Why is this urine bag purple?

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An 80-year-old female with a history of diabetes and chronic constipation presents to the emergency department with a purple urine bag. She is currently bedridden and uses an indwelling catheter. On examination, she is hypotensive and confused. Blood cultures are positive for Proteus vulgaris. Based on this patient’s presentation, which of the following antibiotics should be commenced?

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5 Ways You Can Help Prevent Your AMCAS® Application from Being Delayed

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prevent your AMCAS application from being delayed

Many applicants applying with AMCAS strive to complete and submit their application as quickly as possible. However, an incomplete or incorrect application can cause delays — which may cause you to miss an important deadline. [Here are important dates to be aware of for the 2018-2019 application cycle.] Never fear: We talked to the staff who verify applications, and they shared some quick tips that can help prevent your 2019 AMCAS application from being delayed.

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Did a drug interaction complicate this injury?

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A 76-year-old male presents with a progressive headache, dizziness, and confusion after falling from his bed the night before. He currently takes warfarin following a mechanical valve replacement 11 years ago, and has been recently diagnosed with depression. A CT scan reveals a subdural hematoma and the patient’s INR measures 7.5. Which of the following is most likely to increase the anticoagulant effect of warfarin?

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Q&A with Ms. Carolann Curry, Reference and Outreach Librarian

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Chris Diem

Ms. Carolann Curry is a Library Assistant Professor and the Reference & Outreach Librarian at Mercer University School of Medicine in Macon, Georgia.

Carolann CurryPlease summarize your role at the medical school.
I assist medical school faculty, staff, and students with research, including providing customized literature searches and one-on-one reference consultations. I am the library liaison to multiple faculty departments, including Family Medicine, Community Medicine, Geriatrics & Palliative Medicine, and Medical Education. I am also the library liaison to the Medical Doctor, Master of Science in Biomedical Science, and Master of Science in Preclinical Science programs. In addition to reference responsibilities, I teach classes to medical students, faculty, and residents. Librarians at Mercer University School of Medicine have a faculty designation, so we are able to serve on committees, which allows us to provide additional institutional support to the school. For example this year I am serving on the Research Committee and am co-chairing the annual joint research conference.

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Q&A with Dr. Katherine Semrau, Women’s and Maternal Epidemiology

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Dr. Katherine Semrau, PhD, MPH, is an Associate Epidemiologist at the Division of Global Health Equity at Brigham and Women’s Hospital, Assistant Professor at Harvard Medical School, and the Director of the BetterBirth Program at Ariadne Labs, a joint health innovation center between Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health. The BetterBirth Program is focused on improving quality of care in facility-based childbirth using the WHO Safe Childbirth Checklist. This quality improvement program recently completed a large-scale study of the peer-mentoring implementation of the WHO Safe Childbirth Checklist in facility-based deliveries conducted in Uttar Pradesh, India.

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What’s Causing This Persistent Cough?

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A 75-year-old female presents with a two-year history of a persistent cough and fatigue. The cough is occasionally productive of purulent sputum. She was treated for a community-acquired pneumonia two years earlier and underwent an anterior cervical discectomy and fusion previously, but is otherwise well. On examination, she appears well-groomed, polite, and thin. Chest auscultation reveals wheezing in the mid zones bilaterally and a later chest X-ray and CT scan demonstrate the findings seen here.

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The Secondary Application: Bragging vs. Confidence

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How can you brag about yourself without bragging about yourself?

We are taught from a  young age (most of us, anyway) not to brag. It is better, we may sometimes hear, to show confidence. Listener Rachel wrote in with a question about the secondary application: how does one confidently talk themselves up without coming across as a braggart? Lucky for Rachel, we have Daniel Schnall from our admissions staff on hand to help Mark Moubarek, Kylie Miller, Aline Sandouk, and Gabe Conley with some great advice about how to sell yourself on your application and also back it up.  Don’t want to look like a chump? Dan has your answer, Rachel.

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Hotel Influenza, Confirming Right-to-Try Problems, REM Sleep Revealed

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We love when listeners get in touch, which is why Dave was glad to hear from Adil who, after listening to our discussion of the new national Right-To-Try legislation, sent us a paper he wrote on the subject the year before. It really helped clear some things up that we weren’t sure of. Like the fact that it doesn’t actually do anything to help patients get faster access to experimental drugs, has a kind of informed consent problem, allows patients to further conflate research with therapy, and more.

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Why Is This Patient Profoundly Hypotensive?

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A 70-year-old male is brought to the emergency department with subacute shortness of breath and fatigue. Upon searching her father’s home, his daughter reports she found his medication — a nearly empty bottle of metoprolol, 100 mg bid. She believes her father has coronary artery disease. On examination, the patient is confused. His blood pressure is 69/49 mmHg and he has a heart rate of 48 bpm. An ECG reveals the findings seen here. After initiating oxygen and atropine, which of the following is the best treatment for this patient’s presentation?

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