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Radiology 101

Mon, 30 Jun 2008 05:11:52 GMT

*A–Z of Emergency Radiology *To my mother Darshan. She was a constant source of support, humour and strength through my turmoil-ridden childhood.Without her I would not be where I am today, and I most certainly would not have accomplished what I have. R.R.M. To my mother Sally.Without her I would not be the person that I am. Her drive and work ethic are much to be admired, and have had a positive lasting influence upon me. E.J.H. *A–Z of Emergency Radiology by Erskine J. Holmes, MRCS Specialist Registrar in Accident & Emergency Medicine Oxford Rotational Training Programme Rakesh R. Misra,

Harrisons Manual SHort Version

Mon, 30 Jun 2008 04:35:27 GMT

*HARRISON’S Manual of Medicine *EDITORS Dennis L. Kasper, MD, MA(HON) William Ellery Channing Professor of Medicine, Professor of Microbiology and Molecular Genetics, Harvard Medical School; Director, Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Boston Eugene Braunwald, MD, MA(HON), MD(HON), ScD(HON) Distinguished Hersey Professor of Medicine, Harvard Medical School; Chairman, TIMI Study Group, Brigham and Women’s Hospital, Boston Anthony S. Fauci, MD, ScD(HON) Chief, Laboratory of Immunoregulation; Director, National Institute of Allergy and Infectious Diseas

Internal medicine

Fri, 27 Jun 2008 06:04:51 GMT

*INTERNAL MEDICINE Just the Facts *NOTICE Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the prep

harrisons 16th edition

Wed, 25 Jun 2008 16:10:54 GMT

*16th Edition HARRISON’S PRINCIPLES OF Internal Medicine *EDITORS OF PREVIOUS EDITIONS T. R. HARRISON Editor-in-Chief, Editions 1, 2, 3, 4, 5 R. G. PETERSDORF Editor, Editions 6, 7, 8, 9, 11, 12, 13 Editor-in-Chief, Edition 10 W. R. RESNICK Editor, Editions 1, 2, 3, 4, 5 J. D. WILSON Editor, Editions 9, 10, 11, 13, 14 Editor-in-Chief, Edition 12 M. M. WINTROBE Editor, Editions 1, 2, 3, 4, 5 Editor-in-Chief, Editions 6, 7 J. B. MARTIN Editor, Editions 10, 11, 12, 13, 14 G. W. THORN Editor, Editions 1, 2, 3, 4, 5, 6, 7 Editor-in-Chief, Edition 8 A. S. FAUCI Editor, Editions 11, 12, 13,

treating fractures in the field

Wed, 25 Jun 2008 15:49:07 GMT

U.S. ARMY MEDICAL DEPARTMENT CENTER AND SCHOOL FORT SAM HOUSTON, TEXAS 78234-6100 TREATING FRACTURES IN THE FIELD SUBCOURSE MD0533 EDITION 200 *DEVELOPMENT This subcourse is approved for resident and correspondence course instruction. It reflects the current thought of the Academy of Health Sciences and conforms to printed Department of the Army doctrine as closely as currently possible. Development and progress render such doctrine continuously subject to change. ADMINISTRATION For comments or questions regarding enrollment, student records, or shipments, contact the Nonresident Instruct

splinting

Wed, 25 Jun 2008 15:48:36 GMT

SPLINTING • • • • • • Indications: o Fracture o Dislocated joint after reduction o Sprain: torn or stretched ligaments o Strain: torn or stretched muscles or tendons o Postoperative immobilization Contraindications: o Absolute: none. o Relative: Injuries involving open wounds or infections need easily removable splints to allow soft tissue care. Anesthesia: If injury is grossly stable, use IV sedation (see Appendix C). Equipment: o Cast padding (soft roll) o Plaster/fiberglass o Lukewarm water o Ace bandages o Disposable gloves Positioning: o Ankle/foot: 90° angle between foot and leg, ne

radiology for anaesthesia and intensive care

Wed, 25 Jun 2008 15:48:24 GMT

*Radiology for Anaesthesia and Intensive Care *This page intentionally left blank *Radiology for Anaesthesia and Intensive Care Richard Hopkins Consultant Radiologist Department of Radiology Cheltenham General Hospital Carol Peden Consultant Anaesthetist Royal Bath United Hospital Sanjay Gandhi Department of Clinical Radiology Bristol Royal Infirmary LONDON SAN FRANCISCO *Greenwich Medical Media 4th Floor, 137 Euston Road, London NW1 2AA © 2003 870 Market Street, Ste 720 San Francisco CA 94109, USA ISBN 184110 1192 First published 2003 Apart from any fair dealing for the purposes of rese

manual of laboratory and diagnostic tests

Wed, 25 Jun 2008 15:44:09 GMT

*McGraw-Hill’s Manual of Laboratory & Diagnostic Tests *Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has bee

