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	<title>medcert.com</title>
	<link>http://www.medcert.com</link>
	<description>Internal Medicine exam preparation and review course</description>
	<lastBuildDate>Sun, 11 Jul 2010 16:11:52 +0000</lastBuildDate>
	<docs>http://backend.userland.com/rss092</docs>
	<language>en</language>
	
	<item>
		<title>The Common Cold</title>
		<description><![CDATA[The common cold is an acute respiratory tract infection characterized by mild coryzal symptoms, rhinorrhea, nasal obstruction, and sneezing. Although the incidence of the cold cannot be clearly defined because of seasonal and locational variability, it is estimated to vary from 3-6 cases per person per year. Children younger than 1 year have experienced an average [...]]]></description>
		<link>http://www.medcert.com/the-common-cold/</link>
			</item>
	<item>
		<title>Molluscum Contagiosum</title>
		<description><![CDATA[Transmission of molluscum contagiosum has been reported by direct skin contact and has occurred in wrestlers, patients of a surgeon with a hand lesion, and children sharing baths, towels, gymnasium equipment, and benches. Autoinoculation also occurs as evidenced by linear arrays of lesions on infected individuals. Molluscum contagiosum can likely be vertically transmitted, similarly to other [...]]]></description>
		<link>http://www.medcert.com/molluscum-contagiosum/</link>
			</item>
	<item>
		<title>Hepatocellular Carcinoma</title>
		<description><![CDATA[Hepatocellular carcinoma (HCC) is a primary malignancy of the liver. Hepatocellular carcinoma is now the third leading cause of cancer deaths worldwide, with over 500,000 people affected.  The incidence of hepatocellular carcinoma is highest in Asia and Africa, where the endemic high prevalence of hepatitis B and hepatitis C strongly predisposes to the development of [...]]]></description>
		<link>http://www.medcert.com/hepatocellular-carcinoma/</link>
			</item>
	<item>
		<title>Calcified/Porcelain Gallbladder</title>
		<description><![CDATA[Patients with porcelain gallbladder are usually asymptomatic, and the condition is usually found incidentally on plain abdominal radiographs, sonograms, or computed tomography (CT) images.
Surgical treatment of porcelain gallbladder is based on results from studies performed in 1931 and 1962, which revealed an association between porcelain gallbladder and gallbladder carcinoma.
Porcelain gallbladder is an uncommon condition; recognizing [...]]]></description>
		<link>http://www.medcert.com/calcifiedporcelain-gallbladder/</link>
			</item>
	<item>
		<title>Recurrent Miscarriages/Abortions</title>
		<description><![CDATA[Most studies demonstrate a spontaneous miscarriage rate of 10-15%. However, the true rate of early pregnancy loss is close to 50% because of the high number of chemical pregnancies that are not recognized in the 2-4 weeks after conception. Most of these pregnancy failures are due to gamete failure (eg, sperm or oocyte dysfunction).
In internal [...]]]></description>
		<link>http://www.medcert.com/recurrent-miscarriagesabortions/</link>
			</item>
	<item>
		<title>Retinal Detachment</title>
		<description><![CDATA[Retinal detachment occurs when subretinal fluid accumulates in the potential space between the neurosensory retina and the underlying retinal pigment epithelium.
Symptoms 

Photopsias refer to the perception of flashing lights by the patient. It probably arises from the mechanical stimulation of vitreoretinal traction on the retina. It may be induced by eye movements and appears to [...]]]></description>
		<link>http://www.medcert.com/retinal-detachment/</link>
			</item>
	<item>
		<title>Sudden Vision Loss</title>
		<description><![CDATA[Sudden visual loss is a common complaint among patients of different ages with variable presentations. Some patients describe it as a gray-black curtain that gradually descends or as blurring, fogging, or dimming of vision. It usually lasts a few minutes but can persist for hours. The frequency varies from a single episode to many episodes [...]]]></description>
		<link>http://www.medcert.com/sudden-vision-loss/</link>
			</item>
	<item>
		<title>Pharygitis. . . Treat or Not???</title>
		<description><![CDATA[Pharyngitis is defined as an infection or irritation of the pharynx and/or tonsils. The etiology is usually infectious, with most cases being of viral origin. These cases are benign and self-limiting for the most part. Bacterial causes of pharyngitis are also self-limiting, but are concerning because of suppurative and nonsuppurative complications. Other causes include allergy, trauma, [...]]]></description>
		<link>http://www.medcert.com/pharygitis-treat-or-not/</link>
			</item>
	<item>
		<title>Conjunctivitis</title>
		<description><![CDATA[Conjunctivitis is one of the most common nontraumatic eye complaints resulting in presentation to the office. The term describes any inflammatory process that involves the conjunctiva.

