Medliorate

Improving medical students

Archive for March, 2008

PatientsLikeMe – Powerful Resource for your Patients

Posted by medliorator on March 31, 2008

PatientsLikeMe.com

  • Share your experiences
  • Find patients like you
  • Learn from others

Description via LifeHacker:

Using the site, you can read all about the experiences of other real people who are afflicted with certain illnesses as well as share your own experiences. The purpose, then, is to allow users to interact with one another, track how treatments are working for other members, and explore the side effects patients are seeing with certain treatments. The site’s motto is “Patients helping patients live better every day,” and it provides a ton of tools to help you do just that.

Posted in Communication, Software, Tools | Comments Off on PatientsLikeMe – Powerful Resource for your Patients

Bipolar Disorder: In-Home Testing

Posted by medliorator on March 30, 2008

a company is selling a testing kit that you can use yourself, in the privacy of your own home, to see if you have genes that increase the risk of bipolar disorder.

 

Psynome™ – tests for two mutations of the GRK3 gene that are associated with bipolar disorder.

 

Psynome2™ –tests for gene mutations in the Promoter L allele gene that predicts patient response to serotonin-based drugs, the most commonly prescribed drug therapies in psychiatry today. These tests are useful to your doctor in making a timely and accurate diagnosis of your condition and prescribing the right medication. The tests can be ordered individually or combined.

 

In order to know if the test is worth anything, you would have to do some kind of study that shows that the people who get the test, do better in the long run. It is one thing to be able to tell whether the mutations are present. In is another thing to show that the knowledge makes a difference in the outcome of the treatment.

 

Previous efforts have failed to show clinical utility, even if they are useful in a research setting. Any proposed test will have to meet a high standard before it will make any sense to put it into use. Even then, it is doubtful that it would make sense for a person to do it at home.

In-Home Test for Bipolar Disorder [The Corpus Callosum]

Posted in Diagnostic Examination, Psychiatry, Tools | Comments Off on Bipolar Disorder: In-Home Testing

Confucius Explains Medical Education

Posted by medliorator on March 29, 2008

I hear and I forget. I see and I remember. I do and I understand.

 

We think that we can teach in classes during the first two years. Our students forget much of what they hear. During the 3rd and 4th year they see patients with disease and they start to remember more facts and concepts. During their residencies they participate in patient care (actually they often start this during the clinical student years) and then they start to understand being a physician.

 

This deceptively complex quote explains the problems of the preclinical years and the beauty of the clinical years and residency (at least for learning to be a physician.) We can do this better if we would only recognize the wisdom of this quote.

Confucius on medical education [DB’s Medical Rants]

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Epocrates for iPhone

Posted by medliorator on March 28, 2008

I hear this all the time. What are the two biggest reasons doctors give for not switching to the iPhone?

  1. They don’t want to change their carrier to AT&T and
  2. The iPhone can’t run Epocrates or other third party software.

[reason #2] has been answered with the release of the iPhone SDK (software development kit). And to the surprise of many physicians, Epocrates was one of the first products to be showcased.

 

Health care professionals who are iPhone users — or plan to purchase one — are waiting until June, when the application store for third party iPhone software will go live. …enthusiasm should be tempered by the understanding that third party software like Epocrates has already been available for the Treo and for Windows Mobile. Seen this way, iPhone users are only getting now what they should have received all along.

iPhone Medicine Watch: Epocrates on the iPhone [Efficient MD]

Posted in Software, Tools | Comments Off on Epocrates for iPhone

Diagnosing a Spider Bite

Posted by medliorator on March 27, 2008

Poisonous spider bites are extraordinarily rare; wounds blamed on spiders are extraordinarily common. I have seen dozens of patients who thought they had been bitten by a spider, and I have never made a diagnosis of an actual spider bite.

  • Spider bites are exceedingly rare. Studies have shown that the number of spider bites attributed to spiders far exceeds the number of poisonous spiders living in that area.
  • If you did not see a spider bite you, then it is very unlikely that you were bit by a spider.
  • Spiders do not come out at night to bite you. They are, in fact, reluctant to bite, even when provoked.
  • Very few spiders in the US (some would say only one spider, the brown recluse) are likely to cause a necrotic wound.
  • The black widow spider is also a poisonous spider, but it releases a neurotoxin that causes abdominal pain and paralysis. It does not cause a necrotic skin wound.

Spider Bite (?) [The Derm Blog]

Posted in Dermatology, Diagnostic Examination | Comments Off on Diagnosing a Spider Bite

Drug Search Tool

Posted by medliorator on March 26, 2008

Healthline’s Drug Search

Healthline’s drug seach tool is directed at consumers.
Three novel services are offered: drug information and comparisons, drug identification, and drug interactions.

 

Information provided by Healthline includes a description of the drug and typical uses, side effects, and other information, like what to do if you miss a dose. The drug search tool also allows you to compare two similar medications side by side.

 

The “pill finder” is a novel service offered by the drug search tool. Not sure what that green oval tablet in your medicine cabinet is? By entering the pill color, shape, and any visible markings, you can narrow down the possibilities. (There were 13 results for green oval tablets.)

 

Lastly, the drug search tool also allows you to determine whether there are any significant drug interactions among medications. A word of caution — the drug interaction checker may mark interactions as potentially “severe,” even if the chance of an interaction may be very low and even if the interacting medications are used together commonly.

