Dermatology Atlas

 Access Resources in Dermatology

Dermatology is all about visual identification of lesions. Hence atlases significantly alter the learning curve of dermatology. Here are some great dermatology atlases

DermQuest Atlas

One of the largest image libraries on dermatology. Atlas images are accessible via keyword searches or browsing through categories. Each image is associated with a case description and a diagnosis. Other features of DermQuest are

• Diagnostic Quizzes
• Practice Management Articles

DermQuest requires free registration to access the content. The above links will work only after successful logging in.

DermAtlas

Index of DermAtlas. The Images are classified by Category, Diagnosis and body area affected. The main website can be accessed here.

Interactive Dermatology Atlas

This dermatology atlas provides three modes for learning. They are Case study mode, Atlas mode and Quiz mode.

Case study mode provides clinical details of the patient including pictures for making a diagnosis. This mode require a free registration.

Atlas mode provides fully searchable collection of more than 1000 images. Searches can be performed by lesion morphology, diagnosis, demography etc. There is extensive cross reference to other cases ( Like wikipedia) which helps to clear doubts fast.

Quiz mode tests the ability to identify clinical presentations on a variety of conditions.

Dermatology Atlas

At present this huge atlas contains 7767 images on different dermatological conditions. Though no descriptions are available with images, this site is sufficient to satisfy any image search in dermatology.

DermWeb -15 most common skin problems

 DermWeb - Web Teaching

Online dermatology training modules created by the Department of Dermatology and Skin Science at the University of British Columbia. Currently contains 10 modules including,

• Language of Dermatology. Dermatological lesions types and lesion descriptors are explained with the help of images. Highly recommended for medical students.
• Pathology of Dermatological Conditions - Contains microscopic and macroscopic pathology of 23 of the most common conditions.
• Atlas of Dermatology etc

Optimal Therapy in Dermatology 

An interactive site designed to improve the clinical acumen of the practicing physicians who manages the common skin conditions. Composed of three parts viz

• Differential Diagnosis visual skill test
• Case studies
• Self Assessment tests

DermWeb - 15 most common skin problems

This is a resource guide to 15 most common dermatological problems. The Diseases covered include Acne, Herpes, Vitiligo, Seborrheic Dermatitis, psoriasis among others. All the resources listed in this site are rich in content and provide unbiased information about the respective condition.

The Electronic Textbook of Dermatology

Textbook of Dermatology

An extensive online textbook on Dermatology edited by Rhett Drugge and Heather A Dunn. The contents of this online textbook starts from very descriptive anatomy of the skin and then proceed to more advanced topics. This book also include environmental dermatology topics like radiation effects, sun damage, occupational dermatitis etc.
Terminology in dermatology was always a confusing thing to remember. Here is a list from the textbook comprising most commonly used lesion descriptions in dermatology. This site also contain lot of images of dermatological conditions so that learning curve is shortened. The electronic textbook of dermatology is fully searchable which will ease the finding of required information.

Note: this site uses frames in the designing so you won't be able to go to the home page from the lesion descriptions so use this link to access all the contents.

ImmunoFacts.com - Expert Immunization resources

ImmunoFacts

One of the most up-to-date resource on Immunological practices. The following are the site features.

Vaccine Recommendations

This section is divided in to three sub-sections, viz General recommendations for vaccination from CDC, notes on vaccine preventable diseases and information about vaccine trials.


Practice and Safety

Discuss the quality standards of immunologicals and tips to improve vaccination coverage in different scenarios.

Medscape - Medical Education

Medscape is a part of WebMD Health Professional Network

Emedicine - Medscape reference

Provides medical students and health professionals the most updated and integrated medical information and educational tools. As of now emedicine contains more that 7000 articles on different diseases and conditions.  All the content is organized by medical specialty for the aid of finding the required condition in the quickest way.

Medscape Education

Medscape education offers thousands of free credited CMEs for health care professionals. All the contents are available via desktop and mobile platforms so that a professional has access to any information anywhere.

Occupational Health Factsheets

Occupational Health

Collection of freely downloadable PDF files on almost all occupational diseases. The information in the fact sheets are included with actual occupational scenarios in mind, hence provide a more practical approach than a typical textbook approach.
The different topics covered include Occupational asthma, occupational cancers, prevention of communicable diseases at work, working with pesticides etc.

