k**********d
发帖数: 72 | 1 究竟是什么 以及中文翻译(不好意思，不知道中文翻译心里不踏实）
Renal sympathetic denervation in patients with treatment-resistant
hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial.
lancet上的进展我也看了。
我就是不知道这个Symplicity HTN-2究竟是什么意思！
接下来还看到过：
Conclusions In a swine model, renal denervation via the
Symplicity Catheter System resulted in no clinically significant
adverse renal artery or renal findings 6 months
after the procedure. |
|
e****0
发帖数: 678 | 2 Endometrial hyperplasia types. Risk of cancer treatment
simple 1% Cyclic progestin
complex 3% Cyclic progestin
Simple atypical 8% THA or progestins
Complex atypical 29% THA or progestins
• Prolatinoma and hypothyroidism galactorrhea
• Anesthesia can reduce uterine activity if in the latent phase
• Contraceptive for lactating mother
Progestin-only oral contraceptive
• Pregnancy luteoma
African-ameri... 阅读全帖 |
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e****0
发帖数: 678 | 3 • leukemia
ALL AML CLL
child adult elderly
BM lymphoblasts 25%myeloblasts
lab Lymphocyte 5000, mature-appearing cells
• Osgood-schlatters disease
Adolescent male athletes
Traction apophysitis—quadriceps tendon put the traction on the
apophysis of the tibial tubercle where patellar tendon inserts.
A firm mass =heterotopic bone formation
Pain can be reproduced by extending the kne... 阅读全帖 |
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r*****1
发帖数: 805 | 4 My CCS protocol:
P.S.：多有重复，谨防遗漏，仅供参考。
Screening test: General—Lipid profile/ multi-vitamin; Elderly—DEXA scan&
Calcium& VitD/ Colonscopy or FOBT/ vaccination; F-- >18yo Pap smear; >50yo
Mammogram; reproductive age- folate; menopause- Lipid/DEXA/FOBT; M-- >50yo
PSA; sickle cell dz child-prophylaxis w penicillin till 5yo, CF-prophylaxis
w Abx
Prophylaxis: Pantoprazole, pneumatic compression stocking;
Acute abd w perforation: triple Abx- Gentamycin/ Ampicillin/
Metronidazole (口诀：阿扁举旗庆国庆)
E... 阅读全帖 |
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z******8
发帖数: 844 | 5 ☆─────────────────────────────────────☆
rhcrc11 (Rebel) 于 (Thu May 15 00:13:42 2014, 美东) 提到:
Step3考场壮烈回来。第一天挺累人，最后一个block甚至做到有心无力状，看着题反应
不过来，导致来不及做完。非常没有信心能否通过。所以match之前先考Step3的童鞋，
需要考前调整生物钟，坚持锻炼，提高耐力。
MCQ没有资格说，CCS有一点小感受，拿出来分享下。大家请轻拍砖。
复习资料：
UW 52 online cases : 基础。最好复习早起找高手一起过一遍，尽快摸熟软件，进入
状态。第二遍找一位水平相近童鞋过一遍，不断总结protocol. 考前迅速做一遍，熟练
运用protocol.
UW 41 offline cases: 我当时和partner每个case仔细做一遍，虽然不像online有反馈
，但对练临床思维，补充protocol非常有帮助。最后考试与41 case有异曲同工之处，
遇到复杂case也不慌神。
CD 6 cases： 最后再熟悉下考试软件。与UW相近，但... 阅读全帖 |
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y***c
发帖数: 676 | 6 Pearls:
1. BILATERAL renal aa. stenosis with HTN: what med do you use to treat HTN
Calcium channel blocker. If it was unilateral stenosis then ACE inhibitors.
2. A male patient with thumb base pain: what is dx. De Quervain
Tenosynovitis; treatment is NSAIDs and intrathecal steroids.
3. How do you treat Cocaine abuser with 210/115 BP? Cocaine induced HTN -
treated with Benzo, Nitroglycerin or Nitroprusside drip and Phentolamine 1
mg IV. No beta blockers like propranolol.
4. Bilious vomiting in an |
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n***h
发帖数: 364 | 7 Answer: A
Diagnosis: secondary HTN.
Clues: Stenosis of right renal artery--- low perfusion in kidney---renin
level increased---RAA system activated---HTN.
