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Draft a comprehensive differential diagnosis for acute substernal chest pain in a 45-year-old male with hypertension and hyperlipidemia, diaphoresis, exertional onset, and normal initial ECG/troponin; include life-threatening causes first, key distinguishing features, and immediate diagnostic next steps.

Draft a detailed differential diagnosis for new-onset unilateral throbbing headache with visual aura and brief monocular vision loss in a 32-year-old female on oral contraceptives; include red-flag symptoms, stroke/TIA considerations, and recommended initial workup.

Draft an assessment and plan for stage-2 hypertension (BP 162/98) in an obese 52-year-old with suspected obstructive sleep apnea; include ASCVD risk estimate, lifestyle prescriptions, first-line pharmacotherapy with drug/dose/targets, baseline labs/monitoring, and 4–6 week follow-up.

Draft an assessment and plan for type 2 diabetes follow-up with A1c 9.2% on metformin 1,000 mg BID and eGFR 65; compare adding a GLP-1 receptor agonist vs an SGLT2 inhibitor, address weight loss goals, hypoglycemia education, vaccinations, and micro/macrovascular screening.

Draft a history and physical for a patient presenting with chest pain, including HPI using OLDCARTS, pertinent ROS, PMH/meds/allergies, FH/SH, focused cardiac/pulmonary exam, initial labs and imaging orders, prioritized differential, HEART score risk stratification, and early management.

Draft a history and physical for a new patient with progressive exertional dyspnea, orthopnea, and bilateral leg edema; include differential (heart failure, COPD, PE, anemia, renal disease), targeted exam maneuvers, and first-line diagnostics and management.

Draft a progress note for COPD follow-up two weeks after an acute exacerbation treated with prednisone and antibiotics; include symptom trajectory, CAT score (if available), inhaler technique/adherence, oxygen needs, spirometry plan, smoking cessation counseling, and return precautions.

Draft a progress note for post-operative day 2 after total knee arthroplasty; include pain control strategy, DVT prophylaxis, PT/OT milestones, wound status, bowel/urinary function, labs/vitals review, complications screening, and discharge readiness.

Draft a discharge summary for community-acquired pneumonia admission; include admission/discharge dates, presenting symptoms, radiology/labs, pathogen if identified, inpatient therapies and response, discharge medications with durations, pending tests, follow-up appointments, and return precautions.

Draft a discharge summary for myocardial infarction managed with PCI and drug-eluting stent placement; include cath findings, complications, inpatient course, discharge medications (DAPT, statin, beta-blocker, ACEi/ARB), cardiac rehab referral, and follow-up plan.

Draft discharge instructions for a patient hospitalized with acute decompensated heart failure; include daily weights, sodium and fluid restriction amounts, medication list with dosing, signs of worsening heart failure, follow-up appointments, and lab monitoring plan.

Draft discharge instructions for an asthma exacerbation; include controller and reliever regimen, steroid taper schedule, spacer technique, trigger avoidance, a written asthma action plan, return precautions, and follow-up timing.

Draft a patient handout on managing high blood pressure in plain language; explain what BP numbers mean, key lifestyle steps (DASH diet, sodium limits, alcohol moderation), home BP monitoring instructions, medication adherence tips, and when to call the doctor.

Draft a patient handout for type 2 diabetes education in plain language; cover A1c goals, the plate method, physical activity targets, self-monitoring of blood glucose, hypoglycemia signs and the 15-15 rule, foot care basics, and a vaccination checklist.

Draft a summary of the latest CDC and WHO guidelines for managing community-acquired pneumonia in adults, including empiric antibiotic choices, duration of therapy, and follow-up recommendations.

Draft a plain-language overview of the ADA and AACE guidelines for diabetes management, focusing on A1c goals, weight management, and the use of GLP-1 receptor agonists and SGLT2 inhibitors.

Draft a summary of the 2024 USPSTF breast cancer screening recommendations, including updated screening intervals, risk-based approaches, and the role of MRI for high-risk patients.

Draft a concise summary of NCCN guidelines for melanoma management, including staging, surgical margins, adjuvant therapy, and checkpoint inhibitor recommendations.

Draft treatment alternatives for community-acquired MRSA skin infections in patients allergic to sulfa drugs; include oral and IV options, dosing, and duration.

Draft treatment alternatives for patients with type 2 diabetes who are unable to tolerate GLP-1 receptor agonists due to nausea; include medication substitutions and lifestyle recommendations.

Draft a summary of options for treating refractory depression, comparing ketamine infusions, transcranial magnetic stimulation (TMS), and electroconvulsive therapy (ECT).

Draft treatment options for advanced prostate cancer, including hormonal therapy, radiopharmaceuticals, and novel androgen receptor pathway inhibitors.