CDC - Centre for diseaes control

CDC for Health Care Providers
The above link provide direct access to the resources for health care providers which contain a vast number of topics like Vaccines and Immunization, Community Health Guide, Genomics in Public Health, Emerging infectious diseases etc.

CDC A-Z index
Index of all the health topics in the CDC website. Contains info on practice guidelines, diseases, procedures etc. You can access Diseases and conditions directly.

World Health Organization

WHO

This one resource no introduction even to a non-professioal person. As the primary agency for disease control, disease prevention and health promotion activities, WHO designs the protocols to be followed worldwide.

WHO Health Topics


Lists WHO Projects, initiatives, activities, information products organized by Health Topic. You can also use the search function to avail the specific information (Eg guidelines for management of neonatal tetanus) you seek.

Data and Statistics

This is the WHO's point of access to the world health statistics. Every piece of data made available to WHO is available here in a very organized manner

Evidence Based Guidelines

WHO defines guidelines as recommendations that can impact upon health policies or clinical interventions. Development of recommendations are one of the major functions of WHO. Here are the list of the most recent guidelines listed in the alphabetical order.

WHO Publications

Contains key WHO books including World Health Report, World Health Statistics, International Classification of diseases, International Pharmacopoeia etc. All of these are available for online reference.
Eg Access the International Pharmacopoeia here

TheHeart.org - Medscape division on cardiology

TheHeart.org is a site maintained by Medscape and provides information on caring for people with disorders of the heart and circulation, and on preventing such disorders.
When this site was first added to Medical Resource Links it was a pretty basic one. But the site improved considerably to be called as an all in one resource on cardiology. This site is currently available in three languages viz English, French and Spanish. I will give you a quick walk-through of the features of this site.

Heartwire - The news

The latest news in the field of clinical and interventional cardiology. This will help you to stay up-to-date on the recent advances in the field.

CME Series

The are free access CME on different cardiology topics which are helpful for specialists as well as referring doctors.

The Editorial

This section contains the debate and dialogue between the best cardiovascular specialists.

TheHeart.org Radio

Audio programs in cardiology. Divided into 4 sub-sections

• The Bob Harrington Show - Latest cardiology trends, trials and conferences.
• This week in Caridolog - Weekly cardiology podcast with the latest news.
• Topo & Teirstein : Click & Rub show- Latest news and events in a freewheeling way.
• The Fellows Corner - interviews of thought leaders on training, research, career planning etc.

TheHeart.org in mobile

iphone and ipad app is available for free. This app brings the latest heartwire news, details on clinical trials and theheart.org radio programs to your portable device.

Free registration is required to access all the features of this site.

Clinical Examination of Cardiovascular System - The Cardiac Exam

A guide to examination of cardiovascular system. Includes basics covering anatomy and
physiology and the examination proper. The examination proper is divided into Inspection, palpation percussion and auscultation.
Each section contains images or videos for assisted learning.  The auscultation section is worth special mentioning which has almost all auscultatory findings in the form of wave files and these can be freely downloaded to your computer.

Gold Standards in Medical Field

What is a 'gold standard'?

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The term 'gold standard' can be referred to a test or a method. A test which shows the true status of the patient is termed gold standard. These test are assumed to have 100% sensitivity and specificity. Diagnostic power of other tests are evaluated based on the comparison with the gold standard test.When the term applies to a method or a procedure, a 'gold standard' serves as a basis for evaluation
of other methods.

Gold standard method for estimating resting energy expenditure - indirect calorimetry

Gold standard investigation for diagnosis of Iron deficiency anemia – Estimation of serum Ferritin

Gold standard for proving that the life span of red cell is decreased ( useful in Hemolytic anemia) - Red cell survival study

Gold standard for evaluation of stem cell transplantation therapy - Hemopoietic stem cell transplantation

Gold standard technique for differentiating allograft rejection and reactivation of disease after heart transplantation - Endo-myocardial Biopsy

Gold standard investigation for diagnosis of DVT - Contrast Venography

Gold standard investigation for diagnosis of acute pharyngitis - Throat Culture

Gold standard investigation for diagnosis of pertussis - Culture of nasopharyngeal secretions

Gold standard investigation for diagnosis of Otitis externa caused by P. aeruginosa - Technetium99 bone scan

Gold standard investigation for diagnosis of Acoustic Neuroma – Gadolinium MRI

Gold standard investigation for diagnosis of Shigella infection - Isolation and identification of pathogen from fecal material