Satmar Rabbi

Wed, 11 Jun 2008 15:02:57 GMT

Catskill Mountain’s Satmar Shul Woodridge, NY Rabbi Dr. Arnold Goldenberg wcc9292@aol.com *Founder ******* Satmar Dynasty **********************

Surgery

Tue, 01 Apr 2008 04:50:54 GMT

USMLE Step 2 Surgery Notes * medical *USMLE is a joint program of the Federation of State Medical Boards o f the United States, Inc, and the National Board of Medical Exam~ners. KAPLAN" *G2003 Kaplan, Inc. All rights reserved. No part of this book may be reproduced in any form, by photostat, microfilm, xerography or any other means, or incorporated into any information retrieval system, electronic or mechanical, without the written permission of Kaplan, Inc. Not for resale. *AUTHORS Surgery Carlos Pestana, M.D., Ph.D. Emeritus Professor of Surgery University of Texas Medical School at S

acid-base worksheet

Sun, 24 Feb 2008 06:43:05 GMT

Acid-Base Disorders Worksheet Step 1: Gather the necessary data (electrolytes and an ABG). Make sure the HCO3 from the electrolyte panel and ABG are within 2 (if not, the results are uninterpretable). pH /pCO2 /HCO3 Step 2. Look at the pH. If pH > 7.4, then pt is alkalemic (proceed to Step 3a). If pH < 7.4, then pt is acidemic (proceed to Step 3b). Pt has primary: Acidemia / Alkalemia Step 3. Determine the primary etiology. 3a. Alkalemia: Increased HCO3 = Metabolic alkalosis (go to Step 5). Decreased pCO2 = Respiratory alkalosis (go to Step 4a). Decreased HCO3 = Metabolic acidosis (go to St

ABG Made easy

Sun, 24 Feb 2008 06:43:04 GMT

Simple Method of Acid Base Balance Interpretation A FOUR STEP METHOD FOR INTERPRETATION OF ABGS Usefulness This method is simple, easy and can be used for the majority of ABGs. It only addresses acid-base balance and considers just 3 values. • • • pH, PaCO2 HCO3- Step 1. Use pH to determine Acidosis or Alkalosis. ph 7.35-7.45 Normal or Compensated < 7.35 Acidosis > 7.45 Alkalosis Step 2. Use PaCO2 to determine respiratory effect. PaCO2 < 35 • 35 -45 • > 45 Tends toward acidosis Causes low pH Neutralizes high pH • Tends toward alkalosis Causes high pH Neutralizes low pH N

ABG1

Sun, 24 Feb 2008 06:33:31 GMT

Arterial Blood Gases Made Easy Arterial Blood Gases *Purpose of ABG • Assess degree to which lungs are able to provide adequate oxygen & remove CO2 & degree to which the kidneys are able to reabsorb or excrete HCO3 *You Must Know What is Normal to be Able to Know What is Abnormal • • • • pH = 7.35 to 7.45 PaC02 = 35 to 45 mm Hg PaO2 = 80 to 100 mm Hg HCO3 = 22 – 26 mEq/l *What You Must Look at to Interpret ABGs *Look at Your pH • Is it normal? • Is it high ? • Is it low? *Examples • • • • • pH = 7.36 pH = 7.23 pH = 7.47 A high pH indicates alkalosis A low pH in

123

Sun, 24 Feb 2008 06:31:11 GMT

EKG Examples

Sat, 23 Feb 2008 00:37:26 GMT

ECG review – ACLS Program Ohio State University Medical Center Rhythm Normal Sinus Rhythm (NSR) ECG Characteristics Rate: 60-100 per minute Rhythm: R- R = P waves: Upright, similar P-R: 0.12 -0 .20 second & consistent qRs: 0.04 – 0.10 second P:qRs: 1P:1qRs Example Sinus Tachycardia Causes: Exercise Hypovolemia Medications Fever Hypoxia Substances Anxiety, Fear Acute MI Fight or Flight Congestive Heart Failure Rate: > 100 Rhythm: R- R = P waves: Upright, similar P-R: 0.12 -0 .20 second & consistent qRs: 0.04 – 0.10 second P:qRs: 1P:1qRs Sinus Bradycardia Causes: intrinsic sinus node

