Board Imcourses.mayo.edu Related Courses. Taking the Internal Medicine Board ExamInternal Medicine Board Review And CME Courses Mayo Clinic. 2.Become adept Download The Johns Hopkins Internal Medicine Board Review PDF book free online From The Johns Hopkins Internal Medicine Board Review PDF: Dont gamble on. Posted: (1 week ago) 2017 INTERNAL MEDICINE BOARD REVIEW COURSE Learning Objectives 1.Increase and refresh knowledge of core topics in internal medicine and the subspecialties through discussion of common and not-so-common clinical problems.
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Internal Medicine Board Review Free Online FromThe directives recommend initiating antihypertensive therapy in patients younger than age 60 who have an ambulatory blood pressure of ≥140/90 mm Hg. As shown below, only 23% correctly diagnosed the patient as hypertensive and chose to initiate medical therapy most respondents opted for lifestyle modification instead.What is the most appropriate management approach for an asymptomatic 49-year-old man with a BMI of 32, in-clinic blood pressure readings of 148/90 mm Hg and 150/94 mm Hg, and a 24-hour average ambulatory blood pressure recording of 142/88 mm Hg?A) Diagnose hypertension and initiate medical therapy (23%)B) Diagnose hypertension and initiate lifestyle modification (24%)C) Diagnose prehypertension and initiate lifestyle modification (47%)D) Reassure the patient that the findings are normal (3%)E) Repeat the ambulatory blood pressure monitoring (3%)This pattern of responses likely reflects the controversy that has surrounded the JNC 8 directives since they were released in late 2013. Interpreting Blood PressureOn August 12, we asked participants to interpret the 24-hour ambulatory blood pressure readings of a 49-year-old man and determine the most appropriate next step in his care. If revisions to a question are necessary, we make them immediately and incorporate them into NEJM Knowledge+, so that users are always seeing the latest version of our content.Let’s take a look at some of our most challenging questions to date. We also read each and every comment we receive about our questions, as those comments often provide clues about which elements of a question might have been problematic. Some of the recipients are preparing for their board exams, and some are looking to maintain their knowledge base, but one thing is certain: they’re all looking for a challenge, and so far, NEJM Knowledge+ seems to be delivering.Of the 29 questions we’ve emailed out so far, just over half were answered correctly by the majority of respondents.When one of our questions is answered incorrectly by a large number of individuals, we take a close look to make sure the question is indeed consistent with the current standard of medical care and that we have not inadvertently created a trick question with our wording choices. Icq chatSymptom onset over seconds or minutes suggests a vascular event, whereas onset over several hours or days suggests an abscess progression over an even longer period (weeks to months) would suggest a neoplasm. Only a quarter of respondents correctly concluded that these signs and symptoms were suggestive of a brain abscess most people thought the patient was having a stroke.Which one of the following diagnoses is most likely for an afebrile 40-year-old patient with headache and gradually progressive focal neurologic signs that evolve over 2 days?Although focal neurologic signs can progress in both an abscess and a stroke, the speed of the progression is what helps to differentiate between the two. Recognizing Brain AbscessOn September 9, we asked readers to identify the most likely diagnosis in an afebrile man who had a headache and focal neurologic signs that had been gradually progressing for the past 2 days. The hypertension debate continues, but in the meantime, our hypertension questions will continue to be based largely on the JNC 8 guidelines that establish the standard of care. In NEJM Knowledge+, we pride ourselves on creating solid distractors, the kind that really test your knowledge of the details and the sort that you’re likely to find on the ABIM board exam. However, these disorders typically manifest as polyarticular arthritis rather than the monoarticular arthritis seen in this case patient.Which one of the following diagnostic approaches is most appropriate for a woman with migratory arthralgias and a neutrophilic knee effusion whose synovial fluid is clear and tests negative on Gram’s stain and culture?A) Cervical nucleic acid amplification assay (31%)B) Antinuclear antibody testing and rheumatoid-factor testing (43%)E) Factor VIII testing (2%) “Distractors” Do Their JobAs you’ve seen by now, all the questions in NEJM Knowledge+ offer five answer options – the correct choice plus four “distractors,” options that are plausible but incorrect because of an important and often subtle nuance. The more common response, though, was to test for arthritis related to connective-tissue disorders. About a third of respondents correctly considered gonoccocal arthritis the leading diagnosis and chose cervical nucleic acid amplification testing as the most appropriate next step in evaluation. Internal Medicine Board Review Skin Abscess CausedPredicting Electrolyte Changes in a Hyperglycemic EmergencyOn July 8, we described a patient in a hyperosmolar hyperglycemic state and asked which electrolyte changes would be expected to occur once a continuous intravenous insulin infusion was initiated. However, this case had none of those features even if it did, cephalexin would not be an appropriate option because it does not have activity against MRSA. Exactly half of respondents correctly identified incision and drainage alone as the most appropriate management in this case, but a full 30% chose cephalexin plus incision and drainage.Which one of the following management approaches is most appropriate for a skin abscess caused by community-acquired methicillin-resistant Staphylococcus aureus without associated systemic symptoms or cellulitis?A) Incision and drainage of the abscess (50%)E) Cephalexin plus incision and drainage of the abscess (30%)Antibiotic therapy is an appropriate part of abscess management if the patient has systemic symptoms or signs, extensive involvement (such as multiple abscesses), or significant or rapidly progressing cellulitis. Managing a Staphylococcus aureus Skin AbscessOn June 3, we asked readers to choose the most appropriate management for a skin abscess that was caused by community-acquired methicillin-resistant Staphylococcus aureus (MRSA) and not accompanied by any systemic symptoms or cellulitis.
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