d*********n
发帖数: 18 | 1 this one of my CS protocols, hope can help whoever going to take the test, I
don’t need any more.
not perfect, but good to figure out diagnosis, should not miss the diagnosis
,
do not need to ask all questions , must adjust base the case,
if better ideas, pleas modify to make easier for people who may need
Amenorrhea
Mental check list:
Pregnancy,
hyperprolatinemia,
hypothyroidism,
PCOS,
premature menopause,
depression
asheman syndrome,
anorexia nervosa,
strenuous exercise
Patricia Garrison, a 36... 阅读全帖 |
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e****0
发帖数: 678 | 2 Endometrial hyperplasia types. Risk of cancer treatment
simple 1% Cyclic progestin
complex 3% Cyclic progestin
Simple atypical 8% THA or progestins
Complex atypical 29% THA or progestins
• Prolatinoma and hypothyroidism galactorrhea
• Anesthesia can reduce uterine activity if in the latent phase
• Contraceptive for lactating mother
Progestin-only oral contraceptive
• Pregnancy luteoma
African-ameri... 阅读全帖 |
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f******I
发帖数: 769 | 3
I
t
what are you, bugs bunny? not to my knowledge that eating carrots would
cause secondary amenorrhea, unless the carrots are injected with something,
i would think that if your TSH, prolactin, FSH, and testosterone levels are
fine and you are not pregnant, and overall you feel pretty well, then there
is not much to be concerned, it's probably functional hypothalamic
amenorrhea, |
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g*2
发帖数: 658 | 4 这个要慎入。有问题，查个关键词，看看。
SPECIFIC INJURIES
Hip injuries
Overview and approach — Hip injuries are less common in runners than
injuries to the lower extremity and they can be difficult to diagnose.
Nevertheless, during jogging, the hip joint is subjected to loads up to
eight times body weight and both acute and chronic injuries can occur [55].
In runners, the differential diagnosis of hip pain includes gluteus medius
tendinopathy, piriformis syndrome, stress fracture of the femoral neck,
labral tear, a... 阅读全帖 |
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A*G
发帖数: 256 | 5 http://www.prep4usmle.com/forum/thread/109282/
08/17/11 - 8:40 AM
#1
Hello everyone,
I'd like to share my experience of passing Step 2 CS in the first attempt (
got results today) after 17 days of revision. Internet forums have been very
useful to me during my preparations for all the USMLE exams.
My background
I am a board certified ophthalmologist in the U.K. I went to medical school
in the UK, and graduated 11 years ago. I am of Asian origin and grew up in
Asia. I have not done any gene... 阅读全帖 |
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m******r
发帖数: 1904 | 6 ☆─────────────────────────────────────☆
iUSMLE (i am busy) 于 (Wed Feb 29 12:14:11 2012, 美东) 提到:
亚特兰大考场，住在Quality inn,事先看好考场。听说早上可能下雨，担心鞋子裤子会淋湿，前台说可以搭乘早上7：30去机场的shuttle,给了司机1$ tip,开车也就1-2min,快到考场的时候，告诉司机考场在前面，司机很有经验的park在考场的building前。(是个对付糟糕天气的小经验
恰！＃br />
考试就我一个IMG,也没啥紧张的。考场里面很暖和，穿一件衬衣就够了。
复习用了FA, UW, NJ 2 days course, Dr. PUMA.写了自己的protocol,拖拖拉拉练习了四个月。每个人的情况都很不一样，关键是自己要觉得confident再去考。
我现在在做outpatient OB,感触很多，如果可以的话，应该在准备CS的时候同时OB,也许会事半功倍。
祝大家顺利。
###################
hehe,刚刚在忙儿子吃完饭，匆忙之间没仔细写。... 阅读全帖 |
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q******e
发帖数: 960 | 7 if you are a female, you should spend time to enjoy your life. Otherwise,
you are either a fake lady or amenorrhea. |
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s*****o
发帖数: 65 | 8 一年前开始节食运动，四个月没来例假，未怀孕。看了美国医生，要求停止节食。所以
现在已正常饮食，恢复减肥前体重。但是仍然没例假。医生给了PROVOLON(?), 例假来
了三四次。但现在又有四个月没来。再用PROVOLON， 已经没用。 测了体内全部荷尔蒙
，都正常。诊断说是Hypothalamic amenorrhea ,医生现在给了birth control pill,
还说不一定永久解决问题。请问有什么在美的好的中医，或者好的治疗方法。 |
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f******I
发帖数: 769 | 9
assume 泌乳激素 is prolactin, and 肾上腺素 is FSH??
if you are not pregnant, for the work up of secondary amenorrhea, in
addition to prolactin level and FSH level, another lab test is TSH to rule
out any thyroid disease,
your exercise schedule for me would be strenous but not for normal people,
so doubt if that would be the cause for hypothalamic disorders, which are
functional by the way,
if you have any signs of hyperandrogenism, also check a testosterone level
or DHEA-S level, |
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x******i
发帖数: 26 | 10 By the way, I think you are right, I got TSH tested rather than FSH (sorry I
don't have access to the original email from the physician now). And Also
prolactin test. Those two are normal.
