Best medical diagnosis books according to redditors
We found 152 Reddit comments discussing the best medical diagnosis books. We ranked the 63 resulting products by number of redditors who mentioned them. Here are the top 20.
We found 152 Reddit comments discussing the best medical diagnosis books. We ranked the 63 resulting products by number of redditors who mentioned them. Here are the top 20.
Disclaimer: Some of this advice I consider 'no duh' but I figured I'd say it just in case.
On shelf exams:
On electronic devices and apps:
On boards:
On wards:
On evaluations:
In general: Third year can be frustrating because it varies so wildly. Some of you will have cush rotations where you're done at 10:30 am. Some of you will enter the hospital before the sun rises and leave when it is setting. Some of you will feel like you're shadowing again. Some of you will be treated like interns (and abused because you don't have work-hour restrictions). Some will find out the thing they thought they wanted they hate and others will find out the thing they want is beyond their reach (because of family obligations, board scores, or another thing all together). Some of you will deliver 80 babies a month and some of you won't even do a Pap smear. Every hospital has a different culture; just be polite, professional, and let yourself be immersed. You'll pick it up soon enough.
TL; DR: Life is short. Be excellent to each other.
EDIT: Added some stuff, found out there's a size limit on comments, made a second part.
http://www.amazon.com/Sapiras-Art-Science-Bedside-Diagnosis/dp/1605474118
I highly suggest this book. Gives the usual PE techniques. Plus a breakdown of the sensitivity and specificity of each, alternatives, and other ways to test the same thing.
I just finished this book for my IM rotation. Its a good, quick read, and hits all the points you need to impress your residents and attendings!
https://www.amazon.com/Evidence-Based-Physical-Diagnosis-Steven-McGee/dp/1437722075
If you can find a copy, this book is interesting. There is a JAMA one too.
Rapid Interpretation of EKG's
This is what we use in medical school and it is a great, simple resource. Wish I had used it back in my EMT days.
Y'all do realize that there are countless numbers of care plan textbooks on Amazon you can get used for less than $10, right? They saved my ass in nursing school. Let me find the two I like. Hold on.
EDIT: Here's one. https://www.amazon.com/gp/offer-listing/0803622104/ref=sr_1_14_olp?ie=UTF8&qid=1543618007&sr=8-14&keywords=nursing+care+plans
EDIT: Here's the other. https://www.amazon.com/gp/offer-listing/0323071503/ref=dp_olp_used?ie=UTF8&condition=used
EDIT: And no, I don't advocate copy/pasting. But sometimes you just need a nudge in the right direction, and these books do a great job at that. Like everyone here says, you'll never, ever, EVER use care plans after you leave school.
Rapid Interpretation of EKG's by Dr. Dale Dubin. The classic, definitive textbook for understanding EKG's. It's amazingly simple, with loads of pictures and easy to understand explanations regarding cardiac issues. It is not the most detailed text around, but it is something that you could read in a weekend and walk away knowing much more than you did previously. Highly recommended to EMT's who want some sort of understanding of how to interpret 12 leads.
I cannot top that. But I did once diagnose a hip fracture with a tuning fork, and several pulmonary infiltrates with egophany. I'm a big fan of Sapira The Art of Bedside Medicine. Radiologists think I'm some kind of wizard.
I love what I do, and I love the people I do it for.
Clincals are challenging enough at it is...get the book. This is the one I use: http://www.amazon.com/Nursing-Diagnosis-Handbook-Evidence-Based-Planning/dp/0323071503/ref=sr_1_7?ie=UTF8&qid=1319717408&sr=8-7.
It has all the rationales with references and saves you HOURS.
Dale Dubin wrote the definitive EKG book before going to prison for child pornography and cocaine possession. It's a REALLY good book, but feel free to buy it used!
Rapid Interpretation of EKG's, Sixth Edition https://www.amazon.com/dp/0912912065/ref=cm_sw_r_other_apa_JbnFxbTFMMBZJ
I didn't downvote you and you weren't being offensive at all. This sub has a strong preference against over-using ketostix. I will explain why.
Ketostix are a cheap and relatively accurate way to measure the levels of acetoacetate in urine, one of the three ketone bodies, the other two ketone bodies being acetone and beta-hydroxyburic acid. The stix are very specific and very reliable.
A comparative study of Qualitative tests for ketones in Urine and Serum, Free et al, Clinical Chemistry Vol. 4 Issue 4, 1958
http://www.clinchem.org/content/4/4/323.full.pdf
This is worth repeating, because many people miss it. Ketostix can tell you the levels of acetoacetate in your urine. If you test positive, it does not mean you are in ketosis - it means that this test has detected acetoatate in your urine. If you test negative it does not mean you are not in ketosis - it means that this test can not detect acetoacetate in your urine.
Inferring that purple on the ketostix means "I am in ketosis" and no purple means "I am not in ketosis" is utterly false. All you know is that this test has shown or failed to show acetoacetate in your urine. You need to know more about the ketone bodies, and about the test, to infer meaning from the ketostix measurement.
The stix only measure the concentration of acetoacetate - drink more water and the ketones become diluted. A very common feature of the ketogenic diet recommendations are for dieters to drink much water, and to take electrolytes in solution. It is my personal experience that thirst rises significantly on a KD, and with it my water consumption. Correspondingly, I pee a lot more now - and that pee is dilute. A reason for many false-negative tests is likely to be due to the diluted nature of a ketogenic dieter's pee.
In principle, the ketostix work because they have segments of sodium nitroprusside - also known as nitroferricyanide. Nitroprusside reacts with acetoacetic acid to turn the segments a shade of colour at a precisely measured duration. Some of the fancier blood measuring strips also include sodium biphosphate as an acid buffer.
It is not just acetoacetic acid which turns the stix purple. Captopril, aspirin, methyldopa, mesna, acetylcsteine, levodopa, methyldopa, phenazopyridine and probably other drugs can also trigger a false-positive ketostix reading.
> Basic Skills in Interpreting Laboratory Data – 2013
by Mary Lee PharmD BCPS FCCP (Editor), http://www.amazon.com/dp/1585283436/
The ketostix are not even very good at diagnosing diabetic ketoacidosis - their designed purpose. The levels of acetoacetic acid in urine can be many times higher than the levels seen in blood. As ketoacidosis subsides, beta-hydroxyburic acid degrades into acetoacetic acid - giving a stronger reading on the stix and a false indication of worsening ketoacidosis.
