C******r
发帖数: 790 | 1 29. 这是什么病？和6months前的bronchiolitis (RSV?)或albutero有关吗？
59. 这是个手背上的nodule是什么诊断，SCC？考虑到她在FL，还从事户外运动，也许
是日晒造成的SCC，所以要切除？
100. 老太太只有血小板减少，RBC和WBC都正常，这个是什么诊断？考虑到她接受
radiation therapy for lung cancer，想到可能对造血有影响，所以蒙对了答案E，可
是不清除为什么骨髓问题只是血小板减少。
113. 虽然答案shingle也合理（老人，化疗，CN V1分布），但看到蜜色的lesion，上
来就认定是Impetigo。请问为什么不是Impetigo，因为Impetigo不会是painful或
normal temperature么，或者年龄等其他因素？
115. 此人貌似只有indirect bilirubin增加，其他都正常。答案是A，decreased
conjugation of bilirubin，固然说得通，不过我没想到是什么病这样。我想到的是
Gilbert's syndrome，选了D，delaye... 阅读全帖 |
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b*******e
发帖数: 67 | 2 #29 - this is atopic dermatitis, key word is pruritic, and location (
classically in kids and adolescents are flexural surfaces with lots of
perspiration). treatment is topic steroids. bronchiolitis and albuterol are
distractors
#59 - yes, most likely SCC. old age, sun exposure, increase in size,
recurrent bleeding are all worrisome features. treatment is local excision
with negative margins
#100 - this is most likely bone marrow lesions. her RBC and WBC are both
borderline low (or could be low ... 阅读全帖 |
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m******r
发帖数: 1904 | 3 ☆─────────────────────────────────────☆
eyetoeye (望眼欲穿) 于 (Mon May 14 15:31:18 2012, 美东) 提到:
20. A 58-year-old woman comes to the office for follow-up of fibromyalgia.
You had been treating her for the past several years for nonspecific
muscular aches and pains. In the past you noted that occasionally the pain
could be reproduced on physical examination by applying pressure to certain
muscles; however, these trigger points seemed to change on each physical
examination. Fibromyalgia was diag... 阅读全帖 |
|
e****0
发帖数: 678 | 4 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 |
|
|
h*******r
发帖数: 182 | 6 This morning I found a tick on my calf. It was half in and when pulling, it
was broken and the mouth part is still in my body!!! Now I feel pain and am
wondering if I should go to ED to have it extracted. The lesion is
erythematous and indurated, about 2x2cm.
I did not go to woods,but my family went to wood yesterday. It should be
there less than 24 hours since it was not there when I took shower yesterday
morning. 200mg doxycycline was taken after the failed pulling. What is next?
Any suggestio... 阅读全帖 |
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h*******r
发帖数: 182 | 7 Update:
Now after 48h bite, the lesion is more like lyme's erythema migran: 5X6cm
erythematous rash, second ring is 1x1cm, center is 3x3mm necrosis, around
the center to the second ring is clearing.
The lesson: When you see a small tick such as the size of sesame, go to
clinic or ER to have it extracted. At home, most people are not experienced
or don't have good tick forceps, tweeser to pull it out without breaking it.
If you hold the body, very likely you squeeze the tick's gut and the
spiroch... 阅读全帖 |
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h*******y
发帖数: 1220 | 8 谢谢。可能是题库换了。
VIPOMA 和 GLUCAGNOMA 差别在 GI，血糖，皮肤症状？后个有migratory necrotizing
skin lesion？
Bless 考高分。 |
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x***r
发帖数: 60 | 9 申请要求
Requirements
就是一般要求， 外加 200小时PATIENT care experience
我没有， 不知道how and where to find volunteer opportunity. Any suggestions?
