medschool

5 Endocrinology Pearls for the Internal Medicine Shelf and ABIM Board Exam

Endocrinology is an essential part of the Internal Medicine Medical Clerkship and ABIM Board exam. According to the ABIM exam blueprint, questions testing endocrinology topics comprise ~8% of the exam. Approximately ~5-10% of the NBME Clerkship exam is composed of endocrinology questions.   1. Don’t let thyroid nodules intimidate you. Check out the following post ABIM Exam Prep: How to Work Up a Thyroid Nodule This systematic approach will help you workup a thyroid nodule.   2. Workup of hirsutism is not as difficult as it seems. Follow this approach and you will be able to diagnose the cause of hirsutism. – Hirsutism is caused by either excessive testosterone or excessive 17-OH steroids (DHEA-S) production. – Excessive Testosterone production is seen in ovarian cancer or polycystic ovarian syndrome (PCOS)Ovarian cancer: worked up with trans-vaginal ultrasound to look for adnexal mass. In addition, CA-125 marker is usually elevated in ovarian cancer. – PCOS: Amenorrhea, insulin resistance, and LH:FSH ratio of greater than equal to 3:1 – Excessive DHEA-S production is seen in congenital adrenal hyperplasia (CAH), Cushing’s disease, or adrenal carcinoma – CAH: Usual cause is 21 beta hydroxylase deficiency, which is used to convert 17-OH progesterone to cortisol. Since this enzyme is deficient, 17-OH progesterone levels remain elevated. Decreased cortisol levels will cause an elevated ACTH level through a negative feedback mechanism. With increased ACTH, hyperpigmentation will also occur. – Cushing’s...

5 Lessons From Medical Student Entrepreneurs

“You have an idea and the company becomes the oxygen for that idea. In these times, a company is the best way to spread that idea” – Jack Dorsey, co-founder of Twitter  Would you take a year off from medical school to launch a startup? For many medical students, the idea of running a business as a doctor, let alone as a student, is a terrifying thought. We are trained in pathology and best-practice guidelines, not spreadsheets and business plans. A group of trailblazing medical student entrepreneurs, however, are breaking the traditional medical career mold. I recently interviewed four entrepreneurs who took time off from medical school in order to run a startup. Each at different parts of the startup process, they had lots to say about the steps leading up to their companies, juggling coursework and running a business, deciding to take time-off from school, and how they thought residencies would view them. The interviewees included: Adeel Yang of Picmonic Shiv Gaglani and Ryan Haynes of Osmosis Craig Monsen of Symcat   1. Launching a startup takes more than a great idea A common misconception about starting a company is that the key to success lies in just finding a great idea. The backgrounds of these medical students shows otherwise. Yang worked for a venture capital firm where he met with entrepreneurs and reviewed business plans, Monsen used his...

Know these 7 Vaccinations for the Boards and Shelf Exams, No Matter What Jenny McCarthy Says

While most of the ABIM Examination topics fall neatly into organ system categories, not all of them fit into this schematic. These include: primary care screening guidelines, substance abuse, vaccinations, etc. Here at Knowmedge, we’ve incorporated this important group of subject areas into General Internal Medicine, similar to the American College of Physicians’ Internal Medicine In-Training Exam Blueprint. Earlier this week, we reviewed the 5 key eye diseases seen on the ABIM board and NBME shelf exams. Today we explore the high-yield topic of vaccinations.   A comprehensive adult immunization schedule, by Vaccine and Age Group, can be found on the Centers for Disease Control and Prevention website (unlike other preventive health measures, vaccination guidelines are not released by the USPSTF). Fortunately, you don’t need to memorize the entire CDC chart. Instead, for the ACP Internal Medicine in-training exam, ABIM boards and NBME shelf exam, focus on these 7 vaccinations:  1. Tetanus, diphtheria, pertussis (Tdap) – Administer Tdap to all adults who have not previously received Tdap or whose vaccination status is unknown. – Boost with Td every 10 yrs.   2. Influenza – All individuals age 6 months and older should be vaccinated yearly since the targeted influenza strains changes on a yearly basis.   3. Herpes zoster (Shingles) – Adults 60 years of age and older should receive a single dose of the zoster vaccine. This is regardless of whether the patient has had...

