b**o
发帖数: 5769 | 1 最近一次考试，好多case的考题，刚开始还好，后面一糊涂，连着错了几题，郁闷死了！
怎么样才能透过一堆情况数据看出老师要考得考点呢？
我们开始上module了，第一个是health module，属于introduction的，不是很难，老
师照objective出题。可是信息量还是很大，而且又是pre-quiz,又是case study的搞得
人很疲。
还有4个礼拜这学期就结束了，我是越到后面越没力呀！！！ |
m**s
发帖数: 520 | 2 可否贴一个case，让我们也学习学习。太麻烦就算了
了！
【在 b**o 的大作中提到】
: 最近一次考试，好多case的考题，刚开始还好，后面一糊涂，连着错了几题，郁闷死了！
: 怎么样才能透过一堆情况数据看出老师要考得考点呢？
: 我们开始上module了，第一个是health module，属于introduction的，不是很难，老
: 师照objective出题。可是信息量还是很大，而且又是pre-quiz,又是case study的搞得
: 人很疲。
: 还有4个礼拜这学期就结束了，我是越到后面越没力呀！！！
|
b**o
发帖数: 5769 | 3 考试题不能贴啦。
给一个我们的作业好了。
O.D. is a 18 YO F who presented to your hospital 5 days ago following an
intentional ingestion of Seroquel® after a verbal disagreement with her
mother. O.D. admitted to taking 20—300 mg extended release Seroquel®
tabs. Several hours later, O.D. collapsed and her eyes rolled back in her
head. The paramedics noted seizure activity, and O.D. was transferred to
the hospital for further care. She was noted to have a tonic-clonic seizure
lasting 30 minutes and was intubated and placed on the mechanical
ventilator. She has remained on the mechanical ventilator and is receiving
medical treatment for her seizures. This morning, she was noted to have
some significant laboratory and vital sign abnormalities.
PMH: Bipolar disorder (diagnosed at age 10)
History of depression (diagnosed at age 15)
Social History: Lives with mom
Home Medications:
Per Mom Quetiapine (dose unknown), citalopram (dose unknown), and unknown
oral contraceptive
Current Meds: Per MAR 1. Acetaminophen 650 mg PR q 4-6 hrs PRN fever
> 38.0 C/pain
2. Fentanyl 50 mcg IV q 2 hrs PRN pain
3. Propofol 100 mcg/kg/min IV continuously for seizures/sedation, day 5
4. Levetiracetam 500 mg IV q 12 hrs, day 5
5. Lorazepam 2 mg IV q 4 hrs PRN seizures/agitation
6. D5 NS + 20 mEq/L KCl IV continuously at 90 ml/hr (Maintenance IV
fluids)
Allergies: NKDA
ROS: • General: Sedated, became unresponsive to painful stimuli
this am
• Cardiovascular: WNL
Physical Exam: • Vital signs: HR 125 bpm (nl 55-95), RR 16 (nl
16-22), BP 90/60 (nl 100-
115/65-70), temp-within nl, O2 Saturation- 95% (nl 92-100%)
• Miscellaneous: ht = 165 cm ; wt = 60.1 kg
Laboratory and Diagnostic Studies: • Urine pregnancy test:
Negative
• Complete urine drug screen (on admission): (+) citalopram and (+
) quetiapine
• ABG: pH—6.9, PaCO2—40 mm Hg; HCO3-8, PaO2—90 mm Hg
• EKG: “Peaked T” waves
• Lactic acid: 14.3 mmol/L (nl 0.4-2 mmol/L)
• Chemistries:
Ca2+ Phos Mg2+ T. Bili AST ALT T. Pro Alb
8.4 4.5 2.0 1.2 16 17 6.0 3.4
• WBC with differential: WNL
Current Problems: #1: Acid-base disorder
#2: Hyperglycemia and hyperkalemia secondary to problem #1
#3: Seizure disorder secondary to drug overdose
#4: History of psychiatric disorders
Assignment: Develop a SOAP note using the attached form that addresses only
Problem #1; be sure to assess in your “O” section the patient’s anion
gap. During patient care rounds this morning, the computers have crashed.
