In some patients with arrhythmias, temporary management of the condition can be achieved via carotid sinus massage. With rubbing of the carotids, there is a concomitant increase in nerve activation, specifically in the glossopharyngeal nerve (cranial nerve IX). Which of the following effects is a direct result of this maneuver on the parasympathetic nervous system?

A. Decreased atrial contractility
B. Decreased PR interval
C. Decreased ventricular contractility
D. Increased conduction velocity
E. Increased heart rate

Read the rest of this entry »

A 25-year-old woman diagnosed with acute promyelocytic leukemia begins chemotherapy. Three days following the initiation of treatment, she presents to the emergency room complaining of fever and difficulty breathing. She is severely hypotensive and in respiratory distress. What agent most likely precipitated the cytokine storm responsible for her symptoms?

A. All-trans retinoic acid
B. Cytarabine
C. Daunorubicin
D. Dexamethasone
E. Rituximab

Read the rest of this entry »

Author Dr. Tao Le with First Aid 2009

If you’re looking for the book, you can get it at
McGraw-Hill or Amazon

A 68-year-old woman in the chronic phase of her leukemic disease is treated with imatinib, a tyrosine kinase inhibitor that leads to inhibition of proliferation and the induction of apoptosis of specific leukemic cells. What translocation is associated with this patient’s disease?

A. t(8;14)
B. t(9;22)
C. t(11;17)
D. t(11;22)
E. t(15;17)

Read the rest of this entry »

Interesting article about confidentiality with a pediatric patient. Something we’ll all confront one day.

Click here for entire article

…Your role as a physician is different than your role as a mother,” Dr. Ford said. “If you lose the trust of the kid, you’ve lost a lot; they won’t tell you what’s going on in the future, and that’s not in the best interests of the kid or the parent…

…If I had been his mother, I would have wanted to know. But I was his doctor, and he wanted it kept confidential…

…You do have to make tough choices. There isn’t a little book where you look up, ‘O.K., this can stay confidential and this can’t’…

A 29-year-old man with complaints of weakness and easy fatigability and a history of multiple, recent bacterial infections reports to the clinic. Physical examination reveals multiple ecchymoses bilaterally on his extremities. Laboratory tests show a hemoglobin level of 10.1 g/dL and severe neutropenia. Fluorescence in situ hybridization shows the presence of a PML/RAR-alpha fusion gene. This gene is most commonly the result of which translocation?

A. t(8;14)
B. t(9;22)
C. t(11;17)
D. t(11;22)
E. t(15;17)

Read the rest of this entry »

Take advantage of this special introductory offer!

• 1 month for $57
• 2 months for $77
• 3 months for $97
• 6 months for $147
• 9 months for $197
• 12 months for $247

Hurry! This offer expires December 31, 2008. You can also extend your existing subscription by 15 days ($27), 1 month ($37), or 3 months ($77) if you need more time.

Why choose USMLERx Step 3 Qmax?
Step 3 Qmax has everything you need to ensure success on the USMLE Step 3 exam:

• 800+ top-rated USMLE-style questions with detailed explanations
• Customizable by test mode, subject matter, and question reuse
• Detailed performance feedback
• 100% Pass Guarantee! Pass the Step 3 with USMLERx or we’ll double your subscription! See Terms and Conditions for details.

USMLERx Qmax has already been battle-tested by thousands of users. Here’s what people are saying:

• “I used USMLERx and thought it was incredible… I scored 99 on the exam, which I largely attribute to the First Aid book and USMLERx. Keep up the good work!!”
• “Wow… USMLERx is badass… USMLERx was challenging and required secondary and tertiary analysis (2-step or 3-step thinking)… this is more representative of what the real test is like.”
• “I own Kaplan Qbank as well and completed most of it… but I heard so many good things about USMLERx that I just bought this and I love it! The explanations you provide are awesome compared to Kaplan Qbank.”

Not convinced yet?
Take our free Test Drive to see what we offer you.

A 30-year-old man is admitted to the emergency department after a motor vehicle accident during which he suffered blunt trauma and bilateral humeral fractures. His blood pressure is 80/40 mm Hg, heart rate is 110/min, and respiratory rate is 24/min. He receives multiple units of packed RBCs. Once stabilized, he complains of a tingling sensation in his toes and fingers. What is the best explanation for these new symptoms?

A. Calcium chelation by citrate
B. Delayed-type hypersensitivity reaction to blood products
C. Inflammation of the peripheral nerves following transfusion
D. Ischemia
E. Median nerve compression

Read the rest of this entry »

This weekend is a great opportunity to pre-order First Aid for the USMLE Step 1 2009:
Click Here!

Barnes & Noble is offering it for $29.21 online and has a 40% discount for those that purchase with a MasterCard.

Store Coupon 50-032 and Online Coupon H4D4U8B
Click here for 40% off coupon!

Happy Holidays!

A 70-year-old man with a kidney tumor is preparing to undergo elective nephrectomy and is expected to require blood transfusion during surgery. Packed RBCs compatible with his rare blood type have been in storage for 30 days. Upon transfusion of 2 units, his potassium level increases from 5.4 to 6.7 mEq/L. What is the most likely basis for his hyperkalemia?

A. Graft-versus-host disease
B. Host immune response to transfused RBCs
C. Paraneoplastic syndrome
D. Potassium leakage from RBCs
E. Renal failure

Read the rest of this entry »