Recent advances in the monitoring and management of diabetic ketoacidosis, T.M. Wallace, D.R. Matthews DOI: http://dx.doi.org/10.1093/qjmed/hch132
http://qjmed.oxfordjournals.org/content/97/12/773.2
The ADA says:
> RECOMMENDATION: BLOOD KETONE DETERMINATIONS THAT RELY ON THE NITROPRUSSIDE REACTION SHOULD BE USED ONLY AS AN ADJUNCT TO DIAGNOSE DKA AND SHOULD NOT BE USED TO MONITOR DKA TREATMENT.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114322/#B187
False positives can be seen if the urine is very acidic - after eating lots of vinegar for example. Or if ketones are being produced by intestinal bacteria.
The ketostix degrade on exposure to air - they age badly. They can give false negative readings simply because they have stopped working.
Now, back to nutritional ketosis, the goal of a ketogenic diet. In nutritional ketosis - at least after the initial few days and after a period of keto-adaptation, the majority of ketones produced and cleared are beta-hydroxyburic acid.
Ketone body kinetics in humans: the effects of insulin-dependent diabetes, obesity, and starvation.
http://www.jlr.org/content/25/11/1184.long
There is some indication to suggest that ketotic athletes utilize 100% of free ketones, effectively leaving none for renal clearance:
J Appl Physiol Respir Environ Exerc Physiol. 1978 Jan;44(1):5-11.
Changes induced by exercise in rates of turnover and oxidation of ketone bodies in fasting man.
http://www.ncbi.nlm.nih.gov/pubmed/627499
Acute nutritional ketosis: implications for exercise performance and metabolism.
Cox PJ1, Clarke K2.
http://www.ncbi.nlm.nih.gov/pubmed/25379174
HTH
[edit] speling [sic]
[edit 2]
Hmm this came off a bit more strongly than I intended. The ketostix themselves are not a bad tool. They are just often used inappropriately.
If you know their limitations, and if you are able to mix a number of factors into your reading of the stix beyond just the colour produced (level of hydration, diet over the preceding 12 hours, your own level of keto adaptation etc), then as the OP said it is entirely possible to reliably get value out of them.
Most new keto dieters won't have the expertise necessary though, and so the recommendation to only use them in the beginning, once or twice, and then go back to concentrating on what is being eaten is really great advice - for most people most of the time.
https://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Dubin/dp/0912912065
Worth every penny.
Rapid Interpretation of EKG's, Sixth Edition
Edit: Formatting
Bates!
edit: amazon link: http://www.amazon.com/Bates-Guide-Physical-Examination-History-Taking/dp/1609137620
edit 2: http://meded.ucsd.edu/clinicalmed/history.htm is a great resource as well!
Dale Dubin Rapid Interpretation of EKGs
Life In The Fast Lane
Dr. Smith's ECG Blog
I have a few that I still use after two years in the Emergency Department:
Books
Journals
Blogs/Podcasts
Subreddits
https://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Dubin/dp/0912912065 this book is amazing and explains it to you like you’re 5 years old. Lol
Rapid Interpretation of EKG's, Sixth Edition https://www.amazon.com/dp/0912912065/ref=cm_sw_r_cp_apa_ED5MAbCN0H9CD
Recommended to me by an amazing seasoned ER nurse. Very easy to follow.
Dubin's is hands down the best introductory book on EKGs.
http://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Edition/dp/0912912065
As already discussed, this review has a lot of shortcomings.
I'll reproduce my own comment down below.
Looking at table one, it appears they completely disregard the high likelyhood reverse causality.
The authors state:
>Older subgroups general populations exhibit no positive associations, but often inverse associations between LDL and ASCVD.
and
>All-cause mortality is the most important endpoint for cholesterol-related health issues. In many propesctive cohort studies, high LDL levels are associated with low all-cause mortality due to low rates of cancer, stroke and infectious disease, and high LDL-C is a predictor of longevity.
They completely fail to mention this:
1 Check out Figure 2. Cholesterol concentrations in populations with higher average cholesterol drop in later life. Not in populations with lower avg cholesterol. Obviously we shouldn't over interpret this graph. However, it indicated that disease might cause lower LDL-C and not the other way around.
There are two interesting studies about a man2 and his relatives3 with familial Hypobetalipoproteinemia. The man has LDL-C of 4-8 mg/dl, low HDL and normal-ish Triglycerides. He's healthy overall, even though he has a slight fat mal-absorbtion.
The relatives are healthy, have LDL-C down to 1 mg/dl and have no heart disease. Lifelong LDL-C doesn't appear to be a problem.
However, Hypobetalipoproteinemia is a disease with many faces.4
This study describes children having neurological disorders among other problems. However, their TAG were unusually low. That indicates a larger problem of fat transport in the blood.
Anyways, you can't get your LDL-C this low with diet or normal statin dosage.
The most interesting and important paper, the authors of OPs paper completely disregard.
Cancer, patients often have low cholesterol scores. However, this appears to be because of the cancer and not the other way around.5 By the way the study is great, i'd recommend a read.
>Our results indicate a strong time-dependent association of TSC with overall cancer incidence and several site-specific malignancies in both men and women, with a significant risk excess in the lowest TSC tertile for malignancies diagnosed shortly after baseline TSC measurement. While further research is needed to shed light on the underlying pathophysiological mechanisms, the pattern of association seen in the present study supports the hypothesis that the inverse association of high TSC levels with cancer risk may largely be attributable to reverse causation due to preclinical malignancies.
Neglecting these pieces of evidence sheds doubt on the paper imo.
And u/shlevon's comment.
This paper is honestly pretty weird, looking at it. Besides what u/AcceptableCause pointed out, there are lots of little baffling things strewn throughout.
For instance, in the mendelian randomization section, they lead off with:
>We are relatively new to the field of Mendelian randomization studies and would find it challenging to evaluate the methodology and results in detail.
That's kind of an odd thing to disclaimer, and begs the question of how they're in a position to evaluate this evidence. Not exactly confidence inspiring.
Within their critique of the mendelian randomization studies, the authors keep noting (over and over) throughout this section that the risk reductions seen with the various LDL receptor mutations involve far more risk reduction than statins.
E.g.:
>Analysis of the data in Table 2 revealed that increased LDL-C was highly positively associated with increased MI risk, with a regression coefficient of 0.89 and a 10-mg/dL decrease in LDL-C corresponding to a 48\% decrease in MI risk. An association of this strength has never been reported for cholesterol-lowering medications.
Uh...yah, because risk reduction in statins is usually over compressed timeframes in already-sick populations, and risk reduction with genetic mutations are, by definition, lifelong, acting over decades before these diseases have already manifested. The fact that they're pointing this out as suspicious is pretty odd.
