w******y
发帖数: 4871 | 1 yes, exactly!
if u go get a CXR, u will get bill for doing chest xray(film fee, blah blah)
, tech fee, and also the bill from doctors who read ur chest xray.
For example, I had a pt come in yesterday with bp 225/115, no symptom, what
can I do? I can not let pt go home like that, i have to find out why and
evaluate pt if he needs to be transferred to ER. if pt refuse, he has to
sign AMA(against medical advice).
If they call in, usually nurses will tell them they have to come in to the
office to s... 阅读全帖 |
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h*****a
发帖数: 1992 | 2 You need to swap your Zipp 808 with his Mavic CXR 80:-) |
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s*******9
发帖数: 5 | 3 sql server 2005 安装在windows server 2008 R2
msdtc 出现错误：
MS DTC 组件产生了一个异常。错误说明: The process '"C:Program FilesMicrosoft
SQL ServerMSSQL.1MSSQLBinnsqlservr.exe" -sMSSQLSERVER' hit an exception in a
MSDTC related component.
The following exception (0xc0000005) was generated at 0x00000000016F760F,
Pid:1980.
The process is being terminated.
Additional information useful in a debugger:
You can do '.exr 0x0000000003B1E570' to display the exception record.
You can do '.cxr 0x0000000003B1E080' to display t... 阅读全帖 |
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l*******8
发帖数: 1745 | 4 来自主题: MedicalCareer版 - 请教啊！ 谢谢！ 我怕pneumothorax, then order portable cxr STAT |
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k*****e
发帖数: 372 | 5 1. Chronic cough check HIV/TB/ACEi
怀疑HIV，问Sexual Partner, 记得要问数量还有性别，homosexual是大tip，问
ontraceptive method，问illicit drug use， 既往心内膜炎、骨髓炎病史，问机会
感染
怀疑TB，问sick contact，nursing home 或贫民区是可能的回答，也要问PPD/CXR
结果，
问recent travel Hx，特别是广大“亚非拉美”等在老美眼中“贫穷落后”的地区
ACEi吃多了，也会干咳，问问Medication就好了
2. Rectal exam & FOBC for any abd. cc & fatique cc
肛门指检，请不要吝惜那珍贵的一下！所有胃肠症状（黑便、腹泻、便秘、腹痛、
黄疸，
指指指），所有尿尿不畅症状（夜尿、多尿、尿不尽，指指指），千万不要放过
fatique，因
为一个大DD（differential diagnosis）就是恶性肿瘤，另一个是贫血，均跟结肠肿瘤
相关，
colorectal CA发 |
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s*****e
发帖数: 222 | 6 thanks for sharing
精华区的去也
CXR |
|
C***g
发帖数: 55 | 7 CBC, CXR, LFT, Hepatitis B Panel( HBsAg, HBsAb, HbcAb, HBeAb, HBeAg) |
|
u***e
发帖数: 611 | 8 不佩服风mm不行，又学了不少。
没有人想到PE吗？半夜里把attending叫起来后，她第一个反应是病人又来了一次PE。
病人在做CT前就被上了heparin drip，转到了ICU。PT INR回来后是1.2. SaO2很好，没
有chest pain, SOB.
至于fluid，a-fib八成是和这个有关，病人的确如风mm分析的以前的echo有右心扩大，
LV的EF是正常的，我和senior谈了他还是认为要bolus病人。肺没有crackle，CXR没有
congestion. 脚也不肿，不太像是fluid overload. 现在病人还在run着fluid..... 我
不知道well compensated的右心衰是不是需要fluid restriction.
BMP回来后钾只有2.1，低钾会导致afib吗，不太确定。
BUN 55,Creatinine 1.2, 看上去像dehydration. 这个肾功能你们会让病人去做
contrast CT吗？
下回分解。 |
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R**********n
发帖数: 473 | 9 今天看到Kaplan notes TB-- 说不管vaccinated与否，只要PPD阳性，也不管CXR阴性或
阳性。只要PPD阳性，就得上INH+VitB6 治疗9个月。不知实际情况是否如此？那我们很
多中国人，印度人不都得吃药9个月？还有，吃了9个月后难道PPD就变阴性了吗？如果
还是阳性，那不得再吃上9个月？按这么说，得终身吃药了。如果病人不愿意吃药，只
是按Prescription买了9个月的药，然后扔掉，医师又如何辨别病人是否吃了药？
还有，PPD阳性会对做observation,residency 有影响吗？会被强制吃药吗？多谢指教
！ |
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U******u
发帖数: 5829 | 10 agree and same to me.