因为在德州， 还prefer spainish class
PA Tina Kaufman (right) enjoys the teamwork involved doing indigent care at
Parkland Memorial Hospital.professional or volunteer
We know you’re looking for an educational experience of the highest quality
. To meet your expectations and satisfy accreditation requirements, we set
the bar high for our applicants. Here are the steps you’ll ne... 阅读全帖 |
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S******1
发帖数: 44 | 10 今天得知了step3的成绩，210+，心里的石头终于落下。终于轮到我给USMLE说再见了。
回顾从step1自己闭门造车考了只带一个9的分数， step2开始参加小组学习，做了所有
能做的题只为拿个99，虽胸有成竹且考试感觉很好，最终但又得到一个9的分数。虽然
这次成绩不高，依然很高兴，毕竟不用发愁如果没过的话住院医开始后没有时间复习该
咋办。过去的3年中得到太多人的帮助 (此处略去人名20个)，绝大多数甚至从未谋面。
今天发贴也是为了回报我们这个社区吧。
自我介绍：毕业>15年，220+/220+/1st/210+；
复习时间：6月，头4个月每天约2-3小时，周末由于陪孩子们玩（前两年欠的太多，你
懂得）及做点家务（再不做但心被老婆炒掉），反而复习不了多少；最后2个月每天4小
时，鼓励自己考了这个2年内再不用受这个罪。
复习资料：随大流，MTB 3, UW CCS, UW step3 Qbank, UW step2 Qbank;
模拟：考前2月，NBME 1 190+, 考前1周，NBME 2 220+;
体会：难，考过不容易，考高分更难。主要是因为没有合适的复习资料。UW的1300... 阅读全帖 |
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j*******g
发帖数: 118 | 11 所有今年曾经接到翻译测试的ID，可以核实一下，
要求您翻译的第一段前一半是不是
INTRODUCTION— Gastric inflammatory disease can be broadly categorized into
gastritides and gastropathies. Gastritis is predominantly an inflammatory
process while gastropathy demonstrates minimal to no inflammation. The term
gastritis is used to denote inflammation associated mucosal injury.
要求您审阅纠错的第一段是不是
Given these data, the head of bed position should be individualized for each
patient [14].
• We recommend keeping the head in neutral alignment... 阅读全帖 |
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h*******r
发帖数: 182 | 12 CC: Epigastric intermittent pain for 15 days, nausea and vomiting for 1 week.
PE: Patient is awake and alert, not in acute distress. There is tenderness
in epigastric area upon deep palpation. An epigastric mass is noted,
hepatomegaly, supraclavicular lymphadenopathy (#, size, left side?).
FOBT (+), Abd U/S: ascites is noted, hepatomegaly
EGD: 3x2.5 cm irregular lesion found on anterior wall of antrum.
Dx: Gastric cancer, stage IV.
有错请纠正.
|
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r**********n
发帖数: 9 | 13 Sorry for the sad news about your lovely baby.
ATRT的预后非常差，是肯定的。
如果你想尝试St. Jude or Boston，您可以直接与他们联系。复制并翻译所有的医疗记
录。如果他们接受你的宝宝，通常你需要提前支付作为一个国际病人。St. Jude 是研
究医院，可能对美国人免费。不知对国际病人如何。
因为它是ATRT，你要想清楚你花代价是想要什么结果。
以下转自UpToDate:
Atypical teratoid/rhabdoid tumors — CNS atypical teratoid/rhabdoid tumors (
ATRTs) are highly malignant tumors primarily occurring in young children
less than three years old [91]. Histologically, ATRTs are characterized by
rhabdoid cells and are similar to that of other small ro... 阅读全帖 |
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r**********7
发帖数: 243 | 14 不是我翻的，借花献佛，有错的大家指正，祝好运！
Noncontrast head CT (10/20/2013):
Findings:
The 4th ventricle is not well visualized. Suspicious high density in
the posterior cranial fossa. No obvious dilation or expansion of the
rest ventricles, cisterns or sulcus. No midline deviation. No obvious
cerebral density or morphology change. The bony calvarium is within
normal limits.
Contrast enhanced brain MRI (10/22/2030):
Sequence:T1W/T2W/DWI/FLAIR/MRA
Paramagnetic contrast agent, 0.2 ml/kg, IV bolus.
