Tips set Number 2

Topics in the boards will change at a rapid pace. So should your stream of thought.

Practice retrieving info from different subjects easily and quickly. This random sequence may be of some use.

Patient should not fly the same day as diving. Should wait for at least 48 hours. Not following this will lead to "bends" a very painful condition where dissolved nitrogen from fat is released and closes off the vessels supplying bone and other end arteries. Treatment is returning to ground level.

Patients who malabsorb fat form oxalate kidney stones. Prevention requires them to eat extra calcium which would then bind with the oxalate and make it unabsorbable. This scenario is seen in inflammatory bowel disease.

Raised platelet count should raise suspicion of bleeding or inflammation. Essential thrombocythemia (one without any cause) is treated with Anegrilide.

In cocaine induced chest pain, do not give beta blockers (because they can
cause further vasoconstriction). One uses ASA, heparin and nitrates. The best drug used is Benzodiazepines.

In a patient with gastric ulcer, it is important to repeat endoscopy after 4-6 weeks to confirm healing and rule out malignancy.

If encountered with a chest Xray where you are unable to see any definite thing, 3 things should come to mind. Maybe it really is normal, look for a pneumothorax and think of ASD (especially in a middle aged patient)

Ankylosing spondylitis and hemachromatosis rarely affect females.

SLE rarely affects males.

If a lateral chest Xray is shown and a pleural effusion is not obvious, think of constrictive pericarditis. In this condition, one can see ascites without pedal edema. (Look for calcification of pericardium)

Know the Swan-Ganz parameters for different conditions. Low cardiac output should trigger thoughts of heart failure or hypovolemia. Both have high peripheral resistance but differ in the wedge pressures. Wedge is low in hypovolemia and high in cardiac failure.

High cardiac output should suggest septic shock or spinal shock. Septic shock in later stages becomes a low output failure. Peripheral resistance in both conditions is low.

More to follow. Good luck for the boards. The ABIM is not interested in restricting the number of candidates who pass. It just wants that everyone who passes, scores a pre-set minimum. Work hard for it.