Further, they're kind of ignoring the central point of the mendelian randomization studies presented in the paper they're attempting to critique, which is that the mendelian randomization studies involve many dozens of different mutations all occurring through different biochemical pathways. Despite this, they converge in effect that's directly proportional to the reduction in LDL seen in each of these ~50 different mutations. If what they were suggesting is true (that somehow, despite these being LDL receptor mutations, that their impact on ASCVD is being mediated by incidental non-LDL factors), this would apparently be the world's biggest coincidence.
I also can't help but notice that they don't even attempt to critique one of the cornerstone pieces of evidence used in the European paper, which is that literally every mammal tested to date (including close primate relatives like chimpanzees) can have atherosclerosis induced via elevating their endogenous LDL. In any discussion of LDL's causal role in ASCVD it seems odd not to at least address the many mammalian models of induced atherosclerosis.
You'll also note repeated citation of #10 in their list throughout this paper. I haven't counted but while reading I saw it cited so much I had to look. What is it?
A book co-authored by a lead author in this paper. Citing secondary works like this rather than primary research is generally considered poor form. Citing secondary works that you co-authored even more so.
The book was also co-authored by Uffe Ravnskov, notorious author of the "Cholesterol myth" books. All in all, some pretty big red flags imo.
the resource i always give my students (seems to be well received) is a facebook page called "12 lead ECG i've got the rhythm" run by ambulance personnel in england. 43 thousand people follow the page, all involved in medicine in some way. from interventional cardiologists, ER techs, electrophysiologists, paramedics/EMT's, ER consultants.. etc. people send anonymised ECG's from their patients and everyone gives their interpretation and reasoning. you can read and learn about different methods of interpretation and learn the lingo at the same time. it's essentially a massive catalogue of case studies that evolves every single day. if you do a couple of case studies a day, within a year or two your skills will have advanced considerably.
​
this book is also quite good.. it's what I used when i was in university: https://www.amazon.co.uk/ECG-Interpretation-Made-Incredibly-Easy/dp/1608312895
​
this website is also useful: https://litfl.com/ecg-library/
​
all the best mate
Dubin
I'm not all the way through it but Rapid Interpretation of EKGs is AMAZING
I’m not sure if you’ve come across this text yet but Rapid Review of EKGs was crucial when I was a medical student. You can read it in one sitting and feel so comfortable reading EKGs.
ECGs Made incredibly easy
Personally, I thought most of the books in this series were helpful. Good luck!
Dubin's Rapid Interpretation of EKGs
I think this book is really excellent and I use it often. I was a lab tech prior to PA school.
Clinician's Guide to Laboratory Medicine: Pocket https://www.amazon.com/dp/0972556184/ref=cm_sw_r_cp_api_snRXAbWMAVP27
Best book on the market in my opinion is Rapid Interpretation of EKGs. Its been in print for decades, and its definitely held up over time as the best EKG books out there. It covers everything you need to know to have a solid understanding of the fundamentals of EKGs, and it does so in a way thats easy to understand.
The author is a convicted felon and child pornographer. But don't worry too much about that, its still a great book.
If you really have to study, learn how to interpret EKGs. http://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Dubin/dp/0912912065
This is all you'll ever need. Macleod's Clinical Examination
You can also find the videos here
Good luck :)
https://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Dubin/dp/0912912065
Will edit more resources in a bit..
Here's some of the EKG resources I used in PCP school:
Life in the Fast Lane
Dr. Smith's EKG Blog
Dale Dubin's Rapid Interpretation of EKG's
Dr. Mattu ECG Weekly
Dr. Mattu YouTube Channel (not updated anymore but has 200+ vids)
This paper is honestly pretty weird, looking at it. Besides what u/AcceptableCause pointed out, there are lots of little baffling things strewn throughout.
For instance, in the mendelian randomization section, they lead off with:
> We are relatively new to the field of Mendelian randomization studies and would find it challenging to evaluate the methodology and results in detail.
That's kind of an odd thing to disclaimer, and begs the question of how they're in a position to evaluate this evidence. Not exactly confidence inspiring.
Within their critique of the mendelian randomization studies, the authors keep noting (over and over) throughout this section that the risk reductions seen with the various LDL receptor mutations involve far more risk reduction than statins.
E.g.:
> Analysis of the data in Table 2 revealed that increased LDL-C was highly positively associated with increased MI risk, with a regression coefficient of 0.89 and a 10-mg/dL decrease in LDL-C corresponding to a 48% decrease in MI risk. An association of this strength has never been reported for cholesterol-lowering medications.
Uh...yah, because risk reduction in statins is usually over compressed timeframes in already-sick populations, and risk reduction with genetic mutations are, by definition, lifelong, acting over decades before these diseases have already manifested. The fact that they're pointing this out as suspicious is pretty odd.
Further, they're kind of ignoring the central point of the mendelian randomization studies presented in the paper they're attempting to critique, which is that the mendelian randomization studies involve many dozens of different mutations all occurring through different biochemical pathways. Despite this, they converge in effect that's directly proportional to the reduction in LDL seen in each of these ~50 different mutations. If what they were suggesting is true (that somehow, despite these being LDL receptor mutations, that their impact on ASCVD is being mediated by incidental non-LDL factors), this would apparently be the world's biggest coincidence.
I also can't help but notice that they don't even attempt to critique one of the cornerstone pieces of evidence used in the European paper, which is that literally every mammal tested to date (including close primate relatives like chimpanzees) can have atherosclerosis induced via elevating their endogenous LDL. In any discussion of LDL's causal role in ASCVD it seems odd not to at least address the many mammalian models of induced atherosclerosis.
You'll also note repeated citation of #10 in their list throughout this paper. I haven't counted but while reading I saw it cited so much I had to look. What is it?
A book co-authored by a lead author in this paper. Citing secondary works like this rather than primary research is generally considered poor form. Citing secondary works that you co-authored even more so.
The book was also co-authored by Uffe Ravnskov, notorious author of the "Cholesterol myth" books. All in all, some pretty big red flags imo.
https://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Dubin/dp/0912912065/ref=mp_s_a_1_1/140-8321072-0767464?ie=UTF8&qid=1524925860&sr=8-1&pi=AC_SX236_SY340_QL65&keywords=dubins+ekg+book&dpPl=1&dpID=51dYWaQomOL&ref=plSrch
This book is the gold standard : Rapid Interpretation of EKG's, Sixth Edition https://www.amazon.com/dp/0912912065/ref=cm_sw_r_cp_apa_TMO6xbXE9W8MB
For simple rhythms just search YouTube. There are a lot of videos that go through the basics.
