By Carlos Ayala
This Fourth variation of forums and Wards deals a vital evaluation for scientific scholars getting ready for scientific rotations and for the USMLE Steps 2 and three. Written in a succinct, high-yield define structure, the publication positive factors new board-formatted questions and solutions with particular reasons, and covers each one self-discipline of drugs showing at the USMLE Steps 2 and three, together with dermatology, radiology, and ophthalmology. a variety of tables, full-color illustrations, and "buzzwords" reduction in retention of evidence. This version additionally good points elevated point of content material in ophthalmology, dermatology, and otolaryngology, in addition to elevated illustrations. A better half web site bargains over 2 hundred USMLE-style questions and solutions: seventy five (all new!) from the publication and an extra a hundred thirty online-only.
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Extra resources for Boards and Wards, Fourth Edition
Pacer can be in atrium or at AV junction, and multiple pacers can be active at any one time (MFAT) c. It can be very difficult to distinguish ventricular tachycardia from SVT if the pt also has a bundle branch block d. Tx depends on etiology (1) Correct electrolyte imbalance, ventricular rate control (digoxin, Ca2ϩ-channel blocker, ␤-blocker, adenosine) and electrical cardioversion in unstable pts (2) Attempt carotid massage in pts with paroxysmal SVT (3) Adenosine breaks Ͼ90% of SVT, converting it to sinus rhythm; failure to break a rhythm with adenosine is a potential diagnostic test to rule out SVT 6.
Tx not required 2. Mitral Valve Regurgitation (MVR) a. Seen in severe MVP, rheumatic fever, papillary muscle dysfunction (often 2° to MI) and endocarditis, Marfan’s syndrome b. Results in dilation of left atrium (LA), ↑ in LA pressure, leading to pulmonary edema/dyspnea c. 8 Cardiomyopathy Dilated Hypertrophic Restrictive Cause Ischemic, infectious (HIV, Coxsackie virus, Chagas’ dz), metabolic, drugs (alcohol, doxorubicin, azidothymidine) Genetic myosin disorder Amyloidosis, scleroderma, hemochromatosis, glycogen storage dz, sarcoidosis Si/Sx Right and left heart failure, afib, S3 gallop, mitral regurgitation Systolic dz Exertional syncope, angina, EKG → left ventricular hypertrophy Diastolic dz Pulmonary HTN, S4 gallop, EKG → ↓ QRS voltage Diastolic dz Tx Stop offending agent, once cardiomyopathy onsets, Tx similar to CHF Implantable cardiac defibrillator None d.
Beware of giving loop diuretics without spironolactone (a Kϩ-sparing diuretic), because in the presence of hypokalemia, digoxin can become toxic at formerly therapeutic doses—digoxin toxicity presents as SVT with AV block and yellow vision and can be acutely treated with antidigitalis Fab antibodies (Abs) as well as correction of the underlying potassium deficit E. 8) F. Valvular Dz 1. Mitral Valve Prolapse (MVP) a. Seen in 7% of population; in vast majority is a benign finding in young people that is aSx and eventually disappears b.