Key: RAA level is diff. in primary and secondary HTN. |
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t********m
发帖数: 939 | 8 多谢回复。我现在用的是另外的data structure，就是每个id只有一个record ，程序
如下：
proc phreg data=flatcox;
model months*event(0)=ag1 bmi htn diur ckd creat /risklimits;
array bm(*) bm1-bm8;
array ht(*) ht1-ht8;
array di(*) di1-di8;
array ck(*) ck1-ck8;
array cr(*) cr1-cr8;
bmi=bm[seq]; htn=ht[seq]; diur=di[seq];
ckd=ck[seq]; creat=cr[seq];
run;
我现在就是困惑怎样将data弄成适合用counting process的structure，我需要建两个
新的variable，一个为开始的time，一个为结束的time，然后用如下的程序：
proc phreg data=counting;
id id seq;
model (s... 阅读全帖 |
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U********e
发帖数: 20 | 9 First of all, I am not a doctor.
40 yrs old is relatively young. It is advisable to rule out 2nd cause of HTN
in renal aspect and endocrine aspect.
Social history/surgical history---cigarette smoking? Acute pain, or recent
surgical history?
Per JNC 7, 160/100 is stage II. Most likely he needs two HTN meds to control
his HTN per JNC7.
Try to ask the drug company or physician office. See if there is coupon for
the combination of ARBs and HCTZ. In our state, after coupon discount, pt
only needs to ... 阅读全帖 |
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A*******s
发帖数: 9638 | 10 A real case to share:
A 67 yrs old female, with a history of HTN, presented with syncope. She
complained of a sudden onset of vertigo then LOC for 1 min. She was very
confused at the admission.
PMH: HTN.
SH: No smoking/ETOH
FMH: HTN
ROS: not remarkable except mild confusion.
PE: VSS stable. BP: 140/80 bilaterally per record.
OA x 2 and CVS:irregularly irregular. Other exams were not remarkable.
CNC/CMP/PT/PTT: nl
Cardiac enzyme: neg
EKG showed A-Fib （new onset).
A CT of brain was neg.
Carotid ... 阅读全帖 |
|
A*******s
发帖数: 9638 | 11 A real case to share:
A 67 yrs old female, with a history of HTN, presented with syncope. She
complained of a sudden onset of vertigo then LOC for 1 min. She was very
confused at the admission.
PMH: HTN.
SH: No smoking/ETOH
FMH: HTN
ROS: not remarkable except mild confusion.
PE: VSS stable. BP: 140/80 bilaterally per record.
OA x 2 and CVS:irregularly irregular. Other exams were not remarkable.
CNC/CMP/PT/PTT: nl
Cardiac enzyme: neg
EKG showed A-Fib （new onset).
A CT of brain was neg.
Carotid ... 阅读全帖 |
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s*****e
发帖数: 222 | 12 ☆─────────────────────────────────────☆
lzumc2008 (麦地乖乖虎) 于 (Tue Jul 7 21:02:20 2009, 美东) 提到:
40y male, moderate obese, came to ER with acute chest pain, knife stabbing
sharp pain, consistent, 10/10, with radiation to left arm. no headache, no
nausea, no vomiting.
PE: 130/90, no murmur, RLQ tenderness on abd.
PMH: HTN for a few years, did not follow up with doc,take anti HTN meds on
and off, last time took it was a month ago.
FMH: father died of heart attack in his 50s
deny alcohol, smokin |
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d*******e
发帖数: 89 | 13 Both low and high renin level can be found in essential hypertesion; even 60
% patients with HTN have normal renin level.
The mechanism of HTN is multiple and associated with a lot of hypotheses.
When answering a question, first try to get the idea what is really being
asked.
one |
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h**s
发帖数: 1757 | 14 i would like to pick C.
