t**m
发帖数: 60 | 1 今天收到医院的账单，单词都看不懂，版上的大牛帮忙看看，翻译一下
这里面包括救护车的钱吗？
还是救护车的钱另外寄一个账单？
Pepcid 20mg permix 20mg/50mL
ED-level 4
IV Solutions
CS, Catheter, IV
CS, Heparin Lock
CS, Gauze, Adaptic
ED-Procedure 1
Autom Urinalysis WO micro
HCG, QUAL
Compl CBC W PLT W Autom Diff
Basic Metabolic Panel
Hepatic Function Panel
Amylase
Lipase
Ondansetron 4mg
这些都是啥意思啊？ |
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s*******w
发帖数: 1879 | 2 Pepcid 20mg permix 20mg/50mL 药
ED-level 4 挂号
IV Solutions 输液
CS, Catheter, IV 输液管的一部分
CS, Heparin Lock 输液管的一部分
CS, Gauze, Adaptic 输液管的一部分
ED-Procedure 1
Autom Urinalysis WO micro 尿检
HCG, QUAL 孕检
Compl CBC W PLT W Autom Diff 血常规
Basic Metabolic Panel 血常规生化指标
Hepatic Function Panel 肝功能
Amylase 淀粉酶
Lipase 脂肪酶
Ondansetron 4mg 药
google吧，google都有 |
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a***u
发帖数: 318 | 3 小妹正在攻读NP，前不久完成导师给的case study，等批下来发现分数不理想，原因似
乎是我理解错误（因果不分），读了导师给我的“完美答案”，我心里依然固执地认为
我没错。知道这里的高手如云，所以想来讨个公道，当然输也要输的心服口服。
CASE STUDY
A young woman was admitted with 28 weeks of intermittent abdominal pain and
leg spasms. She had also noted increasing left leg pain for a few weeks
before admission. The leg pain had in-creased resulted in 14 days bedrest
before admission. The leg spasms were related to the movement of the lower
extremities. Review of systems was remarkable for in-creased irritabilit... 阅读全帖 |
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R**********n
发帖数: 473 | 4 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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N****e
发帖数: 31 | 5 38yr, female, present with diarrhea for 4 days, initially loose watery
diarrhea, 3-4 times/days, now every hour, and blood mixed with the stool,
medium volume, non-foul smelling, with mild crampy abd pain. Had a course of
antibiotics (Keflex) 2 weeks ago
Labs:
LFTs/Amylase/Lipase: WNL
Chemo: Na 137 K 3.4 Cl 108 CO2 23 BUN 6 Cr 0.6 Glu
127
CBC: WBC 13.6 Hgb 12.4 HCT 37.9 Plt 264
Coag: PT 12.2 INR 1.1 PTT 29
Hospital Course:
1. IVF, po hydration
2. St... 阅读全帖 |
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N****e
发帖数: 31 | 6 38yr, female, present to PAH on 4/4/10 with diarrhea for 4 days, initially
loose watery diarrhea, 3-4 times/days, now worse and loose watery stool
every hour, and blood mixed with the stool, medium volume, non-foul smelling
, with mild crampy abd pain. Have had 5 BMs since yesterday, and the last
one almost all blood. (+) subjective fever, no chills, no cough/SOB. Had a
course of antibiotics (Keflex) 2 weeks ago (3/9/10- 3/14/10).
PMHx: Kidney stones, Seizure disorders, Vit D deficiency
PSHx: S... 阅读全帖 |
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c****e
发帖数: 188 | 7 I agree with A.
Many patients with chronic pancreatitis have low serum cholesterol that
results in low level of bile acid synthesis. Bile salts from the liver are
needed to break down and absorb fat. Any condition that results in decreased
lipase or bile salts can cause steatorrhea (foul smelling stool).
is
fasting |
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d******0
发帖数: 296 | 8 Case 1
Opening scenario:
Sharon Smith, a 48-year-old female,comes to the clinic complaining of
abdominal pain. Married with four children.
