z******8
发帖数: 844 | 1 ☆─────────────────────────────────────☆
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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r********n
发帖数: 149 | 2 Lithium-ion batteries are ubiquitous in consumer electronics, but the
toxicand flammable organic solvents contained inside can be a safety hazard.
Also, manufacturing is awkward and expensive, and in cases of overcharging
or short-circuiting they can rupture or catch fire. Switching to a water-
based electrolyte would be cheaper and safer but water-based batteries have
not been as reliable as their organic counterparts. Until now, the best
aqueous cells to be developed lose around 50 per cent of |
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b******u
发帖数: 158 | 3
非常同意YAOYUAN MM的话，考题回忆用处不大，因为你不会碰到相同的题（机率很小
）。而且我不记题，出考场就开始丢了，现在也距离考试有一段时间了，说了也不准。
我一个同学晚我一星期考，碰到三题听音两题看图的，可我一道也没有。
我觉得KAPLAN的题就很类似了。我考到的题，比如药题，就是给个名字，题干找不到半
点CLUE，就是要猜用在哪方面的药都不能，KAPLAN 的药题就这样。还有PRIORITY，问
的形式不一样，但归根到底还是问 WHO DO YOU SEE FIRST？比如问一个HOMECARE
NURSE，要去探访以下几个病人，去哪个先？或者有四个电话留言，哪个先回复，其实
换汤不换药嘛。做这种题就想着WORSE CASE SCENARIO,象SICKLE CELL病人COMPLAIN OF
ABDOMINAL PAIN,就想可能RUPTURE OF PANCREAS。象INFECTION CONTROL，会问收进一
个病人，要安排到哪个房间？这些我做KAPLAN时都碰到过的。
不知这样算不算回忆？在这里说不会违规吧？ |
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m*****h
发帖数: 2638 | 4 dressing change: 每7天一次 and prn if dislodged， also change the lock。
那个biopatch， blue to the sky，（不过这个东西有新产品出来了，不在有单独的
biopatch，而是在那个dressing 上面自带的一种jelly样的东西）stat lock，然后
transparent dressing。严格无菌操作，护士带口罩，病人头偏向另一边或者带口罩。
flush： 10ml NS every 8hrs，有的地方用heparin 10units lock，也是every 8hrs
blood draw： 先flush10ml NS，然后回抽，扔掉10ml血，再收集标本，最后再flush
20ml。
每次要用picc时，那个hub要用酒精patch 用力的rub 20 seconds。
remove picc：每个picc 放进去的时候都有个记载，放了几个cm进去了，外面留了几个
cm，总长度几个cm，tip是不是trim 过。这个在病人的chart里头有，或者有的floor有
一个单独的folder... 阅读全帖 |
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d*******g
发帖数: 150 | 5 应该是比较多的head trauma(motor vehicle accident,gunshot wound,stab wound
etc.), spinal cord injury. 有的时候可能会混一些别的比如SAH, ruptured
aneurysm etc. |
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s**********8
发帖数: 25265 | 6 http://en.wikipedia.org/wiki/Balloon_angioplasty
Angioplasty
From Wikipedia, the free encyclopedia (Redirected from Balloon angioplasty)
Jump to: navigation, search
Angioplasty
Intervention
Balloon angioplasty.
ICD-9-CM 00.6, 36.0 39.50
MeSH D017130
Angioplasty is the technique of mechanically widening a narrowed or
obstructed blood vessel, typically as a result of atherosclerosis. An empty
and collapsed balloon on a guide wire, known as a balloon catheter, is
passed into the narrowed locations... 阅读全帖 |
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L****n
发帖数: 12932 | 7 i do like to know your reference regarding :"发生肠麻痹的机率是很高的。真发
more likely from bowel perforation (肠穿孔), rather than bowel paralysis.
and the former can be treated with npo/tpn/rectal decompression.
实际的问题就是， 没有确诊（活检）， 仅靠临床诊断是否需要手术。 algorithm 的
下面是if this is emergency (bowel extention, sign of rupture etc)-if no,
observe then biopsy。megacolon is only in 25% of all newborn intestinal
blockage. if yes, whether can be relieved conservatively (fleet enema,
rectal tube etc), if no, surgery, if yes go ... 阅读全帖 |
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A*******s
发帖数: 9638 | 8 D.
a small amount of free fluid in the cul-de-sac. |
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w***0
发帖数: 222 | 9 it is D. the biggest clue is this
"Three weeks ago, a right adnexal mass was found on routine examination. Her
last menstrual period was 3 days ago" + "no nausea, vomiting..."
and lastly "a small amount of free fluid in the cul-de-sac"
Each of others are all likely but not with the statement clearly stated as a
whole. |
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f****i
发帖数: 129 | 10 Thanks. Coud ovary torsion have any free fluid in the cul-de-sac? |
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w***0
发帖数: 222 | 11 yes, even normal PE could have small fluid in the cul-de-sac. That's why
this is the least important clue in your Q. |
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R*******t
发帖数: 367 | 12 来自主题: Medicalpractice版 - 两个病例 Awesome!!