When I was resident, fellow, and now attending, I changed 3 university, each
PE, PPD +, and I just went to have a CXR, and showed it to health service
it's ng, then I just report each year if I have cough, low fever, weat at
night, and lost weight,etc.
Never taken any INH regimen for chemo.
I think every institute has its own policy. NO universal manditary policy to
take IHN for PPD+ ppl.
dok
CDC |
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R**********n
发帖数: 473 | 11 今天看到Kaplan notes TB-- 说不管vaccinated与否，只要PPD阳性，也不管CXR阴性或
阳性。只要PPD阳性，就得上INH+VitB6 治疗9个月。不知实际情况是否如此？那我们很
多中国人，印度人不都得吃药9个月？还有，吃了9个月后难道PPD就变阴性了吗？如果
还是阳性，那不得再吃上9个月？按这么说，得终身吃药了。如果病人不愿意吃药，只
是按Prescription买了9个月的药，然后扔掉，医师又如何辨别病人是否吃了药？
还有，PPD阳性会对做observation,residency 有影响吗？会被强制吃药吗？多谢指教
！ |
|
U******u
发帖数: 5829 | 12 agree and same to me.
When I was resident, fellow, and now attending, I changed 3 university, each
PE, PPD +, and I just went to have a CXR, and showed it to health service
it's ng, then I just report each year if I have cough, low fever, weat at
night, and lost weight,etc.
Never taken any INH regimen for chemo.
I think every institute has its own policy. NO universal manditary policy to
take IHN for PPD+ ppl.
dok
CDC |
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a****9
发帖数: 773 | 13 Do a CXR,if normal,anti-TB Tx is recommended but not mandatory. |
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b*****m
发帖数: 438 | 14 It seems INH for 9 months is mandatory for many residency programs even if
the candidate has a normal CXR... |
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r*****2
发帖数: 309 | 15 不用啊!pre-employment体检的时候现在的医院让做个Quantiferon-gold test,结果是
阴性的.就什么事也没了.第二年体检的时候告诉他们在前一年没症状,ppd强阳性(一周
后还20公分),拍CXR,正常就没事了.现在在的医院病人大都是移民,曾有military TB的
接触史(工作中),医院也没让牵制性让服用INH的.祝intern year顺利. |
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M****a
发帖数: 577 | 16 偶以前呆的医院一看CXR阴性，就放行了，没让吃INH。过了好一阵子又让我查QFT-Gold
，结果还是阴性，第二次放行。
偶现在这个医院，医务室的大夫很认真，说QFT-Gold不够灵敏，有假阴性，要再做一个
T-Spot。不过大夫还是打电话去跟管事的确认一下，在电话里争了20分钟，最后还是没
做T-Spot,也没吃INH，又一次放行。
INH吃几个月估计也没什么副作用，不过以后你换一个医院做Fellowship或Attending，
PPD还是阳性，到时是吃还是不吃呢？
want
generally |
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t****o
发帖数: 342 | 17
春大侠也来捧场，多谢, 上次指点的预激综合征还历历在目，请有空的时候再多给讲arrythmia,谢拉～
这里是记下的答案，没有桥正过拼写，如果有错，还请大家指出，一起改正
1. What labs will you order to confirm the arrhythmia?
EKG, CXR-if with SOB
2. Name all the supraventricular tachycardia
sinus tachycardia, A fibrillation, A flutter, multifocal atrial tachycardia, atrioventricular reentrant tachycardia, atrioventricular reciprocating tachycardia, paroxysmal atrial tachycardia
3. Which of these tachycardia is associated with irregular rhythm?
multifocal atrial tachycardia, A |
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f*******2
发帖数: 656 | 18 more than often people know you through conversations. 1) try to discuss
patients' condition as much as you can with residents and attendings. most
of time they love to talk about this, even you speak of something they know
already, to them it is still a good reminder. 2) if you notice some changes
while the others don't, raise your concerns and talk to someone around you.