Apart from exercise, another potential factor might be eating carrots. I
have approximately one large carrot per day (about 15cm in length). I don't
know whether that might be a cause since I once read an artical saying
carrots may cause amenorrhea or infecundity... |
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n******s
发帖数: 210 | 11 I would like to suggest you see OB/GYN at the same time.
There is a long list for amenorrhea, some fit Chinese medicine, others need
western medicine.
Watch for defect vision, headache, new body hair growth, progesterone
deficiency, estrogen deficiency, hyper/hypothyroidism. |
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n******s
发帖数: 210 | 12 this is not severe,
If you feel OK, then you are OK, wait for the specialist.
Watch diarrhea, amenorrhea,Af, night sweating. |
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l********g
发帖数: 8819 | 13 谢谢提醒，大部分症状我现在都有
拉肚子，上学期拉了2次，上星期验血的时候也腹泻，吃了药好些了
最近这个星期倒是没有
amenorrhea,以前还挺正常的，这个月明显量少了，
我google了一下也说跟甲亢有关，幸好下周就可以看到医生了
af是什么？？
night sweating没有明显感觉，倒是好像这个冬天比较不怕冷：（
知道验血结果后，到是经常感觉心跳不正常
也不知道是心理作用，还是因为更注意了才察觉到。
请问，饮食上到注意什么？
网上有说尽量不要吃加碘盐，可是现在那里有不加碘的盐么？
海盐应该都有碘吧？
还有海产品也说尽量不要吃。
这些说法都对么？
还有，因为现在饿的快，不知道吃东西应该是饿了就吃
还是跟正常一样比较好？ |
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X*********r
发帖数: 11803 | 15 Short short short
★ 发自iPhone App: ChineseWeb - 中文网站浏览器 |
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|
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X*********r
发帖数: 11803 | 18 暂时没啥利润
★ 发自iPhone App: ChineseWeb - 中文网站浏览器 |
|
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k********8
发帖数: 7948 | 21 daniu, would u explain the meaning of amenorrhea?
have a nice day!
kelvin |
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L********9
发帖数: 85 | 22 If a female is at her birth age, she needs to keep about 18% body fat. Women
with low body fat often do not produce sufficient amounts of sex hormones.
These women can experience a cessation of menstruation, known as amenorrhea.
So if you don't have a child yet, don't play with your hormones too much. |
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L********9
发帖数: 85 | 23 I still run as usual when my period comes. I might chose to run shorter
distance or at slower pace. The exercise helps to release lactic acid faster
which helps to reduce the breast soreness. The exercise also helps to
reduce PMS, so enjoy your running and don't be afraid. However, when your
body fat drops below 18%, the period becomes irregular, so as long as you
are not extremely thin, you should be OK. Only during intense exercise, such
as those performed by professional or extreme athlete... 阅读全帖 |
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w***n
发帖数: 9040 | 24 The Big Book of Endurance Training and Racing
By Dr. Philip Maffetone
CHAPTER 8
THE OVERTRAINING SYNDROME
Overtraining is the most common problem that prevents endurance
athletes from reaching their potential. It’s also the most common cause of
injury and ill-health for millions of athletes. And overtraining is a
problem
that many athletes, coaches, and health-care professionals don’t recognize
until it becomes a more serious condition.
As a result, overtraining is not recognized soon enough to ... 阅读全帖 |
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p********f
发帖数: 5148 | 25 This is a good read:
http://www.puristat.com/glutenintolerance/default.aspx
Excerpt:
Symptoms of Gluten Intolerance
There are dozens, possibly hundreds, of gluten intolerance symptoms.