Reading a EKG

Fri, 22 Feb 2008 03:27:34 GMT

READING AN EKG 1. Rate – if regular, then count the number of large squares between R waves; 1 square = 300 bpm, 2 = 150 bpm, 3 = 100 bpm, 4 = 75 bpm, 5 = 60 bpm, 6 = 50 bpm. Each small box = 0.04 s, each large box = 5 small boxes = 0.20 s. 2. Rhythm – is it regular? (use calipers/ruler to make sure all R-R intervals are the same); are there P waves, and are they in front of every QRS? (in sinus rhythm, P waves will be upright in lead II); are P waves all identical? 3. Intervals  PR interval: normally 0.12 to 0.20 seconds (will not exceed a large box)  QRS interval: normally 0.04 to

sah

Fri, 22 Feb 2008 03:22:06 GMT

SJS Nov-03 HOW NOT TO MISS A SUBARACHNOID HEMORRHAGE (SAH) Edlow JA, Caplan LR. Avoiding pitfalls in the diagnosis of subarachnoid hemorrhage. N Engl J Med. 2000;342:29-36. Vallejo van Gijn J, Rinkel GJ. Subarachnoid haemorrhage: diagnosis, causes and management. Brain. 2001;124:249-78. Take home points: 1. We commonly misdiagnose SAH, especially in stable patients with normal neuro exams. 2. A large number of patients with SAH present atypically; in fact those with benign presentations have greatest potential benefit from surgical therapy. 3. Head CT, in the best of circumstances has only a

EKGs

Fri, 22 Feb 2008 03:16:30 GMT

EKG 101 Deborah Goldstein Georgetown University Department of Internal Medicine *Steps to Interpreting an EKG • • • • • • • • Rate Rhythm Axis Intervals (PR, QRS, QTc) Hypertrophy ST segments T waves Q waves **Rate *Naming stuff *Normal Sinus Rhythm • P before every QRS – Best places to look: II, V1 • QRS after each P *Axis 1. The direction of the mean electrical vector, representing the average of current flow in the frontal plane. 2. Normal axis: –30 to +90 degrees. *Axis *Axis • Look at lead I and aVF. • Then find the isoelectric lead (where the QRS compl

Arrhythmias teacher guide

Fri, 22 Feb 2008 03:15:58 GMT

VI. Arrhythmias: Robert Vu, MD Clerkship Director Indiana University School of Medicine Note: The correct multiple choice answer for each question is underlined. Specific Learning Objectives: Knowledge. Subinterns should be able to describe and define: 1. The types of arrhythmias commonly encountered in the inpatient setting, including: a. Premature atrial/ventricular contractions b. Ventricular arrhythmias c. Atrial arrhythmias d. Supraventricular tachyarrhythmias e. Atrioventricular blocks f. Bradycardias 2. Distinguishing “benign” from significant arrhythmias a. Recognition of “benig

antiphospholipid

Fri, 22 Feb 2008 03:15:56 GMT

SJS Sept-03 ANTIPHOSPHOLIPID SYNDROME – MAKING THE DIAGNOSIS Levine JS, Branch DW, Rauch J. The antiphospholipid syndrome. N Engl J Med. 2002;346(10):752-63. International Consensus Statement – Criteria for the Definite Diagnosis of APLS: In order to make the definitive diagnosis of APLS, the patient must meet at least one clinical criteria and at least one laboratory criteria. Clinical criteria: • Vascular thrombosis (arterial, venous, or small-vessel thrombus in any organ) • Complication of pregnancy - > 1 unexplained fetus death after 10 weeks (morph. normal fetus) - > 1 premature

acs

Fri, 22 Feb 2008 03:15:53 GMT

Guidelines For Management of Acute Coronary Syndromes University of California San Francisco Division of Cardiology Department of Clinical Pharmacy (REVISED May 13, 2003) A. Acute Reperfusion Therapy: MI with ST ↑ or new bundle branch block On presentation with cardiac chest discomfort or other possibly ischemic symptoms such as dyspnea, patients should be considered for acute reperfusion if: Chest pain or symptoms of acute myocardial infarction are of at least 30 minutes in duration and began within 12 hours of presentation to the ED. Patients presenting with symptoms which began greater t

Toxidromes

Fri, 22 Feb 2008 02:55:28 GMT

Toxidromes Toxidrome Anticholinergic Presentation Delirium, Flushed Skin, Dilated Pupils, Urinary Retention, Decreased Bowel Sounds, Memory Loss, Seizures Hot as a Hare, Dry as a Bone, Red as a Beet, Blind as a Bat Vital Sign Changes Causative Agents Tachycardia Hyperthermia Hypertension Antihistamines Scopolamine Jimson Weed Angel Trumpet Benztropine Tricyclic AntiDepressants Atropine Organophosphates Carbamates Mushrooms Cholinergic Hallucinogenic Opiate/Narcotic Confusion, Weakness, Salivation, Lacrimation, Defecation, Emesis, Diaphoresis, Muscle Fasciculations, Miosis, Seizures Disor

