Fick's Formula Calculator for Cardiac Output

Cardiac output is calculated based on arterial and venous oxygen levels and oxygen uptake.
Fick Cardiac Output Calculator

Visit 25,000 - Nagel's Rule

Aids in Africa

Startling information displayed on Google Maps about the AIDS crisis in Africa.
Aids in Africa

aortic stenosis in the elderly

"Valvular Aortic Stenosis in the Elderly"

Wilbert S. Aronow, MD. Cardiology in Review, Volume 15, Number 5, September/October 2007

1.      Etiology and Prevalence

a.       Calcification of aortic valve increases with age: 28% in 55-71, 48% in 75-76, 75% in 85-86

b.      Reduction in aortic valve area 0.11-0.12cm²/y

c.       Risk Factors for progression: smoking and hypercholesterolemia

d.      Aortic stenosis in elderly(average age 80-81): 15% men, 17% women

SOAP Note Creator

Medicine : Saved SOAP Notes

Saved SOAP Notes

If similar SOAP notes are written for each visit, this SOAP note software will save prior SOAP notes. It also has the ability to print the notes with defined left and top margins.

Create SOAP notes below and save them to the fields provided.
Press "Create SOAP" button to make a SOAP note. Answer the question prompts and the SOAP note will be created below. Copy the created SOAP note to the other SOAP note fields to save them.

This page uses Javascript code to save the text in these forms into a cookie. When you come back to this page, the text in the forms will be saved. Be wary of putting this information in a public computer and make sure to log on and off from your account. It is the user's responsibility to protect data. Void where prohibited.

History Taker

History Taker

History Taker A free electronic personal electronic health record. Hit the HPI then PMH buttons to answer questions. Questions: HPI Button - History of Present Illness: How old is this patient? What is the sex of this patient? What is this patient's chief compaint? What is the duration? What are the associated symptoms? PMH Button - Past Medical History, Past Surgical History, Medications, Allergies: What is this patient's past medical history? What is the patient's past surgical history? What medications does this patient take? What are this patient's allergies? Please make any corrections below and then press "Generate Final" to get a personal health record page in the new window. To save the file, select "File>Save As>" and save as an HTML file.

Winter's Formula for Expected CO2

Winter's Formula Calculator

Calculates expected CO2 based on HCO3, bicarbonate.

Expected CO2 = HCO3 * 1.56 + 8.36

SOAP Note Software

Medicine : Saved SOAP Notes

Online SOAP software creates SOAP notes and saves them for later retrieval. This can save small changes made daily to the notes. The notes can be copied into other electronic record systems. If the notes have to be printed, the top and left margins can be defined to place the note within the correct area of the paper.

Complete Step 2 CK Study Guide

"Crush Step 2" is an easy book to read. I read this twice before taking the test. I would say it has more detail than "First Aid for Step 2 CK", yet I read both of them. I thought they complemented each other well.

"NMS Review for USMLE Step 2 CK" provided a 1000 practice questions. I was able to finish the entire book. Its explanations provide a lot of background. Sometimes explanations repeat key points several times over different questions. I did all the questions once and I think it would be pretty hard to do the questions multiple times. Reading and underlining the explanations was probably where I learned the most for Step 2 CK.

"Boards and Wards" is a good pocketbook for clinical rotations as a medical student. It's also a thorough review book for Step 2 CK. I would say it's more detailed than "Crush Step 2" or "First Aid for Step 2 CK". I was able to read this 1-2 times.

"First Aid for Step 2 CK" provided good tables for the test. I read this book twice, yet I thought sometimes it provided too little detail in some areas. Reading multiple books will help the most.

I still think you need access to at least a good medical textbook, either "Harrison's" or "CMDT". Access to Access Medicine is great also. Sometimes the explanations on practice questions will need more background information.

USMLEWorld.com - Although many people found USMLE World to be helpful for Step 2 CK, I couldn't use it for more than 100 questions. Maybe it was because I was early in my studying or I thought the questions were too esoteric. The explanations are very detailed, and reading that much on a computer screen is not a good way for me to learn. There's about 2000 questions available.

NBME Practice Tests - The practice tests are worth the money spent on them, around $40 each. The analysis of your performance on different test areas is helpful early or even late in your studying. Their projected score was pretty accurate also.

Other Methods:
Creating your own questions helps a lot. Group studying works.

FDA Hears Lasik Complaints

Witnesses Tell of Suffering After Lasik - New York Times

Warning on Storage of Health Records - New York Times

Apparently, HIPAA does not apply to web based health information storage. Microsoft (MSFT) and Google (GOOG) have started to offer storage.