Unfortunately, no one symptom is specifically characteristic of this common
ailment. The majority of people with gluten intolerance (and celiac disease)
have intestinal symptoms as well as many others. Common manifestations
include4:
Bone, joint, muscle pain
Delayed/disrupted menstrual cycles (amenorrhea/d... 阅读全帖 |
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l******e
发帖数: 41 | 26 Your bleeding between periods is most likely caused by 经间期排卵出血，不是
闭经，有时候压力大时，也会出现月经不调。 Quetiapine should not cause this
side effect. Lamotrigine can occasionally cause amenorrhea. |
|
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c*******g
发帖数: 2 | 28 for the amenorrhea I think it's A. Because her estrogen level is normal,
ruling out menopause and premature ovarian failure. Progestin challenge
bleeding rule out asherman syndrome. Hypopituitarism is very unlikely
because her normal estrogen level |
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n*****n
发帖数: 119 | 29 别处看到的，觉得还不错，不排除有些拼写错误~
POMR (Problem-Oriented Medical Records)表格式住院病历
Biographical data:
一般项目：
Name Age Sex Marital status Nativity Race
姓名 年龄 性别 婚否 籍贯 民族
Occupation Date of admission Informant History
职业 入院日期 病史叙述者 病史
Chief complaint
主诉
History of present illness
现病史
Past history
既往史：
Previous health status: well ordinary bad Infectious diseases
平素健康状况： 良好 一般 较差 传染病史
Immunizations Allergies: N Y clinical manifestation
预防接种史 过敏史 无 有 临床表现
allergen: Trauma: Surgery:
过敏原 外伤... 阅读全帖 |
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i****E
发帖数: 240 | 30 来自主题: MedicalCareer版 - CS 考经 hehe,刚刚在忙儿子吃完饭，匆忙之间没仔细写。。抱着儿子在罗嗦几句。
刚开始准备的时候，根据不同的case总结自己的protocol,反复练习。体检也是这样准
备的，不同的case要有不同的体检protocol,打个比方： fatigue就要做全套thyroid和
deression( neuro,mmse); amenorrhea要检查eye field, thyroid,abd等等。（很久
没看书了，例子里面可能有错误。。希望大家理解我的意思就好了。。）这样的好处是
，进去之后不慌张，洗手的时候，把该做的体检快速想一下。
我不觉得这个考试容易，多花时间还是必要的。patient note我也反复练习了，因为我
的打字速度不是很快，而且考场上要花时间organize病人的complaint使PN看起来有条
理，对我这个wrting 很差的人来说就必须熟练才行。
如果请了tutor,我觉得communication part没有那么难，就是强调的那几点：微笑，
eye contact,说话语速慢而soft..
我自己练习的时候是8分钟for history taking+physic... 阅读全帖 |
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i**********d
发帖数: 853 | 31 A 43-year-old woman comes to the physician because she has not had a
menstrual period for 3 months. Vital signs
are normal. Examination of the breasts shows expressible galactorrhea
bilaterally; there is no tenderness.
Examination of external genitalia shows no abnormalities. The vaginal mucosa
is pink and moist. There is a small
cervical os with no lesions, drainage, or tenderness; cervical mucus is
consistent with the proliferative phase. The
uterus is small, nontender, and slightly posterior.... 阅读全帖 |
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h*******r
发帖数: 182 | 32 Question: why TSH is at normal level while T4 is low in this patient?
Low T4 will lead to increase of TRH, which stimulates TSH and prolactin. In
the presence of stalk lesion, TSH and prolactin cannot be increased by TRH.
Prolactinoma will cause amenorrhea, but should not change TRH and TSH levels.
So prolactinoma should not be considered even given in the options.
prolactintrophic |
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b******a
发帖数: 704 | 33 Failure of endogenous insulin secretion to be suppressed by hypoglycemia is
the hallmark of an insulinoma. Thus, the finding of inappropriately elevated
levels of insulin in the face of hypoglycemia is the key to diagnosis. A
plasma insulin concentration of >3 microU/mL (20.8 pmol/L) when the plasma
glucose concentration is below 55 mg/dL (3.0 mmol/L) indicates an excess of
insulin and is consistent with insulinoma.
Plasma C-peptide distinguishes endogenous from exogenous hyperinsulinemia.
In p... 阅读全帖 |
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d******0
发帖数: 296 | 34 I practice 8 cases with different people and I feel a little bit upset, `
cause I kept making same mistakes again and again. For instance, Amenorrhea,
I wrote down PPPPT. and forget to ask about Menopause.Last Pep smear,
Menarche.
OK, keep practice.
DaobanID, I add u to the list. |
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d****y
发帖数: 2180 | 35 ☆─────────────────────────────────────☆
zhu84518 (lot) 于 (Wed Aug 8 22:41:34 2012, 美东) 提到:
A previously healthy 32-year-old woman who works as a nurse comes to the
emergency department because of a 3-week history of episodes of dizziness,
nausea, and profuse sweating that resolve with eating. She does not smoke.