I do not think this girl is essential HTN. She could be secondary HTN.
cushing's syndrome is the best diagnosis (She is at the 50th percentile for
height and
95th percentile for weight). so you'd better check cortisol.
refer: FA P63. |
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h*******y
发帖数: 1220 | 15 4. Which of the following is true about african americans with
hypertension
A. Less likely than caucasians to have low-renin HTN
B. More likely than caucasians to have expanded intravascular volume
C. Less lkely than Cambodian Hmong to respond to diuretics
D. More likely than hispanics to respond to Milrinone
E. More likely than Norwegians to respond to Lutefisk
I chose B
blacks are more sensitive to salts/H2O, easy to have HTN, response well to
diuretics |
|
d****y
发帖数: 2180 | 16 ☆─────────────────────────────────────☆
daisyy (daisy) 于 (Wed Aug 22 19:53:02 2012, 美东) 提到:
请大家把记录的笔记，感想放到这个帖子下面，以便于收精华区。
同时也保证你成为以后会议的VIP.谢谢！
☆─────────────────────────────────────☆
tangbutian (糖不甜) 于 (Wed Aug 22 19:55:06 2012, 美东) 提到:
The art of language -- communicate effectively in clinical settings
重点讲在医院里的communication，怎样适应美国的文化，怎么在医院中混的如鱼得水
、风生水起～
关于英文：
细节参见麦地前阵子的那两个有关英文的帖子，补充一点非常重要的：不仅要多说、多
念，更重要的是写作能力，脑子里有多少东西嘴巴才能讲出来多少东西。对CMG来说口
音并不是致命问题，更严重的是语言组织能力差，有条件的最好take一门写作的课程。
语言是一门艺术... 阅读全帖 |
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e****0
发帖数: 678 | 17 Screening
Pap smear for vervical cancer is 21 yo
DM
24-28 weeks
One hour 50 grams oral glucose tolerance test. BG > 140
Three hours glucose tolerance test (if two or more are positive)
1. Fasting BG > 95
2. One hour BG > 180
3. Two hours BG> 155
4. Three hours BG > 140
• Dysfunctional uterine bleeding (DUB)
Heavy vaginal bleeding occurs in the absence of structural or
organic disease
Endometrial biop... 阅读全帖 |
|
d******u
发帖数: 10 | 18 上课的一个糖尿病例：
Blood glucose 378, A1c: 14 ( current )
Blood Glucose 140, A1C: 10 ( 2 years ago)
Weight 218lb (99kg)
Medications:
Metformin 1000mg, 1TAB BID Levemir (long acting insulin), 35units QD
怀疑noncompliance 导致血糖失控. 我是应该:
１。 告诉病人坚持吃药，打INSULIN, do nothing else
２。 增加INSULIN的剂量， 4 units every 3 days until FBG<180, then 2 units
every 3 days until in target range
３。 增加其他糖尿病口服药
４。１+２， １+２+３
Also Anion Gap 15mmol/dL, should I order lab for Ketone and pH to check if
he develops acidosis? By the way,... 阅读全帖 |
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a*********d
发帖数: 2763 | 19 is this a real case or an exam case? answer can vary depending on the
situation. there is absolutely no uniform way to treat a DM patient, lots of
factors should be considered, therapy should be tailored individually.
in this case, if it is a real case, nothing should be done until you look at
the patient's daily glucose data. you SHOULD NOT adjust regimen just base
upon A1c.
it is important to know where the problem is, fasting hyperglycemia?
postprandial hyperglycemia? does he/she have hypogly... 阅读全帖 |
|
t******a
发帖数: 408 | 20 1. where do these questions come from? can you please tell us the source? I
am really curious.
2. I will choose D.
pt is a young healthy F, has HTN.
Suspect secondary HTN.
Because (1)"healthy" pt = Board's code word for ASX(asymptomatic) and (2)
urinalysis are within normal limits ---> unlikely to be
glomerulonephritis (nephritic synd.)
Then suspect: RAS --- renal artery stenosis
In Young female: ---> consider fibromuscular dysplasia
Old male: ---> consider atherosclerosis
[This is a very... 阅读全帖 |
|
s********o
发帖数: 3319 | 21 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: herby (小臭宝), 信区: MedicalCareer
标 题: [合集] 你有生以来做出的最佳临床诊断是什么？
发信站: BBS 未名空间站 (Thu Jun 2 00:01:26 2011, 美东)
☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的... 阅读全帖 |
|
s********o
发帖数: 3319 | 22 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: herby (小臭宝), 信区: MedicalCareer
标 题: [合集] 你有生以来做出的最佳临床诊断是什么？
发信站: BBS 未名空间站 (Thu Jun 2 00:01:26 2011, 美东)
☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的... 阅读全帖 |
|
y***d
发帖数: 33 | 23 在板上潜水有一会了，好像发case的不多啊。是不是这儿attending太多，都没时间写
case了呢？我来抛砖引玉好了。
从今天开始，每星期我会上一个case。 周一history, 周二physical， 周三initial
labs/work up, 周四additional work-up, 周五final diagnosis. 欢迎大家跟贴讨论
。这些case基本上是面向内科resident的。不过attending们也可以复习一下哈。如果
受欢迎的话我会一直贴下去。废话到此为止。 先上第一个case试试反响如何。
CC: bilateral leg swelling and diarrhea
HPI: 72 yo f h/o HTN, diarrhea and pneumatosis intestinalis of unclear
etiology presented to ER for worsening bilateral lower extremity edema and
ongoing diarrhea.
