Question of the Week #489

A 35 Year old woman presents for evaluation of recurrent headaches for the past few months.  Lately, she has been waking up with a headache almost daily though it tends to improve in the latter half of the day. She is frustrated as she can not even get some sleep during the attack since lying down makes her feel worse . She has associated nausea. She has transient attacks of light flashes  that resolve spontaneously. Her menstrual history is unremarkable. On physical examination, she has no neurological deficits. Funduscopic examination shown below: QBANK INSTA AD

Which of the following information, if elicited in the patient history, would increase the clinical suspicion of the diagnosis?

A)     Constipation

B)     Family history

C)      Recent weight gain

D)      Galactorrhea

E)   Urinary Incontinence

Question of the week # 488

A 31 Year old woman diagnosed with suspected diagnosis of Idiopathic intracranial hypertension underwent a lumbar puncture for diagnostic purposes. An MRI of the brain that was obtained prior to lumbar puncture did not reveal any structural abnormalities or mass effect. Laboratory investigations including coagulation parameters were normal. About 12 hours after the procedure, the patient complains of moderate to severe headache. Headache is mainly in the occipital region which increases while sitting up and improves on lying flat. She has two episodes of vomiting in the last one hour. She also complains of dizziness and ringing sensation in her ears.  Physical examination does not reveal any papilledema or focal neurological deficits.

Most appropriate next step in managing this patient?

A) Blood cultures

B) MRI of the Lumbar Spine

C) Non-Contrast CT scan of brain

D) Observation

E) Acetazolamide

Question of the Week #74, 75

74) A 75 year-old man with history of hypertension presents to the emergency room with complaints of shortness of breath and palpitations. His vital reveal a heart rate 142/min, blood pressure 130/86, temperature 98.6 and oxygen saturation of 89% on room air. On auscultation, there are no rhonchii or crepitations, the heart rate was irregular and rapid with out any murmurs. The patient is placed on oxygen by nasal cannula. An urgent EKG is obtained which reveals rapid atrial fibrillation with no evidence of significant ST-T changes. The patient is started on diltiazem. Chest x-ray is normal and a brain natriuretic peptide is 80ng/L. Electrolytes, TSH and complete blood count are with in normal limits. Cardiac enzymes are drawn. Arterial blood gases reveal a pH of 7.48, po2 of 58, pco2 of 20 on room air ( Fio2 of 21%). The next step in establishing the etiology of his atrial fibrillation :

A) Cardiac catheterization
B) Spiral CT scan of the chest
C) Venos doppler of lower extremities
D) 2D Echocardiogram
E) D-Dimer

75) What is the most likely etiology of atrial fibrillation in Case 1?

A) Acute ST elevation MI
B) Acute pulmonary embolism
C) Pneumothorax
D) COPD exacerbation
E) Congestive heart failure

Archer USMLE Step 3 CCS Workshop – August 22, 2010

Archer USMLE Step 3 CCS Workshop – August 22, 2010

Archer online live step 3 reviews aims to bring USMLE step 3 courses on your desktop, at your doorstep! These highly successful live USMLE Step3 online reviews are an extension of our very popular and successful ” Dr.Red’s online ccs workshop, which has reached more than two thousand step3 takers in less than 12 months and has resulted in 98% pass rate. Archer Reviews have achieved a high success rate even with examinees with multiple attempts by our unique approach. These online reviews are done live and in a webinar format. You can stay at home and listen to lectures live and like in a virtual classroom, you can raise your hand and your question will be immediately answered by the instructor. This is a live online classroom which reduces the pain of flying several miles to attend live reviews. These are the only one in the market that offer successful step 3 lectures in this unique, live format. Archer’s most successful endeavor has been Dr.Red’s CCS Workshop which has helped hundreds of examinees to pass easily by excelling on CCS component.

Archer’s next CCS online workshop for the month of January will be on Sunday 8/22/2010 at 10 AM EST.

If you are interested in registering for this course, you can pay for the course on the website at http://www.shop.ccsworkshop.com. Upon payment of the registration fee, your registration request will be automatically approved and an approval e-mail will be sent to you. This approval notice will have a button “Join Webinar” in it. Clicking this button on the day of the workshop will open up the live workshop on your desktop

To participate in the workshop, you will need a computer with internet access. For the audio, you can use either your computer’s microphone or a telephone. You will use the phone for the voice and log in to the conference call while you watch the power-point slides and the CCS demonstration on your desktop via. our unique net meeting software. You can also just opt to use your computer’s microphone in which case you do not need a telephone. Then you will get to practice a case while we watch and analyze your approach and correct it.