Gold standard investigation for diagnosis of Tuberculous meningitis - Culture of CSF

Gold standard investigation for diagnosis of HSV Encephalitis - Brain biopsy (CSF PCR largely replaced brain biopsy in recent times)

Gold standard investigation for diagnosis of histoplasmosis - Fungal Culture

Gold standard investigation for diagnosis of hypertrophic cardiomypathy and atrial myxoma - Echocardiogram

Gold standard investigation for imaging heart valves and valve motion abnormalities - 2D echocardiography

Gold standard investigation for assessment of Myocardial viability (Identification of ischemic or hibernating myocardium)– PET

Gold standard investigation for assessment of LV mass and volume - MRI

Gold standard method for evaluation of renal arteries and identification of renal artery lesions - Contrast arteriography

Gold standard method for evaluation of respiratory gas exchange - ABG

Gold standard investigation for assessment of albuminuria - 24 hr urine collection

Gold standard investigation for diagnosis of PNH (Paroxysmal Nocturnal Haemoglobinuria) – Flow cytometry

Gold standard investigation for diagnosis of ATTR and other AF mutations - DNA sequencing

Gold standard method for identifying and quantifying atherosclerosis in cerebral arteries - X-ray cerebral angiography

Gold standard investigation for evaluating anatomy of arterio-venous malformation - X-ray angiography

Gold standard for diagnosis and classification of ataxia - genotype

Gold standard investigation for diagnosis of of lung infection (Radiotherapy induced) in a cancer patient - open-lung biopsy

Gold standard medical treatment for symptomatic progressive pulmonary hypertension – Prostacyclin

Gold standard investigation for diagnosis of PIH – Serum Urea

Gold standard for assessment of visual impairment - Snellen's chart

Gold standard method of treatment of non-castrate metastatic disease - surgical orchidectomy

Gold standard method for bacterial stain analysis - Pulse-field gel electrophoresis

Gold standard method of treatment of DCIS - Mastectomy

Gold standard approach for resection of anterior and middle mediastinal masses - median or lateral thoracotomy

Gold standard method of treatment of Coarctation of aorta - Surgical repair

Gold standard method for evaluation of coronary artery disease - Cardiac Catheterization

Gold standard method for culture of V. cholerae o139 - Conventional culture method

Gold standard to determine cut-off titer of widal test for diagnosis of Typhoid fever – Nested PCR

Gold standard treatment of brucellosis in adults - IM Streptomycin + Doxycyclin

Gold standard investigation for diagnosis of of chronic arterial mesentric ischemia - Angiography

Gold standard method for treatment of chronic ulcerative colitis - Total proctocolostomy with end ileostomy

Gold standard method for evaluation of imaging modalities for liver tumors - Intraoperative ultrasonography

Gold standard investigation for diagnosis of common bile duct stones - Endoscopic cholangiography

Gold standard investigation for measurement of GFR - Inulin clearance

Gold standard for treatment of organ confined, muscle invasive, bladder cancer is - Radical cystoprostatectomy in men and anterior pelvic exenteration in woman


Gold standard for treatment of femoral shaft fractures - Reamed locked intramedullary nailing

Gold standard method in case of difficult intubation - Flexible fibreoptic intubation scope

Gold standard method for diagnosis and treatment of Ventilator Associated Pneumonia (VAP) - Broncho alveolar lavage

Gold standard treatment of hyperparathyroidism - Surgery

Gold standard investigation to differentiate follicular and papillary carcinoma of thyroid gland- Histology

Gold standard procedure for thymectomy - Trans cervical mediastinoscopy and surgery

Gold standard for treatment of adrenal tumors - Laparoscopic adrenalectomy

Gold standard investigation for diagnosis of breast cancer - Mammography

Gold standard method for staging of breast cancer - Axillary lymph node dissection

Gold standard for evaluation of a stable patient with suspected vascular injury - Angiography

Gold standard investigation for diagnosis of GERD - Ambulatory 24 hr PH monitoring

Gold standard method for treatment of GERD - Laparoccopic Nissens fundoplication

Gold standard for evaluating cure rate in duodenal ulcer patients – Vagotomy

 Gold standard finding for the diagnosis of GI perforation - Finding pneumoperitoneum

Gold standard for diagnosis of Zollinger-Ellison syndrome - Serum gastrin levels( Most patients have serum gastrin levels above 1000pg/mL)