Findings:
Bilatera... 阅读全帖 |
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b****k
发帖数: 409 | 15 See the color of discharge, it's grey. So it's more likely bacterial
vaginosis.Lack of vulvar lesion and sypmtom is another evidence. |
|
w******e
发帖数: 285 | 16 是MRI。。。。
片状影，patchy changes
等信号，iso-intense
低信号，hypo-intense
稍低信号，slightly hypo-intense
病灶动脉期，lesion artery phase
延迟期，delayed phase
线样强化，linear enhancement |
|
p**********r
发帖数: 57 | 17 10. A 25-year-old man who is HIV-positive comes to a physician's office for
treatment of a skin lesion. Because she is afraid of infection, the
physician refuses to treat him. This physician's refusal to treat the
patient is best
described as
(A)unethical and illegal
(B)ethical and legal
(C)unethical but legal
(D)ethical but illegal |
|
p**********r
发帖数: 57 | 18 10. A 25-year-old man who is HIV-positive comes to a physician's office for
treatment of a skin lesion. Because she is afraid of infection, the
physician refuses to treat him. This physician's refusal to treat the
patient is best
described as
(A)unethical and illegal
(B)ethical and legal
(C)unethical but legal
(D)ethical but illegal |
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i**********d
发帖数: 853 | 19 Hawthrone effect: Hauthrone好手 --> 我们是“好手” --> 知道被研究时好好表现。
Collagen 4型 (部分是从别的同学那里听来的)：
1型：老大硬：筋骨皮牙本硬，角膜瞪人，伤口愈合晚不怕
2型：老二软：骨软韧性好，眼睛玻璃软，脊梁髓核软
3型：三妹红彤彤：粉红皮肤，生孩子--> 子宫切，见血管，现胚胎组织，愈合有肉芽
组织
4型：最小，位置最低，住在basement
Hemophilia A (8因子) & B (9因子)--> 阿爸8必救9
Fragile X --> CGG 脆哥哥 --> 脆弱的哥哥注意力不集中 --> ADHD
Spiramycin: given to the mother to prevent vertical transmission of
toxoplasmosis. “弓”黄忠射箭, 披靡-箭是螺旋状 Spiramycin
螺旋霉素
Podophyllin (刨倒树林--把黑树林里的wart给刨了):
1. Remove genital warts; 2. Molluscum... 阅读全帖 |
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i**********d
发帖数: 853 | 20 Hawthrone effect: Hauthrone好手 --> 我们是“好手” --> 知道被研究时好好表现。
Collagen 4型 (部分是从别的同学那里听来的)：
1型：老大硬：筋骨皮牙本硬，角膜瞪人，伤口愈合晚不怕
2型：老二软：骨软韧性好，眼睛玻璃软，脊梁髓核软
3型：三妹红彤彤：粉红皮肤，生孩子--> 子宫切，见血管，现胚胎组织，愈合有肉芽
组织
4型：最小，位置最低，住在basement
Hemophilia A (8因子) & B (9因子)--> 阿爸8必救9
Fragile X --> CGG 脆哥哥 --> 脆弱的哥哥注意力不集中 --> ADHD
Spiramycin: given to the mother to prevent vertical transmission of
toxoplasmosis. “弓”黄忠射箭, 披靡-箭是螺旋状 Spiramycin
螺旋霉素
Podophyllin (刨倒树林--把黑树林里的wart给刨了):
1. Remove genital warts; 2. Molluscum... 阅读全帖 |
|
m*******y
发帖数: 1233 | 21 A 23-year old woman comes to physician because of severe abdominal cramping,
menorrhagia, and low back pain correlating with her menstrual cycle. On
pelvic examination, the physician palpates a nodular, enlarged ovary.
Exploratory abdominal laparoscopy reveals multiple lesions on the exterior
of ovaries bilaterayy.
Which of the following is an adverse effect of drug most commonly used to
treat this patient's condition?