The medical team turns to you as the pharmacist assigned to the team to
provide recommendations for treating O.D.’s acid-base disorder. |
c****m
发帖数: 626 | 4 你们已经上了neuro psych 的pharmacotherapeutics啦？
我们考试的case 题根据老师上课的讲解思路基本没有问题。
【在 b**o 的大作中提到】
: 考试题不能贴啦。
: 给一个我们的作业好了。
: O.D. is a 18 YO F who presented to your hospital 5 days ago following an
: intentional ingestion of Seroquel® after a verbal disagreement with her
: mother. O.D. admitted to taking 20—300 mg extended release Seroquel®
: tabs. Several hours later, O.D. collapsed and her eyes rolled back in her
: head. The paramedics noted seizure activity, and O.D. was transferred to
: the hospital for further care. She was noted to have a tonic-clonic seizure
: lasting 30 minutes and was intubated and placed on the mechanical
: ventilator. She has remained on the mechanical ventilator and is receiving
|
b**o
发帖数: 5769 | 5 没有呢。这个才是最基本的module.
主要针对acid/base problem给 A and P
【在 c****m 的大作中提到】
: 你们已经上了neuro psych 的pharmacotherapeutics啦？
: 我们考试的case 题根据老师上课的讲解思路基本没有问题。
|
b******8
发帖数: 1251 | 6 我们这学期就是neuro psych therapeutics, 但是没有acid base的。 主要就是记住
algorithym, 然后看病人的sx, se from current drug, 然后选药主要就是跟着
algorithym来，药物的比较也多数是比较side effects.neuro的case看着简直是太好笑
了，有时候都要笑疯了。 |
b******8
发帖数: 1251 | 7 我最讨厌写SOAP，但是考试QUIZ都是多选就好办 |
m**s
发帖数: 520 | 8 多谢！
毕竟是正规军啊，看得我一头雾水，学习了。
her
seizure
receiving
【在 b**o 的大作中提到】
: 考试题不能贴啦。
: 给一个我们的作业好了。
: O.D. is a 18 YO F who presented to your hospital 5 days ago following an
: intentional ingestion of Seroquel® after a verbal disagreement with her
: mother. O.D. admitted to taking 20—300 mg extended release Seroquel®
: tabs. Several hours later, O.D. collapsed and her eyes rolled back in her
: head. The paramedics noted seizure activity, and O.D. was transferred to
: the hospital for further care. She was noted to have a tonic-clonic seizure
: lasting 30 minutes and was intubated and placed on the mechanical
: ventilator. She has remained on the mechanical ventilator and is receiving
|
c****m
发帖数: 626 | 9 我也贴一个，不算难的。
Mr. T is a6'4''230 lb and very muscular 35 yo African American who has
recently been diagnosed with schizophrenia but otherwise quite healthy. He
has a tendency to become easily agitated. He has been placed on risperidone
(Risperdal) 4 mg, is doing well. Of the side effects listed below for
resperidone, which one might you be concerned about?
A. sedation
B. Elevated prolactin
C. weight gain
D. Cardiovascular effects.
【在 m**s 的大作中提到】
: 可否贴一个case，让我们也学习学习。太麻烦就算了
:
: 了！
|
m**s
发帖数: 520 | 10 最关心选A，BC也是副作用，但对一精壮黑男来说，没啥
最没可能选D
risperidone
【在 c****m 的大作中提到】
: 我也贴一个，不算难的。
: Mr. T is a6'4''230 lb and very muscular 35 yo African American who has
: recently been diagnosed with schizophrenia but otherwise quite healthy. He
: has a tendency to become easily agitated. He has been placed on risperidone
: (Risperdal) 4 mg, is doing well. Of the side effects listed below for
: resperidone, which one might you be concerned about?
