Did a drug interaction complicate this injury?

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

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

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?

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

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

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?

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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How to Spend a Premed Summer

premed summer

Summer—the season of sun, swimming, relaxing, and traveling. For most people, summer can be the best season of the year and a time to decompress from the demands of normal life. However, most premedical students find themselves in a predicament with regards to summer—do they do something they enjoy or focus on an activity that will help their application to medical school? Depending on who you ask, you will likely get a different answer on how to spend your free time, but after years of advising premedical students, my greatest advice is to do both!

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The Path to Medical School: Application Tips from Medical Students and Residents

path to medical school

Your medical school application can be like a puzzle. Each piece fits together to form a complete picture of who you are as an applicant. As you prepare those pieces, understanding how medical schools review applications is important. While each has their own admission process, many look for core competencies. The AAMC’s Anatomy of An Applicant aims to help explain and illustrate how applicants demonstrated these core competencies within their applications by interviewing medical students and residents about their paths to medical school and how they completed different parts of their application. Additionally, each student or resident provided advice for aspiring physicians when applying to medical school. Here is what they shared:

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Healthcare In Occupied Palestine: The Palestine Children’s Relief Fund

The challenges of providing healthcare in an occupied territory

Steve Sosebee is the president and CEO of the Palestine Children’s Relief Fund. He’s married to Dr. Zeena Salman, a pediatric oncologist working with the PCRF. For 25 years, PCRF has been leading medical missions to help children in the Middle East, helping children get medical treatment abroad, and delivering humanitarian aid. Their recent visit to the Carver College of Medicine gave Short Coats Reem Khodor, Ethan Craig, and Nico Dimenstein a chance to sit down with them to discuss the challenges and realities of working to provide healthcare within the confines of an occupied territory.

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5 Tips for Developing a USMLE Step 1 Study Plan

USMLE Step 1 study plan

Step 1 of the United States Medical Licensing Examination (or USMLE) covers all preclinical topics taught in medical school, from DNA replication to the details of disorders like ulcerative colitis and diabetes. Depending on your school’s curriculum, you may take this test anywhere between completion of your preclinical requirements and graduation, with the majority of schools offering a “dedicated” study period in which to review after wrapping up preclinical classes. No matter when you plan to take Step 1, however, one thing is clear: there is a lot to go over, and you probably do not feel like you have enough time to cover everything. Developing a reasonable study plan as you head into your dedicated study period can help reduce Step 1 preparation from an impossible task to one that seems difficult, yet doable. Studying for Step 1 will never be easy, but these five tips can make it more manageable:

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