Pregnancy and . . .

Pregnant patients will appear on the board exam in one form or another. Please review these random pearls. 85% of women of child-bearing age give birth. In general, expect the cardiac output to increase by 40% partly due to dramatically increased blood volume, and an increased heart rate. Blood pressure should decrease by 12 mmHg. There… Read more »

Glaucoma, Closed Angle

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… Read more »

Malignant External Otitis

Presentation Malignant external otitis is a severe infection of the external auditory canal causing temporal bone osteomyelitis. It usually occurs in elderly diabetics that report severe unrelenting otalgia, temporal headaches, and a purulent otorrhea. The organism is usually (95% of the time) Pseudomonas aeruginosa. The infection begins as an external otitis that progresses into an… Read more »

Retinal Detachment

Retinal detachment occurs when subretinal fluid accumulates in the potential space between the neurosensory retina and the underlying retinal pigment epithelium. Presentation  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… Read more »

Trigger finger

A trigger finger is one of the most common causes of hand pain and disability.  In it, the flexor tendon causes painful popping or snapping as the patient flexes and extends their finger. Presentation They may present with a digit locked in a particular position, most often flexion, which may require gentle, passive manipulation into full extension… Read more »

Antibiotic Prophylaxis for Endocarditis

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… Read more »


Great Review Video !! Statin Benefit Groups 1. Individuals with clinical ASCVD 2. Individuals with primary elevations of LDL–C ≥190 mg/dL 3. Individuals 40 to 75 years of age with diabetes with LDL-C 70-189 mg/dL 4. Individuals without clinical ASCVD or diabetes who are 40 to 75 years of age with LDL-C 70 to 189 mg/dL… Read more »


The jury is still out on a number of issues related to hypertriglyceridemia, so any questions on the exam will focus on what is confirmed, and actively avoid any controversies. Hypertriglyceridemia is correlated with an increased risk of cardiovascular disease in the presence of: low HDL cholesterol levels elevated LDL cholesterol levels. You shouldn’t get… Read more »

No more pelvic exams . . . just PAPs !???

The American College of Physicians has issued new clinical guidelines recommending against screening pelvic examination in asymptomatic, non-pregnant, adult women.   Pelvic examination loosely means the speculum and bimanual examination; it does not include obtaining a Pap smear for cervical cancer screening, which was excluded from the guideline (If you have a curious bewildered look on… Read more »