Gold standard investigation for diagnosis of colonic mucosal disease - Colonoscopy

Gold standard investigation for diagnosis of steatorrhoea - Timed quantitative stool fat determination

Gold standard method for treatment of incontinence with an isolated sphincter defect - Overlapping sphincteroplasty

Gold standard investigation for diagnosis and method of management of Acute arterial occlusion – Laparotomy

Gold standard method for confirmation of mesentric arterial occlusion - Mesentric angiography

Gold standard investigation for diagnosis of celiac disease – Small intestine biopsy

Gold standard for identifying choledocholithiasis – ERCP

Gold standard method of treatment of Symptomatic cholelitiasis – Lap cholecystectomy

Gold standard method for diagnosis of Primary sclerosing cholangitis - ERCP

Gold standard investigation for diagnosis of Hepatitis C – HCV RNA assay

Gold standard test for diagnosis of intraluminal bile duct abnormalities - ERCP

Gold standard method for management of hydatid disease – Surgery

Gold standard for assessing degree of liver injury and fibrosis - Liver Biopsy

Gold standard method for management of blunt hepatic trauma - Non-operative management

Gold standard test for assessment of function of sphincter of oddi – Manometry

Gold standard investigation of diagnosis of Klatskin tumor - Cholangiography

Gold standard investigation for diagnosis of invasive amoebiasis - ELISA

REFERENCES

1. Harrison's principles of Internal Medicine 17th Edition

2. Schwartz's Manual of Surgery 8th Edition

Download the list of Gold standards in PDF format here

PathoPic - Pathology Image Database

PathoPic

PathoPic is a free online image database. This site is a little unique in its way of presentation of data. A search form is used to accurately locate images instead of arranging them in categories. The search criteria include Topography, Stain, Image type ( Histology, Gross, Cytology, Radiology, Frozen Section etc). A description is available with each image to aid in understanding.

Three browser windows/tabs are required to access information from this site. One for search form, one for displaying the search results and the last to view the selected image and its description. If you are confused about the navigation, access the guided tour here.

Atlas of Granulomatous diseases by Yale Rosen

Atlas of Granulomatous Diseases

 Ever seen a picture of asteroid body observed in sarcoidosis before?. If your answer is no you should definitely give this site a visit.

This website contain images of granulomatous conditions. You can start learning with the formation of granulomas and move forward to the details of different granulomatous diseases including TB, Sarcoidosis, infectious granuloma, foreign body granuloma etc. The images include both gross and microscopic ones and are of very good quality.

Image used above is a screenshot from the website. Image is the property of Yale Rosen MD, owner of 'Atlas of Granulomatous Diseases' website.

The Pathology Guy - Lecture notes on pathology

Ed's Pathology Lecture Notes

This is the most elaborate source of lecture notes on pathology. I was amazed to find Ed Friedlander single handedly created this massive site. All the lectures are prepared in a simple easy to understand way that benefit not only medical students but also anyone who seeks information about pathology of a particular disease.

Every lecture note contain lots of pictures to assist in understanding and recall. One unique feature of this site is the extensive integration of scientific studies within the text. This is a must use pathology resource for every medical student.

Biochem Web

Biochem Web

This is an online library of biochemistry, cell biology and molecular biology. The best online resources in these subjects are selected and arranged in topic wise manner so browsing for a particular topic is easy in this website.

The Medical Biochemistry Page

The Biochemistry Page

This is a complete biochemistry resource which is a little above the level for a medical student in undergraduate years. All biochemical pathways are explained using simple but effective diagrams for
better and easy understanding. This biochemistry resource can be used as a study companion not a primary resource as it a little elaborate on many fronts.

OB-GYN 101

OB-GYN 101

An elaborate online resource with good descriptive text, more than 30 videos, ultrasound images, medications in ob-gyn practice, procedure notes, x-rays encountered during gynaecology practice and index cards for quick review of important facts. This site is a must for all . I assure you that you will be getting more knowledge from this site than any other standard undergraduate textbook.

Wikipedia Page about Pregnancy

Pregnancy

You can use this article to get a concise view of pregnancy and related things. Best feature of the this article is the seamless opportunity of cross reference. Learning this article will not take more than an hour and will give you the basic idea in a professional level which can be used as a foundation to build the advanced
knowledge.