In classic presentations, patients complain of eyelids sticking together on waking.
They may describe itching and burning or a gritty foreign-body sensation.
Pus sliding across the eye may distort vision, though visual [...]]]></description>
		<link>http://www.medcert.com/conjunctivitis/</link>
			</item>
	<item>
		<title>Colon Cancer Pharmacological Therapy</title>
		<description><![CDATA[5-Fluorouracil remains the backbone of chemotherapy regimens for colon cancer, both in the adjuvant and metastatic setting. In the past 10 years, it was established that combination regimens provide improved efficacy and prolonged progression-free survival in patients with metastatic colon cancer.
In addition to 5-fluorouracil, oral fluoropyrimidines such as capecitabine (Xeloda) and tegafur are increasingly used [...]]]></description>
		<link>http://www.medcert.com/colon-cancer-pharmacological-therapy/</link>
			</item>
	<item>
		<title>Breast Cancer Pharmacological Therapy</title>
		<description><![CDATA[The American Society of Clinical Oncology (ACOG) has updated their practice guidelines regarding pharmacologic intervention for breast cancer risk reduction. Some of the highlights are are listed below:

Tamoxifen use for 5 years reduces risk for at least 10 years in premenopausal women, particularly estrogen receptor (ER) – positive invasive tumors.

Women 50 years or younger have [...]]]></description>
		<link>http://www.medcert.com/breast-cancer-pharmacological-therapy/</link>
			</item>
	<item>
		<title>BRCA1 &amp; 2 (Breast Cancer)</title>
		<description><![CDATA[The BRCA1 and BRCA2 gene mutations, on chromosome 17 and 13, respectively, account for the majority of autosomal dominant inherited breast cancers.
Both genes are believed to be tumor suppressor genes whose products are involved with maintaining DNA integrity and transcriptional regulation.
Mutation rates may vary by ethnic and racial groups.

For BRCA1 mutations, the highest rates occur [...]]]></description>
		<link>http://www.medcert.com/brca1-2-breast-cancer/</link>
			</item>
	<item>
		<title>ITP vs TTP vs DIC</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/itp-vs-ttp-vs-dic/</link>
			</item>
	<item>
		<title>JNC 7 Part 7 Pharmacological Treatment</title>
		<description><![CDATA[A large number of drugs are currently available for reducing BP. Greater than 2/3 of all patients treated for hypertension will need more than one agent.  For example, in ALLHAT, 60 percent of those whose BP was controlled to &#60;140/90 mmHg received two or more agents, and only 30 percent overall were controlled on one [...]]]></description>
		<link>http://www.medcert.com/abc/</link>
			</item>
	<item>
		<title>CSF Analysis</title>
		<description><![CDATA[Here are the normal parameters :
Pressure          = 50-180 mmH2O
Color                = clear
RBC count       = 0-4 x 10^6/L
WBC count      = 0-4 x 10^6/L
Glucose            = &#62;60% of the serum level
Protein             = &#60; 0.45 g/L
Microbiology   = sterile//no growth
Subarachnoid haemorrhage :
Pressure increased, bloody, RBC count increased, WBC = normal/increased, glucose = normal, protein = increased, sterile
 
Acute bacterial meningitis :
Pressure normal/increased, cloudy/turbid, RBC count = [...]]]></description>
		<link>http://www.medcert.com/csf-analysis/</link>
			</item>
	<item>
		<title>Third Degree AV Block</title>
		<description><![CDATA[Complete heart block, also referred to as third-degree heart block, or third-degree atrioventricular (AV) block, is a disorder of the cardiac conduction system where there is no conduction through the AV node as shown below:
 



 When you see this, emergently place temporay pacing in a hospital setting where plans for permanent pacer and cardiovascular consult can [...]]]></description>
		<link>http://www.medcert.com/third-degree-av-block/</link>
			</item>
	<item>
		<title>Second Degree AV Block</title>
		<description><![CDATA[Second-degree heart block, or second-degree atrioventricular (AV) block, refers to a disorder of the cardiac conduction system in which some atrial impulses are not properly conducted to the ventricles.
Some P waves are not followed by a QRS.
Second-degree AV block is composed of 2 types: Mobitz I or Wenckebach block, and Mobitz II.
The Mobitz I second-degree [...]]]></description>
		<link>http://www.medcert.com/second-degree-av-block/</link>
			</item>
	<item>
		<title>First degree AV block</title>
		<description><![CDATA[First-degree heart block, or first-degree atrioventricular (AV) block, is defined as prolongation of the PR interval on the ECG to more than 200 msec.  
While the conduction is slowed, there are no missed beats. ECG of a patient with first-degree heart block is shown below.

