PA2016! Posted May 3, 2015 Share Posted May 3, 2015 African American patient in stage 3 HFrEF who remains symptomatic despite optimized therapy with ACE-Is, BB, and Aldosterone antagonist...... What's one more medication you could try? Quote Link to comment Share on other sites More sharing options...
Walkoffshot Posted May 3, 2015 Share Posted May 3, 2015 hydralazine/isosorbide dinitrate (bidil) Quote Link to comment Share on other sites More sharing options...
PA2016! Posted May 3, 2015 Share Posted May 3, 2015 Correct! Quote Link to comment Share on other sites More sharing options...
dchampigny Posted May 3, 2015 Share Posted May 3, 2015 What can one expect to see with EOMs in a patient who has orbital cellulitis vs. a patient who has periorbital cellulitis? Quote Link to comment Share on other sites More sharing options...
PA2016! Posted May 3, 2015 Share Posted May 3, 2015 Pain Differences! Periorbital cellulitis will have EOM without pain and changes in visual acuity, and orbital cellulitis will present with pain and changes with visual acuity. Monitor closely for any changes regarding vision, and EOM. If there is ever a doubt.....CT 1 Quote Link to comment Share on other sites More sharing options...
dchampigny Posted May 6, 2015 Share Posted May 6, 2015 Describe the differences between a patient coming in to the ER who has been shocked by AC low current electricity vs. DC (rhythm and associated injuries). Quote Link to comment Share on other sites More sharing options...
crossbone2007 Posted May 27, 2015 Share Posted May 27, 2015 Describe the differences between a patient coming in to the ER who has been shocked by AC low current electricity vs. DC (rhythm and associated injuries).I would guess one is dead, and one is not? Sent from my VS980 4G using Tapatalk 1 Quote Link to comment Share on other sites More sharing options...
Hallcrest Posted June 9, 2015 Share Posted June 9, 2015 Here's one for everybody - At what approximate gestational age (range) is steroid dosing recommended to hasten fetal lung development? Quote Link to comment Share on other sites More sharing options...
ATC-2-PA Posted June 12, 2015 Share Posted June 12, 2015 I think its 24-34 weeks has an indicated benefit. Quote Link to comment Share on other sites More sharing options...
dchampigny Posted July 26, 2015 Share Posted July 26, 2015 What is the most common complication of a rib fracture and how can it be prevented? Quote Link to comment Share on other sites More sharing options...
PA2016! Posted July 27, 2015 Share Posted July 27, 2015 Pneumothorax? ....Ehhhh idk, that is probably one of the more severe, but I doubt it is one of the most common.....ummmmmmm.. Maybe nerve damage would be more common? Quote Link to comment Share on other sites More sharing options...
MediMike Posted July 30, 2015 Share Posted July 30, 2015 Atelectasis/PNA-Incentive spirometry, upright positioning 1 Quote Link to comment Share on other sites More sharing options...
PA2016! Posted July 30, 2015 Share Posted July 30, 2015 That sounds like a much better answer Quote Link to comment Share on other sites More sharing options...
dchampigny Posted August 1, 2015 Share Posted August 1, 2015 Atelectasis/PNA-Incentive spirometry, upright positioning Giddy up! Quote Link to comment Share on other sites More sharing options...
MediMike Posted August 1, 2015 Share Posted August 1, 2015 Differences betwixt Type A and Type B lactic acidoses? Quote Link to comment Share on other sites More sharing options...
andersenpa Posted August 18, 2015 Share Posted August 18, 2015 10 demerits for using the word "betwixt" 1 Quote Link to comment Share on other sites More sharing options...
RealityCheck Posted August 18, 2015 Share Posted August 18, 2015 I am having painful flashbacks to a breast surgeon from 25 years ago who could put 600 titanium heme clips in one mastectomy. Her initials were AML and we all giggled because the M could stand for malignancy. She was MEAN in the OR and had no mercy. An anesthesia resident would hold up anatomy books over my corner of the curtain to try to help me and others from her wrath. I hate Cooper's ligament............................. The residents were evil and threw the new student in on a case with her first thing in the morning with no prep as to who the patient was and no access to the chart. You walked into a draped OR patient and got the joy of retracting a 10-15 pound breast while she painstakingly removed it with every piece of titanium in the state. This thread is so much more fun and meaningful than the berating I received for 6 solid weeks. I will check back in and play along! Quote Link to comment Share on other sites More sharing options...
PA2016! Posted December 7, 2015 Share Posted December 7, 2015 Differences betwixt Type A and Type B lactic acidoses? Perfusion? I think Type A is associated with decrease perfusion and PE exam findings of it where Type B does not have these PE exam findings?? Quote Link to comment Share on other sites More sharing options...
MediMike Posted December 17, 2015 Share Posted December 17, 2015 Type A is generally related to a decrease in tissue perfusion or hypoxia Type B is caused by innumerable other paths, oftentimes related to adrenergic stimulation, beta agonists, seizures, or simply crappy clearance (70% liver, 20% kidney, 10% heart/lung if I remember correctly) So just because you've got an elevated lactate on your lab result it doesn't necessarily mean your patient is hypoxic or in some variety of shock state. They could've been puffing on an albuterol neb with a lame liver. Quote Link to comment Share on other sites More sharing options...
PA2016! Posted December 17, 2015 Share Posted December 17, 2015 MediMike, Thanks! Any body else want to chime in and fire this thread back up before rotations start in a month??? Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted December 18, 2015 Moderator Share Posted December 18, 2015 What is the likelihood of PCN allergy cross reactivity with cephalosporins? Quote Link to comment Share on other sites More sharing options...
marktheshark89 Posted December 18, 2015 Share Posted December 18, 2015 1% for 1st gen, negligible for other gens 1 Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted December 18, 2015 Moderator Share Posted December 18, 2015 Can you tell me why studies in the 60s showed closer to 10%? Quote Link to comment Share on other sites More sharing options...
PA2016! Posted December 18, 2015 Share Posted December 18, 2015 Im gonna throw out two guesses that come to mind because I think I have heard this before. 1) Non-allergic reactions being reported as acute drug reactions. 2) Cross-contamination w/ production of the drug? 1 Quote Link to comment Share on other sites More sharing options...
jbscoops20 Posted December 18, 2015 Share Posted December 18, 2015 I know that newer (later gen) cephalosporins like ceftaz and cefipime exhibit less cross reactivity most likely d/t slight differences in structure...possibly brings the percentage down a bit. Agree with PA 2016 above that reporting of sensitivities vs. true allergies would likely skew numbers as well. Quote Link to comment Share on other sites More sharing options...
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