Antibiotic prophylaxis questions used to be difficult and confusing (and easy to get wrong), but thankfully the current recommendations are very straight forward. The board will put a bunch of confounding (superficially scary) cardiac histories and exam points, and lead you to “want” to give antibiotic prophylaxis, but don’t be fooled!! If whatever they put doesn’t [...]

Insomnia is defined as repeated difficulty with the initiation, duration, maintenance, or quality of sleep that occurs despite adequate time and opportunity for sleep that results in some form of daytime impairment. Approximately one third of adults report some difficulty falling asleep and/or staying asleep during the past 12 months, with 17% reporting this problem [...]

Types of Breast Nipple Discharge Discharge color Duct involvement Risk Evaluation Milky more than one galactorrhea due to medicines or anovulation confirm fat globules in the discharge, draw a serum TSH and prolactin for thyroid and hypothalamic disorders Clear, watery or yellowish one duct breast cancer or fibrocystic breast condition exam, mammogram, ductogram and cytology [...]

Acoustic neuromas are intracranial, extra-axial tumors that arise from the Schwann cell sheath investing either the vestibular or cochlear nerve.  Acoustic tumors, like other space-occupying lesions, produce symptoms by any of 4 recognizable mechanisms: (1) compression or distortion of the spinal fluid spaces, (2) displacement of the brain stem, (3) compression of vessels producing ischemia [...]

Malignant external otitis is an infection that affects the external auditory canal and temporal bone. The causative organism is usually Pseudomonas aeruginosa, and the disease commonly manifests in elderly patients with diabetes. The infection begins as an external otitis that progresses into an osteomyelitis of the temporal bone. Spread of the disease outside the external [...]

Glaucoma is a disease in which the optic nerve is damaged, leading to progressive, irreversible loss of vision. It is often, but not always, associated with increased pressure of the fluid in the eye. The nerve damage involves loss of retinal ganglion cells in a characteristic pattern. There are many different sub-types of glaucoma but [...]

Painless loss of monocular vision is the usual presenting symptom of retinal artery occlusion. Ocular stroke commonly is caused by embolism of the retinal artery. Retinal artery occlusion represents an ophthalmologic emergency, and delay in treatment may result in permanent loss of vision. Immediate intervention improves chances of visual recovery, but, even then, prognosis is [...]

Water-soluble vitamins and their characteristics. Common food sources Major functions Deficiency symptoms Overconsumption symptoms Stability in foods Vitamin C (ascorbic acid) Citrus fruits, broccoli, strawberries, melon, green pepper, tomatoes, dark green vegetables, potatoes. Formation of collagen (a component of tissues), helps hold them together; wound healing; maintaining blood vessels, bones, teeth; absorption of iron, calcium, [...]

Fat Soluble Vitamin Facts Vitamin Source Physiological Functions Deficiency Overconsumption A (retinol) (provitamin A, such as beta carotene) Vitamin A: liver, vitamin A fortified milk and dairy products, butter, whole milk, cheese, egg yolk. Provitamin A: carrots, leafy green vegetables, sweet potatoes, pumpkins, winter squash, apricots, cantaloupe. Helps to form skin and mucous membranes and [...]

Most studies demonstrate a spontaneous miscarriage rate of 10-15%. However, the true rate of early pregnancy loss is close to 50% because of the high number of chemical pregnancies that are not recognized in the 2-4 weeks after conception. Most of these pregnancy failures are due to gamete failure (eg, sperm or oocyte dysfunction). In [...]

Retinal detachment occurs when subretinal fluid accumulates in the potential space between the neurosensory retina and the underlying retinal pigment epithelium. Symptoms Photopsias refer to the perception of flashing lights by the patient. It probably arises from the mechanical stimulation of vitreoretinal traction on the retina. It may be induced by eye movements and appears [...]

Sudden visual loss is a common complaint among patients of different ages with variable presentations. Some patients describe it as a gray-black curtain that gradually descends or as blurring, fogging, or dimming of vision. It usually lasts a few minutes but can persist for hours. The frequency varies from a single episode to many episodes [...]

Pharyngitis is defined as an infection or irritation of the pharynx and/or tonsils. The etiology is usually infectious, with most cases being of viral origin. These cases are benign and self-limiting for the most part. Bacterial causes of pharyngitis are also self-limiting, but are concerning because of suppurative and nonsuppurative complications. Other causes include allergy, trauma, [...]

It is inflammation of the bursa between greater trochanter and iliotibial tract. Overuse of gluteal musculature and pressure over trochanteric region are most common causes. Patients complain of hip pain and pain over outer thigh as well as difficulties walking. Examination reveals localized midtrochanteric tenderness, aggravation of pain by abduction of hip against resistance and [...]

It is inflammation of the flexor tendons of the fingers as they cross metacarpophalangeal (MCP) joint due to overuse (repetitive gripping and grasping). Swelling causes finger to lose smooth movement and instead catch and lock (trigger). Patients complain of either pain or loss of smooth movement. Examination reveals local tenderness at the MCP joints, aggravated [...]