Friday, December 17, 2010

Family Practice Examination & Board Review

Family Practice Examination & Board Review, Second Edition (McGraw-Hill Specialty Board Review)
A Comprehensive Case-Based Review Guide for the Family Practice Boards or Recertification Exam

“The book is both broad and comprehensive, with chapters written by family physicians and specialists who contribute informative, easy to follow, and concise discussions. Chapters cover the main systems of the body as well as HIV/AIDS, men’s health, women’s health, care of the surgical patient, and care of the older patient. In addition, there are chapters not traditionally included in board review books on ethics, end-of-life care, evidence-based medicine, and patient-centered care. Chapters are well written, contain questions consistent with those found on the boards, and provide explanations that will help readers navigate these topics on the exam. The case-based approach provides a comprehensive review of topics commonly encountered in the family physician’s office. Each chapter contains clinical pearls, quizzes, and objectives to ensure that the main points have been addressed. The numerous illustrations include quality images of dermatological conditions, EKGs, and x-rays. Tables provide useful charts and are effective teaching tools.

This will be a wonderful resource not only for those preparing for the family medicine boards, but also for family medicine residents, physicians, and anyone else working in a primary care setting.” — Doody’s

Family Practice Examination & Board Review serves as an ideal study guide for the primary and recertification exam in family medicine and for licensure exams. Containing more than 400 progressive clinical cases that cover all specialty and topic areas tested on the exams, this uniqueguide features a step-by-step approach that ensures you fully comprehend a subject before moving on to a more advanced one.
* More than 400 case studies that reflect the realities of clinical practice

* Comprehensive coverage of ALL topics on the boards and recertifying exam

* Hundreds of “Helpful Tip” boxes that provide valuable clinical pearls

* Learning aids including “Quick Quizzes,” learning objectives, and online resources

* Up-to-date coverage of evolving issues such as multicultural medicine and evidence-based medicine

* High-quality color photographs of conditions most easily diagnosed by appearance

* More color photos and diagrams than in the previous edition

* Improved design — so you can spend more time learning and less time looking for answers

* Completely updated content reflecting all major new developments in diagnosis and treatment

* NEW! Expanded coverage of current topics such as clinical ethics, women’s health, and obstetrics

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Obstetric Evidence-Based Guidelines, Second Edition

This book reviews the evidence for best practice in obstetrics and maternal-fetal medicine. It presents readers with the right information, in the right format, by summarizing evidence in easy-to-use tables and algorithms. Recommendations have linkage to supporting evidence, and quality of evidence and strength of recommendation is stressed. Areas of uncertainty are recognized, and ‘individualized’ care suggested. Recommendations based on randomized trials and meta-analyses are highlighted so that clinical outcomes can be improved. The proper use of each guideline is aimed at “make it easy to do itright ”, so there is appropriate use of proven interventions and no use of harmful interventions. Plenty of evidence is available so that well-informed clinicians can reduce errors (primum non nocere), so the first aim is ultimately to improve the health of mother and fetus by providing quality care.

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Bleomycin-Induced Flagellate Hyperpigmentation

A 39-year-old woman with a long-standing vascular malformation of the posterior tongue underwent intralesional sclerotherapy with a single dose of bleomycin. Within 1 week after treatment, painless, nonpruritic, flagellate hyperpigmentation developed on her trunk. She had no alopecia and no changes in the appearance of nails or mucosa. She reported having no dyspnea or pulmonary symptoms.
Bleomycin is a glycopeptide antibiotic commonly used for chemical pleurodesis, the treatment of cutaneous warts, and the treatment of a variety of cancers. The rate of flagellate hyperpigmentation in patients who are treated with bleomycin may be as high as 20%. Most tissues contain a cysteine proteinase capable of hydrolyzing and inactivating bleomycin. The reduced concentration of bleomycin hydrolase in the skin and lung, as compared with other tissues, may explain the medication's adverse reaction profile.

The patient was counseled that the flagellate hyperpigmentation usually fades over a period of several months after the cessation of the medication. During the past year, the hyperpigmentation in this patient has faded but not yet resolved.

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What is Nanomedicine?


Squamous Blepharitis

Defined as Low grade infection on top of abnormal secretions of the lid glands ,a kind of nonulcerative blepharitis .As a Part of a dermatologic condition that includes the scalp, face, and eyebrows; So it also called Seborrheic Blepharitis .

Clinical signs include greasy, small white scales presents between the lashes. Inflammation is usually minimal.Removal of this scales dosen`t reveals ulceration.
"usually take 2-3 weeks" and includes:
• Treatment of seborrhea.
• Removal of scales: Using 3% sodium bicarbonate or diluted baby shampoo.
• Local antibiotic ointment.

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Patient Preparation and Position for the Ultrasound Examination

Patient Preparation.
The ultrasound examination is most effective if the patient has been NPO for at least 6 hours. This allows the biliary system to be distended and easily imaged by the sonographer. When a patient is fasting there is a a decreased opportunity for gas to accumulate within the colon; gas prohibits the passage of the sound and thus limits visualization of abdominal structures. If the patient is able to consume liquids and the pancreas is not well-visualized, the administration of 32 oz. of water may be given to fill the stomach and duodenum to better delineate the pancreas.

The kidneys are best imaged when the patient is fully hydrated, therefore no patient preparation is necessary when only the kidneys are examined. Full hydration will also enable the sonographer to image the distended urinary bladder.

Patient Position.
The position of the patient for the general abdominal scan is usually supine for the initial images. The patient is then rolled into various degrees of obliquity to better demonstrate the biliary system, pancreas, liver, kidneys, or spleen. If the scanning plane is oblique, the sonographer should indicate the change of position on the documented image without specifying the exact degree of obliquity. The same would apply if the patient were in a lateral, upright, or prone position.