Alejandra

20 years. Mexicana

[thezenangel]

youtube channels to motivate you this semester

♡ abao in tokyo - study with me’s & playlists

♡ advika singh - study & productivity vlogs

♡ allie c. - medical school vlogs

♡ carrot td - study with me’s

♡ celine - study with me’s

♡ deaana - medical school, study with me’s, stationary, etc.

♡ dear mimi - study vlogs

♡ dia - medical student vlogs

♡ dr. rachel southard, do - medical school & residency vlogs & talks

♡ emily feng - medical school vlogs

♡ emilystudying - dental school & study vlogs

♡ emma grace - nursing school vlogs

♡ emmalilyn - study with me’s

♡ ginny - study vlogs

♡ hyobin - medical student vlogs

♡ leighton sanders - nursing vlogs

♡ lucky penny - study with me’s

♡ lunardazes. - uni study vlogs

♡ madi’s nursing journey - nursing school & nursing vlogs

♡ mango oatmilk - study with me’s

♡ maria silva - study & hospital interning vlogs

♡ merve - study with me’s

♡ mishujo - study & productive vlogs

♡ nada - study & productivity vlogs

♡ ray hon - study with me’s

♡ sab yang - medical school & study vlogs

♡ sean study - study with me’s

♡ sierra lyn - nursing vlogs

♡ studymd - study with me’s

♡ study to success - stationary, study with me’s, study hacks, etc.

♡ tani study - study with me’s

♡ yours truly, chloe - study vlogs

♡ yulma - study with me’s

[emmastudies]

Free Intentional Spending Tracker for Notion

It's Day 8 of the 12 Days of Giving!

Track your wishlist and fill in details to help make more informed decisions regarding your purchases. Comes with an comprehensive way to categorise your wants & seeing the impact on your budgets. Whilst this has budgeting features, it's more about how you're spending and making sure those purchases are considered. Features include:

spending goals for 2024

active wishlist & watching space

detailed digital wishlist and budget impact

wishlist categorises & year budgeting

pre-populated dates with calendar view for revisiting items after "cool off period"

gift gifting ideas (by idea, rather than recipient for more intentional gifting!)

recipient database

Download Free Here

Check back in each day for a new free item! Hopefully they're all useful and a fun way to end the year 🥰🎁

[bilboswwaggins]

[studyingmood]

Hope this helps anyone who are nervous about exams (((o(*ﾟ▽ﾟ*)o)))

[thisisnoodle]

More of my anatomy studies, and my dear sunflowers ❤️

Can't wait for July and the summer and the rains so I can read and sleep a lot.

[physiologicdeadspace]

Three wax legs showing treatment of ulcers caused by syphilis, Science Museum, London

[myhoneststudyblr]

my masterpost | my studygram | ask me anything

[click images for high quality]

Other advice posts that may be of interest:

How To Stop Procrastinating

How To Study When You Really Don’t Want To

Active Revision Techniques

[eintsein]

An Overview of Note-Taking Styles

Note-taking is one of the most essential skills a student should master. It allows you to record and review information to be used in the future. But what’s the best way to do so? Here’s an overview of note-taking styles that can help you maximize your learning!

[guy60660]

Maisy Summer Lewin-Sanderson | Print Magazine

[productividays]

01/30 - slow & simple sundays 🤍 (ig : @productividays)

so in love with my new desk and set-up ahhh ✨ this makes work so much more enjoyable tbh, i'm starting not to mind getting work-related tasks done during the weekend 🍃

(s/o to my husband and his patience for building this complicated ikea desk for me hahaha 🤍)

[productivelia]

01.31.22✨

Oh my! I hope January has been good to all of you! So sorry it’s been a while. I got a new journal now since I’m full time at work and I must say it works really well

What do you think? Love the new spreads?

