andersenpa Posted June 2, 2006 Share Posted June 2, 2006 tension pneumo increases intrathoracic pressure. if the pneumothorax is large enough it will cause midline shift to the contralateral side, which can obstruct breathing and decrease blood oxygenation. Consider the effects of intrathoracic pressure on intrathoracic vessels..... Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted June 6, 2006 Share Posted June 6, 2006 Consider the effects of intrathoracic pressure on intrathoracic vessels..... increased intrathoracic pressure --> compression of intrathoracic vessels --> mechanical decrease in venous return --> decreased CO --> decreased coronary circulation also would be a compression of the coronaries, compounding the decreased supply, no? Quote Link to comment Share on other sites More sharing options...
doboy Posted June 7, 2006 Share Posted June 7, 2006 The right atrium colapses from tension pneumos and cardiac tamponades, that prevents blood flow into the heart, heart looses source of oxygen, and dies. Quote Link to comment Share on other sites More sharing options...
v_chicky Posted June 7, 2006 Share Posted June 7, 2006 la, you have stated what my attending was getting at. increased intrathoracic pressure causes mechanical decrease in blood return to the heart by compressing primarily the IVC. no blood in = no blood out (ala starling's law), heart doesn't get enough blood, gets upset and quits pumping. here's one from tonight, easy, so students only please. what is the most common cause of urinary retention post-op and how do you treat it? what is "normal" urine output for healthy-ish adults? how long do you give the pt. after surgery to void before you get concerned? Quote Link to comment Share on other sites More sharing options...
v_chicky Posted June 7, 2006 Share Posted June 7, 2006 oh and here's one from one of the burn residents. what is the most sensitive physical finding that indicates that the burn patient sitting in front of you needs to be intubated? Quote Link to comment Share on other sites More sharing options...
ajnelson Posted June 7, 2006 Share Posted June 7, 2006 soot or burns on the face - especially around the mouth or nose Quote Link to comment Share on other sites More sharing options...
andersenpa Posted June 8, 2006 Share Posted June 8, 2006 What do the letters assigned to pacemakers designate? i.e., DDD, VVI, etc..... Quote Link to comment Share on other sites More sharing options...
ajnelson Posted June 9, 2006 Share Posted June 9, 2006 I can't remember the order - but one letter indicates the chamber that is paced, one indicates where electrical activity is sensed and the other letter decribes what the pacer is supposed to do. For the first two the letters are A,V, or D (atrium, ventricle or dual). Can't remember the letters for the 3rd... Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted June 9, 2006 Share Posted June 9, 2006 here's one from tonight, easy, so students only please. what is the most common cause of urinary retention post-op and how do you treat it? residual effects of anticholinergic paralytics? we learned about urecholine from dr. p as one treatment - don't know (yet) if it is really used, though.... what is "normal" urine output for healthy-ish adults? 0.5 to 1 mL/kg/hr... how long do you give the pt. after surgery to void before you get concerned? 24 hours comes to mind, but not sure why. maybe someone else will chime in? Quote Link to comment Share on other sites More sharing options...
v_chicky Posted June 10, 2006 Share Posted June 10, 2006 on the burn pt, i meant to add that the pt has no visible signs of inhalation injury. Quote Link to comment Share on other sites More sharing options...
andersenpa Posted June 13, 2006 Share Posted June 13, 2006 I can't remember the order - but one letter indicates the chamber that is paced, one indicates where electrical activity is sensed and the other letter decribes what the pacer is supposed to do.For the first two the letters are A,V, or D (atrium, ventricle or dual). Can't remember the letters for the 3rd... Good. 1st - Chamber paced: A, V, or D - atrium, ventricle, or dual (atrium and ventricle) 2nd - Chamber sensed: A,V,D, and O - O for absence on sensing, which will pace without regard to the intrinsic activity 3rd - Response to sensing: I or T, for inhibit or trigger. These are the common settings- the nomenclature extends to 5 parameter, however. 4th letter - Rate responsiveness- pacer can increase baseline rate in response to activity (need for higher cardiac output) 5th letter - presence of multisite pacing- both atria, both ventricles, or more than one site in one chamber The three letter system is most commonly used and relevant for most purposes..... Quote Link to comment Share on other sites More sharing options...
maryfran123 Posted June 13, 2006 Share Posted June 13, 2006 what is "normal" urine output for healthy-ish adults? 0.5 to 1 mL/kg/hr... Remember,the.5-1cc/kg/hr is based on IBW. I currently have a morbidly obese female pt on service, about 5'6" and over 480lbs that nursing kept calling the on call resident because of "low urine output" and the resident just kept chasing by ordering boluses forgetting that the pt's u.o. was adequate based on her IBW. This continued for 3 nites over the weekend, phone call=IVF bolus. When I saw her on Monday, her O2 requirements were up and she had a BNP of over 2000 and required diuresis. Just a friendly FYI.:) Quote Link to comment Share on other sites More sharing options...
v_chicky Posted June 14, 2006 Share Posted June 14, 2006 on the burn pt, i meant to add that the pt has no visible signs of inhalation injury. changing voice/hoarseness are indications for intubation in burn pt Quote Link to comment Share on other sites More sharing options...
ajnelson Posted June 24, 2006 Share Posted June 24, 2006 OK - here's one from my shift tonite: What are Howell-Jolly bodies, and what do they indicate? Quote Link to comment Share on other sites More sharing options...
