Survival Toolkit
For Residents and 3rd/4th year medical students
Embedded Files
Table of Contents
Resources
Resources
Must Haves
Must Haves
Pocket Medicine
Diagnosaurus
Lexicomp (remember, the pharmacist is your best friend!)
MDCalc
Recommended
Recommended
UptoDate (personally prefer looking things up through respective colleges and societies)
Opiate Conversion Calculator (any app will do)
X-Anatomy (really cool CT app)
Visual Dx (especially if your school has a subscription, if you go to PCOM we have one)
Current Medical Diagnosis and Treatment Book (pretty much cliff notes for Harrison's)
Guidelines
Guidelines
ACC/AHA (guidelines for A-Fib, stroke, CHF, ACS, etc.)
IDSA (guidelines for pneumonia, UTI, cellulitis, etc.)
ADA/AACE (AACE has a good diabetes app)
ACP, AAFP (great resource for basic information, highly recommend using AAFP over UptoDate if you are a 3rd year medical student)
CDC (especially useful for vaccination schedules)
American College of Surgeons
AAEM (for those EM people)
Inpatient Worksheet.pdfInpatient Worksheet
Inpatient Worksheet
I came up with this during my 3rd and 4th year. This is my final product after much tinkering. Should have just about everything you need to make sure to cover to look like a rock star on rounds. Just make sure you do a little extra digging for pertinent medical history (i.e. PFTs, echocardiograms, heart caths, endoscopy)
Hyponatremia (you will see this many many times)
Hyponatremia (you will see this many many times)
This flowsheet is adapted mainly from the AAFP flowsheet with some added information from other sources and personal experience.
REMEMBER: HYPERTONIC saline when a patient is symptomatic!
Sodium Imbalances Quicksheet.pdfElectrolyte Replacement Quicksheet.pdfElectrolyte Replacement
Electrolyte Replacement
You will quickly learn how to replace potassium, but everything else you will have to keep looking up. Place this somewhere for a quick reference.
PEARLS: check magnesium when you see hypokalemia; if magnesium isn't fixed potassium will not correct
Phosphate checks usually not indicated unless they are a CKD/ESRD patient and/or you want a calcium-phosphorus product.
Magnesium checks also not routine, but useful in patients with hypokalemia, arrhythmias, and patients receiving magnesium (REMEMBER: check reflexes on patients receiving magnesium)
Antibiotic Coverage
Antibiotic Coverage
Taken from a lecture given by an attending where I did my 3rd year rotation (Cahaba FM Residency in Centreville, AL). I really liked how he drew it out in his chalk talk, so made a digital copy to share with everyone!
Antibiotics Diagram.pdfCAP-HAP-VAP Quicksheet 2019.pdfPneumonia (CAP/HAP/VAP)
Pneumonia (CAP/HAP/VAP)
This flowsheet is based on the IDSA 2016 and 2019 guidelines on HAP/VAP and CAP respectively. There will probably be an update on CAP soon and I will update this flowsheet when they are released.
REMEMBER: CXR findings for diagnosis of pneumonia!
ACS (another thing you will see everyday)
ACS (another thing you will see everyday)
Based on the ACC/AHA guidelines. Know this, you WILL be pimped on the material on this page.
ACS Diagnostic Evaluation Quicksheet.pdfAKI Quicksheet.pdfAKI (again will see everyday)
AKI (again will see everyday)
Flowsheet from UptoDate. Know your AKIN criteria for Stage 1 (>0.3 increase in creatinine from baseline or 1.5x increase in creatinine from baseline). Per many nephrologists and attendings, no need to know the distinction between Stage 2 and Stage 3 as non-nephrologists
Syncope (topic of at least one morning report a block)
Syncope (topic of at least one morning report a block)
Have this one on you when you go to morning report and crush it!
REMEMBER: always look at your vitals and EKGs. I feel a lot of medical students forget/neglect vitals when they initially start
Syncope Quicksheet.pdfDelirium Quicksheet.pdfDelirium
Delirium
Great flowsheet that I found on an article regarding delirium in the elderly.
Big take home: first-line for acute delirium in the elderly is keeping lights on, blinds open, and having the TV on. Ask if they use glasses and/or hearing aids at home as this can also help. Be an osteopath (or a good doctor) and take care of the patient. Medications don't fix everything!
Alcohol Withdrawal Protocol
Alcohol Withdrawal Protocol
Another reason to take a good history. Remember SMASH FM? Social history of drinking? Remember to ask how much they drink and when their last drink was.
Alcohol Withdrawal Quicksheet.pdfEndocarditis Quicksheet.pdfEndocarditis
Endocarditis
What to do with you get that gram positive blood culture. Should you repeat? Get an echocardiogram? Here's a quick summary of the IDSA/AHA 2016 Guidelines
Mnemonics I Live By
Mnemonics I Live By
VINDICATE = building a general differential diagnosis
Vascular
Infectious
Neoplastic
Degenerative
Iatrogenic/Intoxication
Congenital
Autoimmune
Traumatic
Endocrine/Metabolic
I WATCH DEATH = differential for acute delirium
Infection (e.g. syphilis, lyme disease)
NOTE: new IDSA guidelines recommend no antibiotic treatment of asymptomatic UTI in elderly with mental status changes, but rather to search for other causes
Withdrawal (e.g. drugs, alcohol)
Acute vascular (e.g. MI, stroke)
Trauma
CNS pathology (e.g. normal pressure hydrocephalus, vascular dementia, Parkinson's)
Hypoxia
Deficiency (e.g. B12, folate, thiamine)
Endocrine (e.g. thyroid dysfunction)
Acute metabolic (e.g. acidosis, sodium imbalance, uremia)
Toxins
Heavy metals
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