CCS Workshop Includes :

1. Lecture on CCS Strategies
2. Live demonstration of CCS cases
3. Common mistakes committed by the examinees and preventing them
4. Tips to score extremely high on CCS
5. Follow-ups of office and ER cases
6. Efficient use of time, doing more stuff without advancing the clock
7. Avoiding invasive tests
8. Basic set of orders for emergency cases
9. The 5-minute screen – adding/ disconinuing the orders that can matter
10. Obtaing consults and their appropriateness
11. Differential diagnosis for common ER and office presentations and easy tips to get the most out of few orders.
12. Working on efficiency
13. Live practice of 15 to 20 CCS cases by the attendees in the workshop
14. A these in addition to –> 20 minutes of supervised practice of one CCS case by each attendee who volunteers to practice. About 15 to 20 Highyield CCS cases will be practiced. During this time, you will be thoroughly analyzed, corrected and given instantaneous feedback by our experienced faculty

The total course fee is $97 .Slots are limited at 35.
If you are interested in the course, you visit Archer’s online store directly to pay : http://www.shop.ccsworkshop.com

If you have further questions, please directly contact support@ccsworkshop.com

Archer’s other courses include very informative topic reviews and the high-yield rapid review – please check our website.. Archer theory reviews are now available as streaming videos so that you can start accessing them from the beginning of your step 3 preperation and fine tune your conceptual understanding to score maximum on the Multiple Choice Questions on USMLE Step 3

USMLE Step 3 CCS WORKSHOP – MAY 2010

Archer online live step 3 reviews aims to bring USMLE step 3 courses on your desktop, at your doorstep! These highly successful live USMLE Step3 online reviews are an extension of our very popular and successful ” Dr.Red’s online ccs workshop, which has reached more than two thousand step3 takers in less than 12 months and has resulted in 98% pass rate. Archer Reviews have achieved a high success rate even with examinees with multiple attempts by our unique approach. These online reviews are done live and in a webinar format. You can stay at home and listen to lectures live and like in a virtual classroom, you can raise your hand and your question will be immediately answered by the instructor. This is a live online classroom which reduces the pain of flying several miles to attend live reviews. These are the only one in the market that offer successful step 3 lectures in this unique, live format. Archer’s most successful endeavor has been Dr.Red’s CCS Workshop which has helped hundreds of examinees to pass easily by excelling on CCS component.

Archer’s next CCS online workshop for the month of January will be on Sunday 1/24/2010 at 10 AM EST.

If you are interested in registering for this course, you can pay for the course on the website at http://www.shop.ccsworkshop.com. Upon payment of the registration fee, your registration request will be automatically approved and an approval e-mail will be sent to you. This approval notice will have a button “Join Webinar” in it. Clicking this button on the day of the workshop will open up the live workshop on your desktop

To participate in the workshop, you will need a computer with internet access. For the audio, you can use either your computer’s microphone or a telephone. You will use the phone for the voice and log in to the conference call while you watch the power-point slides and the CCS demonstration on your desktop via. our unique net meeting software. You can also just opt to use your computer’s microphone in which case you do not need a telephone. Then you will get to practice a case while we watch and analyze your approach and correct it.

CCS Workshop Includes :

1. Lecture on CCS Strategies
2. Live demonstration of CCS cases
3. Common mistakes committed by the examinees and preventing them
4. Tips to score extremely high on CCS
5. Follow-ups of office and ER cases
6. Efficient use of time, doing more stuff without advancing the clock
7. Avoiding invasive tests
8. Basic set of orders for emergency cases
9. The 5-minute screen – adding/ disconinuing the orders that can matter
10. Obtaing consults and their appropriateness
11. Differential diagnosis for common ER and office presentations and easy tips to get the most out of few orders.
12. Working on efficiency
13. Live practice of 15 to 20 CCS cases by the attendees in the workshop
14. A these in addition to –> 20 minutes of supervised practice of one CCS case by each attendee who volunteers to practice. About 15 to 20 Highyield CCS cases will be practiced. During this time, you will be thoroughly analyzed, corrected and given instantaneous feedback by our experienced faculty