I would avoid test-prep books then-- those tend to skim the surface of things like pathophys and always seem to be more focused on important facts and associations, etc., and not on the science.
Sadly there is no quick answer for getting better at pathophys (it takes 2 years to cover the basics in med school). Working in an ED you don't have massive amounts of time to read either. As a resident I find myself wanting to review stuff all the time but am pretty busy too, so with that in mind, my recommendations would be:
-UpToDate/Dynamed/Medscape/etc. usually have nice sections in their articles on the pathophysiology of various conditions. The temptation is to skip to the "diagnosis" or "management" sections but there is usually some good stuff in those articles that you can read on the fly
-For critical illness and general physiology, The ICU Book is great and not too dry a read. If you want much more in depth stuff on medical conditions, Harrison's Internal Medicine is a great resource but reads like a phonebook sometimes. If you care about the microscopic level, Robbins & Cotran is basically all the pathology for the non-pathologist you will ever need- can also be a bit dry at times too.
-Look up the mechanism of action of meds you don't know about (Micromedex smart phone app is great for that)
-When you consult someone because you are unsure about something, ask them about what is going on (subspecialists are usually not shy about dropping knowledge if you ask for it); it may also help prevent future un-needed consults which they appreciate
Hope this helps.
I recently underwent a similar change, having worked in outpatient orthopedics for 6-ish years (+lots of $$ spent on con-ed including manual therapy certification) and abruptly switching to acute care. My decision was spurred by increasingly high patient volumes (which seems to be a trend in Vegas OP) and an inability to provide what I would consider 1-on-1 patient care in a manner that fit my values. I've been in acute care for about 8 months now and haven't looked back. As a result of this, I do feel like a new graduate at times, but I've been excited to dig into new information and material, while enjoying the pace and exposure to a variety of conditions acute care offers.
Some things I've found useful thus far:
Don't be afraid to ask questions. Most of my fellow co-workers are younger than me, but have more experience in this area. Check your ego at the door.
I've found getting to know the nurses in each unit to be invaluable. Find them prior to seeing your patient, get any further information they may have regarding your patient (outside of your chart review) and discuss with them any pertinent findings of your evaluation.
Chart review! I want to know as much as I can regarding my patient's prior to seeing them. I mostly do evaluations and want to garner as much of a clinical picture as I can including lab values, vital trends, imaging findings / reports, physician notes, nursing notes, surgical reports, pending tests / labs, medications, etc. You can gain a lot of information from the electronic chart.
Vital signs on everyone. This is easier in the ICU where everyone is monitored, but on your ortho and med/surg floors I don't think I can under state this. I've run into countless asymptomatic people who upon assessment have systolic BP > 200, or more recently having a patient who's blood pressure dropped from 85 systolic to 50 systolic following 1 sit<>stand.
Collaboration with your fellow speech, occupational and respiratory therapists. I can be myopic at times, so getting input from findings from your other therapists can be helpful.
Having a good line of communication with your case managers. You are an advocate for your patients and need to have an open line of communication to discuss or challenge d/c recommendations.
Lines. Double check for any lines, tubes or catheters even if nothing stands out. Our electronic chart will tell me what lines are present upon chart review, but it doesn't hurt to double or triple check prior to mobilizing a patient.
Some resources I've found helpful as a new acute PT:
https://physicaltherapyreviewer.wordpress.com/
http://ptthinktank.com/2012/12/18/so-you-think-you-can-walk-acutept/
https://twitter.com/dr_ridge_dpt
https://twitter.com/DrDaleNeedham
www.medbridgeeducation.com ($200/yr with discount code, a number of courses focused on acute care)
http://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Dubin/dp/0912912065
http://c.ymcdn.com/sites/www.acutept.org/resource/resmgr/imported/labvalues.pdf
It's been a learning process with the transition, but I've been thoroughly enjoying it. Plus, I get the added benefit of seeing anatomy on a deeper level when it comes to wound care. Not to mention, the added benefit when you get your patients who are mechanically ventilated up and moving, while seeing their appreciation that they have for your services / help. Enjoy!
Rapid interpretation of EKG's by Dr. Dale Dubin is excellent. Easy read and a great quick reference. Essentially a dummie's guide to EKG. I took a semester long class in EKG in college and am going through it again in paramedic school. This book is what made it click for me.
http://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Edition/dp/0912912065/ref=sr_1_sc_1?ie=UTF8&amp;qid=1406594316&amp;sr=8-1-spell&amp;keywords=rapid+interptetation+of+ekg
I recommend Rapid Interpretation of EKG's 6th Edition by Dale Dublin, MD. I bought in when I was in paramedic school and still use it today.
Maybe something like Symptoms to Diagnosis. It will help you build a differential based off the most common symptoms and diseases. I don't think it's meant to be used at all for Shelfs or general IM knowledge, just learning how to build a solid differential at the M3 level. Check to see if your library has online access through AccessMedicine.
Edit: hopefully I can answer some very basically:
Overall, remember you aren't measuring the conducting fibers with EKG, you are measuring the electrical activity of the myocytes. I think this may be a major sticking point for you - causing some confusion.
There is good discussion (I had a lot of same issues you are having), but as an aside I REALLY recommend you take a look Dubin's Rapid Interpretation (I may have a pdf if you don't have access). My EKG lectures made no sense but I read through the relevant chapter there and felt like I everything made so much more intuitive sense.
http://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Dubin/dp/0912912065/ref=sr_1_1?ie=UTF8&amp;qid=1417975470&amp;sr=8-1&amp;keywords=dubin+rapid+interpretation+of+ekg
The Dubin book is the best! My copy is orange and it'll tell you everything you need to know about EKGs for tests :)
http://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Edition/dp/0912912065
http://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Edition/dp/0912912065
12 years after academy and I still read mine from time to time.
Also, have confidence. =)
I would recommend it. You'll have to be stricter initially and maybe for years but then you should be able to have more stuff. Allergy specialist might not be much help with the MCAS either. But hopefully they will.
I recommend this author and this book is quite useful, if somewhat old. I accidentally stumbled on the histamine intolerance diet in this book - because I was basically already on the diet, just needed to eliminate tomatoes and vinegar. (Which is a nightmare initially but you'll feel better.)
Dealing with Food Allergies: A Practical Guide to Detecting Culprit Foods and Eating a Healthy, Enjoyable Diet There's a newer version "packaged" as a text book for nutritionists. I just bought it used but it's more expensive.