First-degree AV block is more common among African Americans compared with white populations.
The [...]]]></description>
		<link>http://www.medcert.com/first-degree-av-block/</link>
			</item>
	<item>
		<title>Left Bundle Branch Block</title>
		<description><![CDATA[Left bundle branch block (LBBB) occurs when transmission of the cardiac electrical impulse is delayed or fails to be conducted along the rapidly conducting fibers of the main left bundle branch or in both left anterior and posterior fascicles.  Thus, the left ventricle slowly depolarizes by means of cell-to-cell conduction that spreads from the right [...]]]></description>
		<link>http://www.medcert.com/left-bundle-branch-block/</link>
			</item>
	<item>
		<title>S4</title>
		<description><![CDATA[Ventricular filling during atrial contraction
Due to decreased ventricular compliance  (CAD, AS, MR, HCM, Diabetic Cardiomyopathy)
****No S4 during Atrial Fibrillation
The S4 heart sound is associated with any process that increases the stiffness of the ventricle including: 
–&#62;hypertrophy of the ventricle 
–&#62;long-standing hypertension (causes ventricular hypertrophy) 
–&#62;aortic stenosis (causes ventricular hypertrophy) 
–&#62;overloading of the ventricle (causes ventricular [...]]]></description>
		<link>http://www.medcert.com/s4/</link>
			</item>
	<item>
		<title>S3</title>
		<description><![CDATA[
May be normal in people under 40 years of age and some trained athletes but should disappear before middle age.

 

Caused by the oscillation of blood back and forth between the walls of the ventricles initiated by in-rushing blood from the atria.

Due to:
1.Rapid ventricular filling

  Ventricular decompensation (acutely)
  Ventricular Septal Defect

2.Severe aortic or mitral regurgitation
3.Poor Left [...]]]></description>
		<link>http://www.medcert.com/s3/</link>
			</item>
	<item>
		<title>S2</title>
		<description><![CDATA[Closure of aortic and pulmonic valves just after systole.
Persistently split S2 (widened S2) is due to pulmonic stenosis, PE, or RBBB (all cause delayed function of right ventricle.)
A young girl with a split S2 and with RBBB on ECG is Pulmonic Stenosis. Not ASD or VSD.
Normally heard as split during inspiration. The split disappears on expiration.
]]></description>
		<link>http://www.medcert.com/s2/</link>
			</item>
	<item>
		<title>S1</title>
		<description><![CDATA[Normally heard as a single sound, occasionally a narrow split
Heard during the onset of systole
Due to closure of the mitral and tricuspid valve
Loud S1 : pregnancy, anemia, anxiety, thyrotoxicosis, mitral stenosis
Soft S1 : heart failure, mitral regurgitation
]]></description>
		<link>http://www.medcert.com/s1/</link>
			</item>
	<item>
		<title>JNC 7 Part 6 Treatment</title>
		<description><![CDATA[Blood Pressure Control Rates
 Hypertension is the most common primary diagnosis in America (35 million office visits as the primary diagnosis).5 Current control rates (SBP &#60;140 mmHg and DBP &#60;90 mmHg), though improved, are still far below the Healthy People goal of 50 percent, which was originally set as the year 2000 goal and has since [...]]]></description>
		<link>http://www.medcert.com/jnc-7-part-6-treatment/</link>
			</item>
	<item>
		<title>JNC 7 Part 5 Patient Evaluation &amp; Differential</title>
		<description><![CDATA[Evaluation of hypertensive patients has three objectives: (1) to assess lifestyle and identify other cardiovascular risk factors or concomitant disorders that may affect prognosis and guide treatment (table 6); (2) to reveal identifiable causes of high BP (table 7); and (3) to assess the presence or absence of target organ damage and CVD.
 Patient evaluation is [...]]]></description>
		<link>http://www.medcert.com/jnc-7-part-5-patient-evaluation/</link>
			</item>
	<item>
		<title>JNC 7 Part 4 Accurate Blood Pressure Measurement</title>
		<description><![CDATA[The accurate measurement of BP is the sine qua non for successful management. The equipment—whether aneroid, mercury, or electronic—should be regularly inspected and validated. The operator should be trained and regularly retrained in the standardized technique, and the patient must be properly prepared and positioned. The auscultatory method of BP measurement should
be used.58 Persons should [...]]]></description>
		<link>http://www.medcert.com/jnc-7-part-4-accurate-blood-pressure-measurement/</link>
			</item>
	<item>
		<title>JNC 7 Part 3 Cardiovascular Disease Risk</title>
		<description><![CDATA[The relationship between BP and risk of CVD events is continuous, consistent, and independent of other risk factors. The higher the BP, the greater the chance of heart attack, HF, stroke, and kidney diseases. The presence of each additional risk factor compounds the risk from hypertension as illustrated in figure 12. The easy and rapid [...]]]></description>
		<link>http://www.medcert.com/jnc-7-part-3-cardiovascular-disease-risk/</link>
			</item>
	<item>
		<title>JNC 7 Part 2 Hypertension Classifications</title>
		<description><![CDATA[Because of the new data on lifetime risk of hypertension and the impressive increase in the risk of cardiovascular complications associated with levels of BP previously considered to be normal, the JNC 7 report has introduced a new classification that includes the term “prehypertension” for those with BPs ranging from 120–139 mmHg systolic and/or 80–89 [...]]]></description>
		<link>http://www.medcert.com/jnc-7-part-2/</link>
			</item>
	<item>
		<title>JNC 7 Part 1 Overview</title>
		<description><![CDATA[Data from the National Health and Nutrition Examination Survey (NHANES) have indicated that 50 million or more Americans have high BP warranting some form of treatment. Worldwide prevalence estimates for hypertension may be as much as 1 billion individuals, and approximately 7.1 million deaths per year may be attributable to hypertension. The World Health Organization [...]]]></description>
		<link>http://www.medcert.com/jnc-7-part-1-overview/</link>
			</item>
	<item>
		<title>questions_c</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/questions_c/</link>
			</item>
	<item>
		<title>questions_Urology</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/questions_urology/</link>
			</item>
	<item>
		<title>questions_Rheumatology</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/questions_rheumatology/</link>
			</item>
	<item>
		<title>questions_Radiology</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/questions_radiology/</link>
			</item>
	<item>
		<title>questions_Pulmonology</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/questions_pulmonology/</link>
			</item>
	<item>
		<title>questions_Psychiatry</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/questions_psychiatry/</link>
			</item>
	<item>
		<title>questions_ 	Primary Care</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/questions_-primary-care/</link>
			</item>
	<item>
		<title>questions_Pharmacology</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/questions_pharmacology/</link>
			</item>
	<item>
		<title>questions_Otolaryngology</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/questions_otolaryngology/</link>
			</item>
	<item>
		<title>questions_Opthalmology</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/questions_opthalmology/</link>
			</item>
	<item>
		<title>question_Oncology</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/question_oncology/</link>
			</item>
	<item>
		<title>questions_Neurology</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/questions_neurology/</link>
			</item>
	<item>
		<title>questions_Nephrology</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/questions_nephrology/</link>
			</item>
	<item>
		<title>Questions_Infectious Diseases</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/qusetions_infectious-diseases/</link>
			</item>
	<item>
		<title>questions_ Immunology &amp; Allergy</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/questions_-immunology-allergy/</link>
			</item>
	<item>
		<title>qusetions_Geriatric Medicine</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/qusetions_geriatric-medicine/</link>
			</item>
	<item>
		<title>questions_Gastroenterology</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/questions_gastroenterology/</link>
			</item>
	<item>
		<title>questions_	Endocrinology</title>
		<description><![CDATA[]]></description>
		<link>http://www.medcert.com/questions_endocrinology/</link>
			</item>
	<item>
		<title>Felty’s syndrome</title>
		<description><![CDATA[