Vital signs:
BP:135/70 mmHg
Temp:98.5 F
RR:16/minute
HR:76/minute, regular
Protocol:
Knock three times with confidence, a smile, walk in and say:
Good morning, Ms Smith. I am Dr. Dora, and I am here to see you today as
your physician. Nice to meet you .Shake hands. Is everything in the room
alright for you? Let me cover you with this to make you a little m... 阅读全帖 |
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t******9
发帖数: 270 | 9 企图记住口诀，但是从口诀首字母转换成相应的内容总要想半天。而不写下来真的很容
易忘。我想在考试开始之前把所有常用项目写下来，做题的时候对照一下有没有漏。不
知道到时候有没有这个时间和办法写。有纸或者board吗？不知道下面的列表有没有什
么需要加的，请考过的朋友帮忙。谢谢！
Monitor组；
IV access
pulse ox
oxygen
cardiac monitor
bp monitor
三大常规组：
cbc
bmp
mag
pt/inr
ptt
blood type and ab screening
type and cross
blood culture
tsh
lipid profile
beta-hcg
LFT
amylase
lipase
trop
cpk
FSBS
ua
urine culture
stool culture
检查组：
ekg
FEV1
PEFR
chest x-ray
u/s
KUB
ct
echo
eeg
mri
对症处理组：
meds for nausea
for fever
for pain
入院常规：
npo
bed rest
stock... 阅读全帖 |
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m******r
发帖数: 1904 | 10 ☆─────────────────────────────────────☆
dora2010 (dora) 于 (Wed Feb 29 16:55:46 2012, 美东) 提到:
Case 1
Opening scenario:
Sharon Smith, a 48-year-old female,comes to the clinic complaining of
abdominal pain. Married with four children.
Vital signs:
BP:135/70 mmHg
Temp:98.5 F
RR:16/minute
HR:76/minute, regular
Protocol:
Knock three times with confidence, a smile, walk in and say:
Good morning, Ms Smith. I am Dr. Dora, and I am here to see you today as
your physician. Nice to meet you .Shake ha... 阅读全帖 |
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e****0
发帖数: 678 | 11 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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d******g
发帖数: 258 | 12 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 | 13 My CCS protocol:
P.S.：多有重复，谨防遗漏，仅供参考。
Screening test: General—Lipid profile/ multi-vitamin; Elderly—DEXA scan&
Calcium& VitD/ Colonscopy or FOBT/ vaccination; F-- >18yo Pap smear; >50yo
Mammogram; reproductive age- folate; menopause- Lipid/DEXA/FOBT; M-- >50yo
PSA; sickle cell dz child-prophylaxis w penicillin till 5yo, CF-prophylaxis
w Abx
Prophylaxis: Pantoprazole, pneumatic compression stocking;
Acute abd w perforation: triple Abx- Gentamycin/ Ampicillin/
Metronidazole (口诀：阿扁举旗庆国庆)
E... 阅读全帖 |
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z******8
发帖数: 844 | 14 ☆─────────────────────────────────────☆
rhcrc11 (Rebel) 于 (Thu May 15 00:13:42 2014, 美东) 提到:
Step3考场壮烈回来。第一天挺累人，最后一个block甚至做到有心无力状，看着题反应
不过来，导致来不及做完。非常没有信心能否通过。所以match之前先考Step3的童鞋，
需要考前调整生物钟，坚持锻炼，提高耐力。
MCQ没有资格说，CCS有一点小感受，拿出来分享下。大家请轻拍砖。
复习资料：
UW 52 online cases : 基础。最好复习早起找高手一起过一遍，尽快摸熟软件，进入
状态。第二遍找一位水平相近童鞋过一遍，不断总结protocol. 考前迅速做一遍，熟练
运用protocol.