You're going to need to figure out what your body agrees with. Histamine is a bucket to fill. You don't want to overflow the bucket. I'd start by dropping alcohol, tomato, food with preservatives, 90% soda, and vinegar.
You also want to learn about the age of food and how histamine develops as food gets older. You probably don't want to eat cooked food that's older than 2-3 days, assuming it was stored properly. You might not want to go over 48 hours. (Some people will eat leftovers a month later and then don't understand when they get sick. Hopefully this doesn't describe you.)
Be careful of all the websites and recipes and, well, shit, out there. There's so much more now than a few years ago. When you Google histamine intolerance now there's even more to wade through. Joneja has a website and other books. She's a fantastic source.
A more in depth book about MCAS by Afrin came out last year.
THIS is a fantastic academic journal article about histamine. I've seen it cited multiple times. It has a few tables/graphs that are super interesting.
Remember, your first and best sources are doctors and people with licenses. People who are sharing their experiences are great too but they might be very wrong and who knows how your body is different from theirs. You have to learn to understand what your body says is good or bad and some days that varies.
oh! almost forget. You might want to avoid NSAIDs if you don't already. Depends, on you, of course.
edit: I am not actually "officially" diagnosed but I clearly have fucked up mast cells and a fucked up immune system.
Read ~1500 pages of ridiculously dense pathology material in two semesters while keeping up with the extra material from lecture. Then when you move onto 3rd year you can read ~4000 pages of Harrison's while doing rotations 8-12+ hours a day.
Undergrad is understanding 5-10 topics a week. Med school is understanding those same 5-10 topics in a single lecture x 8 lectures/day. Without exaggeration, we literally covered an entire semester of undergrad anatomy in our first week. Covered a year of biochem in 6 weeks at the same time with anatomy and other courses. The pace of material covered is not understandable until you get there.
btw if you still want to read textbooks, here you go:
http://www.amazon.com/Robbins-Cotran-Pathologic-Basis-Disease/dp/1416031219/ref=sr_1_1?ie=UTF8&amp;qid=1373635912&amp;sr=8-1&amp;keywords=robbins+pathology
http://www.amazon.com/Harrisons-Principles-Internal-Medicine-Volumes/dp/007174889X/ref=sr_1_1?s=books&amp;ie=UTF8&amp;qid=1373635885&amp;sr=1-1&amp;keywords=harrison%27s+principles+of+internal+medicine
We tend to use MacLeod's Clinical Examination here in Scotland and it is pretty great! Good detail, nice simple steps and explains what findings might mean, and it has an online resource too. There's a new edition coming out in June 2013 though so if you want the latest edition I'd hang fire or pre-order it.
Hi. Although the book mentioned are great, here is my experience.
I bought this book, studied for literally one day, passed the exam the next day.
Also, I returned the book after I was done since it was only 2 days total. LOL.
https://www.amazon.com/gp/product/1610727991/ref=oh_aui_search_detailpage?ie=UTF8&amp;psc=1
Really good question, but difficult to answer. It all depends on how you define "competent understanding of emergency medicine."
Listening to podcasts and whatnot is a great way to keep up with new advances, but most of the EM podcasts expect listeners to have a broad fund of knowledge. I think your time might be better spent focusing on getting a solid foundation in the basics. Here's my two cents.
It's equally important to know when not to use certain medical terms, as there are quite a few words that carry an "oh shit" connotation. For example, do not describe an abdomen as "rigid" unless their belly feels like your palpating the tires of your ambulance. A true rigid abdomen means they need to be in the OR 2 hours ago. Do not a sleepy sick toddler as "lethargic" unless the kid is pretty much limp and lifeless. You'll end up scaring the shit out of your ED staff and/or making yourself look like an idiot.
Knowing which questions to ask is hugely important. Bates also covers a lot of terminology too, which goes back to point #1. For example, the whole "chest pain patient clutching fist to chest" thing they teach in EMT class...that has a name. That's a Levine's sign. And if you can accurately describe skin findings (eg "diffuse erythematous maculopapular rash" as opposed to "hives"), you'll look like a genius.
TL;DR- Never stop learning.
To start off with, I'd suggest
Dale Dubin's Rapid Interpreation of EKGs
And this article on theEmtSpot
https://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Dubin/dp/0912912065/ref=mp_s_a_1_3?keywords=ekg+interpretation+book&amp;qid=1568959702&amp;s=gateway&amp;sprefix=ekg+int&amp;sr=8-3
A "BART" (Basic Arrhythmia Recognition Training) course is not common in EMS fields(at least in my area). I've seen a couple in-hospital so "transfer staff" can move patients between floors without escorts.
In EMS its kinda 'black and white' either you 'need to know' or 'don't need to know' ECG rhythms.
As for the class, it's an entry level class so they shouldn't require any prep but check out "life in the fast lane" link below if you want to explore more.
https://lifeinthefastlane.com/ecg-library/
If you wanna go real deep, check out the Dale Dubin book.
https://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Dubin/dp/0912912065
If I may ask, whats your reason for taking this class?
Rapid Interpretation of EKG's: Dr. Dubin's Classic, Simplified Methodology for Understanding EKG's https://www.amazon.ca/dp/0912912065/ref=cm_sw_r_cp_api_i_ncd6Cb75KA2DE
ED radiology - the requisites
E copy is available on Elsevier's ClinicalKey website if you have institutional access.
This is the classic introduction to EKG interpretation:
https://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Dubin/dp/0912912065/
I think Learn Rhythm adult is a good way to get started, but certainly pick up an introduction to EKG type book. People love Dale Dubin's EKG book (albeit he has a pretty sketchy background...) so you'll find a lot of people referring it.
If I recall though the Learn: Rhythm Adult course only covers 3-lead EKGs, and for a tech position you do want to learn a bit about 12 leads. The Physio Control 12 Lead made Easy program was fairly decent if I remember correctly.
Rob Kelly
https://www.amazon.com/Cure-your-emetophobia-Thrive-Happiness-ebook/dp/B00H7WRN0E/ref=sr_1_2?crid=QEVFF1BLAT1E&keywords=emetophobia&qid=1570562585&sprefix=emeto%2Caps%2C160&sr=8-2
Get yourself this book, too. It's helped me a great deal but I still get MDs to interpret EKGs for me.
I don't know of any "popular science" books that would actually give you a head start in medical school.
For example, Oliver Sacks' books, especially Musicophilia are broadly neurological in topic and really interesting, but reading them won't actually give you any major advantage when it comes to your studies.
However, if you're determined to get that headstart, I'd recommend reading up on either anatomy or physiology.