Felty’s syndrome is defined by a clinical triad of:

seropositive rheumatoid arthritis (RA)
neutropenia (&#60;2000/uL)
splenomegaly




. . . and, on occasion, anemia and thrombocytopenia.
Develops in individuals with long standing RA
Rare in African-Americans
Hypersplenism has been blamed for the syndrome, but not all patients have splenomegaly and splenectomy does not cure all patients.
Excessive margination of granulocytes caused by antibodies to [...]]]></description>
		<link>http://www.medcert.com/felty%e2%80%99s-syndrome/</link>
			</item>
	<item>
		<title>Eosinophilic fasciitis</title>
		<description><![CDATA[Characterized by painful swelling and thickening of the skin in the extremities, limitations of movements due to contractures, and mild muscle weakness
Labs include elevated sedimentation rate, peripheral eosinophilia, hypergammaglobulinemia, and mildly elevated CK (not always).
Histology shows marked thickening and infiltration of the deep fascia with mononuclear cells and eosinophils.
Most patients respond to glucocorticoids.
]]></description>
		<link>http://www.medcert.com/eosinophilic-fasciitis/</link>
			</item>
	<item>
		<title>Eosinophilia-myalgia syndrome</title>
		<description><![CDATA[More common in women
Associated with ingestion of L-tryptophan (essential amino-acid)
Symptoms include fever and rash, arthralgia and myalgia, cough and dyspnea, and edema.
Accompanied with eosinophilia (>1000 cells/microL).
Peripheral neuropathy, myositis (with lymphocytic and eosinophilic infiltration)
Tryptophan (contaminating L-tryptophan preparations) has been implicated as a cause. 
]]></description>
		<link>http://www.medcert.com/eosinophilia-myalgia-syndrome/</link>
			</item>
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