Skin Prick Testing

This test measures specific IgE attached to Mast cells in the skin

Allergen solutions for skin prick testing: PONI F

• Positive control (histamine)
• Occupational allergens (ammonium persulphate, platinum salts, antibiotics, and latex)
• Negative control (diluent)
• Inhaled allergens (house dust mite (HDM), grass pollen, cat dander, dog hair)
• Food allergens

Disadvantages of skin prick test: FISH

• Food allergens (less standardized), less reliable than inhaled allergens
• Itching
• Skin conditions (eczema or dermatographism) interfere with interpretation
• Histamine antagonists (antihistamines) suppress skin reaction

Mitral Valve Prolapse and Mitral Regurgitation

Mitral valve prolapse and consequent mitral valve regurgitation is seen during TEE examination in a patient undergoing mitral valve repair. The P2 scallop of the posterior mitral leaflet is seen as prolapsed with a flail chord. Color Doppler shows a mitral regurgitant jet.

Increased Medical Student Debt

The average medical school debt today, according to the Association of American Medical Colleges(AAMC), is $156,456. USA is the only country in the world were future doctors have to bear such a financial burden of their education. That places significant strain on any relationship involving an American medical student.
Student debt statistics
•  $156,456 – According to the Association of American Medical Colleges (AAMC), the average educational debt of indebted graduates of the class of 2009.
•  79 percent of graduates have debt of at least $100,000.
•  58 precent of graduates have debt of at least $150,000.
Why medical education debt has increased
Medical education debt is driven by rising tuition. AAMC data show that median private medical school tuition and fees increased by 50 percent (in real dollars) in the 20 years between 1984 and 2004. Median public medical school tuition and fees increased by 133 percent over the same time period. Other recent 20-year periods show similar trends. Tuition is just one source of increasing debt burdens. Other causes include:
•  Interest accrued on loans over time significantly adds to the total cost of student debt.
•  Students are now entering medical school with more education debt from undergraduate education.
•  Increasing numbers of “non-traditional” students who have children to support.

Diagnostic Criteria for Transverse Myelitis

The term “transverse myelitis” describes a heterogeneous group of inflammatory disorders that are characterized by acute or subacute motor, sensory, and autonomic (bladder, bowel, and sexual) spinal cord dysfunction (Table above).
The clinical signs are caused by an interruption in ..........

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Excisional biopsy in melanoma

A 42-year-old female presents with the lesion (shown below) on the back of her calf. She has no significant medical problems and otherwise feels well. The lesion has not bled, but seems to have grown over the last few months. Appropriate initial management of this skin lesion should be??

• A) observation and removal if bleeding or further change occurs
• B) complete excision with normal margins
• C) complete excision with wide margins
• D) shave biopsy
• E) electrodessication and curettage

The answer is B. (Complete excision with normal margins) Even in the hands of experienced dermatologists, there is an approximately 15% false negative rate in determining the presence of melanoma based on examination alone; therefore, histologic confirmation is essential for both tumor diagnosis and staging. A complete excision with normal skin margins is preferable when possible as the first diagnostic step (e.g., excisional biopsy).
An incisional biopsy can be performed for larger lesions when complete excision is not practical and when the suspicion of melanoma is low; incisional biopsy does not adversely affect survival. Shave biopsies should be avoided because they may not provide enough tissue for diagnosis and do not allow for accurate depth measurement. All biopsies of lesions suspected of being melanomas should provide a piece of full-thickness skin extending to the subcutaneous fat.

When considering the diagnosis of melanoma, shave biopsies should be avoided because they may not provide enough tissue for diagnosis and do not allow for accurate depth measurement. All biopsies of lesions suspected of being melanomas should provide a piece of full-thickness skin extending to the subcutaneous fat.

Little Black Book of Emergency Medicine

Steven E. Diaz, "Little Black Book of Emergency Medicine"
Jones & Bartlett Pub 2006 | ISBN-10: 076373456X | 507 Pages | CHM | 2,2 MB



Thoroughly revised and updated, the second edition of this pocket-sized handbook provides comprehensive, concise, evidence-based information on diagnosing and treating illness and injury in the emergency setting. The Little Black Book of Emergency Medicine is a convenient resource offering quick access to vital information and makes a great reference for solving pressing problems on the ward or in the clinic.

For Free Download :

CLICK HERE

Musculoskeletal System &Lumbar Spine Examination