A. Hyperkalemic metabolic acidosis
B. Increased breast cancer rish
C. Pseudot... 阅读全帖 |
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j*****o
发帖数: 137 | 22 A 42-year-old woman, gravida 2, para 2, comes to the physician because of a
3-month history of swelling of her legs and mild abdominal pain and bloating
. Abdominal examination shows no abnormalities. Rectovaginal examination
shows fullness in the right adnexa. Transvaginal ultrasonography shows an
irregular mass in the right ovary with some solid components to a
predominantly cystic lesion. Her serum CA 125 level is 120 U/mL (N<35).
Treatment with which of the following is most likely to have p... 阅读全帖 |
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E***a
发帖数: 60 | 23 Fragile X is X dominant, but have variable penetrance, it depend on the
number of the triple repeats, in female, usually the repeat is less than 200
, they may not show metal retardation or only mild MR.
Q2: you need to link to the X-ray, it clearly shows a lesion in lung, why do
you think about renal? if renal, should have hematouria or increase
creatinin.... |
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w*******t
发帖数: 928 | 24 想请教大家一个问题，如果皮肤科大夫处理了很多shaving lesion procedure,然后也
确是送去pathologist那里了。那怎么来判断该皮肤医生是否实在给病人做美容，而不
是真的医疗需要呢？比如除个斑点啥的。
★ 发自iPhone App: ChineseWeb 1.0.1 |
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w*******t
发帖数: 928 | 25 如果医生大量做shave,而不是做biopsy,是不是有美容嫌疑呢？shave biopsy 只能算
biopsy,也就是只能切部门皮肤，而shave procedure是整个都切掉了。另外想问一下，
如果病理结果是malignant lesion. 该医生大量用excision,而不是用destruction ,怎
么感觉跟一般皮肤科的医生不一样？
断。
★ 发自iPhone App: ChineseWeb 1.0.1 |
|
R****y
发帖数: 411 | 26 agree with initial recommendation, if lesion so small, not growing fast, non
diagnostic on CT or MR, conservative management with observation and short
term follow up is the safest approach.
Any medical imaging would be expensive without insurance. US is probably
cheaper and can be done on cash basis at certain out patient imaging centers
. However, keep in mind that US is operator depended, you need to a
competent tech to do a good exam, can't be sure of the quality of strip mall
imaging facili... 阅读全帖 |
|
o******h
发帖数: 198 | 27 国内同学的小女孩4岁纤维瘤 想报名这里clinical trial
大家帮我看一下 哪里要修改的
检查部位和名称：头颅增强
检查技术：FLASHT1 ,TSE T2,T2 tirm dark-fluid,DWI, 对比剂采用0.5mmol /ML 欧乃
影，外周静脉推注
放射学表现：左侧基底节区，脑干及双侧小脑可见多发斑片状高信号，增强后未见异常
强化灶，脑室系统未见明显扩大，中线结构居中。DWI未见异常高信号。
Examination location : head Enhanced
Examination: head Enhanced Inspection techniques: FLASHT1, TSE T2, T2 tirm
dark-fluid, DWI, contrast agents using 0.5mmol / ML Omniscan, peripheral
intravenous injection Radiological findings: the left basal ganglia, brain
stem and cerebellum shows multi... 阅读全帖 |
|
t*****r
发帖数: 1765 | 28 医学英语的定义汇总
AOT:
A common abbreviation for "adenomatoid odontogenic tumor."
ARC:
AIDS-related complex; once an intermediate between AIDS and carrier stages
AZT:
A drug that interferes with reverse transcriptase of HIV.
Abnormal Mitotic Figures:
A feature of anaplasia in which division of cells appears irregular,
deformed, and bizarre.
Abscess:
A common lesion of acute inflammation consisting of a localized area of pus.