UW 41 offline cases: 我当时和partner每个case仔细做一遍，虽然不像online有反馈
，但对练临床思维，补充protocol非常有帮助。最后考试与41 case有异曲同工之处，
遇到复杂case也不慌神。
CD 6 cases： 最后再熟悉下考试软件。与UW相近，但... 阅读全帖 |
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t********o
发帖数: 228 | 15 Just found out i passed it. Well, not a big surprise and finally, I can say
good by to USMLE
Material: MTB3 and UptoDate. Step 1/Step2: 250/249 but those were 3 years
ago. Step 3: 227. Time: on/off for 3 months.
Good luck to everybody.
Not a whole lot of thoughts about this test. if you can memorize MTB3 and UW
, then there should be NO problem to pass it.
here are some thoughts about this CCS (combined mine and others)
Step I: patients: VASCULAR
Vitals/Age/Sex/Chief complaint/Urgent sympt... 阅读全帖 |
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y******7
发帖数: 17 | 16 The following is what I collected when I was a student doing capstone in a
local hospital. Not sure if it is useful.
Lidocaine topical is a amide-type local anesthetic. for production of
topical anesthesia, relief of pain associated with postherpetic neuralgia,
reduction of gagging during dental procedures, prevention and control of
urethral pain, anesthetic lubricant for endotracheal intubation, and relief
of hemorrhoidal pain.
Polyethylene glycol(Miralax) is a nonabsorbed solution used to trea... 阅读全帖 |
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z*******o
发帖数: 136 | 17 我是想寻找一种酶可以模拟药物载体材料在血液中循环，但是不知道哪种酶更适合，还
有不知道血液酶的活性大概是多少Units？谢谢
Pseudomonas lipase from cepacia? |
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z*******o
发帖数: 136 | 18 我是想寻找一种酶可以模拟药物载体材料在血液中循环，但是不知道哪种酶更适合，还
有不知道血液酶的活性大概是多少Units？谢谢
Pseudomonas lipase from cepacia? |
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z*******o
发帖数: 136 | 19 我是想寻找一种酶可以模拟药物载体材料在血液中循环，但是不知道哪种酶更适合，还
有不知道血液酶的活性大概是多少Units？谢谢
Pseudomonas lipase from cepacia? |
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c****m
发帖数: 626 | 20 CF病人要补胰腺的蛋白酶：
Amylase
Lipase
Protease
补少了就营养不良，腹泻，补多了容易痔疮。
还容易得糖尿病。挺可怜得～ |
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l******k
发帖数: 27533 | 21 有呀，是一种三联酶，美国这边不少老年人用：amylase/lipase/protease, brand
name Creon, and others...
就是给胰脏分泌酶不足的人用帮助每顿饭消化的，没啥副作用，不过要处方。非处方的
我不熟，你自己查查
★ 发自iPhone App: ChineseWeb 8.7 |
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y***d
发帖数: 33 | 22 Sorry for the absence yesterday. Lost my labtop to burglary. What a pain!
Anyway, looks like VictorG kept everyone entertained at least.
So I believe we left off at labs. Since this is a relative short case, I
will post the initial labs along with the hospital course today. Final
diagnosis tomorrow.
Na 135 TB 1.0 WBC 2.8 PT 16.2
K 4.4 AST 55 Hgb 15.2 PTT 30.6
Cl 103 ALT 105 Hct 43.8 INR 1.3
HCO3 24 ALP 119 PLT 55
B... 阅读全帖 |
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L*****r
发帖数: 722 | 23 Dr. Aplusplus (Hakuna Matata)：Good decision-making comes from experience,
and experience comes from bad decision-making.