say, this patient has increased o2 dependency compared to yesterday, you may
hit a good point if they order a CXR and find o |
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l********y
发帖数: 2295 | 19 【 以下文字转载自 Pre_Resident_Club 俱乐部 】
发信人: lovelypony (pony), 信区: Pre_Resident_Club
标 题: case presentation 学习笔记
发信站: BBS 未名空间站 (Tue Feb 22 20:03:05 2011, 美东)
昨天第一次参加了由现任斑竹chipmunk和元老knockingdown主持的case presentation
，觉得收获很大，后面慢慢的把自己的学习笔记贴出来，后面的同学看了可以少犯些我
们犯过的低级错误，这样前辈们也可以省些力气。前辈们牺牲自己宝贵的私人时间，聆听我们支离破碎，毫无章法的presentation ，耐心细致的指出错误，提出建议，pony真的觉得没有更好的语言来表达自己的感激之情。就希望能抛砖引玉，大家能互帮互助，提高我们CMG的整体水平，这样前辈们的心思也算没有白花，希望大家都能来补充和指出错误，多谢了！
要present一个case，结构一定要完整。
1. CC: 第一句话永远是chief complaint，怎么样用一句话简明扼要的把CC说好了，还是要花大... 阅读全帖 |
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R**********n
发帖数: 473 | 20 昨天和今天考了step3，但愿pass, 跟usmle说88了。从考完CK到现在，都一年了。当中
经历了跨州搬家，CS, OB, 第二个宝宝出生，申请，面试。
去年6月就买了uw ， 但只做了mcq, 后来肚子太大懒得去考，就搁下了。直到差不多面
完，12-1月才pickup。这次又买了3个月的uw mcq+ccs, 重新做题。MTB是上次看的，这
次没看，但是看了一遍CK first aid, 因为很多基本的东西都忘了。Family practice
看了一半。从考试内容来看，如果说什么东西还占上点边，那就是uw了。还有CK基础很
重要。我可以这么说，pony要是明天就去考step3, 假设她ccs已经练好了，肯定是99，
因为实在没有什么额外的东西。我考的不好是因为基础就不扎实，再让我看上一年也就
这样了，因为脑容量有限，记不住就是记不住。
第一天7个block, 5个office觉得还能handle。那2个 ER, 题目又臭又长，很多看了2遍
也不知所云，勉强做完。前一晚又没睡，考时觉得恶心，然后跳出来的图又增加了恶心
感。昨晚吃了安眠药，今天总算survive了。（我们这里天天... 阅读全帖 |
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A*******s
发帖数: 9638 | 21 This case is tough. 20 WB for the first. (from BZ)
A 35 yrs old WF, was sent to ER by her husband in AM since he could not wake
her up.
The patient was entirely normal before last dinner. They planned to have
BBQ, but after she drank a can of beer and 3 cans of soda, she felt sick. So
she went to bed directly.
At ER, she was stuporous, a drug screen was neg. CT of brain, EKG, CXR were
all normal. LP is neg. UA(-), Blood culture was sent. All lab was normal
except Glucose was 60. So she was gi... 阅读全帖 |
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h****6
发帖数: 41 | 22 I will choose B.
He has fever and physical reveals decreased breath sound and wheezing, might
be having pend respiratory failure ( will need intubation).I think it's
better to admit him and monitor him with ABG, CXR.....
Please correct me if I am wrong. |
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h***y
发帖数: 834 | 23 ☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的目的就达到了。
希望所有ID， 包括考生， resident， fellow， attending，PA/NP, nurse 和中国来
的医生不再从事医疗工作的， 都能奉献你的pearl. 英文中文都行。
我先来：
CC: Left leg pain for 5 days.
35 y... 阅读全帖 |
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h***y
发帖数: 834 | 24 ☆─────────────────────────────────────☆
Aplusplus (Hakuna Matata) 于 (Sun Mar 27 11:11:49 2011, 美东) 提到:
首先我申明，我放弃我的ignore list， 欢迎所有ID参加。
每个医生护士或者其他相关人员， 无论在中国还是美国， 肯定都有一些case刻骨铭心
。 请大家把你印象最深的一例写出来， 与大家分享。 比方说， 清华男被鉈杀案，
那个中国来的护士就是诊断的关键， 相信本例就是她一辈子也忘不了的诊断。
我觉得这样的讨论有助于大家提高学医热情，丰富医学知识，开拓临床思维， 间接帮
助考版医生复习，准备CS，和 interview. 你要是能从中挑一个case让你PD
impressed，我想我的目的就达到了。
希望所有ID， 包括考生， resident， fellow， attending，PA/NP, nurse 和中国来
的医生不再从事医疗工作的， 都能奉献你的pearl. 英文中文都行。
我先来：
CC: Left leg pain for 5 days.