For anatomy, I'd recommend the Thieme Atlas of Anatomy books, although I might be biased, since one of my professors co-authored them and therefore used them religiously.
The books aren't text books in the classical sense, so there is little explanation given, but the illustrations are arguably the best I've seen so far.
You might also want to check out the google body project, although I found it severely lacking in terms of features, you can't, for example, look up innervations or muscle insertion points. Or maybe those are available once you shell out for premium content, I haven't tried that.
For physiology, I found Boron/Boulpaep's Medical Physiology to be thorough, detailed and very easy to read and understand. So this might actually be the book you're looking for. Even with limited or no prior knowledge in physiology and minimal experience with science in general, you'll be practically guaranteed to gain a deep working knowledge of physiology, which is arguably the basis for medicine in general and will serve you well throughout your studies at medical school.
If you already feel confident in both anatomy and physiology, maybe because you've done both in your undergraduate studies, I can't recommend Harrison's Principles of Internal Medicine enough. Almost everything you'll ever need to know about medicine is contained in this book and it is generally pretty well written. If you'd actually have enough time in medical school to thoroughly read and digest this two-volumed beast of a textbook, med school would be less about cramming than it is today.
So maybe get a headstart on that one.
Edit: On the other hand, you might as well enjoy your time before medical school and keep the fire burning by shadowing a physician from time to time or watching the first couple of seasons of House. That'll be more fun.
http://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Edition/dp/0912912065
Can't go wrong with this book.
I've got two sites...
The best site to tell you what criteria you need for each rhythm is probably ECGpedia.
The next site I would recommend is really just a compilation of all the best ECG websites on the internet...Life in the Fast Lane ECG references
Also, some may disagree, but I think Rapid Interpretation of ECGs by Dale Dubin is the perfect book to start with.
Rapid EKG Interpretation. Easy read and it will help you so much. It's got pictures in every page so it's perfect for us slow people.
Rapid Interpretation of EKG's, Sixth Edition https://www.amazon.com/dp/0912912065/ref=cm_sw_r_awd_IO7LwbFARMW0Z
I have quite a few suggestions.
Specifically for nurses:
The following books are more for med students and MD's but I believe as nurses we need to understand rationales behind what MD's do, so these are good references:
Miscellaneous books:
Also consider subscribing to some journals. I'm subscribed to a few of them.
I'm an ER medicine nerd, so I love reading this stuff but by no means do you need to have all these books. I just enjoy learning as much as I can about EM.
If you haven't yet read it, a good book on the subject is Death by Regulation by Mary Ruwart.
That's a good mneumonic but can trip you up if you totally blank out on one of the categories.
Symptom to Diagnosis is a good one to helps start off with.
www.amazon.com/gp/product/0071803440/
and there's the Diagnosaurus on Google Play/iTunes and on accessmedicine but doesn't fully categorize the broad issue complaint into subcategories like VITAMIN C.
I've been always up to seeking a better book that actually has them organized in that mnemonic-like fashion. Anyone come across one to recommend?
I used Thomas Garcia's 12-Lead ECG: The Art of Interpretation. It goes above and beyond what you are required to know into stuff that is useful to know. It also breaks it down and gives tons of real world examples. This is how I learned EKGs. It might be better to start with something simpler, like Dale Dubin's Rapid Interpretation of EKG's, but I would make sure you know more than the simplistic version presented there.
Most books by Osler, Sobotta, [The Notebooks of Leonardo da Vinci] (https://www.foliosociety.com/usa/the-notebooks-of-leonardo-da-vinci.html?gclsrc=aw.ds&amp;&amp;gclid=CjwKCAjw4ZTqBRBZEiwAHHxpfgPxik4ed54AJw4oxOncCoz8KZJ0LaXPblrclVgpgp3OhplEGU4pgxoCspUQAvD_BwE), Sapira's Art and Science of Bedside Diagnosis.
yes they are. That's why I'm pretty desperate to find a way to lock them into my memory. Here you go. Amazon UK for your convenience.
http://www.amazon.co.uk/Macleods-Clinical-Diagnosis-Alan-MBChB/dp/0702035432/ref=sr_1_1?ie=UTF8&amp;qid=1394311545&amp;sr=8-1&amp;keywords=macleod+clinical+diagnosis
http://www.amazon.co.uk/The-Patient-History-Evidence-Based-Approach/dp/0071624945/ref=sr_ob_1?ie=UTF8&amp;qid=1394311514&amp;sr=8-1
I have the perfect book for you my friend.
The Patient History: Evidence-Based Approach (Tierney, The Patient History)
https://www.amazon.com/Patient-History-Evidence-Based-Approach-Tierney/dp/0071624945/ref=sr_1_1?ie=UTF8&amp;qid=1465792447&amp;sr=8-1&amp;keywords=the+patient+history
It has flowcharts for many common presenting symptoms, including even super broad ones such as "fever" or "headache." Abnormal vaginal bleeding flowchart is on page 512, jaundice is on page 382.
Go read the very excellent book evidence based physical.
http://www.amazon.com/Evidence-Based-Physical-Diagnosis-Expert-Consult/dp/1437722075
So much good stuff in there. I heard there is a PDF copy floating around the internet, should you willing to be a swarthy medical pirate.
I really liked this book. I found the reading to be much more easier and enjoyable than a textbook...
Also I'll give a second vote to the Skillstat website posted by /u/JemLover
Because I love reading non-fiction books, I do not have a particular author that I prefer, Generally, The relationship between the book and the Author often come in fictional books, I am now going to read a book about The Diagnosis Of Sexual Ambiguities I am excited, A book related to medicine but I do not mind, although it is not my specialty
&#x200B;
Nancy Caroline's Emergency Care in the Streets is the "national registry" text book. And it's fairly decent. If you read it cover to cover and have half a brain you should pass national registry no problem.
Study whatever your state has published for drug protocols and treatment guidelines.
While I'm sure you saw a lot of EKG's at the hospital you worked at you still need to read Dubin's Rapid Interpretation and should probably get a practice book like Jane Huff's ECG Workout If you actually faithfully do Jane Huffs book cover to cover there is virtually no way you will fail statics or dynamics. And if you faithfully read Dubin's, including all the silly things he makes you do, you'll come out having a good knowledge of EKGs.
Read this before/during shadowing (you can find a PDF if you look hard enough). http://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Edition/dp/0912912065. None of it may make any sense but at least you may get some sort of idea of what is going on while shadowing a doc.
Go hang out in /r/premed. Avoid SDN forums.