Guest obyomeni Posted June 24, 2006 Share Posted June 24, 2006 Howell-jolly bodies are erythrocyte abnormalities that are seen after splenectomy, leukemia, pernicious anemia, or some severe hemolytic anemias. Quote Link to comment Share on other sites More sharing options...
Guest lisnek Posted June 24, 2006 Share Posted June 24, 2006 also sickle cell anemia Quote Link to comment Share on other sites More sharing options...
Guest Macrophage Posted June 25, 2006 Share Posted June 25, 2006 Wow! I'm so impressed by this fascinating medical knowledge. You guys are a wealth of amazing information in medicine. I'm also distressed that I really knew none of the answers, though I understood most of them, and did make educated guesses. Of course, I don't start my PA Master's program until July. . . I'd better learn A LOT in the next 2 years!! Quote Link to comment Share on other sites More sharing options...
JenGintheED Posted June 25, 2006 Share Posted June 25, 2006 Wow! I'm so impressed by this fascinating medical knowledge. You guys are a wealth of amazing information in medicine. I'm also distressed that I really knew none of the answers, though I understood most of them, and did make educated guesses. Of course, I don't start my PA Master's program until July. . . I'd better learn A LOT in the next 2 years!! 1. You'll learn a lot in PA school! 2. You'll forget more than you learn! 3. Looking up the answers isn't cheating; it's part of the learning process. {with #3 I don't mean to insinuate that the posters didn't know the answer... I meant it to encourage you and others to participate ;) } Quote Link to comment Share on other sites More sharing options...
ajnelson Posted June 25, 2006 Share Posted June 25, 2006 Howell-jolly bodies are erythrocyte abnormalities that are seen after splenectomy, leukemia, pernicious anemia, or some severe hemolytic anemias. also sickle cell anemia Good Job guys! Quote Link to comment Share on other sites More sharing options...
Marlene G Posted June 26, 2006 Share Posted June 26, 2006 Ok, let the behavioral peron have a little go at it. What are some of the main features in the mania stage of Bipolar Disorder? Quote Link to comment Share on other sites More sharing options...
andersenpa Posted June 27, 2006 Share Posted June 27, 2006 What is the: Ligament of Marshall? Ligamentum Arteriosum? Transverse Sinus? Oblique Sinus? all the same organ....... Quote Link to comment Share on other sites More sharing options...
v_chicky Posted June 27, 2006 Share Posted June 27, 2006 flight of ideas, decreased need for sleep, expansive thinking, pressured speech, easy distractability... that's all i can think of off the top of my head. Quote Link to comment Share on other sites More sharing options...
Guest jennie783 Posted June 27, 2006 Share Posted June 27, 2006 What is the: Ligament of Marshall? Ligamentum Arteriosum? Transverse Sinus? Oblique Sinus? all the same organ....... please bear with me. i haven't started school yet but i wanted to give it a shot and look this stuff up anyway. the organ is the heart the ligament of marshall is an epicardical neuromuscular bundle on the left atrium that is believed to be the origin of atrial tachyarrrythmias the ligamentum arteriosum is a fiberous band that connects the superior surface of the left pulmonary artery to the inferior surface of the aortic arch the transverse sinus is a pericardial strip between the superior pulmonary veins on top of left atrium. i also read that the right pulmonary artery is a transverse sinus structure. does this mean that it is part of the transverse sinus? the oblique sinus is located behind the posterior to the heart and has an inverted U shape. it is formed from the visceral and parietal pericardium and separates the left atria from the esophagus Quote Link to comment Share on other sites More sharing options...
caldje Posted June 27, 2006 Share Posted June 27, 2006 the ligamentum arteriosum is a fiberous band that connects the superior surface of the left pulmonary artery to the inferior surface of the aortic arch what did it used to be? in fetal developement and why was it there? Quote Link to comment Share on other sites More sharing options...
Marlene G Posted June 27, 2006 Share Posted June 27, 2006 flight of ideas, decreased need for sleep, expansive thinking, pressured speech, easy distractability... that's all i can think of off the top of my head. \ Good answer. Did I make it too easy? Quote Link to comment Share on other sites More sharing options...
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