35 y... 阅读全帖 |
|
T****t
发帖数: 616 | 25 UA: Urinalysis
ECG: Electrocardiogram
CBC: Complete Blood Count
LFT: Liver Function Tests
CXR: Chect X-ray
U/S abdomen: Ultrasound abdomen(liver, gallbladder, spleen, pancreas,
kidneys) |
|
J********1
发帖数: 66 | 26 一晃眼，五周的内科OB做完了。虽然严格遵守规定，眼看手不动（不想给sponsor我的
医生带来麻烦），但还是很有体会的。看到了resident们和intern们的真实生活，看到
自己和他们的差距，明确了自己努力的方向，当然，也拿到了想要的推荐信，^_^。
头两周，在out-pt。感觉就像cs场景一样，比较轻松。后面的三周，在in-pt， 跟着
resident team，见到了如果match上就要开始的真实的intern生活。因为我OB的医院是
一个community hospital， 接近400床，规模不大。加上地处加州，西海岸比较不太中
规中矩，所以他们的wards round和我想象中不太一样。我跟的team是一个hospitalist
，带一个R3， 两个intern，还有一个从Standford来的医学生。每天早上7点intern来
接班，看病人，然后8点到9点morning report，由night float选一个mini case，主要
是看影像学的片子；然后一个正式的case report，由PD或者带教的attending主持，一
起学习有意思的病例。9点半，正... 阅读全帖 |
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l*******8
发帖数: 1745 | 27 来自主题: MedicalCareer版 - 请求帮助 chief complain到底是？
体检？vital sign?耳朵前庭的检查。decreased lung breath sound? JVD? heart
murmur(intensity? location? diastolic or systolic)? lower extremity edema?(
pitting or non pitting?)check手指头too.
Lab: CBC, BMP, urine analysis, urine micro albumin, EKG(不知道最近的那个EKG
只有LVH还是有别的什么），Echo, CXR, carotid U/S, may need head CT
最好还是去好医院看看吧。 |
|
w***0
发帖数: 222 | 28 two things I will discuss---your exposure to "active TB" and the BCG.
First of all, I don't believe your post. However, It might be a good
chance
to talk about BCG and TB exposure.
I don't know where you are practicing or if you are a dentist, or
assistant.
the tuberculosis, especially active, is a affirmative reportable
disease
to the State; and the patient has been documented and been regulated for
his
/her activities. If the patient is in the US, it is very strange to see.
if you did have cl... 阅读全帖 |
|
w***0
发帖数: 222 | 29 two things I will discuss---your exposure to "active TB" and the BCG.
First of all, I don't believe your post. However, It might be a good
chance
to talk about BCG and TB exposure.
I don't know where you are practicing or if you are a dentist, or
assistant.
the tuberculosis, especially active, is a affirmative reportable
disease
to the State; and the patient has been documented and been regulated for
his
/her activities. If the patient is in the US, it is very strange to see.
if you did have cl... 阅读全帖 |
|
a*********m
发帖数: 26 | 30 Good News!!! Research volunteer position available in Dr. Pan's office in
Flushing, NY. The following is Dr. Pan's message to ACAP.
As we have rapid expanding clinical research activities in my private
practice ( currently 8 clinicl trials on site), I would like to offer one
voluntary position for CMG who like to commit a minimum of 20 hours a week
on clinical research for consecutive 12 months. As a clinical research
assistant working with me, the candidate will have the opportunity to
interac... 阅读全帖 |
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m******r
发帖数: 1904 | 31 1.没用过。不懂。
2.Common abbreviations for SP note
BP Blood pressure
P pulse
R respiatory rate
T temperature
yo year-old
m male
f female
b black
w white
L left
R right
hx history
h/o history of
c/o complaining of
NL normal limits
WNL within normal limits
Ø without or no
+ positive
- negative
Abd abdomen
AIDS acquired immune deficiency... 阅读全帖 |
|
A*******s
发帖数: 9638 | 32 1. 钱的问题不是问题，做完residency就好了， 所以说你是杞人忧天。
2. 如果有选择， 当然到好的program， 好的training是你的一切， 你一辈子的本钱
， 其他因素都不重要。 如果只有一个选择， 去不去都得去吧？
3. 心肝叩摸不出来不要慌张， 没有人天生就有这个本事， 但基本的要知道， 肥胖病
人查不出来很正常， 但如果怀疑那方面的病， 留神一点Lab，CXR， U/S等等。 不要
太纠缠个别细节， 但问完病史查完体说不出诊断和治疗方案就不妙了。
叩摸不出来咋办？ |
|
s*****1
发帖数: 273 | 33 非常感谢tele的热心和细心指点。听完以后大概知道如何准备Case Presentation了。
总之还是要多练多说。
另外多谢去年鼠大提供的DT的模板。
==
SUMMARY:
A 42-year-old male with PMH of alcohol abuse x 20 years, h/o multiple
substance abuse was brought to the ER by his family in a state of confusion.