High school grades/scores do not matter for medical school. Shadowing/volunteer work in high school does not count for medical school applications. Major in something you enjoy in college. Don't be a typical pre-med bio major. Be open minded and don't set your heart on cardiology (hah) as it will likely change when you do 3rd and 4th year medical school rotations.
18 months ago I completed a B to P class through Good Fellowship in West Chester. Between class and clinicals it required most of your time, but worth it in the end. PM me if you want to know more. Read through Dubin's Rapid Interpretation Book it helped immensely.
I have this book. Definitely recommend. It doesn't get all the way down to the detailed physiology, but it does address basic pathophys in a way that should help you identify what you know or don't know.
If you really want to get into nitty gritty details, I'd recommend one of ~the~ physiology texts, like Boron & Boulpaep or something, but not for reading straight through. Just as a reference to look up that stuff you realized you didn't know.
https://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Dubin/dp/0912912065
This is the book I used the most.
This book is pretty helpful, and I like it in particular because it basically does a "physiology pertaining to EKG's for dummies".
And yes, I know that Dubin turned out to be a sex offender and a creep, but the book is still good.
An entire book https://www.amazon.co.uk/Death-Regulation-Robbed-Golden-Reclaim-ebook/dp/B07CHKRSFH/ref=sr_1_1?keywords=death+by+regulations&amp;qid=1572298908&amp;sr=8-1
2 other great ECG books
ECG Interpretation Made Incredibly Easy!
http://www.amazon.com/Interpretation-Made-Incredibly-Easy-Series/dp/1608312895/ref=sr_1_2?ie=UTF8&amp;qid=1377718462&amp;sr=8-2&amp;keywords=ecg+made+easy
12-Lead ECG: The Art of Interpretation
http://www.amazon.com/gp/product/0763712841/ref=oh_details_o07_s00_i00?ie=UTF8&amp;psc=1
Link to amazon. you can buy used for for like $70.
https://www.amazon.com/Bates-Guide-Physical-Examination-History-Taking/dp/1609137620/ref=sr_1_1?ie=UTF8&amp;qid=1480534198&amp;sr=8-1&amp;keywords=bates+medical+physical+assessment+book
3 lead or 12 lead?
If only 3 lead buy Rapid Interpretation of EKG's.
https://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Dubin/dp/0912912065
You be able to read a 3 lead within a day.
They banned it for the same reason they banned other AIDS drugs but pushed AZT or prevented vitamin makers from telling people that folic acid prevents spina bifida or prevented beer makers from putting in NAC which would have prevented liver disease or they approved Vioxx or they arbitrarily tell parents of dying children they can't get experimental drugs, etc, etc.
Because they can and they have no accountability.
Since they have no accountability their real loyalty is to the firms which can bribe them. And now the bribery is built into the system with research 'fees' they must be paid.
It is naive to think an organization which has no accountability to the public would care about the public.
They have your money.
Every failure means they get more of your money.
That's a system designed to kill people.
And it does.
https://www.amazon.com/dp/B07CHKRSFH
ancient.
This book but it's over so This would be great
Just wanted to reply with some links to see if these are the books are referring to.
I found both a standard text and pocket edition of Physical exam techniques by Bates. Is there a significant difference between the two besides size and perhaps less detail in the pocket edition?
http://www.amazon.com/Bates-Guide-Physical-Examination-History-Taking/dp/1609137620/ref=sr_1_fkmr2_1?ie=UTF8&amp;qid=1427548257&amp;sr=8-1-fkmr2&amp;keywords=physical+exam+techniques+Bates
http://www.amazon.com/Pocket-Physical-Examination-History-Taking/dp/1451173229/ref=sr_1_fkmr2_2?ie=UTF8&amp;qid=1427548199&amp;sr=8-2-fkmr2&amp;keywords=physical+exam+techniques+Bates
For clinical presentation, I found this on amazon.
http://www.amazon.com/Clinical-Encounter-Medical-Interview-Presentation/dp/0815113749/ref=sr_1_1?ie=UTF8&amp;qid=1427547965&amp;sr=8-1&amp;keywords=clinical+presentation
For Diagnoses and treatment "The Merck Manual" I found this
http://www.amazon.com/Merck-Manual-Robert-S-Porter/dp/0911910190/ref=sr_1_1?ie=UTF8&amp;qid=1427548053&amp;sr=8-1&amp;keywords=diagnoses+and+treatment+%28Current+2015%2C+Merck
Couldn't find anything on Harrison's anatomy on amazon. I currently have rapid interpretations of EKG, the latest addition as well.
To be honest I've not come across any truly "must have" emergency CT books. The "Emergency Radiology: The Requisites" book is something I've personally used - it's ok but I don't think many of my colleagues use it, and I've used it far less than I thought I would. Not as many pictures as I would have liked - it's a text book rather than a practical book, and it doesn't show enough different examples to be truly useful.
In terms of other books - what uses do you mean? As in do you want books to study for exams, practical books to get better at CT etc, essential reference books or books to have to hand during on-call/during reporting acute radiology?
This is a full post that I "stole" from another very knowledgeable user. Lots of information and a few sources in here.
Ketostix are a cheap and relatively accurate way to measure the levels of acetoacetate in urine, one of the three ketone bodies, the other two ketone bodies being acetone and beta-hydroxyburic acid. The stix are very specific and very reliable.
A comparative study of Qualitative tests for ketones in Urine and Serum, Free et al, Clinical Chemistry Vol. 4 Issue 4, 1958
http://www.clinchem.org/content/4/4/323.full.pdf
This is worth repeating, because many people miss it. Ketostix can tell you the levels of acetoacetate in your urine. If you test positive, it does not mean you are in ketosis - it means that this test has detected acetoatate in your urine. If you test negative it does not mean you are not in ketosis - it means that this test can not detect acetoacetate in your urine.
Inferring that purple on the ketostix means "I am in ketosis" and no purple means "I am not in ketosis" is utterly false. All you know is that this test has shown or failed to show acetoacetate in your urine. You need to know more about the ketone bodies, and about the test, to infer meaning from the ketostix measurement.
The stix only measure the concentration of acetoacetate - drink more water and the ketones become diluted. A very common feature of the ketogenic diet recommendations are for dieters to drink much water, and to take electrolytes in solution. It is my personal experience that thirst rises significantly on a KD, and with it my water consumption.
Correspondingly, I pee a lot more now - and that pee is dilute. A reason for many false-negative tests is likely to be due to the diluted nature of a ketogenic dieter's pee.