She drinks four glasses of wine weekly. Vital signs are within normal limits
. Physical examination shows no abnormalities. While in the emergency
department, she becomes dizzy and... 阅读全帖 |
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e****0
发帖数: 678 | 36 Screening
Pap smear for vervical cancer is 21 yo
DM
24-28 weeks
One hour 50 grams oral glucose tolerance test. BG > 140
Three hours glucose tolerance test (if two or more are positive)
1. Fasting BG > 95
2. One hour BG > 180
3. Two hours BG> 155
4. Three hours BG > 140
• Dysfunctional uterine bleeding (DUB)
Heavy vaginal bleeding occurs in the absence of structural or
organic disease
Endometrial biop... 阅读全帖 |
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W******y
发帖数: 60 | 37 下个月要考CS；这些天在练各种Cases；网上练，也跟老婆练习。昨天开始试着写
patient note，发现好多专业名词不会写。比如，diarrhea，amenorrhea，这些还算好
的；到了消化道那部分，好多bacteria和parasites，更是不会写了。不知道过来的人
是怎么解决这个问题的？你们都会写吗？我想这个应该是会影响得分的。 |
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m********7
发帖数: 32 | 38 边听边做的记录，有些不准确或不全面的地方，欢迎大家指正和补充。
再次感谢几位前辈的分享！
CS webinar
Adrienne：
全职
熟悉fa大case
鉴别诊断做笔记
练两周后，上kaplan班，再练两周考试
应试的考试
不需要完美的英语，12个病人，10-12分钟交流，内容很熟悉，目的：得到你想要的信
息，诊断，病人想说的信息问出来；需要病人听得懂（简单的语言，语速不要太快，模
板，避免she/he, hands, tense这种错误，不用复杂的单词，地道，语调，语气：同情
等，不要像背书，脱口而出，跟情景语气等符合），病人的话听得懂（100%注意力，同
时要做笔记），避免彼此的重复，注意病人是否听着费力，不要经常用一种开头或
response，但是仍然要简单
CIS: 听懂病人情绪变化，病人暗示了，一定要接上给response, non-verbal, 打招呼
，眼神，坐得比病人低（病人心理出于劣势，仰视病人，不要站着- 感觉rush，没有足
够的关注），关心，身体前倾。情绪变化很subtle，要察觉到，安抚等。
洗手，开头介绍
急腹症，一直微笑，no!!!；不是很急的，可以... 阅读全帖 |
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k******e
发帖数: 80 | 39 我是08年10月底开始申请加州考试的，今年1月底通过审核。中间因为找学校教务处盖
章很麻烦，耽误了2个多月，材料才得以从学校寄出。个人觉得申请算是比较顺利。把
我当时准备的情况跟大家说一下也许对将要申请的人有一点帮助。
我个人从这里寄出去的材料包括：
1.国内护士执照的公正，在这里网上找的公证处，在纽约，叫最佳公正，电话
7183212810
2.指纹卡，就在我住的地方的警察局办的，free
3.handbook上的申请表，贴一张照片在右下角（handbook链接：http://www.rn.ca.gov/pdfs/applicants/exam-app.pdf）
这一页有一项是填社会安全号，我当时没有就空着的，没有关系。
4.两张支票，一张办指纹的($51)，一张申请的($75)
5.写了一封信，表示感谢，一张纸，很客气的几句话
从学校寄出的材料：
1.中英文成绩单（学校有，我来之前到学校教务处办好的）
2.学位证书和毕业证书中英文版（来之前自己办好到学校教务处办好的，盖好了章）
3.课程描述9门（内外妇儿、精神科护理、生理、解剖、免疫、微生物，好像是这些，
请参考的人自己再斟酌。）... 阅读全帖 |
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a*******g
发帖数: 2813 | 40 DESCRIPTION OF Traditional Chinese Medicine
Course Name: Traditional Chinese Medicine
Theory Hours: 40 (1 semesters)
Clinical Hours: 40
Objectives:
This course is very foundation of Traditional Chinese Medicine, mainly
focuses on fundamental principles, theory knowledge and diagnostics skills
of Traditional Chinese Medicine. This course is designed to introduce
Chinese medical theories and clinical uses, help users learn basic concepts
in Chinese diagnostics such as diagnosis, symptoms, patterns... 阅读全帖 |
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a*******g
发帖数: 2813 | 41 DESCRIPTION OF Traditional Chinese Medicine
Course Name: Traditional Chinese Medicine
Theory Hours: 40 (1 semesters)
Clinical Hours: 40
Objectives:
This course is very foundation of Traditional Chinese Medicine, mainly
focuses on fundamental principles, theory knowledge and diagnostics skills
of Traditional Chinese Medicine. This course is designed to introduce
Chinese medical theories and clinical uses, help users learn basic concepts
in Chinese diagnostics such as diagnosis, symptoms, patterns... 阅读全帖 |
|
w******y
发帖数: 4871 | 42 I dont know.
but this is the side effect of tamoxifen:
Adverse Reactions Significant
>10%:
Cardiovascular: Vasodilation (41%), flushing (33%), hypertension (11%),
peripheral edema (11%)
Central nervous system: Mood changes (12% to 18%), pain (3% to 16%),
depression (2% to 12%)
Dermatologic: Skin changes (6% to 19%), rash (13%)
Endocrine & metabolic: Hot flashes (3% to 80%), fluid retention (32%),
altered menses (13% to 25%), amenorrhea (16%)
Gastrointestinal: Nausea (5% to 26%), weight loss (23%... 阅读全帖 |
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