Last drink 3 days ago. His family member provided history because he is a
poor historian. He hasn't have seizure before. He has been having auditory
hallucinations, tremors, nausea, fever, tachypnea, 2 episodes of non bloody
vomiting, and insomnia for one day. N... 阅读全帖 |
|
s**********t
发帖数: 217 | 34 Normally, I let the residents to report the new cases to me, not the interns
. Sorry for the new interns.
So, here, I am going to focus on what do you need to know for the follow up
patient.
As an ICU intern, you will get a sign out from your night intern(s), either
oral or in written or both the first thing in the morning. So, you know what
’s going on after you leave. That is from doctor’s standpoint. Then go to
talk to the nurse. You will get information from the nurse’s standpoint.
Sometime... 阅读全帖 |
|
e****0
发帖数: 678 | 35 翻翻我的箱子底， 找到我自己临考前的单子。
•Pregnancy
CBC/BMP
Blood type and Rh
Atypical antibodies/rubella AB
UAUCX
HIV/RPR/HBSag
Chlamydia/pap smear
•All disease
Diet
Exercise
Consult/counseling/consent/vaccine/screening/monitoring
PT/OT
•Acute R distress
Oxygen
ABG
Chest X ray
Pulse oximetry q 1hour
•COPD/asthma PEFR+Elevated head of bed
•All arthritis
Synovial fluid
•All office cases
CBC/BMP, PT/PTT, UA/UCX, FOBT, LIPD/LFT, ESR/TSH, EKG/Glucometer/CXR
•Surgery
NPO/bedres... 阅读全帖 |
|
B****r
发帖数: 1737 | 36 看了三次医生，没有任何进展。可能下周要收入院了。小地方没有儿童医院，也不知道
该不该换个别的医生。恳请大家帮着瞧瞧 （病人情况如下）。万分感谢。
5 yo female with persistent cough x 14 days and fever x 10 days. Fever runs
102-104 F, but does normalize when given motrin or tylenol. Symptom no
improvement after 4 days of Azithromycin. Began to have loose stool /watery
diarrhea for past 3-4 days. She had complained of abdominal pain (mostly
peri-umbilical) intermittently for the past 2-3 weeks. Has a history of
problems with constipation. Slightly decreased PO intake, ... 阅读全帖 |
|
m******r
发帖数: 1904 | 37 ☆─────────────────────────────────────☆
oldclock (oldclock) 于 (Wed Apr 18 10:59:11 2012, 美东) 提到:
1。step2 CS的UW video要单买还是在CS的UW题库里都包括了？
2。patient note可以写ABBREVIATIONS吗？除了FA上的ABBREVIATIONS，还有其他哪些
地方的ABBREVIATIONS可以用呢？
3。此外，看到麦地里有提到过patient note用子弹体方式书写，什莫是子弹体啊？哪
里可以找到范文呢？ 给扫扫盲吧。
多谢各位了！
☆─────────────────────────────────────☆
medwater (小麦) 于 (Wed Apr 18 11:08:03 2012, 美东) 提到:
1.没用过。不懂。
2.Common abbreviations for SP note
BP Blood pressure
P pulse
R respiatory rat... 阅读全帖 |
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J*********l
发帖数: 1185 | 38 娃persist ent wheezing差不多俩月了
病史如下，娃17months，有eczema，但是outgrow 了。fulltime in daycare
3月有咳嗽，流浓鼻涕。偶尔听到wheezing。和儿医提到wheezing，她说不要太容易给
娃贴标签。上抗生素10天，效果明显。
4月中搬家后，收拾院子。娃经常在边上玩。
娃开始明显wheezing，同时runny nose， cough。尤其是哭闹后明显。
5月初看儿医。当时在诊所做inhale albuterol。o2 sat 97%. 治疗前的o2 sat 没查，
娃哭闹厉害。儿医说，wheezing在albuterol 后有改善。开抗生素10天，和albuterol
液体。
10天后，runny nose 有改善。wheezing 继续。
6月初看儿医。albuterol 和 steroid inhaler。一周后，没反映。继续wheezing，周
一轻度发烧。
上周二看儿医，口服prednisone，steroid inhaler，albuterol inhaler。娃还是
wheezing。
同时... 阅读全帖 |
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r******y
发帖数: 146 | 39 今天和一个med student聊天，他掏出iPad给我演示学校送的学习解剖的App，当场被迷