In principle, the ketostix work because they have segments of sodium nitroprusside - also known as nitroferricyanide. Nitroprusside reacts with acetoacetic acid to turn the segments a shade of colour at a precisely measured duration. Some of the fancier blood measuring strips also include sodium biphosphate as an acid buffer.
• The stix must be measured at a precise point in time (15seconds), leave them longer and they will always get darker.
• The stix are not sensitive to acetoacetate concentrations less than 50mg/litre.
• The stix do not react (much) to acetone, one of the three ketone bodies.
• The stix do not react at all to beta-hydroxyburic acid. This is the major cause of a false-negative reading.
It is not just acetoacetic acid which turns the stix purple. Captopril, aspirin, methyldopa, mesna, acetylcsteine, levodopa, methyldopa, phenazopyridine and probably other drugs can also trigger a false-positive ketostix reading.
Basic Skills in Interpreting Laboratory Data – 2013 by Mary Lee PharmD BCPS FCCP (Editor),http://www.amazon.com/dp/1585283436/
The ketostix are not even very good at diagnosing diabetic ketoacidosis - their designed purpose. The levels of acetoacetic acid in urine can be many times higher than the levels seen in blood. As ketoacidosis subsides, beta-hydroxyburic acid degrades into acetoacetic acid - giving a stronger reading on the stix and a false indication of worsening ketoacidosis.
Recent advances in the monitoring and management of diabetic ketoacidosis, T.M. Wallace, D.R. Matthews DOI:http://dx.doi.org/10.1093/qjmed/hch132
http://qjmed.oxfordjournals.org/content/97/12/773.2
The ADA says:
RECOMMENDATION: BLOOD KETONE DETERMINATIONS THAT RELY ON THE NITROPRUSSIDE REACTION SHOULD BE USED ONLY AS AN ADJUNCT TO DIAGNOSE DKA AND SHOULD NOT BE USED TO MONITOR DKA TREATMENT.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114322/#B187
False positives can be seen if the urine is very acidic - after eating lots of vinegar for example. Or if ketones are being produced by intestinal bacteria.
The ketostix degrade on exposure to air - they age badly. They can give false negative readings simply because they have stopped working.
Now, back to nutritional ketosis, the goal of a ketogenic diet. In nutritional ketosis - at least after the initial few days and after a period of keto-adaptation, the majority of ketones produced and cleared are beta-hydroxyburic acid.
Ketone body kinetics in humans: the effects of insulin-dependent diabetes, obesity, and starvation.http://www.jlr.org/content/25/11/1184.long
There is some indication to suggest that ketotic athletes utilize 100% of free ketones, effectively leaving none for renal clearance:
J Appl Physiol Respir Environ Exerc Physiol. 1978 Jan;44(1):5-11. Changes induced by exercise in rates of turnover and oxidation of ketone bodies in fasting man. http://www.ncbi.nlm.nih.gov/pubmed/627499
Acute nutritional ketosis: implications for exercise performance and metabolism. Cox PJ1, Clarke K2.http://www.ncbi.nlm.nih.gov/pubmed/25379174
3rd Degree's are like my favorite. I'm a complete nerd. Some people collect silver spoons, shot glasses, stuffed animals: me, I collect rhythm strips and empty IV med vials.
So 3rd degree heart blocks are pretty interesting. You have irregular ones which are usually completely unstable: you stopped looking at the monitor because their BP and SpO2 are wack, it's time for ACLS.
But when you get used to stable 3rd degrees you start to notice something interesting. You start noticing a lot of regular intervals. You start seeing a lot of 2 regular rhythms put together to form something irregular.
So disclaimer here: you see a 3rd degree put on the pacer pads until a cardiologist tells you otherwise.
But if you notice that the QRS complexes have a regular interval and then the P waves have regular intervals. Well that's kind of neat. Because you start seeing those p waves and qrs complexes where you expect them. And you have no problem differentiating a P and a T.
T waves are cool and all. I mean they indicate something. But most of the time they just follow the qrs and a p pops in there where ever it feels like, it's almost musical really. Not a super big deal in 3rd degree. You see an R wave fall on a T; well that's different.
But enough about how cool or interesting it is. What's really going on here? Well a pace maker cell in a heart will fire unless it's inhibited. So lets say you have a higher pacer firing at it's faster programed speed up there in the atria but there is a block between that pacer and a lower one down below the bundle. The lower one doesn't get inhibited by the higher atrial pacer cell and vice versa. So basically you have 2 cells firing at two different speeds but at regular intervals independent of one another. They just don't know the other exists.
You know what? I'm not the guy you should be asking: BOOM you're now an expert.
As an edit I'd just like to mention something I've come across in the past few years. Sometimes you get these 3rd degrees that are almost stable but have periods of instability or long pauses. You're like wtf man you're supposed to be stable, the cardiologist is not coming in until, at the earliest, 6am, more like 8am. Stop making my transcutaneous pacer fire! I mean, does that feel good?!
So 3rd degree's are the product of some disease process right? What am I noticing with you? CAD and OSA maybe? You're having some long pauses with a drop in BP with a period of apnea? What can we do about this until you get your pacer surgery in the AM?
My Mom is taking this test in a month or so and she's really overwhelmed as to what she needs to focus on. She's worked as a tech for 15+ years in the same pharmacy and there is a new law that requires all techs be certified. Her employer isn't paying for any of their techs to become certified, so she doesn't want to mess up and have to take the test a bunch of times; she also graduated college in 1980 so it's been some times since she's done standardized testing.
She doesn't have the internet at home, so she did get this PTCB math test book as well as this study guide. Should I tell her to mainly focus on the math since she'll have a general idea of most of the other stuff (since she's working with it daily)? She's just kind of wondering what to expect. Thanks for your input!
Master The Boards, its 2 books by Conrad Fischer. It's the review book of choice for most international graduates (at least from South Asia).
http://www.amazon.com/Master-Boards-USMLE-Step-Edition/dp/1609787609
http://www.amazon.com/Master-Boards-USMLE-Step-3/dp/1607148439/ref=pd_bxgy_b_img_y
Generally both books (CK and step 3) are used for CK because the CK book alone misses out on a few topics.
My only advice would be to work the road as a basic to see what it's like. I worked the road for a little while (wish I woulda waited longer) but when you start learning everything in medic school everything seems to come together from what you saw on the read and what you read in class. But definitely
http://www.amazon.com/gp/aw/d/0912912065/ref=mp_s_a_1_1?qid=1397575975&amp;sr=1-1&amp;pi=SY200_QL40
Not sure how to link it differently on mobile but this is a great book. You spend a lot of time on cardiology.