l****7
发帖数: 148 | 1 upon request, I start a new for saving time to turn pages all the way to the
end, here is a dilemma question that I don't know the answer yet, up to our
discussion:
A 40-year-old woman is brought to the emergency department by her daughter
who states that she found her mother at home several hours ago, confused,
lethargic, and unable to get up from her chair or speak. Her mother has a
seizure disorder for which takes an antiseizure medication. She also has a
history of alcohol abuse in the remot | w********2
发帖数: 86 | | f***k
发帖数: 11 | 3 seem like (C) Valproic acid, liver toxicity and hyperammonia, but why
pinpoint pupil, can you explain? | w********2
发帖数: 86 | 4 Maybe you are right.
My reasons:
1)nystagmus & Asterixis
2)glucose 50 mg/dL
3)AST> ALT
4)pH of 7.20
respiratory rate & pupils may be the other reason, Barbiturates? used as
anticonvulsants? I am not sure. | n***8
发帖数: 634 | 5 pinpoint pupil 是脑水肿, 压迫动眼神经, 有一点矛盾,sodium 150 mEq/L, 这样高渗
还会脑水肿吗?
好象没有选择是对的. | n***8
发帖数: 634 | 6 酒经酸中读, 是乳酸引起的, 阴离子要增大, 这里是0, 好象是代酸, 碳酸根少了.
实在选不出. | d*******e
发帖数: 89 | 7 C ,Valproic acid overdose? | s*******i
发帖数: 48 | 8 In the Q stem, it is osmolar gap, NOT anion-gap. Osmolar gap is increased in
Ethanol, methanol (and others) intoxication. I believe the answer to this Q
is valproate. See the link: http://www.medscape.com/viewarticle/445062_3
【在 n***8 的大作中提到】
: 酒经酸中读, 是乳酸引起的, 阴离子要增大, 这里是0, 好象是代酸, 碳酸根少了.
: 实在选不出.
| l****7
发帖数: 148 | 9 Answer is valproate.
in
Q
【在 s*******i 的大作中提到】
: In the Q stem, it is osmolar gap, NOT anion-gap. Osmolar gap is increased in
: Ethanol, methanol (and others) intoxication. I believe the answer to this Q
: is valproate. See the link: http://www.medscape.com/viewarticle/445062_3
| l****7
发帖数: 148 | 10 A 58-year-old woman is diagnosed with bilateral pulmonary emboli and
metastatic uterine adenocarcinoma to the liver. Two years ago, she had a
right lower-extremity deep venous thrombosis at the time of her diagnosis of
stage II uterine cancer. She underwent anticoagulation therapy with
warfarin for 6 months following surgery.
After an initial 7-day course of low-molecular-weight heparin, which of the
following is the most appropriate for preventing recurrent venous
thromboembolism in this patien
【在 l****7 的大作中提到】
: upon request, I start a new for saving time to turn pages all the way to the
: end, here is a dilemma question that I don't know the answer yet, up to our
: discussion:
: A 40-year-old woman is brought to the emergency department by her daughter
: who states that she found her mother at home several hours ago, confused,
: lethargic, and unable to get up from her chair or speak. Her mother has a
: seizure disorder for which takes an antiseizure medication. She also has a
: history of alcohol abuse in the remot
| | | n***8
发帖数: 634 | 11 是 continue low molecular weight heparin 吧.
我FA 上肯定看到过, 说WAFARIN 通INACTIVATE PROTEIN C 导至皮肤坏死, 所以
HEPARIN 要和WAFARIN 共用一段时间的. | l****7
发帖数: 148 | 12 yes, you are right.
【在 n***8 的大作中提到】
: 是 continue low molecular weight heparin 吧.
: 我FA 上肯定看到过, 说WAFARIN 通INACTIVATE PROTEIN C 导至皮肤坏死, 所以
: HEPARIN 要和WAFARIN 共用一段时间的.
| n***8
发帖数: 634 | | f***k
发帖数: 11 | 14 To lchen7
can you explain why valproate intoxication has pinpoint pupil? Thanks. | w********2
发帖数: 86 | 15 baoma,
"WAFARIN 通INACTIVATE PROTEIN C 导至皮肤坏死, 所以HEPARIN 要和WAFARIN 共用一
段时间的"--你的解释不对吧 | n***8
发帖数: 634 | 16 Pls let me know your idea about it.
It seems I had seen some where in FA. But when I tried to find out again, I
didn't.
Thanks |
|