住了。名字叫Essential Anatomy 2，$24.99，在Apple的App Store上。记得学CNS
neural pathways的迷惑吗，一级级下传，一个个孔出来，一头雾水；记得学ECG、CXR
的时候，对4个chambers位置的疑惑吗。这个app里头，完全是3D，可以转到任何角度观
察，可以剥去或者半透明显示覆盖的结构，图像质量无与伦比。支持按系统搜索/显示
，解释详尽，允许拷屏，有发音。要是早有这个app，3年前复习Step1的时候就容易多
了。强烈推荐！
下面附张screen shot: the relative position of the right and left atria is
shown w/o the presence of the right and left ventricles. |
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d*********n
发帖数: 18 | 40 Confusion case: O CFDP P ADL, IADL, TIA/stroke, depression, DM, thyroid,
normal pressure hydrocephalus, PAMHUGSFOSS
insulin induced hypoglycemia
Electrolyte abnormalities
Vitamin B12 deficiency
Medications
TIA
Multi-infarct dementia
Chronic subdural hematoma
Alzheimer’s dementia
Normal pressure hydrocephalus
Intracranial tumor
Neurosyphilis
Depression
Hypyothyriodism
DDx Confusion
DEMENTIA
D-Diabetes /Dementia/ Drugs
E-Epilepsy
M-Migraine/Mult Infarct Dementia
E-Ethanol (withdrawl / Toxicity)
N... 阅读全帖 |
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J******i
发帖数: 1 | 41 Hi all,
There was a saying that much more residency programs are willing to provide
J1 instead of H1B visa. Is it true? I won't be able to obtain a green card
before Match; therefore, I definitely need a J1 or H1B. If the options left
were programs only providing J1 visa, am I supposed to get a job in a
Chinese hospital beforehand? Since I also heard that you want to have a base
in your citizenship country so that the program could apply to the US
department of immigrants for a ds-2019 for you.
... 阅读全帖 |
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d******g
发帖数: 258 | 42 How to manage step3 CCS?
It’s hard in the beginning, kind of clueless for me. But you will be able
to get the idea pretty quickly after 5-6 cases in computer. Here’s my
thoughts how to manage it quickly and try not to miss things.
1. Differential if need urgent care.
All Chest pain, SOB, AMS, post-trauma, little infant all need to be ordered
with ER order before physical exam.
ER order mnemonic will be POC IV, ( have to poke someone for IV line)
Pulse oxygen
Oxygen
Cardiac monitor and BP mon... 阅读全帖 |
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r*****1
发帖数: 805 | 43 还有部分Abx总结，以前有经验贴分享USMLEforum的经典贴。但自己总结的东西容易记
住。希望给大家一点帮助。
P.S.: 顺着iamreallybad&斑竹思路，旁注中文为mnemonics.
Menigitis: G- use Ceftriaxone; bacilli use Gentamycin; DXM- in S. pneumonia
& unknown microb infection
G+ cocci: Vancomycin+Ceftriaxon
G+ bacilli (Listeria): Ampicillin + Gentamycin +
dexamethasone
G- cocci: Ceftriaxon
G- bacilli: Ceftriaxon+ Gentamycin
Fungus: Amphotericin+ Flucytosin IV-> Flucona... 阅读全帖 |
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w**********0
发帖数: 6 | 44 来接力seminar note:
我粘！
人际关系： 目的是学东西，平衡心理。
Don’t mind the workload. You will be in charge of 25 pts when being an
attending. Look at the big picture. (10 max for intern)
Actively looking for interesting cases, common mistakes, to be independent,
ask questions.
Respect nurse. Call and remind them if you add a lab.