: A. sedation
: B. Elevated prolactin
: C. weight gain
: D. Cardiovascular effects.
|
|
|
b**o
发帖数: 5769 | 11 cardio risk due to overweight?
【在 c****m 的大作中提到】
: 我也贴一个，不算难的。
: Mr. T is a6'4''230 lb and very muscular 35 yo African American who has
: recently been diagnosed with schizophrenia but otherwise quite healthy. He
: has a tendency to become easily agitated. He has been placed on risperidone
: (Risperdal) 4 mg, is doing well. Of the side effects listed below for
: resperidone, which one might you be concerned about?
: A. sedation
: B. Elevated prolactin
: C. weight gain
: D. Cardiovascular effects.
|
l******k
发帖数: 27533 | 12 经常做经常写呀
慢慢会熟能生巧的
认真写每一个SOAP
刚开始我每个SOAP都要花整个周末写
从看教科书到看guideline
不要投机取巧的看答案，要自己总结，收集整理
到P3下学期的时候，SOAP的考试已经能比较轻松的完成了
现在在clinic做MTM，虽然写的是言简意赅，但思路还是一样的，以前SOAP的练习非常
重要
了！
【在 b**o 的大作中提到】
: 最近一次考试，好多case的考题，刚开始还好，后面一糊涂，连着错了几题，郁闷死了！
: 怎么样才能透过一堆情况数据看出老师要考得考点呢？
: 我们开始上module了，第一个是health module，属于introduction的，不是很难，老
: 师照objective出题。可是信息量还是很大，而且又是pre-quiz,又是case study的搞得
: 人很疲。
: 还有4个礼拜这学期就结束了，我是越到后面越没力呀！！！
|
c****m
发帖数: 626 | 13 答案是D, risperidone 会引起QT prolongation, cardiovacular effects should be
concerned even though he is young and otherwise healthy.
Sedation is a side effects but the patient is agitated, so it would be ok in
this case.
risperidone
【在 c****m 的大作中提到】
: 我也贴一个，不算难的。
: Mr. T is a6'4''230 lb and very muscular 35 yo African American who has
: recently been diagnosed with schizophrenia but otherwise quite healthy. He
: has a tendency to become easily agitated. He has been placed on risperidone
: (Risperdal) 4 mg, is doing well. Of the side effects listed below for
: resperidone, which one might you be concerned about?
: A. sedation
: B. Elevated prolactin
: C. weight gain
: D. Cardiovascular effects.
|
c****m
发帖数: 626 | 14 我也正在学psych
【在 b******8 的大作中提到】
: 我们这学期就是neuro psych therapeutics, 但是没有acid base的。 主要就是记住
: algorithym, 然后看病人的sx, se from current drug, 然后选药主要就是跟着
: algorithym来，药物的比较也多数是比较side effects.neuro的case看着简直是太好笑
: 了，有时候都要笑疯了。
|
c****m
发帖数: 626 | 15 还有5个星期这个学期就完了。now or never
了！
【在 b**o 的大作中提到】
: 最近一次考试，好多case的考题，刚开始还好，后面一糊涂，连着错了几题，郁闷死了！
: 怎么样才能透过一堆情况数据看出老师要考得考点呢？
: 我们开始上module了，第一个是health module，属于introduction的，不是很难，老
: 师照objective出题。可是信息量还是很大，而且又是pre-quiz,又是case study的搞得
: 人很疲。
: 还有4个礼拜这学期就结束了，我是越到后面越没力呀！！！
|
m**s
发帖数: 520 | 16 谢谢！把最重要的QT副作用忘掉了，呵呵！
be
in
【在 c****m 的大作中提到】
: 答案是D, risperidone 会引起QT prolongation, cardiovacular effects should be
: concerned even though he is young and otherwise healthy.
: Sedation is a side effects but the patient is agitated, so it would be ok in
: this case.
:
: risperidone
|
