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Practical Question Strategy— A 67-Year-Old Man with Cough with Brian Radavansky from MedSchoolTutors | (USMLE Question Dissection)

Practical Question Strategy— A 67-Year-Old Man with Cough with Brian Radavansky from MedSchoolTutors | (USMLE Question Dissection)

July 21, 2018

Intro

In this episode we dissect the following practice question with Dr. Brian Radvansky from MedSchoolTutors. 

Question Stem

A 67-year old man presents to the Emergency Department with a 2-day history of progressively worsening cough. He has a history of poorly-controlled hypertension, 30 pack-year smoking history, well-controlled diabetes, and a STEMI 4 years prior. He complains of mild sharp chest pain while coughing, some shortness of breath while walking around his apartment, and lightheadedness when standing up. Vital signs on arrival are HR 114, BP 100/55, RR 26, T 101.9 ℉, SpO2 86% on 4 L nasal cannula. Physical exam is significant for general ill appearance, decreased breath sounds in the right lower chest, tachypnea, tachycardia, and use of accessory muscles of breathing. His is somewhat alert and oriented only to person and place. ABG shows pH 7.29/pCO2 60/pO2 69. EKG shows Q-waves in the inferior leads.

Which of the following is most likely to improve the patient’s clinical status?

  1. Dobutamine
  2. Furosemide
  3. Doxycycline
  4. Vancomycin and Piperacillin-Tazobactam
  5. Pleurocentesis
  6. Aspirin and Heparin

The full post is not yet published. But you can read more high-yield question breakfowns on the MedSchoolTutors excellent blog. 

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Our audio qbank is THE PERFECT companion for studying for the boards on the go. And we're adding content and improving it all the time.  

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Legal Stuff

InsideTheBoards is not affiliated with the NBME, USMLE, COMLEX, NBOME or any professional licensing body. InsideTheBoards fully adheres to the policies on irregular conduct outlined by the aforementioned credentialing bodies. 

Music: "Anaesthetist" off The Mindsweep by Enter Shikari (used with permission).

Practical Question Strategy—Fever and Oliguria in a 24-Year-Old Female with Brian Radavansky from MedSchoolTutors | (USMLE Question Dissection)

Practical Question Strategy—Fever and Oliguria in a 24-Year-Old Female with Brian Radavansky from MedSchoolTutors | (USMLE Question Dissection)

July 7, 2018

Intro

In this episode we dissect the following practice question with Dr. Brian Radvansky from MedSchoolTutors. 

Question Stem

A 24-year old female with no past medical history presents to her primary care doctor complaining of a fever. 

The fever started two days ago, though she was unable to take temperatures at home and has just felt “hot.” Review of systems is positive for fatigue, arthralgia, and decreased urine output in the last day or so. 

She recently completed a course of trimethoprim-sulfamethoxazole for an uncomplicated urinary tract infection. Vital signs are temperature 101.3F, heart rate 104 bpm, blood pressure of 114/74, and respiratory rate of 18. Physical exam is significant for a diffuse, non-pruritic maculopapular rash on the torso, but is otherwise normal. Lab studies show the following:

Sodium 141 mEq/L
Potassium 4.4 mEq/L
Chloride 99 mEq/L
Bicarbonate 23 mEq/L
BUN 30 mg/dl
Creatinine 2.1 mg/dl
Glucose 102 mg/dl

Urinalysis shows pyuria w/many eosinophils and no bacteria. What is the most likely etiology of this patient’s chemistry abnormalities?

A.  Decreased renal perfusion secondary to dehydration
B.  Post-obstructive nephropathy
C.  Granulomatosis with polyangiitis (Wegener’s disease)
D.  Sloughing of tubular epithelium into the tubule
E.  Allergic immune response in the renal interstitium

You can read the full blog post, "A Young Woman with Fever and Oliguria" on the MedSchoolTutors blog.

ITB Audio Qbank and iOS Beta App

The Audio Qbank by InsideTheBoards mobile app has both free and premium features and is available on both Android and iOS

To get started, first, create a Boardsinsider Account on our website insidetheboards.com

Free Features 

  1. All of our podcasts in one place organized into playlists for easy studying (also with less ads and exclusive content) 
  2. Mindfulness meditations designed specifically for medical students 
  3. A monthly offering of high yield content (questions dissections, audio qbank samples) available only on our mobile app. 

Premium Features

Subscribe to an ITB premium account and get additional features 

  1. Access to 500+ audio optimized board style practice questions in our Audio Qbank. The Step 1 version is powered by Exam Circle and the Step 2 Version is powered by OnlineMedEd. New questions added each month. 
  2. High Yield Pharmacology (powered by Lecturio) with 100 of the top pharm questions you need to know for both Step 1 and Step 2 
  3. Audio Flashcards (coming soon) 

Our audio qbank is THE PERFECT companion for studying for the boards on the go. And we're adding content and improving it all the time.  

Learn more about the Audio Qbank by InsideTheBoards mobile app here

Legal Stuff

InsideTheBoards is not affiliated with the NBME, USMLE, COMLEX, NBOME or any professional licensing body. InsideTheBoards fully adheres to the policies on irregular conduct outlined by the aforementioned credentialing bodies. 

Music: "Anaesthetist" off The Mindsweep by Enter Shikari (used with permission).

Family Medicine Part 5 – Audio Qbank Third Year (powered by OnlineMedEd)
Premium

Family Medicine Part 5 – Audio Qbank Third Year (powered by OnlineMedEd)

July 3, 2018

Content courtesy of OnlineMedEd. Copyright OnlineMedEd. Questions have been optimized and edited for audio consumption. For more great content go to onlinemeded.org.

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