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米国にて内科修行中。何ができるか模索している過程を記録していく

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General internal medicine (memo from NEJM knowledge plus and MKSAP)

<general medicine> ・management of patient with general weakness, slow gait, recent fall prescribe vitamin D without obtaining level ・dumping syndrome avoid refined carbohydrate ・zoster vaccine live vaccine ・linezolid toxicity type B …

Cardiology (memo from NEJM knowledge plus and MKSAP)

・dual antiplatelet Tx for STEMI avoid prasugrel for patient with h/o stroke, >75 yo, body weight < 60kg ・Tx for HTN in HFpEF patient ARB (candesartan) reduce hospitalization in patient with HFpEF ・first-line monotherapy for hypertensive…

Pulmonary and Critical care medicine (memo from NEJM knowledge plus and MKSAP)

・Tx for idiopathic pulmonary arterial hypertension require long-term anticoagulation ・management of acute pulmonary embolism in patient with h/o HIT argatroban (parenteral direct thrombin inhibitor) or others ・duration of ABX for ventil…

Nephrology (memo from NEJM knowledge plus and MKSAP)

・statin for CKD no benefit for dialysis patient, but reduce all-cause of mortality in patient with CKD not on dialysis ・management of patient with acute myeloid leukemia on chemotherapy, on normal saline IV at 200ml/hr and rasburicase fo…

Gastroenterology (memo from NEJM knowledge plus and MKSAP)

・how long patient with upper GI bleed and high-risk lesion on upper endoscopy need to be observed in hospital after successful procedure 72 hours (high-risk peptic ulcer: active bleeding, visible vessel) ・management of opiod-induced cons…

Rheumatology (memo from NEJM knowledge plus and MKSAP)

・DDx of patient with rheumatoid arthritis on methotrexate and etanercept who develop fever, arthralgia, pleuritic chest pain, nonblanching purpuric rash, pancytopenia, proteinuria drug-induced lupus erythematosus (TNF alfa inhibitor) ・ma…

Hematology and Oncology (memo from NEJM knowledge plus and MKSAP)

・target platelet count in the setting of intracranial hemorrhage 100,000, transfusion as needed ・management of superior vena cava syndrome secondary to small cell lung cancer chemotherapy ・diagnosis of polycythemia vera elevated Hb, JAK…

Infectious disease (memo from NEJM knowledge plus and MKSAP)

・ABX for extensively drug-resistant pseudomonal infection (resistant to fluoroquinolone, carbapenem, aminoglycoside) intravenous colistin (polymyxin E) ・first recurrance of mild to moderate C.difficile colitis metronidazole for 14 days …

Neurology (memo from NEJM knowledge plus and MKSAP)

・diagnostic test for patient with 1 week constant headache, worse in the morning, no focal sign, with bilateral papilledema, valsalva maneuver increase pain, using tobacco and oral contraceptive, normal brain MRI without contrast MR venog…

Endocrinology and metabolism (memo from NEJM Knowledge plus and MKSAP)

・Tx for acute episode of diabetic neuropathy glucose control, low-dose tricycle antidepressant (desipramine), capsaicin cream ・mechanism of hypercalcemia due to disseminated tuberculosis macrophages in tuberculous granuloma activate vita…

Job Search for J1 VISA Holder

Timeline (my experience) 4/2015 Registration to job search websites 5/2015 Start contacting recruiters 8-9/2015 Interview / contract (the earlier the better for J1 waiver spots) 12/2015 Application to FCVS 2/2016 Application to American Bo…

THE WAY OF THE PRIMARY CARE PHYSICIAN

ICU notes are usually written based on organ system. The concept is that physicians try not to miss any issues which need to be addressed by reviewing all the body system. This method can also be applicable to outpatient visit summary. Usi…