Instagram: productivelia

[usmlestep2cs-jamesyu-blog]

Patient Note_Basic Format 2 ( Physical Examination)

VS (Vital Signs): Copy & Paste!  or bp 90/60, p 80, T 36C, rr 17

GA (General Appearance):  NAD (No Acute Distress)

 HEENT & Neck

Head: NCAT, NT: NormoCephalic/ATraumatic, Non-Tender

Eyes: no scleral icterus/ anemic/ erythema/ exudate. PERRLA, EOMI,

           Fundi- red reflex intact, no papilledema / No visual defect.  

Ears: no discharge. NT. EAC NL, TM intact or TM: No bulging, perforation, redness b/l

         Rinne AC>BC, Weber not lateralized  

Nose: no nasal congestion, discharge, erythema, and perforation or salute

Throat: MMM (Mucous Membranes Moist). no exudate, tonsillar enlargement, erythema, exudates, vesicular lesions /

Neck: no LAD(Lymphadenopathy) / no Bruits, JVD/ thyroid No enlargement, nodules, tender and bruits

Full CV: RRR (Regular Rate and Rhythm), S1S2NL, no MRGs (Murmurs, Rubs, or Gallops), PMI (Point of Maximal Intensity) not displaced.  Carotid: no bruits, no JVD, Pulses: Radial, DP, PT (Dorsalis pedis, post. Tibialis) 2+ b/l.  No Edema in LE , Fundoscopy: no vessel changes & Exudate & Hemorrhage, no papilledema.

Chest:  NT, equal chest excursion b/l, TVF NL (Tactile Vocal Fremitus Normal), Lungs clear to A&P(Auscultation, percussion) b/l, no WRR(Wheezing, Rales, Rhonchi).

Abdomen: no scars or bruises. Soft, ND (NonDistended) / BS (Bowel Sound) + x 4Q, no bruits.  / tympanicx4Q. no masses & HSM(Hepatosplenomegaly)/ NT (NonTender)  

Negative- Murphy, Rovsing ’s, psoas, obturator sign. CVA tenderness.

Full Neuro:  

A&O3 (Alert to Oriented x3)

Eyes: no visual defect, EOMI, Fundoscopy- no vessel changes, hemorrhage,

CN2-12 grossly intact. motor 5/5 in all 4 ext, DTR: 2+ in all 4 ext., Sensory Intact to light touch SILT/position/vibration intact b/l.

No dysdiadochokinesia (flip hands), no dysmetria or [coordination intact], Roberg negative, Gait - NL,

Brudzinski +/ Babinski - / Kernig -

Extremities: IPR MSRP (Inspection, Palpitation, Range of movement, Motor, Sense, Reflex, Pulse)

No swelling, erythema, warmth, tenderness (Inspection, Palpitation)

ROM intact

Motor 5/5, Sensation intact to light touch, sharp and dull, DTR 2+ in all 4 extremities.

Peripheral pulses: 2+ DP, TP, Radialis b/l.

[sosuperawesome]

Vinyl Stickers / Washi Tape

Kyari Kreations on Etsy

[lovelysticker]

lovely mongmong 4

[moonlitswims-deactivated2024010]

some art posters I'd put up in my dream home

[we-need-medicine]

Physical Examination Flow: Cardiovascular

I. Introduction

“Hi, I’m __________, and I’ll be the PA/NP/MD/DO, etc. seeing you today”

“Today I will be performing a physical exam of the cardiovascular system, ok?”

II. Eyes

Opthalmoscopic examination for hypertensive retinopathy (usually already done if HEENT exam is performed)

III. Neck

Inspect for JVD

Have patient turn neck to the left

Have patient neck be elevated to 30°

Measure centimeters of elevation comparing to sternum level

Normal level should be > or = to 3 cm

If patient is elderly, auscultate for bruits prior to palpation

Palpate carotids, separately

IV. Chest

Inspection      

Stand on right side of patient, examine precordial area

Vizualize PMI, heaves

Identify cardiac areas of palpation and auscultation

Aortic: 2nd right intercostal space along sternal border

Pulmonary: 2nd left intercostal space along sternal border

Tricuspid: 4th or 5th left intercostal space along sternal border

Mitral: 4th or 5th left intercostal space along midclavicular line

Palpation

Thrills using metacarpal phalangeal joints

PMI (point of maximal impulse) with pad of finger

Note ICS and vertical location of PMI

Auscultation

Note rate and rhythm

Note character of first (S1) and second (S2) heart sounds

S1: closure of AV valves - onset of systole

S2: closure of semilunar valves - onset of diastole

Assess splitting of S2 (right side slightly delayed with decreased pressures)