Initially presented 2 month PT... 阅读全帖 |
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W***2
发帖数: 60 | 24 I found that some time a pt has too many PMH which is not related to Chole.
76 yo M p/w RUQ pain for 2 days with N/V. F/C. PE indicated ABD soft, RUQ
tenderness, no rebound, no guarding. Afebrile, WBC 17, TB 1.2, DB 0.3. U/S
showed GS. For the PMH, he had HTN, COPD, CHF, Hypothyroidism, He is on
Lasix, anetolol, ASA, Lynthoid. PSH: gastric cancer 10 yrs ago, ventral
Hernia repair 5 yrs ago.
Or you think this is better?
76 yo M p/w RUQ pain for 2 days with N/V. F/C. For the PMH, he had HTN, COPD
... 阅读全帖 |
|
A*******s
发帖数: 9638 | 25 Although DM nephrolopathy could be the cause of renal insufficiency, I would
rather believe HTN is the main culprit to blame.
He needs better control on his HTN. |
|
A*******s
发帖数: 9638 | 26 What is the point to screen primary HTN genetically? It makes sense to me
for secondary HTN though. |
|
s*******0
发帖数: 367 | 27 Secondary HTN 还screen 啥呢？ 只要把orginal 的病因去除不就完了嘛，比如，服用
激素过多。
primary HTN 才是潜在的杀手，很多时候人们根本意识不到，直到并发症出现。它和基
因有很大关联。所以，通过screening 就可以直自己是否携带 salt sensitivity 等相
关基因。这样就可以尽早采取防护措施。比如，注意饮食，多锻炼，常测血压。 |
|
g*****d
发帖数: 991 | 28 His BP is not well controlled, or called isolated diastolic high blood
pressure, likely 2nd to volume issue. Make sure on good diet, weight loss,
and consider to add diuretics.
Left ventricular wall thickening, or remodeling, is related to his long
history of uncontrolled HTN. The major issue is to control HTN, please
consulting with his doctor, adjust medications. Likely he also has diastolic
dysfunction, consider fluid restriction.
Headache could be due to many causes. His headache can not rul... 阅读全帖 |
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k****g
发帖数: 1509 | 29 this is damn right. This afternoon I saw one pt with lot of problems, u name
it, CHF, OA, DM, HTN, chRONIC PAIN, drug abuse, etc. She told me: my
goodness, we were so nervous, they (Rep) said they will take foodstamp and
wellfares away."
and |
|
n******s
发帖数: 210 | 30 only a few of diseases can be cured in internal medicine.
pneumonia can be cured by penicillin
and arrhythmia can be cured by ablation
others, just controlled.
HTN and DM can not be cured, just controlled.
So if HIV can be controlled with affordable price, it will be a big success
of human being, right? |
|
y*****g
发帖数: 193 | 31 what's his LVEF% post OR? It sounds still like his heart problem. What's his
2DEcho report say? Did he take beta blocker and ACE inhibitor for worsen
CHF? After CABG, pt could still get their bypass blocked again.
The reason he got dizziness or syncope after walking, it called dyspnea on
exertion, and low cardiac output. it is all related to his heart. He might
also have pulmonary HTN just looking at his cardiac history. |
|
s********g
发帖数: 290 | 32 if it's a true ESRD, your 外公 may live for another 2 weeks. If you do not
want him to suffer, you can take comfort care. I don't think the reason of
not doing hemodialysis (HD) is HTN. If he may not tolerate peritoneal
dialysis, why not just try HD? |
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a**********2
发帖数: 3726 | 33 Does he smoke cigarettes? Any history of HTN? MI? Diabetes? Peripheral
vascular diseases? Stroke? family history of hear attack?
