Treatment of Ureteral Calculi

Regarding ureteral calculi, which of the following is FALSE?

A. The incidence of kidney stones in the general population appears to be increasing, as does the medical cost associated with this disease.

B. The majority of individuals with urolithiasis have small (<5 mm) stones, located in the distal ureter, that are able to pass spontaneously.

C. Both stone expulsion and time to expulsion of ureteral stones depend heavily on stone size and location.

D. Urologic intervention is recommended for ureteral stones that persist for more than 2 months.

E. A meta-analysis demonstrated that neither calcium channel blockers nor alpha-antagonists increase the rate of stone passage.

excerpt from The Kaji Review Read more

What is the risk of HIV post exposure?

A 24 yo male presents to the ED saying that he had receptive anal intercourse without the use of a condom with an male partner who was known to have had sex with other men. He is also worried because many years ago she was not treated for a needlestick injury. TRUE statements about postexposure prophylaxis (PEP) for HIV include which of the following?
 (Choose three answers.)

A. A case-control study in 1997 demonstrated that health care workers who received AZT after needlestick exposures were 81% less likely to undergo seroconversion to positivity for HIV.
B. The use of PEP does not assume that the person who was exposed to HIV is HIV negative.
C. The overall rate of HIV transmission through percutaneous inoculation through a needle is reported to be 0.3%.
D. The estimated risk of transmission from receptive… Read more

Demystifying the Editorial Levels of WikEM

All content on WikEM is reviewed by editors who are committed to content quality and correctness.  The WikEM organization is extremely egalitarian with an open and transparent promotion process. The more your contribute to the wiki, the greater your level of influence and recognition within the organization. The wiki software tracks contributions and ranks authors based on contribution

As more content moves to the internet on platforms other than textbooks and journals, WikEM will use metrics such as these to advance the academic and educational careers of our contributors.… Read more

Sponsorship: MedNexus

WikEM is proud to announce  this week’s sponsor, MedNexus, a search engine designed for healthcare providers.  They are developing a really exciting set of tools using semantic search to create a “Google for Medicine”.  Their search and discovery tools allow a provider to quickly find the most relevant articles, reviews, guidelines, and medical content to answer clinical questions while caring for patients.

The power of their system rests in a sophisticated ranking system to organize content by quality and relevance.  This means their results are not only more targeted to your clinical question but also of greater quality than a stand web search.

MedNexus offers a web search portaliOS app, and they have an Android version on the way! We also had the privilege of talking… Read more

Hyponatremia Review Question

A 60kg female patient is seizing and has a serum sodium of 113 mEq/L with no underlying history of seizures. What should be the treatment of her hyponatremia?

A. Hypertonic saline 3% – 290 ml over 2 hours
B. Normal saline 3% – 50 ml over 30 minutes
C. Phenytoin 1 gram
D. Hypertonic saline 3% – 1000 ml IV bolus
E. Hypertonic saline 3% – 750 ml over 2 hours

Read more questions from the Kaji Review… Read more

Automated creation of a critical care reference

One of the reasons we are so passionate about using a wiki for knowledge organization, is the ability to intelligently derive information from other information. The wiki is a dynamic platform.  Caution up front, this post will not focus on medical knowledge as many of our blog posts, but will discuss the technical details of how we used the wiki to automate the creation of 14 pages of data with over 50 medication and equipment doses.   The process provides an example of how placing medical knowledge on a wiki provides an exponential number of opportunities of organization, derivation, and advanced learning.

 

The first concept to explore is structured vs unstructured data.  At the most basic form, data that has information attached to it is structured and data that has no describing information… Read more