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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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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8 Ways to Make “Typical Premed” Activities Exceptional

Medical School like

It’s hard to be a pre-med. There are high expectations for the types of experiences you need, the classes you have to take, and the quality of person you become through it all. But for how hard it is to be a pre-med, it’s pretty easy to come off as “typical”.

Here are 8 key activities, experiences, and essay topics that can make you read as a “typical pre-med”, unless you take the following advice:

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How would you manage this patient’s reaction?

A 32-year-old female presents with a headache and a rash on her trunk and extremities. She has had unprotected sex with multiple partners over the last two months, but denies any history of sexually transmitted infections. Examination reveals generalized non-tender lymphadenopathy, a diffuse macular rash on her chest and arms, and patchy hair loss. Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody-absorption (FTA-ABS) tests are both positive, and she is given a single dose of penicillin G benzathine intramuscularly. She returns within a few hours with a worsening rash (seen here), myalgia, and a fever.

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Routines, Right To Try, and Reviews

What Routines Do Medical Students Find Helpful When Drinking from the Firehose?

Listener Meghan is about to start med school in the fall, and is thinking about what sort of regular habits medical students like Aline Sandouk, Tony Rosenberg, and new co-host Jayden Bowen use to keep them on track. Not only do we look at some routines they use (and debate whether they’re even helpful), but we also have a suggested routine for the new student.

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What is causing this woman’s recurring abdominal pain?

A 19-year-old female exchange student presents to the emergency department with severe abdominal pain and a swollen right knee. She has had recurrent episodes of abdominal pain for the past 5 years which last 2-3 days before resolving spontaneously. Previous investigations have all failed to identify a cause. She mentions that several family members back home in Turkey have similar symptoms. On examination, she has a temperature of 39.4°C and a heart rate of 125. Her abdomen is diffusely tender with rebound tenderness. A right knee effusion is present, and a raised, tender erythematous lesion on her left lower leg is noted. Laboratory testing reveals an elevated white cell count with a neutrophilic predominance, as well as elevated ESR, CRP, and SAA protein.

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What treatment should be administered for this patient’s rash? | Figure 1

A 28-year-old woman presents with a one-week history of a slightly raised erythematous lesion on her chest. She has been experiencing fatigue and joint pain since taking a walk through the woods in eastern Massachusetts earlier this month. She is 33-weeks pregnant and is otherwise well. An enzyme-linked immunosorbent assay (ELISA) test comes back negative for Lyme antibodies.

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How To Get More CARS Questions Right

Get More CARS Questions Right

One of the questions that we hear most often from students is “How do I get more answers right on MCAT CARS practice passages and in the exam itself?” That’s a critical question because your score depends totally on how many questions you answer correctly in the time allotted. When you look at the methods described in most MCAT CARS practice books, they give you a lot of tips and tricks on how to answer questions. And when you learn these tips and tricks and use them on practice passages, the first thing you notice is that they don’t work very well. You’re still getting a lot of wrong answers.

Why is that? It’s because these methods are anecdotal rather than scientific. Think of it this way: when a patient comes to see you with a serious medical condition, are you going to use tips and tricks to treat her?  No, You’re going to use your basic knowledge of medicine combined with your reasoning ability to do a proper diagnosis and treatment.

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How Nontraditional Students Benefit Traditional Students

surgical specialties

In both high school and college, we get used to our peers being our age. Everyone turns the same age in the same range year after year. This makes it easy for friendships to form based on common interests and just being in the same stage of life. After college, however, most of our paths can diverge in a variety of different ways. Many of my non-preprofessional school friends got jobs and are even buying houses now. Others went straight into medical school, and still others waited a few years and lived out their lives before going back to school to study medicine. I think that is actually one of the most interesting and beautiful parts of medical school: the diversity in age and experience.

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