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About cobramarty

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  1. Christine Bruce the program director at Desales has recently suddenly resigned. Does anyone know where she went? What is she going to do? Did she go to Hershey PA?
  2. Brainlock says it quite clearly. There are prerequisites for medical school that PA's are lacking i.e. biology II, chemistry II, organic chem I + II, physics I + II, MCATs. I don't get it, in another post about MD to PA there were lots of arguments including the importance of the 'journey' and attitude and not the tests. Here in the PA to MD you have the opposite arguments and want to skip over some classes when you don't even meet the minimum course requirements for entrance. "I then say that the information that is new, ie the basic sciences, really isn't as clinically relevent... There is definitely new information that will be presented but imo a practicing PA going to medical school so that they can learn about the metabolism of a specific protein or to memorize a detailed cascade in immunology isn't going to prepare them any better for treating patients than where they were when they started the process." This is wrong- it is relevant to the in depth knowledge of pathophysiology of the human being. It is this depth of knowledge that makes the difference. I'll give you an analogy which you seem to like, a 20yo female comes to see you with an abscess with surrounding cellulitis and is allergic to PCN, got a rash to a ? med she took in college for UTI, and got C.Diff. from clindamycin for a tooth abscess last year. What antibiotic do you use? Another is the elderly hispanic female who comes to you after going to the movies with her translating daughter with severe eye pain and loss of some vision. She is a diabetic, asthmatic, and got a rash as a teen in Mexico when treated for a UTI. How do you treat her?
  3. Try and figure what would be your minimum worst case if you see only 10-15/d. Always have a way out it it fall below a set level.
  4. I had to re-read from the start. No one asked is she SOB, cough, DOE, pain on breathing, can't take a deep breath. Abnormal VS T99.2 RR20. Dry mouth- mild dehydration and lungs clear- could be a lung process with no abn lung sounds due to dehydration. Daughter telling you pneumonia in past. Cipro not great choice for CAB/CAP.
  5. Percussion is a great examination technique to help ID pneumothorax vs. other causes of decreased breath sounds. So what is the DDx. of decreased breath sounds? unilateral? bilateral? and what are their assoc. findings? Where do you 'needle' and where do you do the chest tube?
  6. 100+ visits to your ER and probably 100+ visits to the ER across town. I've worked at multiple ERs and saw a patient at one ER and the next day saw them again at a different ER- boy were they surprised.
  7. Admit the guy and take the tickets for yourself to use. Can't let good tickets go to waste.
  8. Thanks for all the replies. Great points. Keep them coming. I am leaning towards Iphone and my son towards droid and my wife needs a keyboard b/c of her nails.
  9. Need to check labs, plts, coags, BS, lytes, EKG. If there is no bleed, Do you give her TPA? Do you transfer to a 'stroke center', Do you have neurosurgery available?
  10. Has he had recent dental work or colonscopy? 50+yo male with insurance could have had either one recently.
  11. Endocarditis? with septic emboli? sed Rate and blook cultures ordered?
  12. Maybe fever, tachycardia and slightly elevated sed rate means something is going on, they are all non-specific, vague indicators of something, so don't dismiss them and keep digging and looking. At least be able to explain them. Fever b/c he just drank a cup of coffee, tachycardia b/c he is in pain, ESR b/c it's winter/he had a cold last week/he is coming down with a cold. 3 independent explanations when 1 common explanation will explain all three findings. I'm not a probability expert, but...
  13. We have been using T-system which is very fast as I chart at the bedside all of my hx. and are soon going to Welsoft. We will see.
  14. cobramarty

    Patient Case

    That's cool. I never heard of Hypnic HA.
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