BMI Calculator

BMI Calculator: "Fill in your height and weight, and this BMI calculator will show your BMI. It will also show your ideal weight range."

Cheese Quesadilla Recipe

Ingredients
-Flour Tortilla
-Cheese - American, Cheddar, etc.
-Optional: Meat, Pasta Sauce, hot sauce
Directions
Place tortilla on microwave safe plate and cover one half with cheese. Add meat or sauce if necessary. Microwave on high for 1 minute, and fold tortilla. Cut into fourths with a pizza cutter.
Health Benefits:
Less greasy than fried version.
Cheese is a good source of calcium.
Tortilla can have lower carbs than white bread.
Pasta sauce's tomatos can have heart protective factors.

Bread Recipes:
http://opossumsally.homestead.com/bread.html

BRAIN NEUROTRANSMITTERS

BRAIN NEUROTRANSMITTERS

Chemistry 8, SMA 7, Chem-7 Analyzer

Chem 7 Analyzer - Analyzes analyzes serum sodium, potassium, chloride, carbonate, BUN, creatinine, glucose, and calcium.

Substance Abuse

Substance	Intoxication	Withdrawal
Alcohol	- (1+) Slurred speech - Incoordination - Unsteady gait - Nystagmus - Impairment in attention or memory - Stupor or coma (t) folate 1mg , thiamine 100mg	- (2+) Autonomic hyperactivity - Increased hand tremor - Insomnia - Nausea or vomiting - Transient visual, tactile, or auditory hallucinations - Psychomotor agitation - Anxiety - Grand mal seizures (t) Benzodiazepines - oxazepam, IV; Dilantin; Haldol
Cocaine / Amphetamine	- (2+) Tachycardia or bradycardia - Pupillary dilation - Elevated or lowered blood pressure - Perspiration or chills - Nausea or vomiting - Evidence of weight loss - Psychomotor agitation or retardation - Muscular weakness, respiratory depression, chest pain, or cardiac arrhythmias - Confusion, seizures, dyskinesias, dystonias, or coma (t) self-limited, anti-psychotics	- (2+) Dysmorphic mood - Fatigue - Vivid, unpleasant dreams - Insomnia or hypersomnia - Increased appetite - Psychomotor retardation or agitation (t) self-limited, observation
Opiates - morphine - codeine - meperidine - hydromorphone	- papillary constriction (dilation) - (1+) drowsiness or coma - slurred speech - impairment in attention or memory - euphoria > dysphoria - psychomotor agitation or retardation - impaired judgement (t) Methadone 5-20 mg> 60-100 mg	- (3+) dysphoric mood - nausea or vomiting - muscle aches - lacrimation or rhinorrhea - papillary dilation, piloerection, or sweating - diarrhea - yawning (t) Clonidine

Sources : Diagnostic Criteria from DSM-IV, Blueprints Psychiatry 3^rd ed

Is Microsoft Dropping Cryptic Hints About a New Gadget? - New York Times

Is Microsoft Dropping Cryptic Hints About a New Gadget? - New York Times

A tablet style pc with wireless internet access would be good for some of the medical related web pages I've posted.

Prescription Writer

Medsoft : Prescription Writer: "Creates a prescription which can be printed, stored on a USB flash drive, or e-mailed. "

How to write a prescription:
Zoloft 500mg 1 tablet PO qday Dispense: 30 Refill: 2
Drug Dosage tablets route frequency Dispense: Refill:

History and Physical for Paper or USB

History and Physical for Paper or USB: "Create a history and physical document, then store it on a USB key chain drive or print it out to present to healthcare professionals."

Combined Plastics Residencies

http://www.med.nyu.edu/irps/residency/

http://www.surgery.vcu.edu/content/edu-plas.htm

http://www.hopkinsmedicine.org/plasticsurgery/Program/combinedletter.htm

http://www.brighamandwomens.org/surged/Medical/harvardPlasticSurgery.asp

http://www.surgery.upmc.edu/Plastics/Residency/Integrated_Program.htm

http://www.massgeneral.org/plasticsurgery/training/

http://www.mc.uky.edu/surgery/Plasurgery/plasrez.asp

http://www.dhmc.org/plastic_surgery_residency.cfm

http://www.um-surgery.org/education/gme/training/plastic.shtml

http://www.siumed.edu/surgery/plastics/integrated.htm

http://www2.kumc.edu/plastics/gen/resdcy.htm

http://www.siumed.edu/surgery/plastics/resdiency.htm

http://faculty.washington.edu/engrav/PSResLong.htm

http://www.ucdmc.ucdavis.edu/surgery/residency/plastics/index.shtml

http://www.surgery.usc.edu/plastics/Residency.html

http://www.llu.edu/llu/medicine/plastics/resltr.html

http://cpmcnet.columbia.edu/dept/cs/residency/plastics.html

http://www.urmc.rochester.edu/smd/Surg/Plastic_Surgery_Residency.html

Incision

8 AM - My first surgical incision
Made three incisions in the surgery that totaled less than 3 cm. They were for a suburethral sling. Also got to close in both surgeries.

Ovarian Tumors

Ovarian Tumors

1. Introduction

a. Malignant ovarian tumors are the leading cause of death from reproductive tract cancer.

b. Majority of ovarian tumors are benign.

c. General lifetime risk is 1.6% and 5% with a first degree family relative.

d. Lifetime risk with BRCA1 gene is 45% and with BRCA2 gene is 25%.