Acidogenic Theory:
A theory of caries pathogenesis suggesting that enamel calci |
|
B****e
发帖数: 441 | 29 Common Way:
Skeletal Survey to detect bone lesion
Bone Marrow Biopsy to examine plasma cell %
Serum Protein Electrophoresis to detect Paraprotein (monoclonal protein)
Urine Protein Electrophoresis to detect free light chain
New Assay:
FreeLite
http://www.freelite.co.uk/intactimmunoglobulinmm-12.asp |
|
n****n
发帖数: 492 | 30 there is a mechanism for returning excess cholesterol to the liver, where
it is either processed and put back into the blood circulation or used for
the production of bile salts. the vehicle for returning cholesterol to the
liver is HDL. and this process is called reverse cholesterol transport, by
which HDL may prevent the entry of cholesterol into atherogenesis or even
remove cholesterol from atherosclerotic lesions. the above finding has
been supported by animal experiments.
but for human s |
|
c********h
发帖数: 330 | 31 我觉得可以这样理解，像是lesion study里面，首先有一个roc curve对应于y ~ x1 +
x2.
然后model1 roc和model2 roc分别是去掉x2和去掉x1后的roc，如果model1 roc >
model2 roc，说明在x1存在的情况下，去掉x2的影响，要比在x2存在时去掉x1的影响小。
相应的看p-value，对于y ~ x1 + x2里每个变量的p-value，也是significance in
addition to the existence of the other variable。不知道这样理解会不会好一点？
你说的情况，我觉得可能会出现，毕竟roc和p-value不是等价的，还有可能出两条roc
intersect。p-value的话，就比较straightforward，对应于一个hypothesis test。
一点点想法，不对的话，请指教~ |
|
a*i
发帖数: 1652 | 32 http://247wallst.com/2011/07/18/the-eleven-most-implanted-medic
11. Implantable Cardioverter Defibrillators
> Number of procedures: 133,262
> Total annual expenditure: $5.5 billion
> Average cost per procedure: $40,000
> Major manufacturer: Medtronic (40%), St. Jude Medical, and Boston
Scientific
Cardiac arrhythmia, or improper electric signaling in the heart, occurs in
millions of people a year. While the vast majority are benign, a select few
— usually in patients with a history of heart attac... 阅读全帖 |
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A*******s
发帖数: 9638 | 33 A real case of mine.
A 21 years old male with severe mental retardation, was sent to ER for
mental status change and ataxia.
He was found to be dehydrated and had a UTI. After the dehydration and
sepsis being corrected, he still could not walk. Because he was not able to
cooperate for MRI, a CT of C-Spine and L-spine was ordered. Results were
not remarkable.
The patient was discharged back to nursing home.
At the followup, his family member finally showed up and told me that about
1 month a... 阅读全帖 |
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A*******s
发帖数: 9638 | 34 Because of the disc disease.
Depending on your exam, you can do cervical spine for UMN lesions, and
Lumbar spine for LMN problems.
But there are always exceptions. |
|
h*********t
发帖数: 116 | 35 是你说的"Depending on your exam, you can do cervical spine for UMN lesions,
and
根本就理解错了，能解释一下么。
谢谢你的案例。学习了
我本人的神经内科太弱，可还是很有兴趣，所以在这儿学习呢 |
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A*******s
发帖数: 9638 | 36 You can localize a UMN or LMN lesion based on your exam. Once you decide,
you can easily order a corresponding test.
C-spine is for spinal cord.
L-spine is for Cauda equina
, |
|
C*****D
发帖数: 1299 | 37 教你一快速学英语法:
没事瞎问. 只要有屁大事就打电话去问, 要买任何东西逮着营业人员瞎问.找秘书,
JANITOR, 瞎聊. 绝对比上语言学校好. 说多了就好了.要态度好能忽悠.
A male attending asked a female resident the diagnosis of penile lesion:
she said your penis is too hard for me. |
|
C*****D
发帖数: 1299 | 38 教你一快速学英语法:
没事瞎问. 只要有屁大事就打电话去问, 要买任何东西逮着营业人员瞎问.找秘书,
JANITOR, 瞎聊. 绝对比上语言学校好. 说多了就好了.要态度好能忽悠.