Healthline’s New Drug Search Tool [Healthline]

Posted in Pharmacology, Tools | Comments Off on Drug Search Tool

Common Chief Complaints in the ER

Posted by medliorator on March 25, 2008

list of most common diagnosis codes used in our ER, in order:

  • 786.50 UNSPEC CHEST PAIN
  • 789.09 ABDOMINAL PAIN OTHER SITE
  • 465.9 ACUTE UPPER RESP INFECTIONS UNS
  • 847.2 SPRAIN/STRAIN LUMBAR REGION
  • 558.9 OTH NONINFECTIOUS GASTROENTERITIS
  • 486 PNEUMONIA ORGANISM UNS
  • 466.0 ACUTE BRONCHITIS
  • 780.99 OTHER GENERAL SYMPTOMS
  • 784.0 HEADACHE
  • 346.90 UNS MIGRAINE NOT INTRACT
  • 847.0 SPRAIN/STRAIN OF NECK
  • 079.99 UNSPECIFIED VIRAL INFECTION
  • 599.0 URINARY TRACT INFECTION UNSPEC
  • 724.2 LUMBAGO
  • 338.19 OTHER ACUTE PAIN
  • 780.2 SYNCOPE/COLLAPSE
  • 780.97 ALTERED MENTAL STATUS
  • 786.09 RESPIRATORY ABNORMALITY OT
  • 428.0 CONGESTIVE HEART FAILURE UNSPEC
  • 787.03 VOMITING ALONE
  • 381.00 UNS ACUTE NONSUPPUR OTITIS MEDIA
  • 491.21 OBSTRUCT CHRON BRONCHITIS W EXAC
  • 493.92 ASTHMA UNSPEC W ACUTE EXACER
  • 625.9 UNS SYMPTOM FEMALE GENITAL ORGANS
  • 780.4 DIZZINESS/GIDDINESS

There are no fewer than ten different “Chest pain” codes.

Why do people go to the ER? [Movin’ Meat]

Posted in ER | Comments Off on Common Chief Complaints in the ER

How to Get the Most out of Lecture

Posted by medliorator on March 24, 2008

Here are 11 small tips to get the most out of the lecture process:

  1. Prepare for the lecture by reading up on the subject. Approaching the lecture with a basic overview can improve your comprehension and boost the clarity greatly
  2. Take a bottle of water with you. Your mind will wander if you get thirsty half way through the lecture.
  3. For each set of notes, write down the module title, the date, and that lecture’s topic.
  4. Number your pages of notes if you write a lot.
  5. Leave plenty of white space in the margins, so you can make further annotations, if necessary.
  6. If you have further questions that haven’t been answered, NOTE THESE DOWN
  7. Mark/Highlight any sections, ideas, or concepts that the lecturer says is important and likely to form part of an essay or exam.
  8. Listen. Yes, I know you’re supposed to listen, but engage with your own mind as the lecture moves along. Ask yourself questions, try and evaluate points through what you already know, get involved in the meat of the topic even though you’re just listening to another person speak.
  9. Even if you’re told a printout will be given of presentation slides from the lecture, still make notes. It’s not an excuse to stop writing.
  10. If the lecturer does present on Powerpoint and (for some strange reason) doesn’t distribute the slides, ask them for a copy. No harm in asking…the worst they can say is ‘No’.
  11. Organise your notes as soon as you can after the lecture. The longer you leave them alone, the less they’ll end up making sense and helping you when you revise from them.

The little things you might not always think about for lectures [TheUniversityBlog]

Posted in How-To | Comments Off on How to Get the Most out of Lecture

How to be a Good 3rd Year

Posted by medliorator on March 20, 2008

Anna Burkhead at The Differential:

I’ve compiled a list of things that make a medical student “bad”:

  • BAD ATTITUDE. If you balk when your intern asks you to write the note on your patient for that day, or if you repeatedly say no to scrubbing in on late afternoon OR cases, you may be a bad medical student.
  • Disappearing. for extended periods, multiple times per day, to read or nap or goof around. I’m not saying you need to be married to your team, but make them aware you’re available and willing to help.
  • Not appearing interested. Even if you detest surgery, or if you’d rather poke yourself with a MRSA-flavored fork than interview a manic patient, try to make a conscious effort to look engrossed. This may be as simple as altering your resting facial expression.
  • Correcting your resident on rounds, or its extreme variant, “The Reverse Pimp”. Some medical students get so bent out of shape over being asked difficult “pimp” questions that they decide to try the “taste of your own medicine” routine. If you ask your resident or attending a question that is fact-based, a picky detail, or something that you’d find in a long paragraph of your basic science book, and you don’t ask it in a curious “I’m asking because I don’t know” manner, you may be a Reverse Pimper. Steer clear.

even if you’re not the smartest 3rd year ever to don a short white coat, never fear. Not knowing answers does not make you a bad medical student. Attitude and work ethic count for a lot!

What Makes a Bad Medical Student? [The Differential]

Posted in Clinical Rotations, Tips & Advice | Comments Off on How to be a Good 3rd Year

Establish Rapport with Patients

Posted by medliorator on March 19, 2008

Perhaps imitating one’s patients sounds outlandish, but according to new psychological research as described in the NYTimes’ article “You Remind Me of Me,” such mimicry plays a key role in establishing rapport in everyday social interactions. The article describes how salespeople use mimicry to subconsciously build trust with their clients.

 

Social mimicry can and does go wrong. At its malicious extreme, it curdles into mockery, which is why people often recoil when they catch of whiff of mimicry, ending any chance of a social bond.

 

Yet, perhaps a bit of imitation wouldn’t hurt. After all, it is the sincerest form of flattery, no?

Relating to Patients by Mimicry [Scrub Notes]

Posted in Communication, Tips & Advice | Comments Off on Establish Rapport with Patients