2. Clinical Findings

a. Symptoms and Signs

i. Most patients are asymptomatic.

ii. Mild nonspecific gastrointestinal symptoms or pelvic pressure

iii. Pelvic exam can detect early disease.

iv. Advanced disease can present with bloating, abdominal pain, ascites, and palpable abdominal mass.

b. Lab Findings

i. CA 125 level greater than 35 units can indicate malignancy.

ii. CA 125 elevated in 80% of epithelial ovarian cancer and only 50% in early disease.

c. Imaging Studies

i. Transvaginal Ultrasound for screening

ii. Ultrasound helps differentiate from benign and malignant neoplasm.

3. Differential Diagnosis for an Ovarian Mass

a. Functional

b. Benign Neoplastic

i. Premenopausal woman, asymptomatic, mobile, unilateral, simple cystic mass less than 7.5 cm

c. Potentially Malignant

d. Predictive factors include age, size of the mass, ultrasound configuration, CA 125 levels, symptoms, and symmetry

4. Treatment

a. Malignant neoplasm – surgical staging, abdominal hysterectomy, bilateral salpingo-oophorectomy

i. Advanced disease

1. removal of all visible tumor

2. post-operative chemotherapy

a. cisplatin or carboplatin with paclitaxel

b. Benign neoplasms – tumor removal or unilateral oophorectomy

5. Prognosis (5 yr survival)

a. Distant metastases – 17%

b. Local spread – 36%

c. Early disease – 89%

Source:

1. Tierney, Jr, Lawrence M., Stephen J. McPhee, and Maxine A. Papadakis. Current Medical Diagnosis & Treatment 2005. 44th ed. New York: McGraw Hill, 2005: 719-722.

Old Main at Penn State

A picture of Old Main, the administrative building at Penn State with snow on the ground. The color picture was changed using the filter photocopy in Adobe Photoshop.

Pregnancy, Preeclampsia, Severe Preeclampsia, Eclampsia

	Normal Pregnancy	Preeclampsia	Severe Preeclampsia
Blood Pressure	Fall in first 24 weeks, rises to baseline by term	140/90 after 20 weeks gestation	>160/100
Kidneys	GFR increases 50%, renal plasma flow increases serum urea and creatinine decrease; enhanced waste metabolite removal; glycosuria	Vasospasm and capillary endothelial swelling -> reduction in GFR Serum uric acid and creatinine increased Proteinuria > 300 mg in a 24 hour collection	proteinuria > 5 g/24h, oliguria (<500cc/24h) Oliguria <>
Edema	Normal	Presenting sign but 1/3 don’t have it
Hemostatic	Venous stasis from hypercoagulable state	Systemic vasospasm, coagulation system activation, abnormal hemostasis Cycle – endothelial injury, platelet activation, platelet consumption
Prostanoid Changes	Both prostacyclin (PGI) and Thromboxane A2 (TXA) elevated, PGI > TXA	TXA > PGI PGI – vasodilator and inhibitor of platelet aggregation TXA – vasoconstriction and platelet aggregation
Autonomic		Increased sympathetic state – vasoconstriction
Nitric Oxide		Reduced
Free radical oxidation products		Increased
Hematologic	Plasma vol inc, RBC mass inc à “physiologic anemia” of pregnancy Hgb 11.5 mg/dl WBC count increases Hypercoagulable state – inc fibrinogen, factor VII to X increase – venous stasis		- Thrombocytopenia - <100,000 class="MsoNormal">- fibrinogen decreased - coagulation time increased (PT, PTT) -Can progress to DIC
Hepatic	Signs of liver disease Spider angiomata and palmar erythema – elev estrogen Serum – dec albumin, elev alk phos, elev cholesterol Estrogen increased proteins – fibrinogen, thyroid hormone binding globulin, ceruloplasmin Hepatic enzymes – AST/ALT, PTT unchanged	10% - transaminase elevation	impaired liver function (AST/ALT >70)
Pulmonary			pulmonary edema
Neurological			Cerebral or visual disturbances Headache
GI			Epigastric pain - hepatic subcapsular hemorrhage -stretch or rupture of liver capsule
Seizures			Severe cases -> Eclampsia

HELLP Syndrome - hemolysis, elevated liver enzymes, low platelets - severe preeclampsia.

Sources:

1. Rubin, Emanuel . Rubin's Pathology: Clinicopathologic Foundations of Medicine. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2005 : 986-7.

2. Tierney, Jr, Lawrence M., Stephen J. McPhee, and Maxine A. Papadakis. Current Medical Diagnosis & Treatment 2005. 44th ed. New York: McGraw Hill, 2005: 747-9.

Sensitivity Specificity Positive Predictive Value and Negative Predictive Value Calculator

Sensitivity Specificity Positive Predictive Value and Negative Predictive Value Calculator: " calculator will determine these values based on true positives, false positives, true negatives, and false negatives"

First Day of Ob-Gyn

Today was my first day of Ob-Gyn, and I saw two deliveries. One patient was having frequent contractions and she started to have the baby while I was telling a resident about the patient. Actually, she was having such bad contractions, I hurried my interview and told my resident about her. She was rushed into the delivery room, and while my fellow medical student and I were looking for shoe protectors, in two minutes, she had the baby. The second delivery was a caesaraen section which was iminent. The whole process of deciding to do the C-section and taking the baby out took about 15 minutes. It was truly amazing how fast labor and delivery can progress.

Parkland Formula - Fluid Resucitation for Burns

Parkland Formula - Fluid Resucitation for Burns

Nagel's Rule for Pregnancy Due Date

Nagel's Rule for Pregnancy Due Date
Can calculate a due date based on LMP. Similar to a Pregnancy Wheel and Ovulation Calendar.

Christmas Babies, One After Another, After Another

http://www.nytimes.com/2005/12/27/health/27case.html

Marketing Fortified Food to Those Leery of Drugs

http://www.nytimes.com/2005/12/28/business/28food.html

Citation Machine

Fill out a form, and it will create citations.

http://citationmachine.net/