g***r
发帖数: 285 | 1
not enough details, such as her stroke, what had caused it and what is the
treatment, how well is her diabetes controlled, and such,
if you are concerned about if she has peripheral arterial disease, you can
perform a simple screening test at home ABI, an ankle-brachial index, you
basically measure systolic pressure at brachial and ankle, and check their
ratio, |
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e****0
发帖数: 678 | 2 • Exaggerated deep tendon reflexes can be seen in lock in syndrome.
• Non bleeding varices are managed with nonselective beta-
adrenergic antagonists, such as propranolol.
• Sclerotherapy, endoscopic band ligation, and surgery are
indicated after a patient has a first episode of variceal bleeding.
• TIPS is a last resort in variceal bleeding unresponsive to
medical and endoscopic intervention.
• Ischemic colitis
CT—thickening of eth bowel ... 阅读全帖 |
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l*****7
发帖数: 8463 | 3 This is a Google translation of the first paragraph:
Chun Xi Emperor two years, Uzbekistan chaos, confusion can not be made &#
8203;public in Europe, America, Ukraine monarch, has been lodged in
Russia, a letter to help. Russia's Putin anxious sweat
Zhaozhu lords meeting, the desire Qianjun flat black chaos. Or said: Wu Qian
Cheng of the country, long silence and Russia, and there is the United
States, Europe and the help, be it
War-torn, covered Afghanistan before the car, regret less th... 阅读全帖 |
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h**********c
发帖数: 4120 | 4 From the inside of my little finger to the lower side of the forearm to the
arm brachial three to the armpit, when there is cold, tingling feeling
谷歌translation
从我的小指内侧到前臂的下侧，到臂的臂三个到腋下，当有冷的时候，刺痛的感觉 |
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f******I
发帖数: 769 | 5
maybe the way you slept impinged on your brachial plexus, should go away
within a couple weeks |
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g***r
发帖数: 285 | 6
not enough details, differential is wide, could range from stroke/tia to
brachial plexus injury, |
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d*******n
发帖数: 216 | 7 非常感谢你的回复。
我妈妈的糖尿病是03年检查出来的，当时大家都不是十分清楚它的危害，没有足够的重
视，就只吃药治疗了，血糖倒是经常测，都控制在8以内。正因为血糖控制的不错，所
以都觉得没问题，根本没有预料到后来会脑出血，而且不时量量血压，也都正常。 05
年脑出血，当时送到医院时血压极高，260/130。 医生诊断是”高血压基底节区出血
50cm."做了开颅手术,清除了积血。后来昏迷了半个月左右才慢慢恢复意识。 我们问医
生为啥事前血压都正常，血糖控制也正常，他们也说不出来个所以来就说事前是“糖尿
病引发的隐形高血压。” 我们也不懂。
我们出院后就吃两种药，诺和龙控制血糖，洛丁新＋尼群地平控制血压。 血糖绝大部
分时候在9。0以内，大部分时候在7,8左右。偶尔出现过几次10.几的情况。但是血糖肯
定是在缓慢升高，因为她的诺和龙用量已经从开始时的每次0.5ml 上升到现在的每次1.
0ml 了。
不好意思，没有中文词典， systolic pressure是指量血压得到的两个数字里高的那个
吧？还有brachial是指那个部位呢？就用一般的血压计就可以量了吗？我觉得脚踝那里
瘦骨伶仃， |
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g***r
发帖数: 285 | 8
wow, it worked, didn't know how to post pictures,
anyway, when you get ankle brachial index done, the blood pressure was
measured using a dopplar probe, but you can get by with a stethscope at home,
the idea behind it is that, if you have significant peripheral arterial
disease, it will limit blood perfusion/flow to the distal vessels, such as
vessels in feet/toes, by measuring and comparing the pressure difference you
can get a guesstimate of the peripheral arterial disease, with the theory
th |
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g*****y
发帖数: 1891 | 9 bless
如果不是脱臼或骨折的话，有没有可能是神经压迫或损伤，因为臂丛 brachial plexus
或 腋神经 axillary nerve 损伤也可能造成上肢不能外展
你们有没有在她腋下塞什么东西？ |
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d**********e
发帖数: 72 | 10 A-a: alveolar-to-arterial gradient
ABG: arterial blood gas
ABI: ankle-brachial index
Abx: antibiotics
AMA: against medical advice
A&P: assessment and plan
BE: base excess
Bid: twice daily
BM: bowel movement
BMP: basic metabolic panel, aka, Chem 7 (Na, K, Cl, HCO3, BUN, Cr, Glucose)
BNP: brain natriuretic peptide
BP: blood pressure
BSOO: bilateral salpingoopherectomy
BTP: breakthrough pain, is pain that comes on suddenly for short periods of
time and is not alleviated by the patients' normal pain |
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l********y
发帖数: 2295 | 11 oh, I just realized you may need a textbook for brachial plexus, it's
heavily tested and neither kaplan note nor HY is good about it, not sure if
kaplan medessential is good or not.