Best of the Best: Our 6 Favorite Tweets From Match Week

Match Day is just a day away! While this day causes many 4th year med students an almost unbearable about of anxiety, let’s not forget that it is also a very exciting and rewarding time! We’ve had our eyes out for the best tweets of Match Week to share and celebrate the success of all M4s. Good luck!!   1. I feel like you can’t look at this picture and without feeling happy and excited. We truly enjoy seeing smiling faces for dreams made a reality!   2. As difficult as it is sometimes, following your dreams wholeheartedly will be worth it.   3. It’s always nice to hear someone who has already been in your shoes explain that going into medicine brought them happiness. I think that hearing these words of encouragement during times of great stress and uncertainty is reassuring and reminds med students of how fortunate they are to have reached their goals.   4. Awesome to see so many med students who’ve likely been through the rough times together now with huge smiles and enjoying each other’s success. For me, this demonstrates the importance of collaborating and building relationships in med school. Gotta have people by your side for the good times and the bad!   5. Not only is Match Day exciting for the M4s who match, but also for their friends and family....

How Remus Lupin and Yoda Taught Me the Power of Mentorship

A big part of medical education is mentoring. The term ‘mentor’ originates from Homer’s the Odyssey and refers to an advisor. The roles of mentors vary, but generally serve to guide mentees through work, support them during the process, keep them grounded and focused on the task at hand, and provide general moral support. Over the weekend, at the Pritzker Revisit session on Scholarship and Discovery, our own students stated the number one thing to consider when finding a project was finding a great mentor. How does one find a great mentor? Well, our students are encouraged to seek “CAPE” mentors- think Superhero mentors. The mentor should be Capable, Available, have a Project that is of interest to the student, and Easy to get along with.  Capable means that the mentor has the skills to not only be a good mentor, but also to carry out the task or project at hand. This may sound odd, but sometimes faculty are so excited to have a medical student work for them, they may make the false assumption that the medical student will help them with tasks (i.e. statistics) that they themselves don’t know. Availability is especially important as the number one reason our students state they had a less than optimal experience in the summer doing scholarly work is that their mentor was not available. While availability of all doctors is an issue, the question is often whether...

The 80 Second Refresher on Parts of the Brain… by The Brain

If you’re in need of a a quick 80 second refresher on the parts of the brain, who better to teach you than Brain? (and Pinky, of...

What Does the AOA/ACGME Residency Merger Mean for Medical Students?

In a statement released in late February 2014, the AOA and the ACGME announced they have finally agreed to a single accreditation system for graduate medical education. The surprising news comes on the heels of previously failed negotiations in July 2013. From the official press release:   – From July 1, 2015 to June 30, 2020, AOA-accredited training programs will transition to ACGME recognition and accreditation. – There will continue to be osteopathic-focused training programs under the ACGME accreditation system. Two osteopathic review committees will be developed to evaluate and set standards for the osteopathic aspects of training programs seeking osteopathic recognition. – DOs and MDs would have access to all training programs. There will be prerequisite competencies and a recommended program of training for MD graduates who apply for entry into osteopathic-focused programs. – AOA and AACOM will become ACGME member organizations, and each will have representation on ACGME’s board of directors.   What does this mean for current medical students, MD and DO alike?   – The inevitability of a common match: Given all residency programs will fall under a single unification banner by 2020, a single match process is the next logical step. The current system, which forces DO students to choose between the AOA match in February and ACGME match in March, will be streamlined to allow medical students to apply to all US-based residencies at the same time. There is no exact date for...