That's exactly what he had, two silicone implants to correct his pectus
excavatum. The crescent shaped dark signal structures are silicone implants.
The more medial one is kinked and has fluid around it due to the
inflammation. It is not uncommonly seen that silicone implants have fluid
filled cavity around the capsule. There is no silicone leak to suggest
rupture yet.
He needs surgical removal and replacement of his implant, since now his
anterior chest wall has a bulging contour, whi... 阅读全帖 |
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f*********1
发帖数: 189 | 13 Icetea, you are right, and I was shocked when I saw it:)
Here is what I found after googling:)
"A
lthough the spleen is the most vascular organ in the
body, it is an infrequent site of tumor metastases.
1
Explanations proposed for the relative paucity of splenic
metastases have included (1) the sharp angle made by the
splenic artery, which makes it difficult for tumor emboli
to enter the spleen; (2) the rhythmic contractile nature of
the spleen, which squeezes out the tumor embolus and
pre... 阅读全帖 |
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b****p
发帖数: 239 | 14 最近读到一篇关于ZocDoc的文章，感受很深．省时间的可以看看我自己的总结如下，原
文链接（http://mashable.com/2013/01/08/zocdoc/）读起来感觉更好．
分享出来，仅以抛砖引玉，望多指点．
业务模式总结：
其聪明之处把握住了，急性疾病但没有生命危险，病人的痛苦程度取决于ER和预约医生
的延迟，大城市非常突出．所以起点是NewYork的牙医，利用医生的空余slot来满足突
发病人的需求．
不知道更深一步做此结论是否正确：Zocdoc更是给年轻医生一个机会和一个新的渠道，
来更快的建立起自己的病人群体．而已经做得很好的医生因为病人群体大，空余时间少
，加盟Zocdoc的经济意义不大．
公司发展的概要：
A short journey of ZocDoc：
1. A painful experience from a well-trained consultant
In 2007 a McKinsey consultant, Massoumi, had a sinus infection. As the plane
descended, he f... 阅读全帖 |
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l*********n
发帖数: 831 | 15 今天去看骨科医生了，结果很好。
做了X光，骨头没有一点问题，医生检查了膝盖，很快的就下了结论：Quadriceps and
Patellar Tendon RUPTURE。因为四头肌没有力量，大腿外层肌肉比内侧肌肉力量大，
大腿两侧力量不均衡，导致膝盖骨偏离正轨。这个问题在女RUNNER中很常见。原因很大
程度是跑步姿势，还有肌肉太紧没有充分STRETCH。总之，医生说做牵引，带BRACE，4-
6周就应该完全恢复，MRI根本不用做，和韧带，软组织，积液，还有手术什么的都完全
没有关系。（我在网上查了很多膝盖疼痛的例子，给自己看得直害怕）
总之，没大问题。从医院回家的路上我又开始想三项的事情了。好久不敢看那个三项的
录像了，现在可以看看了。看恢复情况，我很想参加10月初的小三。
不想写抒情散文了，总之，太激动了。我不停的问医生，我还能跑吗。医生回答说太没有问题了，1-2月保证好。早知道应该早看医生，白浪费了半年时间忍受疼痛和胡思乱想。 |
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l*********n
发帖数: 831 | 16 今天去看骨科医生了，结果很好。
做了X光，骨头没有一点问题，医生检查了膝盖，很快的就下了结论：Quadriceps and
Patellar Tendon RUPTURE。因为四头肌没有力量，大腿外层肌肉比内侧肌肉力量大，
大腿两侧力量不均衡，导致膝盖骨偏离正轨。这个问题在女RUNNER中很常见。原因很大
程度是跑步姿势，还有肌肉太紧没有充分STRETCH。总之，医生说做牵引，带BRACE，4-
6周就应该完全恢复，MRI根本不用做，和韧带，软组织，积液，还有手术什么的都完全
没有关系。（我在网上查了很多膝盖疼痛的例子，给自己看得直害怕）
总之，没大问题。从医院回家的路上我又开始想三项的事情了。好久不敢看那个三项的
录像了，现在可以看看了。看恢复情况，我很想参加10月初的小三。
不想写抒情散文了，总之，太激动了。我不停的问医生，我还能跑吗。医生回答说太没有问题了，1-2月保证好。早知道应该早看医生，白浪费了半年时间忍受疼痛和胡思乱想。 |
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p***o
发帖数: 216 | 17 刚看到的一个blog，希望对大家有所帮助，关注健康，不要低估风险。
Five years ago on my 41st birthday I accomplished something that had taken
me 12 years of intensive training to complete. I qualified for the Ironman
World Championship in Hawaii. I successfully completed this prestigious race
consisting of a 2.4 mile swim, 112 mile bike, and a full marathon.
