Some of these resources you may use regularly, but check out the breadth of resources available. We often have more than one resource that will address your questions, each in its own way. |
Resources for this Case
Textbooks (look left) DDX Resources -- Redux Natural Medicine Database --Redux Featured Resources : Cardiac Exam Videos Selected Look Up Tools -- Textbooks and Drug Resources Synthesized Decision Support Tools -- Up to Date, Medscape, & Micromedex Searching for Titles in PubMed (e.g., supraventricular tachycardia) Another Place to Look - Other than PubMed Databases |
Calculators
You may not need these for the beginning of the case, but here are a couple that could prove useful as you advance to the clerkships. For more on mobile resources - see that online guide.
Calculate [Free ] |
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MedCalc, [Free] |
Sometimes, an internet search will help you understand what your patients are finding out on the web. But when it comes time for finding good evidence about those items, we have a really great resource for you on alternative, complementary, or integrative medicine: Natural Medicines.
Natural Medicines
Natural Medicines Comprehensive Database the information aims for evidence-based practice principles and uses as many references as they can find on their topics. Links to the references allows you to put your EBMI skills to good use in evaluating that component - typed of study and levels of evidence. The interface does a good job at calling attention to possible interactions and the possible strength of the interactions. Search or browse the resource.
See what they have for guarana. Look for the Professional Monograph for the details. The others would give you info on specific products.
Where Else to Find Info on Herbs & Supplements?
Approaching the Herbal Supplements Question from Another Direction - Toxicology
How about using toxicology texts for information on how herbal supplements might affect one's health. We have a great text called Goldfrank's Toxicologic Emergencies and it has information on herbal supplements as well as guarana.
Cardiac Exam Videos
From JOVE, we have a few videos that might be helpful for you this week.
Passing along a Tip from Dr. Gates regarding a DDX & Symptom Checker
Dr. Gates has found a very helpful text within Access Medicine - Symptoms to Diagnosis: An Evidence Based Guide. Presented through a series of cases of patients complaining of a specific issue, then walks you through buiding the DDX and prioritizing it, and making the diagnosis. Unlike the interactive tools that give you a list, this text helps explain the thinking process. Topics include a variety of non-specific complaints from low back pain to weight loss to GI bleeding, to abdominal pain. Check out Chapter 1 as an overview of the diagnostic process.
Also listed below are some of the interactive DDX tools.
Online & Print Books
Differential Diagnosis in Primary Care
(WB 141.5 C712d 2008) The book lists alphabetically a variety of symptoms. Each category provides a section on the "approach to diagnosis" and other userful tests to consider. Some sections have short case presentations to test your skills.
Differential Diagnosis in Primary Care
(WB 39 R231d 2009) Yep - two books with the same name, different authors. This book presents information organized by areas of the body.
Differential Diagnosis of Common Complaints
(WB 141.5 S467d 2007) The book is organized around common presenting complaints. Sections also include details on associated symptoms, physical findings, diagnostic studies, and presents a summary of these in a handy table format.
Interactive Tools
Decision Support Tools
Some of your favorite tools are the ones that give you a clinical overview as well as specific clinical details. If you have not checked out DynaMed Plus before, this would be a good week to look at it from palpitations to atrial fibrillation and more. DynaMed has quite a few images and that may appeal to some of you - see what they have regarding atrial fibrillation.
Finding and Keeping Up with Guidelines
Did you know some of the cardiovascular guidelines were updated recently? Revisions to the guidelines may include guidance for at one point should someone start anti-coagulant therapy. So, how do you easily find them? Well, you can always go to the main source, if you know who would put out guidelines, or, you can use one of the medical search engines like TRIP.
Once you do your search, the filters on the right side will let you see just the guidelines that match your search topic.
Textbook Resources
I'm sure you are very familiar with the first one on this list, but how about the others? If the answer is not in Access Medicine what do you do? Each of these 3 collections of textbooks have a few similar texts but also some unique coverage of other topics. I think MDConsult has the best search results page - it provides a bit more detail about your term within the context of the paragraph it is found and it is clear about the results from textbooks as those from the other resources available in that tool.
Don't forget, knowing your question (background or more clinical) can help you know which resource to try.
Last tidbit - all three of these resource have great results for echocardiogram, event, & holter monitoring. You might also like the info on holiday heart.
Searching PubMed
Cutting through articles in PubMed - see if your most central term(s) can help you find good articles. I've mentioned this before, but this is another time where a title search gives you some really good articles and a couple of good chapters in the open access book StatPearls.
A key phrase for this case is supraventricular tachycardia, so set that up for PubMed to search the title using [ti]. Something like:
supraventricular tachycardia[ti]
You could also add other terms to the search, perhaps management, or if you need evaluation details add evaluation.
Additionally, if you have a favorite journal, say the New England Journal of Medicine, you can add NEJM to your search terms.
Another Place to Look - Other than PubMed Databases
Once your question starts to bridge over to the bioengineering field, there are other databases to use to see the development and research being conducted. If your question was about electrocardiographic monitoring devices, One of the following resources might give you a picture different than what PubMed provides.
Drug Information Resources
From beta blockers to coumadin to many more, if your question concerns a drug or you need to know the drug to use, try one of the following sources. Don't forget you can search for the condition or disease in question. Micromedex has some nice overview tools along with the drug information.
The following 2 resources are the only online drug resources approved by USD Medical Center.
MedlinePlus is a great place to find consumer-friendly materials along with directories, a dictionary & encyclopedia, and more. Take a look and see what you find for smoking cessation.