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.
Medical
Learn about medicine and how to become a physician in our articles for pre-medical students (including the MCAT), medical students, resident physicians, and practicing physicians.
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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How To Present a Patient: A Step-To-Step Guide
Updated and verified by Dr. Lee Burnett on March 19, 2022. The ability to deliver … Read more
Challenges as Opportunities to Grow
Up until medical school, my life was relatively smoothing sailing. I did not really have … Read more
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?
Should You Consider a Direct Admission to Medical School Program?
There are so many paths that people can take to get to medical school. In … Read more
How to Spend a 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!
The Path to Medical School: Application Tips from Medical Students and Residents
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:
What proportion of patients with psoriasis may develop accompanying arthritis?
A 70-year-old female with psoriasis presents with a four-month history of worsening arthralgia. She mentions she has pain and stiffness in her big toes and most of her fingers. On examination, a telescoping finger deformity is seen on her right second digit.
5 Tips for Developing a 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:
8 Ways to Make “Typical Premed” Activities Exceptional
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:
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.
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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Q&A with Adaira Landry, MD, MEd, Harvard Emergency Medicine Assistant Residency Director
Adaira Landry, MD, MEd, is the Assistant Residency Director for the Harvard Emergency Medicine Residency. … Read more
Another Test Anxiety Killer, Physician Bias, and Suspicious Meat
Her snacks were delicious, but you’ll never guess her secret ingredient. Irisa Mahaparn, Tony Rosenberg, … Read more
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.
Should You Consider a Long-Distance Relationship In Medical School?
I resisted dating my long-time friend for months after it became obvious that we were … Read more
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.
Relax or Prepare? Advice for Incoming Med Students
Spoiler alert: don’t “prepare” during the summer before you arrive at medical school. Listener Amanda … Read more