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Disclaimer: Disclaimer: Dr.Harpreet Singh is a practicing internal medicine doctor, co-host of Talk Medicine Radio on Big Country 100.9 WWBR,  a wellness coach, speaker, author, a USMLE Instructor and coaches Step 2 Clinical Exams has written this article. He is a founder of Vital Checklist and He has not been paid by any pharmaceutical companies nor endorses any medications. ... Read More »

Boerhaave Syndrome


Boerhaave Syndrome- Spontaneous rupture of esophagus. Meckler Triad: Hamman’s sign: Crunching sound on auscultation, suggestive of air in the mediastinum Diagnosis: Gastrograffin swallow study                      -Water soluble solution, non-toxic to mediastinum unlike Barium. Treatment: Nil per orally (NPO) Left thoracotomy with immediate primary repair Cervical esophagectomy Antibiotics     Read More »

Thyroid Complications

In this quick review, we will discuss salient features of two complications of thyroid disorders Myxedema coma, a complication of hypothyroidism Thyrotoxic crisis (thyroid storm), a complication of hyperthyroidism   A.   Myxedema Coma   It is a medical emergency and a rare presentation of severe hypothyroidism. Depressed levels of consciousness in elderly who appear myxedematous/ obese should raise suspicion for ... Read More »

Human Immunodeficiency Virus


HIV virion contains: Enveloped truncated conical capsid (type D) 2 copies of single stranded (+) RNA RNA dependent DNA Polymerase (Reverse Transcriptase) Integrase Protease Gp 120 interacts with CD4+ co-receptors on T-cells Gp 41 is a fusion protein that fuses with cell membrane to allow entry of the virus. Gp 24 Capsid- First Antibody detected in HIV infection     ... Read More »

Facts about Hypercalcemia


Hypercalcemia can manifest as: Osteitis fibrosa cystica Cystic and hemorrhagic bone lesions due to increased osteoclastic activity. Most commonly involves the Subperiosteal bone resorption of phalanges and tooth sockets. Salt and pepper appearance of the skull on X-ray. Primary Hyperparathyroidism- Causes: 80%- Adenoma (Right Inferior Parathyroid- most common) 20%- Primary Hyperplasia (All 4 Parathyroid glands are involved) (Clear cell hyperplasia- ... Read More »

Normal Pressure Hydrocephalus


Normal Pressure Hydrocephalus  —   CSF is not absorbed- A form of communicating hydrocephalus, where CSF pressure is normal. Ventricles are chronically dilated. Clinical symptoms– Triad Diagnosis: Exclude treatable causes of dementia (e.g. Vitamin B12 deficiency, Hypothyroidism) Screening Test: CT Scan, MRI Scan Confirmatory Test: (Gold Standard) Ventricular Shunting- Diagnostic and therapeutic. Improvement of symptoms on removal of CSF- Not generally ... Read More »

Whipple’s Triad


Whipple’s triad Whipple’s Triad is a triad of symptoms suggestive of hypoglycemia. It includes: Spontaneous hypoglycemia with blood sugar levels less than 50mg/100ml CNS or vasomotor symptoms that may range from excessive sweating, dizziness, syncope to odd behavior and seizures Relief of symptoms by oral or intravenous administration of glucose. Chronic hypoglycemia leads to attenuated autonomic response. Therefore, it may ... Read More »

Why medical students fail in USMLE Step 2 Clinical Skills Exam?

 Live training sessions Vital Checklist Workshop at Houston Why medical students fail in USMLE Step 2 Clinical Skills Exam? USMLE Step 2 CS exam has three components—Integrated Clinical Encounter (ICE), Spoken English Proficiency (SEP) and Communication and Interpersonal Skills (CIS). Students appearing for Step 2 CS test have to pass all the components in one sitting. As a USMLE Instructor, ... Read More »


ROLE OF PHYSICIAN IN MULTIPLE SCLEROSIS PATIENT- A YOUNG PHYSICIAN’S PERSPECTIVE A physician plays an eminent role in chronic diseases for which treatments are not curative. Multiple sclerosis as of now is one of those diseases. It is a chronic neurological disorder that damages the myelin sheath of the nerves i.e. it affects the nerves and damages their information delivery ... Read More »

Vital Checklist Mentorship Program

What is Vital Checklist Mentorship Program? Please contact Amanda Joy, program co-ordinator of VitalChecklist for information on  Step 2 Clinical Skills Workshop conducted by Dr. Harpreet Singh. The  USMLE Step 2 CS workshop will be held at Baymont Inn, Houston.   Read More »

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