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That was great

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Elevated TSH with a normal free T4 indicates subclinical hypothyroidism, not overt hypothyroidism. Treatment is nuanced, but generally, levothyroxine is recommended if: -> TSH is above 10 mIU/L -> Patient has hypothyroid symptoms -> Positive TPO antibody These criteria help identify who may benefit most from treatment.

this is the best. thank you~

Common causes include infections like vaginitis and cervicitis in women, prostatitis in men, kidney issues such as stones or transplant rejection, and certain infections (e.g., Chlamydia, TB, Ureaplasma) that don’t show up in regular cultures.

Sterile pyuria is when white blood cells are found in the urine, but no bacteria grow in the culture. It’s identified by having a certain number of white blood cells in the urine sample or a positive dipstick test for infection markers, yet without bacterial growth.

As cold season begins, many may experience nasal congestion and runny nose. Over-the-counter and prescription options offer varying effectiveness. For symptom relief, I suggest short-term use of nasal spray decongestants like oxymetazoline, which reduces nasal blockage within an hour and lasts up to seven hours. However, limit use to three to five days to avoid rebound congestion (rhinitis medicamentosa).

So, next time you detect protein on a urine dipstick, make sure to follow up with a urine albumin-creatinine ratio.

They report that only 1 in 15 dipstick tests indicating proteinuria in primary care is followed up with albuminuria quantification testing.

According to Medscape in October 2024, follow-up rates for abnormal urine dipstick tests showing proteinuria have been low.

Thank you.

The National Institute of Alcohol Abuse and Alcoholism defines a standard drink as: A 12-ounce beer (usually about 5% alcohol). A 5-ounce glass of wine (usually about 12% alcohol). 1.5 ounces of distilled spirits (usually about 40% alcohol).

The CDC defines a binge-drinking episode as at least four drinks for women or five drinks for men within a two-hour period. This is enough to raise your blood alcohol level to .08, which would result in impaired driving.

To patients: How can apoB be useful? ApoB is proving to be a better predictor of heart disease risk than LDL cholesterol. For those unsure about starting statins, an apoB test can guide the choice: low levels may mean no statins, while high levels suggest starting them. Though not yet standard, apoB helps refine heart risk assessment, especially when LDL levels are borderline.

To doctors: How can apoB be useful? Apolipoprotein B (apoB) is emerging as a stronger predictor of cardiovascular risk than LDL cholesterol. For patients on the fence about starting statins, measuring apoB can help guide decisions: low levels may support holding off, while high levels suggest statin therapy. Though not standard yet, apoB is valuable for refining risk assessment, especially when LDL is borderline or already managed.

2nd line treatment, such as polyethylene glycol (PEG), also called Miralax, or Lactulose. They pull water into the intestinal lumen by osmosis, helping to soften stool and speed intestinal transit (increases peristalsis).

📕 Studies show it’s not proven effective. 🌱 Instead, start with bulk-forming laxatives like Benefiber or Metamucil. 💊 If needed, try osmotic options like Miralax before moving to stimulant laxatives. 🤔 Let’s make smarter choices for better relief!

Knowing the right tool to rule out a DVT could make all the difference! Let’s break it down! A more straightforward approach to diagnosing a DVT or a PE is to assess the patient’s clinical pretest probability. Wells’ score is a validated test for DVT and PE. It classifies patients as low, intermediate, or high risk. In patients suspected of having DVT with a low to moderate pre-test probability, a d-dimer test is the initial step. Imaging is deferred unless the d-dimer result is positive. A negative d-dimer test typically obviates the need for further imaging. Conversely, a positive d-dimer test warrants a confirmatory Doppler ultrasound of the affected extremity. For patients with a high clinical suspicion of DVT, direct evaluation with a Doppler ultrasound is advisable to locate the thrombus.

Head over to TH-cam and search for ‘drpalana’ to watch my short video on my SIMPLE approach to DVT and PE! Or, comment “clot” and I’ll send you the link directly. I hope this helps you take great care of your patients!

To patients: For treatment, there are different options like antacids, H2 blockers, and PPIs. A PPI is usually the best choice, and we typically prescribe it once a day for about 8 weeks. If you need to stay on it longer, we’ll aim for the lowest dose possible, and you may even take it only when you need it. For those with mild or uncomplicated GERD, we’ll work toward reducing or stopping the medication when appropriate.

Thank you!

I am obstructive apnea patient. Using oxygen Is it reversible? From Ethiopia.

Great video!

Very common / Do not miss for Step!

Excellent

To those studying for USMLE step 2, knowing when to order a d-dimer or a venous duplex is high yield! Thank you for simplifying this for us.

What a great info! As an intern, I always get this confused.

The USMLE exam is very difficult to pass, I can't believe i failed step 1after studying with so many materials😞

Nice.. Thank you

Another great video... Can you please make Video explanation about approach to patients that came with Ascites or Edema... Where we expect it because of the disorder of kidney? Liver or Heart... Thank you

Aspirin exacerbated respiratory disease

Hello Dr., I’m so glad I found your channel. Thank you so much for sharing your knowledge.

Thank you for the comprehensive explanation

Whoa, you actually know what you're talking about? Hey, even if you don't get many views can you please keep doing stuff like this?

Plz continue making these videos..these are really helpful..thanx

Yes! Thank you!!!

Well explained

Promo>SM 😒

Thank you!

Thank you so much doctor! I'm matched to IM and preparing for IM. Your videos easy to digest and remember.

Amazing review! Very helpful, I’m reviewing IM as I prepare for my Step 2!! Thank you 😊

Thank you more information is better than less😎

Extremely handy in wards

Thank you so much for this.

Is it the same as NT pro-BNP?

I am so glad that I found your channel! Appreciate all the teaching. Feels like mini-rounds on TH-cam!!

'PromoSM'

Hello goose ❤❤❤❤

Curious to see if researchers will find a connection between alpha-gal and “long hauler” Lymes disease pts.