Have patient exhale and hold to assure splitting is only physiologic and not pathologic

Extra Sounds

Ejection click: early systole

Diseased aortic valve

Opening snap: early diastole

Mitral disease

S3: rapid deceleration of blood

S4: atrial kick

Murmurs

Timing (systolic, diastolic) and duration (early, middle, late)

Shape

Crescendo/decrescendo - aortic stenosis

Plateau - mitral regurg, tricuspid regurg, ventriculoseptal defect

Decrescendo - aortic regurgitation

Location

Radiation

Pitch (low, medium, high)

Quality (musical, rumbling, blowing, harsh)

Intensity - Graded on a 1-6 scale

Grade 1: very faint, not heard in all positions

Grade 2: easily heard but faint

Grade 3: moderate

Grade 4: loud with palpable thrill

Grade 5: heart with stethoscope partially off chest wall

Grade 6: heart with stethoscope off chest wall

Special Positions

Left lateral decubitus: if mitral stenosis, S3, or S4 suspected

Sitting, leaning forward, breath out and hold: if aortic murmur is suspected

Standing, squatting, valsalva: if MVP or aortic stenosis is suspected

V. Abdomen

Auscultation for bruits

Aorta

Renal aa

Iliac aa

Femoral aa

Palpation

Hepatojugular reflex for JVP

Aortic size - should be < 3 cm

VI. Extremeties

Inspection

Edema - Scale 0-4

0: no edema

1: swelling of ankle

2: swelling to tibia

3: swelling to femur

4: swelling to sacrum

Varicosities

Hair loss - peripheral artery disease

Nail beds - splinter hemorrhages

Stasis dermatitis

Palpation

Compare bilaterally

Brachial aa

Radial aa

Femoral aa

Popliteal aa

Dorsalis pedis aa

Posterior tibialis aa

Capillary refill 

Signs of phlebitis - venous tenderness, warmth, cords

Allen Test - competency of radial and ulnar aa

Palm up

Patient clenches fist

Compress radial and ulnar aa

Patient relaxes hand

Observe pale palm

Release ulnar a

Findings

Normal - pink in 3-5 seconds

Abnormal - repeat test releasing radial a

[i-eat-booooks]

perfect!

[we-need-medicine]

Radiology: Pathology on Chest Image Basics

Consolidation: a SOLID appearance; indicates accumulation of tissue or fluid in alveoli and small airways

Infiltrate: a PATCHY appearance; also indicates accumulation of tissue or fluid in alveoli and small airways

The important radiologic signs on the chest image are:

Tracheal deviation: the trachea should be at the midline, with carina at the T4 or T5 level

Deviation is a sign of pathology

Patient rotation can mimic deviation

Tracheal deviation towards the right side.

Mediastinal shift: shift of the mediastinum 

Caused by tension pneumothorax, pleural effusion, atelectasis, tumor

Mediastinal shift, as pointed out by the arrow.

Silhouette sign: when an object is in contact with another of different density, the adjoining edge is visible; when objects of the same density are in contact with each other, the adjoining edge is not visible

Loss of a specific contour can be a presentation for pathology

Silhouette signs and their pathologies

Right mediastinal border - pathology of RUL

Right heart border - pathology of RML

Right hemidiaphragm - pathology of RLL

Left mediastinal border - pathology of LUL

Left heart border - pathology of lingula

Left hemidiaphragm - pathology of LLL

Silhouette sign of right mediastinal border, a sign of pathology in the RUL.

Air-bronchogram sign: a tubular outline of an airway made visible by filling of the surrounding alveoli by fluid or inflammatory exudates

A key sign of alveolar disease

Air-bronchogram sign, as pointed out by the arrows.