Internal Medicine

A career in medicine requires tremendous dedication. From the number of hours we spend training at the hospital to the neverending board exams, it’s a path that is by no means easy. We hold ourselves to such high standards in our careers that it’s often a challenge to equally apply those standards to our personal read more…

If you’ve emailed Rosh Review for anything, from requesting CME to asking for an extension or seeking clarification about which subscription to purchase, it’s likely that you and I have spoken. I’ve handled the majority of Rosh Review’s customer support for the past three years. We operate with the mindset of equanimity, which means staying read more…

I was inspired and energized at last night’s launch of TIME’S UP Healthcare at the New York Academy of Medicine. I was there as an emergency physician who witnessed gender discrimination and sexual harassment in the workplace, as a father who wants my daughter and son to grow up in a world that treats them read more…

The Internal Medicine Shelf Exam Qbank is now available for medical students preparing for their Internal Medicine Advanced Clinical (Shelf) Exam. Topics are compatible with the actual NBME® Internal Medicine Advanced Clinical Exam. System General principles 5–10% Immunologic disorders 1–5% Diseases of the blood 5–10% Mental disorders 1–5% Diseases of the nervous system 5–10% Cardiovascular disorders read more…

Epiglottitis Patient will be complaining of rapid onset of fever and dysphagia PE will show the patient leaning forward, drooling, inspiratory stridor Imaging will show “thumbprint” sign Most commonly caused by H. influenzae, Streptococcus Treatment is IV antibiotics and airway management Sample question: A 5-year-old boy presents to the emergency department because of difficulty breathing that began a few hours prior to consult. read more…

Just as pediatricians need to bring up uncomfortable conversations about sex to keep their patients safe and healthy, isn’t it equally the responsibility of physicians to bring up diet and nutrition?

Ottawa Foot and Ankle Rules X-rays required if Patient cannot bear weight for 4 steps Distal 6 cm tibia/fibula tenderness Medial/lateral malleolus tenderness 5th metatarsal tenderness Navicular tenderness Sample question: A 16-year-old boy presents complaining of right ankle pain after injuring himself while playing basketball. He states that he “twisted his ankle” when he landed on read more…

Sample question: A 17-year-old boy presents to the clinic with right-hand pain after punching a wall. Physical examination reveals swelling over the dorsum of the right hand with bony tenderness noted with palpation of the fifth metacarpal. What is the most likely diagnosis?

Sample question: You are called to the nursery to examine a newborn boy. He was born at 36 weeks via C section to a 32-year-old G3, P3 mother. APGAR scores were 7 and 9. After six hours, the neonate developed respiratory distress. On examination, respiratory rate is 70, with nasal flaring, expiratory grunting, intercostal retractions, decreased breath sounds, and diminished read more…

“Keep your minds open,” the dean announced at M3 orientation, “maybe you’ve always dreamed of becoming an orthopedic surgeon but will fall in love with psychiatry.” As freshly minted third year medical students with wrinkle free and yet to be coffee/pen/bodily fluid stained short white coats we entered clinical rotations much like undifferentiated cells, eager to be shaped and influenced as we transformed into the future physicians we were to become. However, for many students, choosing a specialty is not as easy as dreaming and falling in love. There is a fine line three quarters into M3 year when the reaction to uncertainty about choosing a specialty changes from a response of “you’ve got time” to a reaction that may make you feel like somehow over a few short months you became defective. In the midst of the uncertainty and doubt you then receive an email that it’s time to schedule your fourth year electives and are advised to “choose them wisely” as you are reminded that residency applications will be due just three months into the year. If that story sounds all too familiar of you anticipate that this could happen to you, don’t panic, you’re not alone, let’s get through this together.

Septic Arthritis Patient will be complaining of fever, monoarticular pain with decreased ROM Labs will show WBC > 50,000 with > 75% PMNs Diagnosis is made by arthrocentesis Most commonly caused by: Age < 35: N. gonorrhea, S. aureus overall Treatment is IV ABX, surgical washout Sample question: A 23-year-old man with a history of intravenous heroin use presents to the emergency department with a read more…

Sample question: Which muscle is most commonly involved with rotator cuff injuries?

Megaloblastic Anemia Patient will be a vegan or alcoholic Complaining of fatigue, weakness PE will show pallor, glossitis Labs will show MCV > 100 and hypersegmented neutrophils Most commonly caused by vitamin B12 (Cobalamin) or folate deficiency Comments: only vitamin B12 deficiency results in neurological symptoms Sample question: A middle-aged patient in the ED has a hemoglobin of 8.1 g/dL with an MCV of 112 fL. Which of read more…

Coarctation of the Aorta PE will show higher blood pressure in the arms than in the legs EKG will show LVH CXR will show notching of ribs Diagnosis is made by echo Treatment is balloon angioplasty with stent placement or surgical correction Comments: associated with Turner syndrome Sample question: A 5-year-old girl with Turner syndrome is found to have systolic hypertension. Further examination read more…

Sample question: A 71-year-old man presents to the emergency department after falling on ice outside his home. He complains of neck pain. He has an abrasion to his chin and decreased strength in his bilateral upper extremities. Strength is intact in his lower extremities. Which mechanism of trauma is most consistent with the suspected diagnosis?

Today’s teaching image is about alkaptonuria, or black urine disease. For more teaching images, try a free trial of our board review qbanks.

Today’s teaching image is about traumatic iritis. For more teaching images, try a free trial of our board review qbanks.

Scabies Patient will be complaining of severe pruritus that is worse at night PE will show small papules, vesicles and burrows in the webbed spaces of the fingers and toes Diagnosis is made by microscopic visualization Most commonly caused by Sarcoptes scabiei hominis Treatment is permethrin 5% Sample question: A 15-year-old boy presents with an itchy rash on his hands and wrists. read more…