USMLE Case Review
@medrx_educationJoin us to review evidence based medicine. Review the Cardiology (2016) w/ https://t.co/sGU5FAdFXf #USMLE #ABIM #ABFM #PLAB #NCLEX Powered by Chirag Navadia, MD
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PCSK9 Inhibitors (#Evolocumab, #Alirocumab) - Increases clearance of LDL - given for uncontrolled LDL levels in #combination with statins or #monotherapy in patients who cannot tolerate statins - do not lower mortality #MedRxed #MedEd #USMLE #ABIM #Cardiology #PCSK9
EMPHYSEMATOUS CHOLECYSTITIS - Symptoms: Fever, Right Upper Quadrant pain, Nausea and Vomiting - Diagnosis: Gas in Glabber wall, Air fluid level - Most common cause: Clostridium - Rx: Emergent Cholecystectomy, Antibiotics #MedRxed #MedScape #USMLE #ABIM #MedStudents #Cholecystitis
HYPOTHYROID MYOPATHY - Fatigue, Wt gain - Myalgia, Proximal weakness - Hyporeflexia - Normal ESR, High Creatine Kinase - Dx: TSH, free T4 #MedRxed #USMLE #Meded #MedStudents #hypothyroidism
LINAGLIPTIN, SITAGLIPTIN - DPP-4 Inhibitor (reduces glucagon and blood glucose level by increasing incretin levels) - Most common side effects: upper respiratory tract infection and headache. Rarely cause severe joint pain & pancreatitis. #USMLE #MedRxeD #MedED #Diabetes #ABIM
EMPAGLIFOZIN - SGLT-2 (sodium-glucose co-transport) inhibitor: increases clearance of glucose in urine - Most common side effect: UTIs - Lowers mortality from any cause, - a/w weight loss, & reduction in blood pressure #MedRXed #USMLE #Diabetes #ABIM #primarycare #Jardiance
The main reason is to avoid future CHF, thus, is reasonable to add a bit more “drama” to the classification. Perhaps patients would take more seriously the salt intake and the need for aerobic exercise
Prehypertensive patients feeling uncomfortable after categorizing them into either Stage 1 or the frightening word "elevated". What is your opinion for this new classification and impact on the general population? #residency #match2018 #physicians #doctors #medicine
New Drug: EMICIZUMAB - FDA approved for Hem A w/ factor VIII inhibitors - bridges activated Factor IX & X - reduces frequency of bleeding episodes (once weekly inj) - Warning: thrombotic microangiopathy & thromboembolism on rescue Rx w/ aPCC #MedRXeD #Hematology #Updates #ABIM
HEMOPHILIA A w/ Factor VIII Inhibitors - If inhibitor titer < 5 Bu/ml: Increase dose of FVIII - If titer > 5: Activated prothrombin complex concentrate, Activated recombinant FVII, Porcine Factor VIII WE NOW HAVE ONE MORE FDA APPROVED DRUG... #MedRxeD #ABIM #Hematology #Meded
HEMOPHILIA A - Treatment: Desmopressin (for mild cases), Factor VIII Replacement (for severe cases). - Patient may develop inhibitor or antibodies to Factor VIII and requires treatment modification..... #MedRXeD #USMLE #ABIM #primarycare #Meded
HEMOPHILIA A - Factor VIII deficiency, X-linked recessive - Increased bleeding risk (after minor trauma or surgery) - High PTT corrected on mixing study, normal PT, normal bleeding time #MedRxed #USMLE #medschool #meded #Medicine
SHINGRIX - Recombinant Adjuvanted Zoster Vaccine (90% efficacy) - Approved by FDA for adults age 50 years and older - 2 doses within a 6-month interval #MedRXed #Meded #medicine #Updates #ABIM #USMLE #PrimaryCare
New ACC/AHA High Blood Pressure Classification - 11/13/2017 Bye, Bye "Prehypertension".....Welcome "Elevated" #MedRx #USMLE #MedRxeD #ABIM #medstudents #medschool #MedEd #primarycare
Effectiveness of statins in pts w/ chronic renal insufficiency or heart failure is unclear. #Prescribe it unless contraindicated! #MedRXed
Clinically Significant Atherosclerotic Dz [2/2] - Hx of stroke, Transient ischemic attack - Severe peripheral arterial disease #MedRXeD #Med
Clinically Significant Atherosclerotic Dz [1/2] - ACS; MI, stable/unstable angina - Coronary or other #arterial revascularization #MedRXeD
INDICATIONS of HIGH INTENSITY STATINS - Significant atherosclerotic dz in <75yo - LDL >190mg/dL - Diabetics 40-75yo w/ 10yr ASCVD risk >7.5%
MODERATE INTENSITY STATINS - Atorvastatin 10-20mg - Rosuvastatin 5-10mg - Simvastatin 20-40mg - Pravastatin 40-80mg - Lovastatin 40 #MedRxED
HIGH INTENSITY STATINS - Atorvastatin 40-80 mg - Rosuvastatin 20-40 mg #MedRxed #ABIM #ABFM #USMLE #Foamed #meded
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