Mistakes are common, if other people remind you, or vice versa, try to
maintain you and your colleague’s authority in front of pts, making
everyone happy.
早有计划，主要目的： 1. 安身立命的本身。 学好医术,学好本事。... 阅读全帖 |
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发帖数: 1 | 45 感谢组织者和几位前辈的无私分享！响应讲者的号召，我也来接力，把自己的笔记贴上
来。
麦地Webinar：Survive Intern Year (Internal Medicine) 4/6/2016
嘉宾：Jenny、Coffee、小麦哥
首先目标要明确，有2个：
1.掌握安身立命之本——独立执业的能力
2.建立职业发展人脉——有人为你说话、写推荐信（包括PD、faculty、目标
fellowship的faculty）
工作方面：
1.关于Pre-round：
每个病人至少预留20分钟，这是比较保守的时间；但即使最快的也要10min，别忘了还
有在不同病房穿梭的时间；
一定要亲自问病人情况，因为护士可能情况不报给PGY-1只报给PGY-2，而恰好有些刚上
任的PGY-2喜欢show-off自己的领导能力。
2.关于Intern的职责和如何表现：
Intern的两大工作：1）采集信息；2）干活（跟各种人communicate + put in order）。
首先要明确别人对自己的expectation，要注意Resident和Attending很不同：
对于Resident：就是希... 阅读全帖 |
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发帖数: 1 | 46 adeno (天夺其魄) 于 (Wed May 6 16:22:43 2009) 提到:
成绩出来了，涉险挤入了９９队伍。总的来说，准备的不是很充份，详见以前贴的＂我
的step ３经历＂，主要是在吃CK的老本；其他乏善可陈，成绩单里唯一的一个星号是
给了CCS，这里就说一说CCS好了。
以前总把CCS和CS混淆，其实这两个有一个共同点就是open choices和uncertainty。在
这总场合，最重要的可能就是要有一个严格的protocol，这样可以尽量避免遗漏。考过
CS的同学都知道LIQOR AAA和PAMHUGSFOSS的重要性。CCS也一样。网上比较流行的是
Neeraj的protocol，用google一搜就能找到。非常有用。我把他的protocol稍微整理了
一下，自以为是更加简洁有条理一些。给几个朋友用了用，有的朋友觉的没有时间应用
，有的朋友用了觉的还成，让我贴出来，最后的决定是如果考出来还行就贴，要不就不
出来吓人了。
象CS一样这个protocol充满了mnemonics，开始考试之前第一件事就是把所有的
mnemonics写下来。下面９个case都可... 阅读全帖 |
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T****g
发帖数: 705 | 47 Jet’s CK (score 250+)
考经写得很详细，希望能写出Reference的效果。如果同学感兴趣用什么学习资料，有
学习资料篇；如果同学感兴趣做题分数，有分数记录篇。总之希望有同学通过我的考经
受益。
在这里，给大家讲讲考经里没有涵盖的内容。
“知识点，背一遍不如讲一遍。”记得当年复习Step 1生化时，被安排讲FA上的那张大
表。如何把所有的生化的知识融会贯通，清楚明了的给同学讲出来，是要花功夫，还需
要练习的。鼓励大家在学习中，多讲。
“避免强化错误思维”做错一道题，着重想一下正确的解题思路和题目要考察什么。因
为，正确的思路只有一个，但错误的想法可以是多种多样。不必要去重复想自己错误的
想法为什么错，以免类似考点出现是第一反应的下意识是错的。
“做题时间是个挑战”，如何应对这个挑战，要有足够的练习，还要有技巧。
想得到足够的练习，比如可以用Kaplan的题库，新鲜的题目来进行。
阅读技巧：如果有图（EKG, CXR），先读；如果有报告单，先读：然后读选项，知
道要考什么方向的知识；然后读问题，已经倒数的一两行；最后再读题干。
达到一目五六行，并且还记... 阅读全帖 |
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l**********t
发帖数: 1212 | 48 pat, pat though i know nothing about it. |
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R******7
发帖数: 53 | 49 I don't know what happened and why I had infiltration. I have no coughing
no fever at all, and all my blood test result is within normal range. And
idea? |
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y*********c
发帖数: 1014 | 50 Maybe your immune system can fight those symptoms now. If i were you , I
would worry my health at this moment. If i were your patient, I wouldn't
want you to take care of me either. I am sorry to say that. You are not only
protecting yourself but also your patient. |
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