Those are all used to estimate the risk for heart problem. If he didn't have
heart attack history or not diabetic, his LDL is perfectly fine. Otherwise,
LDL below 100 or 70 is the goal. |
|
a**********2
发帖数: 3726 | 34 Calm down, don't panic. Most likely it is a TIA, although stroke cannot be
completely ruled out. But for management, it is not an emergency anymore at
this time (for ischemic stroke, tPA window period is 3.5 to 4 hours. For TIA
, statins and aspirin are all you need to do plus source investigation.
Unlikely
hemorrhagic stroke, you didn't mention HTN history and symptoms unlikely
improve so fast). You can go to ER to get an CT or MRI, but the most
important thing is CTA or MRA +/- ECHO to look fo... 阅读全帖 |
|
w******y
发帖数: 4871 | 35 职业习惯啊，现在又有人中医回答高血压了。也没问楼主以前做过什么检查已经r/o
2nd HTN了嘛？
每个人都象你这样based on ur personal experience to give suggestion,你还是意
识不到潜在的危害性有多大。（俺说了许多次了）。
俺们家娃生病从来不到网上问，直接去follow up with our doctor.
希望你家娃娃如果生病，你来求些网友的建议就管用了，哈。 |
|
w******y
发帖数: 4871 | 36 http://www.mitbbs.com/article_t/NextGeneration/35965343.html
这个帖子你看了吧？对别人不了解的情况下，就给出自己的建议，不错，是好意。
可是发贴的人是一个potential不想吃药治疗的人，那么年轻就有高血压，没错是有家
族史，可是心脏血管，肾动脉狭窄，等其它导致2nd HTN的原因有没有被以前排除掉过
？等等等等？俺不想多说了。有人直接就说用小锤子敲。如果病人真的听了，她其实准
备去买小锤了，然后决定不吃药了，后果会是什么？都是因为人们好心给的建议所造成
的。那些好心给建议的人难道不是无形的杀手吗？ |
|
w******y
发帖数: 4871 | 37 以前做过检查吧，把那些个什么renal artery stenosis之类的能引起HTN的病都给排除
掉了吧？
以前难道没有看过PCP吗？他们refer你去high risk OB可能预约不会等那么长时间。
你以前没有看过OB,对于OB来说你是位新病人，OB可以给你预约或不给你预约sometimes
it is based on ur insurance situation. 血压很高再有点症状的话，应该马上去急
诊。
俺们科就是很严重的哮喘发作的病人头一次自己打电话来预约，基本上都是一到两个月
以后才能排的上appointment ,一般前台都会告诉病人得follow up with their PCP or
go to ER if it is an emergency. 那时候病人还没在俺们诊所看过病，俺们对这个
病人没有liability的。 |
|
M*****8
发帖数: 17722 | 38 股票符号 日期 最后价 跌幅 百分比
AAR, 20110520, 24.4999, -0.1624, -0.7
AAUKY, 20110520, 23.8300, -0.0513, -0.2
AAWW, 20110520, 63.9700, -1.4313, -2.2
AAXJ, 20110520, 62.6625, -0.3633, -0.6
AB, 20110520, 21.5300, -0.0545, -0.3
ABAX, 20110520, 30.8500, -1.4335, -4.6
ABB, 20110520, 26.3200, -0.0229, -0.1
ABCO, 20110520, 50.9300, -0.4103, -0.8
ABFS, 20110520, 25.3500, -0.7916, -3.1
ABW-A, 20110520, 25.2... 阅读全帖 |
|
|
w******y
发帖数: 4871 | 40 Bill as "follow up visit" level 3-5, diagnosed as annual health exam, rule
out allergic rhinitis, rule out otitis media, then add other possible
diagnosis: HTN, hyperlipidemia.
