I'm a 27-year-old medical graduate using this channel to discuss study strategies, review for medical school exams, and productivity tips, among other things.
I think where you shine compared to other medicine RU-vidrs is your explanation and logical, common sense thought process and reasoning behind certain things. It really made me understand somethings by logically thinking, instead of regurgitating facts and memorizing uworld table. It’s similar to the way divine teaches and some Emma Holiday, but your even better at explaining in simple terms that any common man could understand without using complex terminology.
Super helpful! For HDS BAT w/o peritoneal signs, looks like all roads lead to CT? Regardless of whether the FAST is +/- the next step is CT, either to plan surgery or to look for another cause for the symptoms... so why even bother with the FAST? Is it mostly if a patient is borderline going unstable and you want info fast? Otherwise as the algorithm is written it looks like "waste" since it wouldn't alter the diagnostic path. But I could totally see the utility of FAST for quick info incase things went south fast
Unstable and no peritonitis, but fast scan is positive > laparatomy. Mainly for that, bec there is fluid leakage, no peritonitis, and there unstable, so surgical exploration is needed. Fast scan negative + unstable or fast scan positive + stable = CT bec it’s not urgent danger and have time to investigate further.
The below comment hit it on the head, great point! Imaging is always helpful for localizing a source of trauma but FAST is faster, and done at bedside without any potential delay meanwhile CT may take time to transfer, wait time, and then the process of completing the scan itself. So FAST is a more time-efficient way to confirm that there is significant intra-abdominal injury to warrant surgery. CT will give a more detailed survey but the downside is the time it takes could delay surgery by even a few minutes, so its only ideal when there is time (either the patient is stable, or FAST is negative and there's indeterminate location of an injury).
Do you know of a resource that has the diagnostic and management algorithms/steps for these cases? I can identify most of these things but need more concise next best step in management or treatment in each case or scenario. Thanks
Case Files - Internal Medicine fourth edition by Toy and Patlan is what a lot of us are using. Maybe not specifically for emergency medicine but it has a lot of examples that you're describing. Maybe you can buy it but I know people just airdropped PDFs of it so it's probably around
“Surgery because it freaks me out…” lord please don’t ever be my doctor. Stanford type B is medical management, but glad to know that student thinks surgery for everyone.
Thank you Tim! For your Jakafi example, do we just assume that they did a valid study with appropriate significance all the the ad itself gives no details on how the study was conducted?
Yes, that's exactly the thought! Unless you can see the measures of significance in detail or if they mention some internal flaws of the study, it's usually best to just interpret with those assumptions (unless they specifically mention otherwise).
That's a tough one. There are probably several that are decent but hard to fine one that is totally comprehensive. The Amboss library, U-World summary tables, Divine Intervention series, and even Up-to-Date articles can all be useful!
this was a very good video with just enough explanation of basics to understand everything without memorization and keeping it brief to the high yield information. My only feedback is that I would have preferred if you also explained how to spot the subcortical stroke symptoms so we could get the full picture.
Great question! The main things to keep in mind are using whatever diagnostic criteria they are giving and using those when you can. Like for example with schizoaffective, they will almost always emphasize a 2-week period with psychotic symptoms and no features of the mood disorder. Otherwise sometimes it can be helpful to try and figure out what the primary symptom(s) are and which seems more "accessory" or "secondary". For example in bipolar disorder with psychotic features, the hallmark symptoms of mania will be the focal point of the question with some added notes about hallucinations. For sure though these can be difficult and it's a combo of using diagnostic criteria and using the "picture" they are trying to paint to find the underlying primary diagnosis.
That's a reasonable thought, it is pretty early in the timeline for troponin to be significantly elevated. Because it is such a highly sensitive marker though, it can be useful early on in management to see what the "baseline" value is and see if that changes over time. So even if it was normal or only mildly elevated, being able to trend it over the next several hours will be very useful in management. Great point though!
Dr. Tim! these reviews are so helpful! carried me thru OBGYN, Peds, and Psych. Have my Medicine self in a few days. Would love to see if you have pulmonary review. watching the other dedicated systems rn throughout the week. Thank you for the great presentations through out!
Thank you so much for this! The timing of this was perfect as I'm taking my IM shelf next week and don't have a ton of time to review ID. I also used your content for psych as well. Looking forward to more content!
Phenomenal job! Great content! Perfect pace! And brilliant slides! Please put your name on all your slides. Sometimes I screenshot them to reinforce the material & on occasion share with a classmate. Thank you for your work‼️
For the second question can you explain why the answer was NOT sarcoidosis? The explanation provided afterward basically showed that all the hints you gave applied to both, so I am curious as to what the reasoning to be used there to discriminate them
Great question. Sarcoid could definitely be considered solely based on the lab findings alone including the restrictive pattern and even reduced DLCO. The way to differentiate it from ILD was the history and demographic information. The age-range and "fine" crackles fits more with ILD and helps deter from sarcoid. They could show you a similar question with a young female with no prior history and that shifting of the background and demographic would be more typical of a sarcoid question!
@@Doctor_Tim Thank you doctor. I am in medical school and surprisingly (or surprising to me) This topic (plus biostats) is worth 11% of my total grade from year 1 and year 2 of medical school and a substantial part of my Step 1 Exam. Its become a huge topic in medical school.
This was the BEST cardio video I have ever seen. The explanations are amazing! Can not believe cardio has never been taught to me this way. Thank you!!!!
Wouldn't wide-spread vasodilation lead to decreased peripheral vascular resistance and pooling of blood in the peripheral tissues. As a result, wouldn't blood flow to the extremities be compromised? Wouldn't this lead to cold extremities due to decreased perfusion and circulation to those areas?
That's a great question. What you are saying could be possible after an extended period of distributive shock. However, they tend to primarily test the initial insult and the direct cardiovascular manifestations of that dysfunction. And in the short term, the decreased SVR and relative pooling of blood in the extremities is how the extremities stay warm in contrast to the other types of shock.