Dr. Lexian (蒙古大夫)：ideally, get your experience from OTHER'S bad
decision making :-)
1. When you order cultures, please write “before antibiotics are given”;
while order starting antibiotics, please write “after blood and urine
cultures are collected” . 因为用抗生素会显著影响细菌培养的结果；
注意有些特殊情况，尤其要考虑先取材培养，再上抗生素。
（1）怀疑骨髓炎，应该先probe the bone to get deep tissue culture, since
superficial cultur... 阅读全帖 |
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N*G
发帖数: 217 | 24 昨天我刚送走一个肝衰竭的病人。一个墨西哥人，肝硬化+腹水，多次以胰腺炎入院，
入院后然后很快lipase 降到正常出院。 我们怀疑他酗酒，他本人坚决否认，他老婆也
肯定说没有。又一次他入院时我们做了酒精浓度的测试，很高。看到结果，病人承认他
每天都跑出去喝不少。他老婆看到结果，她在床前哭了，她骂病人欺骗她出去喝酒。我
们才知道，他俩已经分开多年。 当初分开不知道是不是和男的酗酒有关。 但男的当地
没有亲人，子女都很远工作。 每次入院都是他前妻来照顾。
他已经hepatorenal， 昨天我们给他联系了家hospice送走了。 他前妻是个善良的中年
妇女，我给她谈病情和hospice的时候，她很伤心的哭了。 尽管分开多年，她真的关心
他。一日夫妻百日恩。
在生死和亲情面前，还有什么更重要吗？ |
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A*******s
发帖数: 9638 | 25 我会查amylase/lipase。
ruby， 你肯定在等她order吧， CT还是CTA还是VQ-scan？lol |
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b******a
发帖数: 704 | 26 Case 12-2013 — An 18-Year-Old Woman with Pulmonary Infiltrates and
Respiratory Failure
N Engl J Med 2013; 368:1537-1545
Presentation of Case
Dr. James Sawalla Guseh (Medicine): An 18-year-old woman was admitted to
this hospital because of pulmonary infiltrates and respiratory failure.
The patient had been well until 3 weeks before admission, when fever and a
cough productive of white, nonbloody sputum developed. During the next week,
night sweats, extremely painful pharyngitis, pleuritic chest ... 阅读全帖 |
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w*****s
发帖数: 230 | 27 【 以下文字转载自 Biology 讨论区 】
发信人: wwwjobs (minimouse), 信区: Biology
标 题: 请看看附件图片文字，建议我们能做什么呢？
发信站: BBS 未名空间站 (Thu Jan 16 12:24:03 2014, 美东)
附件是主治大夫的reasoning(email回复，红字)， 他的水平我们还是很佩服的，因为
他已开始猜了个病就和我们宝宝症状非常一致，可惜后来发现不是；而且他不是代谢病
专家。
问题是坚持宝宝不吃长链脂肪酸的奶粉后，他奇迹般地改善了；完全出乎医生们的预料
。我感觉医生列的是常见的代谢病，而我们感觉宝宝吃长链脂肪酸似乎是慢性中毒，大
概需要一个月左右才能体现出来。因为过程很慢，我们怀疑很多方法查不出来。
我们最大的问题是如果是这种病怎么查？不能确认的话他一辈子吃饭都受影响，基本也
就很难出门时间长一点了。尤其是他的肝已经在要换的边缘。医生们现在改口说他的病
程都是偶然，可我们不能同意。为什么每次都是长链吃一段时间就得病，尤其是这次停
了鸡蛋后马上改善。。
谢谢大家。 （下面是文字，可惜设置不成红色）
Q: Our big... 阅读全帖 |
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q********g
发帖数: 10694 | 28 观点很象这里Jenny12以前说的。从中也学习到一些分析医药股的方法。例文欣赏。
http://seekingalpha.com/article/895051-sarepta-therapeutics-loo
Sarepta Therapeutics Looks Highly Undervalued
September 28, 2012 | 37 commentsby: Sean Anderson | about: SRPT
R.S. Analytics wrote up the long case for Sarepta Therapeutics (SRPT)
earlier this month here. I agree with that thesis, and won't bore everyone
by repeating it here since R.S. did such a great job telling it already.
There are, however, a few points that I'd like to expand on.
In ... 阅读全帖 |
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