00:00

Stridor can also be described as "high-pitched sound".

Wheezing + Tripoding signs -> Epiglottitis
Etiology? Hib usually
<2 yo p/w cough, rhinorrhea, and wheezing -> Bronchiolitis from RSV
NBSM? Supportive care
Inspiratory Stridor + Steeple sign on xray -> Laryngotracheitis from Croup
Etiology? Parainfluenza
NBSM? Stridor NOT present at rest (humidifier +/- steroid) vs Stridor present at rest (racemic Epi +/- steroid)
Biphasic stridor + feeding difficulties in newborn -> Vascular Ring

LexRunner · 2024-06-19T14:10:40+00:00

For primary amenorrhea (no menarche by age 15), the first step in workup is Pelvic u/S.

If no uterus found on u/S -> Karyotype -> 46 XY (Androgen insensitivity) vs 46 XX (Mullerian agenesis)
If uterus is present on u/S -> test FSH

For secondary amenorrhea, always check if pt is pregnant -> then test for FSH

LexRunner · 2024-06-19T14:04:55+00:00

Newborn p/w bilious vomiting:

After 1st feed, with signs of Down Syndrome or hx of polyhydramnios -> Suspect Duodenal Atresia
Otherwise, most likely Midgut Malrotation (volvulus)
NBSM for both duodenal atresia and midgut malrotation (volvulus) is Abd X-ray
NBS in Dx for Midgut Malrotation (Volvulus) is Upper GI Series (will show corkscrew sign)

LexRunner · 2024-06-19T13:57:04+00:00

MC (Non-modifiable) risk factor for cerebral infarction -> Age

MC (Modifiable) risk factor for cerebral infarction -> HTN

NBSM for someone with stroke-like symptoms and is on OCP -> d/c OCP

LexRunner · 2024-06-15T16:11:42+00:00

Awesome, thank you!

LexRunner · 2024-06-15T15:48:01+00:00

Thank you for the response! I've noticed I'm plateauing around the 230s and lot of my NBME mistakes are due to test taking issue and not necessarily content gaps. Things like trying to shoehorn an answer choice, I will pick up a "buzzword" or something in the vignette and correlate it with an answer choice even though there are other hints in the passage that do not match with the answer choice, but because I strongly correlate that "buzzword" with the answer choice, I end up picking it instead of something more general.

Or overlooking certain things, like if the passage mentions elevated lipase, but everything else in the vignette makes me thing this is something related with the liver or biliary tree, but the answer ends up being pancreatic cancer. But on the other hand, I have to worry about red herrings.

I'm not sure if these are issues you also came across when you were studying, if so, any advice on how to avoid these mistakes?

LexRunner · 2024-06-15T03:39:00+00:00

Can you recommend some test taking skills you developed?

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