Internal Medicine Residency Education

Internal medicine residency education has evolved from providing exposures to meet objectives and measuring competencies. The internal medicine curriculum is designed to educate internal medicine residents to deliver compassionate, evidence-based medicine curriculum, high-quality, cost-effective care to adults and adolescents. Adult learning principles are encouraged and utilized including self-directed learning and tutorials.

It is Professor EBM goal to offer outstanding training for medical students, residents, fellows and practicing physicians. We provide an outstanding balance between hands-on clinical experience, didactic learning and exceptional quality of life.

Through a flexible curriculum structure, Internal Medicine residents are afforded the opportunity to focus their training in specific areas that are of most need in the medical community such as Hospitality Medicine.

Brief Introduction of Status Epilepticus (SE)

Status Epilepticus (SE) refers to a life-threatening condition in which the brain is in a state of persistent seizure. Definitions vary, but traditionally it is defined as one continuous unremitting seizure lasting longer than 30 minutes, or recurrent seizures without regaining consciousness between seizures for greater than 30 minutes (or shorter with medical intervention).

Subtle Status Epilepticus consists of electrical seizure activity that endures when the associated movements are fragmentary or even absent. This is confusing and is sometimes called a type of nonconvulsive Status Epilepticus.

Traditionally, Status Epilepticus was defined as 30 minutes of continuous seizure activity or a series of seizures without return to full consciousness between the seizures. Many believe that a shorter period of seizure activity causes neuronal injury and that seizure self-termination is unlikely after 5 minutes; some suggest times as brief as 5 minutes to define Status Epilepticus.

For detailed information on Status Epilepticus, read internal medicine teaching by Professor EBM.

An Introduction to Pleural effusion – Health Care

Pleural effusion is excess fluid that accumulates in the pleural cavity, the fluid-filled space that surrounds the lungs. Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during inhalation.

Pleural effusion is defined as an abnormal accumulation of fluid in the pleural space. Excess fluid results from the disruption of the equilibrium that exists across pleural membranes.

Both parietal and visceral membranes are smooth, glistening, and semitransparent. Despite these similarities, the two membranes have unique differences in anatomic architecture, innervation, pain fibers, blood supply, lymphatic drainage, and function. For example, the visceral pleurae contain no pain fibers and have a dual blood supply (bronchial and pulmonary).

Normally, very small amounts of pleural fluid are present in the pleural spaces, and fluid is not detectable by routine methods. When certain disorders occur, excessive pleural fluid may accumulate and cause pulmonary signs and symptoms. Simply put, pleural effusions occur when the rate of fluid formation exceeds that of fluid absorption. Once a symptomatic, unexplained pleural effusion occurs, a diagnosis needs to be established.

Internal Medicine Teaching by Professor EBM is a complete medical solution.

Diastolic Heart Failure

The diagnosis of diastolic dysfunction is now fairly common, especially among older women, most of whom are shocked to hear they have a heart problem at all. While some of these patients will go on to develop actual diastolic heart failure, many will not - especially if they get appropriate medical care, and also take care of themselves.

The diagnosis of diastolic heart failure, unfortunately, is often missed by unwary physicians. Because once the patient presenting with diastolic heart failure has been stabilized, unless the doctor looks specifically for evidence of diastolic dysfunction on the echocardiogram, the heart can appear entirely "normal."

Diastolic heart failure, a major cause of morbidity and mortality, is defined as symptoms of heart failure in a patient with preserved left ventricular function. It is characterized by a stiff left ventricle with decreased compliance and impaired relaxation, which leads to increased end diastolic pressure.

Patients who have had an episode of diastolic heart failure have a somewhat better prognosis than patients with traditional, systolic heart failure - but a far worse prognosis than patients without heart failure or diastolic dysfunction. Given this relatively poor prognosis, patients should be aggressively evaluated and treated even after their acute episodes of heart failure have been resolved.