Sample Internal Medicine Admission Note

Fri, 22 Feb 2008 02:55:24 GMT

Sample Medicine Admit Note Amar Krishnaswamy Internal Medicine Admission Note ID: Identify pt and reason for admission (working Dx). Also include relevant PMHx. ex: The pt is a 72 yo gentleman with h/o CHF, CAD, DM now admitted with suspected CHF exacerbation CC: Quote the patient’s own words. ex: “I couldn’t breathe” HPI: Begin by commenting on the pt’s comorbid illnesses (Dx, severity, treatments) that are relevant to the current presentation. Then address the chronology of the pt’s current illness (Pt in USOH until…), including pertinent ROS positives. Mention relevant ROS ne

pocket stemi

Fri, 22 Feb 2008 02:55:23 GMT

Learn and LiveSM ACC/AHA Pocket Guideline Based on the ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction Management of Patients With ST-Elevation Myocardial Infarction July 2004 a *Management of Patients With ST-Elevation Myocardial Infarction July 2004 ACC/AHA Writing Committee Special thanks to Elliott M. Antman, MD, FACC, FAHA, Chair Daniel T. Anbe, MD, FACC, FAHA Paul Wayne Armstrong, MD, FACC, FAHA Eric R. Bates, MD, FACC, FAHA Lee A. Green, MD, MPH Mary Hand, MSPH, RN, FAHA Eli Lilly and Company supported this pocket guideline through an ed

ORDERS- ROBERT KATZ MD

Fri, 22 Feb 2008 02:55:14 GMT

STANDING ORDERS ROBERT KATZ MD Phone: 718/516-470-3495 Beeper: 888-634-3863 FAX: 718-347-0468 Email: katz@lij.edu 4/30/04 rev. 5/02 *CONTENTS Topic Abdominal Pain ....................................................…………........... Abrasions Allergic Dermatitis Anaphylaxis Asthma Bites - Animal Bites - Human Bites - Insect Bites - Snake Bites - Spider Bites – Tick Burns - Superficial 4 4 4 5 6 6 6 6 7 7 7 8 8 9 9 10 10 11 11 11 12 12 12 13 13 13 14 14 14 15 15 15 16 16 ............................................................................................ .....................

Miami Contract

Fri, 22 Feb 2008 02:55:12 GMT

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JNC 7

Fri, 22 Feb 2008 02:55:01 GMT

Clinical Practice Guideline Hypertension Evaluation and Treatment The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) was released in May 2003. Premera has adopted the National Heart Lung and Blood Institute’s JNC 7 guideline. The Reference Card from the guideline is attached and the complete guideline text is available online at: www.nhlbi.nih.gov/guidelines/hypertension/index.htm. The key focus of JNC’s new guideline is to get patients accurately diagnosed, evaluated and on therapy in a reasonable amount o

Everything Electrical and Cardiac

Fri, 22 Feb 2008 02:49:41 GMT

Everything Electrical and Cardiac: An EKG Treatise By Michael Garcia August 18, 2001 Note: You will need the notes to look at the EKGs. I believe that Campbell will test us from those patterns. There is also a ton of great sites with classic EKG patterns on them. Just search www.Google.com, EKG and you will find all the resources you need. The Basics – First things First Cardiac Electrophyisiology – a very brief overview The heart is depolarized by a wave of positive charges traveling down the heart from their origin in the SA node in the right atrium until their endpoint at the end of the

EKGs

Fri, 22 Feb 2008 02:49:37 GMT

EKG Reference Sheets

Fri, 22 Feb 2008 02:49:01 GMT

333 Personal Quick Reference Sheets (pages 333 to 346) from: Rapid Interpretation of EKG’s by Dale Dubin, MD COVER Publishing Co., P.O. Box 1092, Tampa, FL 33601, USA The owner of this book may remove pages 333 through 346 to carry as a personal quick reference, however, copying for or by others is strictly prohibited. The entire text of Rapid Interpretation of EKG’s is fully protected by domestic United States copyright as well as the Universal Copyright Convention, and all rights of absolute imprimatur are enforced by COVER Publishing Co. RAPID INTERPRETATION OF EKG’s Dr. Dubin

Chuver legal Documents

Fri, 22 Feb 2008 02:47:03 GMT

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amedd

Fri, 22 Feb 2008 02:46:17 GMT

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VitKguidelines

Fri, 22 Feb 2008 02:35:47 GMT

Guidelines for the Administration of Vitamin K Drug Information Center C-113 Chandler Medical Center, (859) 323-5320 Introduction In 2001, the American College of Chest Physicians (ACCP) Task Force on Antithrombotic Therapy published the proceedings of their Sixth Consensus Conference on antithrombotic therapy. These recommendations, published in CHEST, address the management of patients receiving oral anticoagulation therapy. Warfarin-associated coagulopathy, or excessive prolongation of the INR, places patients at an increased risk for severe bleeding complications. In addition, therapeutic