Warning on Storage of Health Records - New York Times

Diesel Savings Calculator

Diesel engines have become more efficient, decreased their noise, and become an alternative to gas engine cars. They can provide mileage similar to a hybrid car. Here's a calculator that will take into account the price difference between gas and diesel along with the miles per gallon difference between the two fuels. This can also be used as a Flex-Fuel Calculator to account for the lower price of ethanol fuel and difference in miles per gallon.

Diesel Savings Calculator

Hybrid Savings Calculator

Hybrid
Savings Calculator
Calculates the
gas money saved by buying a hybrid based on hybrid miles per gallon,
standard miles per gallon, miles driven, and gas price.

For example, a hybrid averaging 40 miles per gallon versus
a standard car with 25 miles per gallon will save $9,300 over
200,000 miles when the price of gas is $3.10.

Hybrid Gallons = 5000

Standard Gallons = 8000

Hybrid Gas Price = 15500

Standard Gas Price = 24800

Savings = 9300

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2009 Federal Budget Spending on Health Care

http://www.whitehouse.gov/omb/budget/fy2009/pdf/budget/hhs.pdf

The 2009 federal budget includes $736 billion dollars to be spent on health care including Medicare and Medicaid out of the total $3.1 trillion dollar budget.

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Crush Step 2 CK Review

Crush Step 2 CK was a basic review for the USMLE Step 2 CK. It's a good book to read several times over before taking the boards. Although if you need help understanding a topic, it would be better to go to a more thorough source such as a textbook. The topics are organized into small paragraphs which basically list important facts. Practicing questions with a book like NMS Review for Step 2 CK is necessary to grasp concepts. I think First Aid for Step 2 CK is probably more well written although it will take longer to read.

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NMS Review for Step 2 CK Book Review

NMS Review for Step 2 CK has been an excellent resource. The test questions focus on large topics that will be tested on the boards. The questions do tend to repeat several concepts but this is a good way to learn. The explanations provide adequate depth, and sometimes even provide anecdotal stories that will help you remember key points. It's well written. Questions based on pictures are limited, but the board media questions are hard to replicate. The book has about 1000 questions and it will take about 1 month to finish.

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USMLE World For Step 2 CK Review

I used USMLE World for Step 2 CK for about four weeks. Although many people do highly suggest it, this product didn't work for me. I thought the questions were too detail oriented and the explanations were even more detailed. The explanations can easily fill the entire computer screen with each answer taking up to 300 words. I really stopped using the product after about 1 week of solid use. I switched to books afterwards - mainly NMS review and Crush.

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no urine output after a sore throat

A 21 year old presents to the office two weeks after a sore throat. The rapid strep test came back positive as well as cultures showing group A beta-hemolytic strepococcus. He finished his course of antibiotics and came back to the office two weeks later with the main complaint of swelling in his feet. He also noticed he's not urinating as frequently and the urine he does make is smoky-brown.  His vital signs were significant for an elevated blood pressure of 150/80. What is the most likely diagnosis?
A) Wegener's granulomatosis
B) Goodpasture's syndrome
C) Alport's syndrome
D) IgA Nephropathy
E) Postinfectious glomerulonephritis
What additional lab tests can be ordered?
A) c-ANCA
B) serum C3
C) ASO titer
D) fat pad biopsy

Answer: This patient most likely has postinfectious glomerulonephritis, an immune complex nephritic syndrome. A serum C3 would be decreased and an ASO titer would be positive.

Source:
1. Le, Tao. First Aid for the USMLE Step 2 CK. 5th. New York: McGraw-Hill, 2006.
First Aid for the USMLE Step 2 CK (First Aid for the USMLE Step 2: Clinical Knowledge)

poison signs and symptoms

Mercury - stomatitis, abdominal pain, nausea and vomiting, and explosive, bloody diarrhea.
Iron - vomitting, hematemesis, diarrhea, hypotension, and metabolic acidosis
Arsenic - skeletal muscle cramps, abdominal pain, watery diarrhea, vomiting
Lead - headache, abdominal pain, constipation, coma, convulsions
Selenium - garlic breath, hair loss, skin depigmentation, abnormal nail growth, fatigue

Source: NMS review for USMLE Step 2 Ck

Expensive efficiency in medicine

This NY Times article looks at the cost of promoting efficiency in medicine. An office of four doctors had to spend $140,000 to install electronic medical records.
Who Pays for Efficiency?

Regional differences in Medicare

The NY Times compiled an interactive graphic about regional differences in Medicare looking at reimbursements, surgery rates, and enrollees.
http://www.nytimes.com/ref/business/20070611_GAP_GRAPHIC.html