First Full Day of Peds

I saw a grand total of three patients by myself. The emphasis is on being by myself. Basically, I see a patient and report the findings to the attending. Then, the attending sees the patient for the final assessment and plan. It's similar to being an intern with a lot less responsibility.

What I learned my first day of pediatrics

Little kids punch anything at their level, so watch out for low blows from 2.5 year olds. Sick kids are still hyper-active.

PDAs on eBay

USMLE Step 1 Books on ebay

PDA for Rotations

I have to get a PDA as I start rotations for third year. Minimum requirements are 32 megabytes in memory space for medical programs.

	Palm LifeDrive Its got a 4 gigabyte hard drive, which sets it apart from any other PDA on the market. Another distinguishing aspect is its price, $500. It might be more than I need for rotations at the hospital, but it would also serve as an mp3 player.
	Treo 650 This PDA has everything bundled into one small package, including a a camera and a phone. I would only have to carry one device to the hospital, and its memory is expandable with SD cards. One drawback is its small size. The Treo has a much smaller screen than other PDAs after seeing it at an electronics store. The size is good for carrying it around as a phone, but I wouldn't be too happy staring at a small screen in the hospital.
	Tungsten T5 The T5 is the top of the line flash drive based PDA, with a large 256 mb of internal memory. This is its main selling point, along with its fast processor and large screen.
	Tungsten T3 The T3 is probably the best value for the money among the high end PDAs. Its got a large screen accessible by pulling open the PDA. Its a unique design, but I would rather have a large screen available at all times.
	Tungsten E This is the minimum suggested PDA for rotations. Its got 32 mb of internal memory, which is enough for medical applications.

First Aid for Step 1

This book provided a good foundation for reviewing for the boards.

Books for Medical School

USMLE Books on Amazon

BRS Books

Merck Manual Online

http://www.merck.com/mrkshared/mmanual/sections.jsp

Two Days Before Step 1

I'm glad I put in this much work; it's one reason I feel calm about the upcoming test, putting in everything I had for this time.

bald 1

bald 1
Originally uploaded by jks184.

Advantages of being bald - less shampoo, no need to dry hair, no need for a comb.

bald 2

bald 2
Originally uploaded by jks184.

I lost about 2 pounds of hair since the previous picture.

my life right now

IMG_0381
Originally uploaded by jks184.

Laying on a bench in the quad, with my full beard, and using my bookbag as a pillow, the only thing distinguishing me from a bum was reading my pathology flashcards.

Sensitivity, Specificity, Positive Predictive Value, Negative Predictive Value

Go across for the PPV and NPV formulas; go down for the sensitivity and specificity formulas.

	Actual
	+	-
+	TP	FP	PPV
-	FN	TN	NPV
	Sens	Spec

Silicosis

Silicosis is a nodular fibrosis of the lungs. Its typically found in people exposed to free silica (SiO2) in their working areas, such as mining or stonecutting. Patients develop a progressive fibrosis of their lungs based on their exposure, and the disease can be fatal within two years. Silicosis has a wide range of presentation. Acute silicosis has profuse miliary infiltration or consolidation. Milder silicosis show small opacities and possible coalescence. The hilar nodes are the lymph nodes of the lungs, and they may become calcified. Hilar lymph nodes with an "egg shell" appearance are a classic presentation of silicosis on radiographs. The pulmonary nodules of silicosis, which are found in the upper lobes of the lungs, may lead to progressive massive fibrosis and subsequent restrictive and obstructive lung disease. This may lead to ventilatory failure. Patients with silicosis are more prone to develop Tuberculosis (Mycobacterium tuberculosis) and other atypical mycobacterial infections.(1)
Even ten to thirty years after exposure, silicosis can be asymptomatic. Patients can present with dyspnea, cough, or sputum production. Chest radiographs show small pulmonary nodules, from 1 mm to 10 mm, in the upper lobes of the lungs. Silicosis' complications include with lung cancer, chronic respiratory failure, and cor pulmonale. Patients should be treated for tuberculosis infections and other lung ailments. Other than for severe cases, prognosis is generally good for silicosis with possible mild respiratory symptoms.(2)

Medical Student Report
(1) Harrison's Online
(2) Hanley Pulmonology
McGraw-Hill's AccessMedicine

BRS Biochemistry

BRS Biochemistry provides excellent diagrams explaining processes. Most of the book is in an outline format of the major pathways. The endocrine chapter seems to be covered in several other books. The last chapter on biochemical abnormalities provides a good summary of biochemical pathology. The clinical correlation at the end of each chapter provides excellent material for board review, and it may be the only important parts of this book for a person with a strong understanding of biochemistry. This book would be great to have during the course since it does provide sufficient detail.

BRS Behavioral Science

At 260 pages, this is an easy read in two days. The tables covering physician and patient interaction are excellent. Some chapters are very good at covering other aspects of reviewing, such as the chapter on psychiatric medications. Much of this book is related to psychiatry.

Higher Student Loan Interest Rates for 2005

Effective July 1, 2005, student loans dispersed on or after 1998 will have an interest rate of 4.7% during school and 5.30% during repayment. Rates have increased significantly since last year's rate of 2.87%. If you still have the option of consolidating previous student loans at low rate, now is the time to consolidate outstanding debt at one low rate. This can reduce your interest payments and monthly payments. However, payingreduced monthly payments over a longer repayment time can cause increased interest payments overall. Online calculators for repayment and consolidation are available from lenders.

BRS Pharmacology

This is a difficult book to read during USMLE Step 1 review. Its very condensed, yet still maintains to be 428 pages long. It presents drugs basically in a list guideline format, and their descriptions are basic. A better resource would be a combination of First Aid's pharmacology section and PharmCards.

Reviewing Qbank

Use First Aid to take notes while going over a Qbank test section. It's absolutely amazing how many questions can be answered from facts in First Aid for the USMLE Step 1.

Levinson & Jawetz : Medical Microbiology & Immunology

Although the sections on the pathogens may be too extensive for USMLE review, the introductory sections on virology and bacteriology are important to review. The 70 pages on immunology are excellent and concise, especially the hypersensitivity and immunodeficiency sections. The best part of this book is the Brief Summaries of Medically Important Organisms.