Draft a summary of recent research on mRNA vaccine technology beyond COVID-19, including applications in oncology and autoimmune disease prevention.

Draft an easy-to-understand overview of long COVID research, summarizing major symptoms, hypothesized mechanisms, and emerging treatment approaches.

Draft a summary of current research on Alzheimer’s disease biomarkers, including amyloid and tau imaging, and discuss how they influence diagnosis and trial design.

Draft an explanation of the interaction between warfarin and antibiotics such as ciprofloxacin or TMP-SMX, including INR effects and management recommendations.

Draft a summary evaluating drug interactions for patients taking Paxlovid and common cardiovascular drugs; include mechanism and recommended dose adjustments.

Draft a summary of the common and serious side effects of semaglutide, including GI intolerance, gallbladder disease, and thyroid-related warnings.

Draft an overview of potential side effects associated with long-term corticosteroid use, including osteoporosis, glucose intolerance, and adrenal suppression.

Draft a summary of essential lab tests to order in suspected acute pancreatitis, including amylase, lipase, liver enzymes, and metabolic panels, with interpretation guidance.

Draft laboratory workup recommendations for suspected hypothyroidism, including TSH, free T4, thyroid antibodies, and when to consider secondary causes.

Draft an explanation of which labs should be monitored in patients receiving methotrexate therapy, including CBC, LFTs, renal function, and frequency of monitoring.

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Course: Association of Public Health Measures During the COVID-19 Pandemic With the Incidence of Infectious Conjunctivitis

CME Credits: 1.00

Released: 2021-11-18

Key Points

Question What were the associations of COVID-19–associated public health measures with the epidemiology of infectious conjunctivitis?
Findings A model involving publicly available smartphone mobility data was able to show the difference in actual behavior compared with expected trends based on data from previous years and included analysis of noninfectious eye conditions for comparison. The adoption of COVID-19–associated public health measures was associated with a 34% decrease in conjunctivitis-associated search activity and a 37% decrease in emergency department encounters for infectious conjunctivitis.
Meaning These findings show that search metrics in conjunction with mobility data may provide quantifiable metrics of the associations of public health interventions with transmissible diseases.

Abstract

Importance Infectious conjunctivitis is highly transmissible and a public health concern. While mitigation strategies have been successful on a local level, population-wide decreases in spread are rare.
Objective To evaluate whether internet search interest and emergency department visits for infectious conjunctivitis were associated with public health interventions adopted during the COVID-19 pandemic.
Design, Setting, and Participants Internet search data from the US and emergency department data from a single academic center in the US were used in this study. Publicly available smartphone mobility data were temporally aligned to quantify social distancing. Internet search term trends for nonallergic conjunctivitis, corneal abrasions, and posterior vitreous detachments were obtained. Additionally, all patients who presented to a single emergency department from February 2015 to February 2021 were included in a review. Physician notes for emergency department visits at a single academic center with the same diagnoses were extracted. Causal inference was performed using a bayesian structural time-series model. Data were compared from before and after April 2020, when the US Centers for Disease Control and Prevention recommended members of the public wear masks, stay at least 6 feet from others who did not reside in the same home, avoid crowds, and quarantine if experiencing flulike symptoms or exposure to persons with COVID-19 symptoms.
Exposures Symptoms of or interest in conjunctivitis in the context of the COVID-19 pandemic.
Main Outcome and Measures The hypothesis was that there would be a decrease in internet search interest and emergency department visits for infectious conjunctivitis after the adaptation of public health measures targeted to curb COVID-19.
Results A total of 1156 emergency department encounters with a diagnosis of conjunctivitis were noted from January 2015 to February 2021. Emergency department encounters for nonallergic conjunctivitis decreased by 37.3% (95% CI, -12.9% to -60.6%; P?<?.001). In contrast, encounters for corneal abrasion (1.1% [95% CI, -29.3% to 29.1%]; P?=?.47) and posterior vitreous detachments (7.9% [95% CI, -46.9% to 66.6%]; P?=?.39) remained stable after adjusting for total emergency department encounters. Search interest in conjunctivitis decreased by 34.2% (95% CI, -30.6% to -37.6%; P?<?.001) after widespread implementation of public health interventions to mitigate COVID-19.
Conclusions and Relevance Public health interventions, such as social distancing, increased emphasis on hygiene, and travel restrictions during the COVID-19 pandemic, were associated with decreased search interest in nonallergic conjunctivitis and conjunctivitis-associated emergency department encounters. Mobility data may provide novel metrics of social distancing. These data provide evidence of a sustained population-wide decrease in infectious conjunctivitis.


Educational Objective
To identify the key insights or developments described in this article


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