NBME Answers : jd1's page

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submitted by thajoker(21), visit this page

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Wtf, Wells Criteria for DVT says always do confirmation thru US/D-Dimer before treating...

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jd1 @thajoker It's not a DVT (vein), it's an arterial embolus which needs Heparin EM, (DVT would not have absent pulses or be cold b/c the blood is stuck inside vs with an artery the blood can't get in (also AFIB makes you think arterial anyway) @kingfriday management of an acute episode is different from chronic arterial embolus where assessment would start with an ABI and management would start with exercise. In an acute episode, patient needs EM heparin and likely thrombectomy after +15

thajoker lol brain fart, thank you for this +4

drzed Just to add on to this, if you are fairly certain that a person is having a PE, you would actually heparinize them FIRST and then test LATER (at least, as per up-to-date). +1

submitted by step_prep(148), visit this page

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Patient with recent antibiotic usage develops severe diarrhea and abdominal pain, which is most consistent with C. difficile infection
Key idea: C. difficile leads to diarrhea by producing two main toxins that lead to enterocyte damage
Key idea: Toxic megacolon can be seen secondary to C. difficile infection and ulcerative colitis (at least for NBME purposes)

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seagull I choose sterilization because C-diff is essentially an imbalance of colonic flora due to antibiotic "sterilization" leading to expansion of C. Diff. However, I ca see how toxin- mediated is the true mechanism but the question seems dirty to me. +8

jd1 I think also technically sterilization refers to inactivating spores (as opposed to disinfection which would not), so would imply Cdiff would be killed off too +7