By Tao Le, Vikas Bhushan, veronique
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Extra info for First Aid for the USMLE Step 3, Second Edition (First Aid USMLE)
An open procedure is appropriate if gland size is > 75 g. H IG H-YI E LD FACTS Patients complain of frequency, urgency, nocturia, ↓ force and size of stream, and incomplete emptying → overﬂow incontinence. Exam reveals a ﬁrm, rubbery, smooth prostatic surface (vs. the rock-hard areas that suggest prostate cancer). TA B L E 2 . 1- 1 . Recommended Cancer Screening Guidelines TYPE OF CANCER RECOMMENDATIONS Cervical cancer An annual Pap smear is recommended starting at age 18 or at the onset of sexual activity.
Aspirin before doses ↓ ﬂushing. 42 SYMPTOMS ■ ■ ■ Acute endocarditis: Presents with fever, rigors, heart failure from valve destruction, and symptoms related to systemic emboli (neurologic impairment, back pain, pulmonary symptoms). Subacute bacterial endocarditis: Characterized by weeks to months of fever, malaise, and weight loss. Also presents with symptoms of systemic emboli. Noninfectious endocarditis: Generally asymptomatic. Can cause heart failure by destroying valves. EXAM ■ ■ ■ H IG H-YI E LD FACTS Look for a new murmur.
When taking the exam, also keep the following in mind: ■ ■ ■ 12 Read through the HPI carefully. Use it to develop a short differential that will direct your physical exam and initial management. Often, the diagnosis is apparent before you even do the physical. Jot down pertinent positives and negative so that you don’t have to come back and review the chart. Keep in mind any drug allergies. Any unstable patient needs immediate management. If the vital signs are unstable, you may want to do some basic management such as IV ﬂuids and oxygen before doing your physical exam.