If its a private practice, 当然要bill所有的diagnosis啦。有的医生收到你保险公
司的reimbursement就算了。有的就保险不cover的就找你要了。太正常了！
你要是在诊所打一针Vitamin B12, 那就还要再bill你一笔，哦，这个好像听说是bill
as procedure的。
没什么好抱怨的。就象修车年检，年检是年检费，其它修理是修理费用。
建议你先问问你的保险公司再说 |
|
G***a
发帖数: 27294 | 41 （4）谣言到底是怎么来的？又是怎么走的？
就在他死后不久，一个来自Nebraska的医生，成立了一个反对atkins的组织。
（很奇怪，他在人家生前不成立）
他不知道用什么办法，拿到了atkins生前的medical record
（这点本身就是unethical practice)
在这个里面，有一张多年前的手写字条，上面写着"h/o MI, CHF, HTN"
这几个字的意思是
myocardial infarction－－－心梗
congestive heart failure－－－梗塞性心衰
hypertension －－－高血压
也就是说，Ａｔｋｉｎｓ在很多很多年前，曾经有这些疾病（不是死前）。
后来这个医生，就传出了“atkins died of his own diet" 的谣言。
再后来，这个谣言被很多Ｖｅｇａｎ ｇｒｏｕｐ无耻利用了（不好意思，不得不说无
耻）
再后来，Dr. Dean Ornish在没有调查清楚地情况下，在Ｎｅｗｓｗｅｅｋ上发表了这
些谣言。
造成了很大很大的影响。
这个造成了轩然大波，官司打了很久。Ａｔｋｉｎｓ的官司的各种证据也浮出水面。
最后，２... 阅读全帖 |
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m******u
发帖数: 43 | 42 希望能交流一下，特别是在不确定环境下的htn planning方面。
msn: m*******[email protected]
谢谢 |
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c****y
发帖数: 59 | 44 Thanks. You're probably right. I checked the latest CDC adult vaccination
guideline. PCV should be given to all that have chronic cardiovascular
diseases,but they didn't tell me how they define the chronic cardiovascular diseases.
I agree that well-controlled HTN perhaps is not a risk factor that warrants PCV.
not
like
DM |
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s*******8
发帖数: 118 | 45 来自主题: MedicalCareer版 - 请教啊！ 这是很正常的。我们常说在班上想马上回家，可回家后还会惦记着病人。我有时会打电
话给护士下些order.不过不要给自己太多的压力，学会放松是很重要的。肾活检的一个
并发症是retroperitoneal hematoma.一般病人都要f/u CBC. 你的病人HTN，
tachycardia 2/2 pain. I don't know why have pleutitic CP. Pneumo?
should
on |
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k*****e
发帖数: 372 | 46 ROS: Neg. except as above
- 不管你有无给SP系统回顾，写上这么一句就OK，因为你阳性的都写在上面了，所
以来
一句“Neg. except as above”是万能的。FA上的Case绝大多数都如此。
All：NKDA or allergic to sulfa drug, skin rash
- All不是急淋，是allergy的缩写。NKDA是no known drug allergies. 一般case可以
这么写，如果有，就写allergic to XXX + allergic Sx
Med: aspirin，trazodone when needed
- Med就是medication的缩写，列举病人常用的药。一般像HTN、DM、CHD、asthma的病
人都是长期用药的，就写“XXX”就可以了。
- 如果是sleeping pills, laxatives, antacid, pain killer，是有需要才吃的话，
就加上“when needed”
PMH/PSH: UTI 3mo ago, treated w/ TMP |
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a*********d
发帖数: 2763 | 47 dig IV is the best one for afib if pt has BP issue. adenosin is best for
PSVT. if pt unstable due to a fib with RVR, sync cardioversion is the choice
, but when i was a resident, i rarely had chance do that unless you have
cardio guys with you.
the most common reason for acute a-fib, is fluid overload, uncontrolled HTN,
and MI. everytime you see a pt run a new diagnosed Afib, it should be a
reflex to check her cardiac enzymes.
did you give her NS 1L for bolus? if you wrote NS 1L, they would
auto |
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W******g
发帖数: 143 | 48 What’s kind of acid-base imbalance the patient has?
60 y.o. AAM c history of HTN, alcoholism presents with dizziness, and
hemoptysis for 2 days. The last drinking was 3 days ago. on admission,
hypotensive, tachcardia and orthostasis, pale. Otherwise normal.
Lab Na 137, Cl 97, K 3.6, CO2 18, BUN 12 Cr o.8, Glu 83, Ca 8.4
ABG on RA 7.40(PH)/30(PCO2)/87(PO2)/18.8(HCO3)
Explain the acid base disorder please. |
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a**e
发帖数: 5094 | 49 I have seen two for ED consult of HTN encephalopathy. |
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a**e
发帖数: 5094 | 50 are you in PCP clinic?
Most common cases in family medicine:
URI, UTI, depression, HTN,DM, annual pap smear. be prep for those cases
Got to know those medications, name, dose, side effects.
笑。 |
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