The total course fee is $97 .Slots are limited at 45.
If you are interested in the course, you visit Archer’s online store directly to pay : http://www.shop.ccsworkshop.com

If you have further questions, please directly contact support@ccsworkshop.com

Archer’s other courses include very informative topic reviews and the high-yield rapid review – please check our website. Next 3-Day Step 3 Rapid Review is in JULY -2010. Archer theory reviews are now available as streaming videos so that you can start accessing them from the beginning of your step 3 preperation and fine tune your conceptual understanding to score maximum on the Multiple Choice Questions on USMLE Step 3.

Archer launches PayPerView for USMLE Step 3 audio/video lectures

Archer Review releases Pay-Per-View option for those who missed out on their live reviews
Pay-Per-View enables you to watch the streaming video lectures for USMLE step 3 at your own convenience. These recordings are similar to the live webinar review in that you can see the powerpoint presentation running on your desktop screen while you also listen to the instructor’s audio.

Archer Review answers some of the frequently asked questions regarding Pay-Per-View
Please see below

What is Pay-Per-View?
Pay-Per-View system allows you to access the streaming video lectures online at your convenience and watch them at your home on your own desktop. You may purchase the full length course or topic-wise access.

Can I watch a Demo?
Yes! Contact us

What lectures for USMLE Step 3 do you currently offer via. Pay-Per-View?

The lectures that are currently available via. Pay-Per-View areA. Archer Full length ( 36 hours) USMLE Step 3 Review Course. B. Archer USMLE 3 Topic-Wise Lectures ( Hematology, Cardiology, Gastroenterology, Nephrology/Acid-base/Electrolytes, Pulmonology/Ventilators, Infectious diseases, Endocrinology, Neurology, Ethics, Rheumatology/ orthopedics/ sports medicine, Oncology, Preventive medicine, Psychiatry, Gynecology, Pediatrics and Dermatology )C. Lectures for USMLE Step2 CK will be available very soon.

What are these Video Lectures? Are they similar to your live reviews?

These streaming video lectures are the recordings of our live webinar sessions. These are exactly similar to our live review in that you can see both the powerpoint presentation ( a capture of the instructor’s desktop screen) as well as listen to the audio in conjunction with the powerpoint presentation. This eliminates the need for looking at a hand out or notes while listening to the lecture as you can directly see the powerpoint running on your screen.

Are we provided with any hand-outs or lecture notes?

Yes, you will be provided with relevant Archer USMLE Step 3 notes by e-mail once you purchase the streaming video for a particular topic or for the entire review.

Is Pay-Per-View more expensive than live review?

At this time, the cost of live review as well as Pay-Per-View is similar.What are the benefits of Pay-Per-View over the Live review?Live review needs to be attended at a designated time. Pay-per-view can be watched at your convenience. In Pay-Per-View, you can pause and listen to a particular portion again. You can also listen to the same lecture almost one and half times with the “watch time” that we currently provide.

What are the limitations of Pay-Per-View when compared to Live Review?

During the live review, you can directly ask questions and talk with the instructor. There is no such possibility via. Pay-Per-View. However, you may send us questions by e-mail and our instructor will try and answer them in about 3 days.

What is “Watch Time”?

Watch time is the amount time you are provided to watch the lecture. You are approximately provided with a watch time that is 50% greater than the length of the review. This allows to rewind and replay certain portions of the lecture if you wish. Watch time will not expire when you exit the lecture. Any unused watch time will be stored in your account and you can use it on an other day. When you resume the lecture, make sure to forward the player to the point where you left off. You can also replay the previous session as long as you have sufficient watch time in your accountFor each lecture, you will be provided with the duration of the lecture and the “Watch time” when you begin.

Do I need any special system requirements to play these?

These are WMV files and will play with any Windows Media Player.

How about the Internet connection requirements?Dial-Up connections are ok but broad band connection is preferred for uninterrupted access.

If interested, please visit Pay-Per-View to sign up!

Archer USMLE Step3 Rapid Review – Samples

Rapid review sample video lectures will be posted soon after our current rapid review. Subscribe to the blog for updates!

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