Just eight weeks later, I celebrated the birth of my second child, a
beautiful baby girl. I was on top of the world at 41, fitter than I had
ever been. With my second ch... 阅读全帖 |
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I***i
发帖数: 14557 | 18 Pistol shrimp have one normal claw, and one claw that is about half the size
of their bodies. The claw stays open until a muscle causes it to snap
closed, ejecting a powerful jet of water traveling at an incredible 60mph.
The snapping sound itself reaches 218 decibels - your eardrum ruptures at a
mere 150.
A bubble forms in the low pressure area behind the stream of water, which is
called a cavitation bubble. As the bubble implodes, it produces a flash of
light and the interior temperature reach... 阅读全帖 |
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M****o
发帖数: 7045 | 19 While this action is probably too rudimentary and spontaneous to be
considered to be anything approaching the policy-shaping behaviour of a
political institution, such protests could be said to reflect the elements
of the research of Jennifer Gandhi. As she explains in Political
Institutions under Dictatorship, rules and norms do not exist for how
dictatorships ‘should’ operate, and so authoritarian regimes exhibit a
plethora of institutional arrangements (2008, p.38).
尽管这一活动是如此原始而自发，甚至都不能被看作是政治... 阅读全帖 |
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l**0
发帖数: 1493 | 20 "revealed a rupture to his left Achilles tendon",看来是确诊了。
发圈包子bless一下，早日康复吧，能不能踢已经不重要了，不知道还能做什么。 |
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l**t
发帖数: 10440 | 21 http://www.google.com/hostednews/ap/article/ALeqM5g_t8INIwVq1YXNIc6jggGwua_jAgD9BM7A680
SAN FRANCISCO — Crews are working to clean up a fuel leak in San Francisco
Bay a day after an oil tanker spilled hundreds of gallons into the water.
Coast Guard officials say skimmer boats are scooping up shipping fuel
Saturday about 2.5 miles southeast of the San Francisco-Oakland Bay Bridge.
An estimated 400 to 800 gallons of oil spilled into the water after a fuel
line ruptured Friday during a fuel transfe |
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h********u
发帖数: 2207 | 22 这费了牛劲，好不容易怀上了，前天有一点spotting,医生说要卧床休息。赶紧躺了两
天，没有再出现，刚松了一口气。昨天睡到半夜，被小腹的剧痛唤醒，肚子里面是那种
绞痛，就像有人要把里面的东西拽出来似的，疼的我浑身发抖冷汗直流，心里核计这不
是宫外孕就是要流产了。但是奇怪的是并没有出血。
赶紧叫醒老公直奔ER。也服了美国ER的效率了，3点多到的，等到6点才做上超声。好在
疼痛在进了医院以后减轻了。医生开始非说是stomache flu。我怎么都觉得stomache
flu不会疼到小肚子那里去的。超声的结果是卵巢里有一个5厘米大的囊肿，然后这个囊
肿破掉了，里面的液体流了出来，导致了之前的肚子痛。这个囊肿应该就是这次怀孕开
始长的，最后一次做超声是打HCG那天，从来没看到过囊肿。
人算不如天算，我担心这担心那，万万没想到来了这么一出。这下倒是不用担心宫外孕
了，今天看到了胎囊和胎芽，因为只有五周，还看不到胎心。
回家google了一下，好像这个ovary cysts rupture还是时有发生的。写出来给JM们提
个醒，万一碰到类似的情况，也好有个心理准备。 |
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I******Y
发帖数: 148 | 23 周五晚上还没有测到surge，所以周六又去做了超声，结果卵子已经长到25mm,卵泡还没
有rupture，周六晚上还是没有测到surge,所以打了trigger shot，星期日早上去看，
卵泡已经破了，做了iui,可惜老公只有2.9mil motile sperms，所以星期日晚上自己又
做了一次功课。
右, |
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w*******y
发帖数: 60932 | 24 this is my first post... so hopefully this will help someone out. we have a
soon to be 7yrs old mini dachshund that recovered naturally from her
ruptured disc when she was only 4yrs old. since then our vet had suggested
we give her glucosamine to help maintain her back.
long story short, usually 5oz bag runs for $4.89 the cheapest i've seen at
whole food in the past. and tonight at local target, 15oz bag is $15.25
something and the 5oz is buy 2 bag for $10. drugstore.com - 5oz is $5.99
and 1... 阅读全帖 |
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f*****x
发帖数: 675 | 26 WASHINGTON — U.S. Coast Guard Adm. Thad Allen, who is overseeing the
federal response to the Gulf of Mexico oil spill, on Sunday said progress
was being made to contain the oil, but predicted that the cleanup effort
could extend into the fall.
"We're making the right progress," Mr. Allen told CNN. But "I don't think
anybody should be pleased as long as there's oil in the water."
Earlier Sunday, BP PLC Chief Executive Tony Hayward said a containment cap
was now funneling off more than 10,000 barr... 阅读全帖 |
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