1. Differential for solitary ring-enhancing brain lesion on neuroimaging: MAGIC DR
-Mets
-Abscess
-Glioma/GBM
-Ischemia (subacute)
-Contusion
-Demyelinating
-Radiation necrosis
{video}
2. Neuroimaging findings of MS: 
-Dawson's fingers (hyperintense lesions in corona radiata),
-open ring sign (half circle, with the white matter half hyperintense and grey matter half hypointense)
3. Spinal cord ependymomas
-50% in c-spine, 25% c-t junction, 25% thoracic spine
-Arise from ependymal cells in central canal
-Frequently accompanied by syrinxes, hemosiderin cap from bleeding
-Hyperintense T2, iso/hypointense T1,
{video} {another video of lumbar MRI}
4. New guidelines for hyperlipidemia: no longer aiming for LDL cutoffs. Instead, there are 4 groups that should get statins:
-People with clinical atherosclerotic cardiovascular disease. => high intensity statin for goal of >50% reduction in LDL
-People with LDL >190 mg/dL (i.e. familial hypercholesterolemia) => high intensity statin for goal of >50% reduction
-People 40-75 years old, no evidence of atherosclerotic cardiovascular disease, who have diabetes and LDL between 70 and 189 mg/dL. => moderate intensity statin, for goal of 30-49% reduction
-People without evidence of cardiovascular disease or diabetes, but who have LDL between 70 and 189 mg/dL and a 10-year risk of atherosclerotic cardiovascular disease>7.5%. => moderate intensity statin, for goal of 30-49% reduction
{circulation} {medscape}
5. Statins:
-High intensity (shown to lower LDL >50%): Atorvastatin 80mg, Rosuvastatin 20-40mg,
-Moderate intensity (shown to lower LDL on avg 30-49%): Atorvastatin 10-20mg, Rosuvastatin 10mg, Simvastatin 20-40, Pravastatin 40,
-Low intensity (lowers LDL on avg <30%): Simvastatin 10mg, pravastatin 10-20, lovastatin 20

6. New hypertension guidelines (JNC 8/NHLBI) {JAMA} {AAFP summary} 

-Over 60: meds to lower BP below systolic 150 or diastolic 90 

-Under 60: meds to lower BP below systolic 140 or diastolic 90

-Over 18 with DM or CKD: meds to lower BP below systolic 140 or diastolic 90

-Non-black (+/- DM): start with thiazide diuretic, CCB, ARB/ACEI 

-Black (+/- DM): start with thiazide, CCB

-Over 18 with CKD & hypertension (+/- DM): should be on ARB/ACEI to protect kidneys

-Do not do both ARB and ACEI at same time. 

7. Do not aggressively treat older people with antihypertensives as it can lead to orthostatic hypotension, syncope, falls. 

8. Diabetes diagnosis & Screening: 

-Fasting glucose > 126 or random glucose > 200 

-Hb A1C > 6.5 (controversial, some say you need 2) 

Screening for: 

-Everyone over 45 years old

-Any age if they have a sustained BP > 135/80

-Any age if they are overweight & have 1+ risk factors (BP > 140/90, 1st degree relative with DM, HDL<35, triglyceride >250) 

9. Diabetes management:

-Microvascular complications (retinopathy, kidneys): manage hypertension, glycemia

-Macrovascular complications (PAD, CAD, cerebrovascular): manage lipids, BP, quit smoking

-Metabolic & neurovascular: manage glycemia

-First line is metformin

10. OTC antihistamine eye drops: {source}

-Pheniramine: rebound hyperemia & chemosis

-Ketotifen: less of the above