best luck. |
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l*******8
发帖数: 1745 | 12 写的很好！刚开始培训，被人使唤很正常。我经常早会一结束就交代医学生他们今天要
做的事情，并指出几点前我需要哪个report. CHF病人是很麻烦，ejection fraction很
低的话，补液是不能给多。最讨厌的是CHF+ESRD on HD with no urine output的病人
，一但补液多了搞出个pulmonary edema,用lasix是不会管用的，因为病人本身就无尿
啊，只好去emergent HD,这在我co-intern身上发生过，折腾的他一晚上都没有睡好。
central line里抽血是可以但是要小心别带来不必要的感染，我不太会抽静脉血，如果
要抽血，我基本上都是从病人的radial artery or brachial artery抽血，估计抽了一
百多例以上了，就等于是做个ABG. IV access在那些黑人或胖子身上是很难打，护士
们都在病人胳膊上都打不出来，就call我，我只好做EJ line,要是我找不到EJV,就只好
喊外科来做central line了。妹妹一定要格外格外小心niddle stick,还有要做好
isolation防护 |
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A*******s
发帖数: 9638 | 13 来自主题: Medicalpractice版 - a case 这个case的最重要一点是pain。 我开始想到了carotid dissection， 但应该引起对侧
的偏瘫。 一般stroke是没有pain的， 当然有些posterior fossa的stroke可能会引起
headache。
ascending aortic dissection可以引起ischemic neuropathy。 我想病人的症状是
brachial plexus ischemia。 如果没有gut给TPA， heparin是必须的。
What was your followup，宝宝？ |
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R*******t
发帖数: 367 | 14 Carotid stenosis and renal artery stenosis at 60-70% is not critical. I have
seen a lot of patients follow even more severe stenosis.
Your father eventually needs diagnostic angiogram with aortic and bilateral
lower extremities run-off to evaluate for occlusion. Or he should at least
get arterial dopplers to check the waveforms and ABI (ankle brachial index)
first. |
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A*******s
发帖数: 9638 | 15 来自主题: Medicalpractice版 - 阿司匹林 现在的阿司匹林好像跟维生素一样广泛使用。 今天有个病人跟我说，反正没有什么副
作用，吃了可以防止心脏病和中风。 没有副作用是不正确的，当然小剂量应该没太大
问题。 问题是什么人该吃，什么人不该吃？吃了又怎么样？这个问题肯定是仁者见仁
，智者见智。
对中风的预防，我主张有症状的病人服用， 比方说TIA和stroke病人。 但如果临床上
病人有高风险发生中风，比方说众多的中风危险因素以及MRI的发现，我会使用阿司匹
林。 其他没有症状的病人，我是反对使用的，因为阿司匹林还是有副作用的， 而且没
有足够证据证明ASA可以预防原发中风。
对心血管医生来说，他们有他们的标准，病人使用阿司匹林是为了预防冠心病，与中风
预防无关。 Garland或其他心脏病医生可以谈谈你们的使用原则。
下面是一些关于ASA的使用guidelines：
1. The use of aspirin for cardiovascular (including but
not specific to stroke) prophylaxis is recommended
for persons whose risk is s... 阅读全帖 |
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B*****e
发帖数: 2220 | 16 zz
林中药，INTP不擅交际.不要跟厦门人讲睡懒觉好吗.
收起
芮芮芮、王克宇、梅文韬 等人赞同
-------- 2015.07.29更新 --------
我顾着开脑洞被折叠了..so sad.
脑洞放在后面.
----
先补充正确答案:
章鱼的触手具有很强的再生能力.
在危机时刻,章鱼也会像壁虎一般,舍弃触手以此摆脱猎手的追击.
舍弃的触手在几天后就会重新长出来.
而章鱼的自食行为可能是因为饥饿与疾病.
再生本身需要消耗能量,不可能无限循环.
或许最终这一行为导致了自身的死亡.
具体参照此问题: 章鱼为什么会自体吞噬？
以下是国外文献,感谢 @邓巧玲
This paper describes an automutilation syndrome (OAS) in three species of
captive octopuses, Octopus dolfleini, O. bimaculoides, and O.maya,
characterized by external arm and mantle lesions. Three clinical patterns in... 阅读全帖 |
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