A male attending asked a female resident the diagnosis of penile lesion:
she said your penis is too hard for me. |
|
I****a
发帖数: 407 | 39 Bone scan might not reveal the lytic bone lesions. Bone survey is the way to
go. What is the UPEP and SPEP result? |
|
a*******n
发帖数: 82 | 40 Sorry for late followup(on vacation:)
The patient had lung nodule biopsy. It was diffuse large B-cell lymphoma.
PET scan revealed lesions in skull, lung, abdominal lymph nodes, pelvic and
hip joints. She received one cycle of RCVP as palliative chemo.
Before this dx, for her nausea, I had been giving her dexamethasone, which
worked magically for her nausea. My big name H/O attending said "You have
been treating her cancer and pretreating her from tumor lysis syndrome
before chemo" Yeah! |
|
I****a
发帖数: 407 | 41 Bone scan might not reveal the lytic bone lesions. Bone survey is the way to
go. What is the UPEP and SPEP result? |
|
a*******n
发帖数: 82 | 42 Sorry for late followup(on vacation:)
The patient had lung nodule biopsy. It was diffuse large B-cell lymphoma.
PET scan revealed lesions in skull, lung, abdominal lymph nodes, pelvic and
hip joints. She received one cycle of RCVP as palliative chemo.
Before this dx, for her nausea, I had been giving her dexamethasone, which
worked magically for her nausea. My big name H/O attending said "You have
been treating her cancer and pretreating her from tumor lysis syndrome
before chemo" Yeah! |
|
V*****G
发帖数: 337 | 43 Thanks, they heard there is a medication that can alleviate the skin lesions
, is that true? 3x. |
|
V*****G
发帖数: 337 | 44 Thanks, they heard there is a medication that can alleviate the skin lesions
, is that true? 3x. |
|
A*******s
发帖数: 9638 | 45 I noticed there are some changes. Thanks for the updates.
For a case like that, you have to make sure if the patient has true weakness
. In some cases, the patient could not walk or feel weak just because of
PAIN. I haven't noticed you mentioned the pain which I believe she has.
I would check ERS/CRP and CK, a lot of cases like that, especially an aged
woman, could have PMR.
DM amyotrophy is another DDx if PMR can be R/O.
With both sensory/motor involvement on a single leg, radiculopathy is mo... 阅读全帖 |
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I****a
发帖数: 407 | 46 Zytiga will be very popular given its oral form plus "not so bad" side
effect profile. XL184 is an interesting drug. We do not know whether
resolution of bone lesion translates to longer survival, I guess it should.
Its side effect profile is no kidding though. |
|
I****a
发帖数: 407 | 47 Zytiga will be very popular given its oral form plus "not so bad" side
effect profile. XL184 is an interesting drug. We do not know whether
resolution of bone lesion translates to longer survival, I guess it should.
Its side effect profile is no kidding though. |
|
l***o
发帖数: 578 | 48 For pt 1, you almost did everything.
The differentiation diagnosis list including but not limited to:
1. cervical poly;
2. cervical ectropian;
3. cervcial dysplasia or cancer;
4. cervititis;
5. vaginal injury/vaginitis;
6. IUD dislocation.
If you still don't have any clue, you should refer her to Gyn. It doesn't
matter how many order you requested, the key point is how much you can
recognize the lesion.
Good luck.
. |
|
V**y
发帖数: 788 | 49 no.and no.
At the time of a C-section, pieces of the uterine lining could be
transplanted in the incision and start growing. In a study of 56 cases of
endometriosis in surgical sites, almost half of the cases followed a C-
section. These lesions cause local cyclical pain and, on occasion, even
cyclical bleeding. Treatment is obviously surgical removal of the involved
area. |
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R*******t
发帖数: 367 | 50 来自主题: Medicalpractice版 - 合同律师 Thats why I was shocked to see people do 4000 a year, and it is a full time
job... It must take different time span to generate 1 RVU in different
fields. There is a chart showing in details of RVU correlates on every
procedure or service. Such as for ENTs, removal of an inner ear lesion is
about 30 RVUs, etc.
how |
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