OBSGYN.net Educational tutorials

OBGYN.NET- Tutorials

Presentations in different topics from gynaecology, obstetrics and infertility issues. All the presentations are downloadable as Power point files. Presentations are user submitted and reviewed by the obgyn.net team.

25 signs in Obstetrics and Gynaecology

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These are 25 clinical and radiological signs in obstetrics and gynaecology.

Bagel sign : Ultrasonographic sign. Gestational sac in the adnexa with hyperechoic ring.

Ball Sign : Radiological sign of intrauterine fetal death. X-ray shows crumpled up spine of
the fetus.

Banana Sign : Ultrasound sign in open spina bifida. Shows abnormal anterior curvature of
cerebellum. Due to the associated Arnold-Chiari malformation.

Chadwick’s Sign : Bluish hue to the vestibule and anterior vaginal wall. Seen in first trimester of
pregnancy. Cause is increased blood flow to the pelvic organs. Also known as
jacquemier’s Sign.

Cullen Sign : Bluish discoloration of skin around umbilicus. Occurs due to intra peritoneal
hemorrhage. Seen in ruptured ectopic pregnancy.

Double Bubble Sign : Useful in prenatal diagnosis of duodenal atresia. Duodenal atresia usually
presents with polyhydramnios and produces dilatation of stomach and first part of
duodenum.

Double decidual sac Sign : Normal Ultrasonographic appearance of intrauterine gestational sac. Seen as two concentric echogenic rings separated by a hyperechoic space.

Goodell Sign : Marked softening of the cervix in contrast to non pregnant state. Also due to
increased blood flow.

Hegar Sign : An indication of Pregnancy. Softening of the lower parts of the uterus enables
approximation of vaginal and abdominal fingers in bimanual pelvic examination. Vaginal
fingers are placed in the posterior fornix and abdominal hand pressed down behind the
uterus.

Jacquemier’s sign : Refer Chadwick Sign

Kustner’s Sign : Sign of placental separation. On pushing the uterus upwards does not move the
cord with it due to the separation.

Ladin’s Sign : Softening in the midline of the uterus anteriorly at the junction of the uterus and
cervix. It occurs at about 6 weeks gestation.

Lambda Sign : Ultrasonographic sign seen in dichorionic pregnancies. Due to the chorionic tissue
in between the two layers of the membrane between the twins.

Lemon Sign : Ultrasound sign in open spina bifida. Shows abnormal anterior curvature of
cerebellum. Due to the associated Arnold-Chiari malformation.

Osiander’s Sign : Pulsations in the lateral fornix due to the increased vascularity.

Palmer’s Sign : Regular rhythmic contractions of uterus felt as early as 6-8 weeks . It is a sign of
pregnancy.

Piskacek’s Sign : Asymmetric growth occurs to the uterus in initial stages of pregnancy due to the
lateral implantation of the blastocyst. The area of implantation feels soft compared to
the other parts.

Robert’s Sign : Radiological sign of intrauterine fetal death. X-ray shows presence of gas in the
fetal great vessels. Earliest radiological sign of intrauterine fetal death

Schroder’s Sign : A sign of placental separation. Uterus rises up when the separated placenta is
passed downwards.

Spalding Sign : Sign of intrauterine fetal death. Overlapping of skull bones after fetal demise.
Observed by ultrasonogrm.

Stallworthy’s Sign : Slowing of fetal heart rate on pressing the head down I to the pelvis and prompt
recovery on release of pressure is termed Stallworthy’s sign. This sign is suggestive of
posterior placenta praevia.

Stuck Twin Sign : Seen in twin to twin transfusion syndrome. Due to the severe oligohydramnios
smaller twin is held in a fixed position along the uterine wall. This is called stuck twin
sign.

‘T’ Sign : Ultrasonographic sign seen in monochromic twins. As the intertwin membrane
does not have any chorionic tissue it gives rise to ‘T’ sign in ultrasound.

Turtle Sign : Failure of restitution seen in shoulder dystocia is called turtle sign.

Von Braun-Fernwald's Sign : Irregular softening and enlargement of the uterine fundus during early
pregnancy. It occurs at 5-8 weeks gestation.

Use the link below to download the file in pdf format for free

25 signs in obstetrics and gynaecology

Biochemistry Animations for Medical Students

Easiest and the best way to learn biochemistry is through animations and interactive tutorials. Below are the best of biochemistry animations available in the web.

Power Point Animations in biochemistry by Southern Illinois University