ACL or MCL

[pedsmedstudent]

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USMLE Secrets says ACL is the most commonly injured ligament in the knee. World says it is MCL. Which is it?

 

[OveractiveBrain]

USMLE Secrets says ACL is the most commonly injured ligament in the knee. World says it is MCL. Which is it?

They won't test epidemiology. So long as you can link history and physical with diagnosis (then know that MRI is the best test) you're in good shape.

That is, because ACL, MCL, and PCL tears are SO different in presentation, you should not have trouble determining the diagnosis by the vignette, deciding how to diagnose, and choosing therapy.

ACL - Anterior Draw Sign, MRI, Surgery
MCL - CLICK, MRI, let is heal (non athelete) vs surgery
PCL - Posterior Draw Sign, MRI, Surgery

Oh look. The things you'll be asked are MRI or Surgery. Makes the question really easy to answer.

Didn't answer your question, did I? For Step II, it don't matter...

 

[LouisianaDoctor]

Didn't answer your question, did I?

Maybe not, but I truly appreciate posts like yours where it just breaks it down as simple as it can be. I copy and paste them into a little document and add to my list of things to read over.

Does anyone have a simple way to manage GERD/peptic/duodenal ulcers?

 

[OveractiveBrain]

Maybe not, but I truly appreciate posts like yours where it just breaks it down as simple as it can be. I copy and paste them into a little document and add to my list of things to read over.

Does anyone have a simple way to manage GERD/peptic/duodenal ulcers?

GERD
First Step is NOT diagnosis, it is life style modifications and PPIs
THEN EGD with Bx to see if its gastritis vs barret's
THEN decide between PPI (GERD), Nissen (Barret's), or surgery (Cancer).

remember to get a 24-hr pH monitor which is the best test (though rarely done) before you go to surgery. you get every test under the sun (manometry, 24-hr pH, egd) before you go to surgery

 

[mjl1717]

Overactive Brain is the best!!

 

[ThePursuit]

And if you have Barret's, you'll need f/u with Bx b/c of increased risk for cancer...

 

[DocInProgress]

GERD
First Step is NOT diagnosis, it is life style modifications and PPIs
THEN EGD with Bx to see if its gastritis vs barret's
THEN decide between PPI (GERD), Nissen (Barret's), or surgery (Cancer).

remember to get a 24-hr pH monitor which is the best test (though rarely done) before you go to surgery. you get every test under the sun (manometry, 24-hr pH, egd) before you go to surgery

I think the exceptions might be for patients over 50 and those with symptoms for more than 2 years (in these cases, you might want a EGD w/Bx first).

 

[OveractiveBrain]

I think the exceptions might be for patients over 50 and those with symptoms for more than 2 years (in these cases, you might want a EGD w/Bx first).

ALARM symptoms lead you to EGD with Bx first. Weight loss, dysphagia, odynophagia, hematemesis. I'm pretty sure its not age. 77 year olds can have GERD too. I was trying to be succinct.

And if you have Barret's, you'll need f/u with Bx b/c of increased risk for cancer...

EGD with Bx means "Esophogastroduodenoscopy with Biopsy." You get the biopsy with EGD. You wont be asked about repeat biopsies or surveillance intervals on Step 2.