s**********3
发帖数: 205 | 1 来自主题: MedicalCareer版 - 医学笑话 医学笑话，面试的时候用的着.....
1.good news and bad news
Patient: I'm in a hospital! Why am I in here?
Doctor: You've had an accident involving a bus.
Patient: What happened?
Doctor: Well, I've got some good news and some bad news. Which would you
like to hear first?
Patient: Give me the bad news first.
Doctor: Your legs were injured so badly that we had to amputate both of them.
Patient: That's terrible! What's the good news?
Doctor: There's a guy in the next ward who made a very good offer on your
slippers... 阅读全帖 |
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g******z
发帖数: 77 | 4 我今年30岁，男，190lbs
axial的图片序列在下一个帖子里面
十分感谢 |
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g******z
发帖数: 77 | 8 有两张图片感觉好像是和胰脏连着的，我跟本不会看其实。。。 |
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z****o
发帖数: 368 | 9 你把图片也发到你medical practice版上的帖子吧，那里有经验的医生多
请问最近有没有不明原因的体重减轻？夜汗？大小便正常吗？ |
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z****o
发帖数: 368 | 10 sorry,不知道是什么。觉得做个PET看看代谢情况再做决定需不需要biopsy，尤其是如
果没有体重改变和其他症状的话 |
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s********o
发帖数: 3319 | 12 你酗酒吗？有过外伤吗？以前得过什么有发热症状的病吗？ |
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g******z
发帖数: 77 | 13 我很少喝酒，但是以前抽烟，一年之前戒掉了
外伤没有过，但是发烧感冒之类的肯定有过，小的时候有几次烧得挺厉害的 |
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c******s
发帖数: 5583 | 14 there is oral contrast only. No IV contrast study (pre and post）？ |
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g******z
发帖数: 77 | 15 请问是不是上面标有 “ultravist 370”的？
是看到每个方向有两个很像的序列 |
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e****0
发帖数: 678 | 16 • leukemia
ALL AML CLL
child adult elderly
BM lymphoblasts 25%myeloblasts
lab Lymphocyte 5000, mature-appearing cells
• Osgood-schlatters disease
Adolescent male athletes
Traction apophysitis—quadriceps tendon put the traction on the
apophysis of the tibial tubercle where patellar tendon inserts.
A firm mass =heterotopic bone formation
Pain can be reproduced by extending the kne... 阅读全帖 |
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t******a
发帖数: 408 | 17 continue from part1,
http://www.mitbbs.com/article_t/MedicalCareer/31568337.html
here is the second part.
四、motivate yourself/ mental preparation
找到very very strong reason for doing this USMLE. Preparing for Step 2 CK is
like preparing for a marathon.
Start with a motivation: Motivation and mental preparation are critical in
starting this journey. 这会帮助我们在准备考试的学习中，truly enjoy 这个过程
，而不是觉得痛苦。
五，Do NOT fall in the trap of being familiar with something!!!
Active recall is the way to go （王道）.
If you ... 阅读全帖 |
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J*********4
发帖数: 1274 | 18 It seems that your mother's disease is indolent
Assume your mother was asymptomatic before the treatment, no weight loss,
low fever, no loss of appetite, no enlargement of lymphonodes, no enlarged
spleen
If her lymphocyte count <30,000/microL, blood lymphocyte doubling time >12
months, hemoglobin ≥13 g/dL, her survival statistics could be similar to
those of an age and sex-matched group.
For 慢淋, even extreme increased lymphocytosis, without symptoms or impaired
bone marrow function such as anemi... 阅读全帖 |
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l**x
发帖数: 110 | 19 知道这个版的专业医生很多，所以占宝地求指点。恳请大家一点给点指导，下一步怎么
办合适？
患者44岁，男，6年前因为肝癌做了肝移植 （符合米兰标准），之后无灾无病好几年。
去年2016年初发现轻微贫血，血色素12，因为当时在服小剂量阿司匹林，于是停服，看
看有没好转。托托拉拉到了年底，还是贫血，血色素10.5。医生说做个内镜。于是在胃
内发现一个肿瘤，内镜医生直觉是GIST。随后CT，但CT却没有异常。4月初第二次胃镜
，GIST依然还在，取样活检表明可能肝癌转移或者是非常罕见的HAC。第二次CT 报告大
小46x35mm，说比较第一次32mm变大了。可能第一次看片医生那天喝多了？肿瘤位置在
Fundus，非常接近GOJ。
AFP好久没有查了，因为肝上的情况一直很好，肝移植前AFP 100多，移植后AFP一直小
于2。上一次至少是2，3年前。也是疏忽了。现在AFP 254. 显然胃上这个要么是转移，
要么是HAC。
下周二医生还要安排一次PETCT，周三见外科医生，估计排除转移外就安排切除了。 求
这里的专家教授指点，这个情况如何是好？下面我贴上最近几个报告。
个人感觉肝移植后5，6年转... 阅读全帖 |
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l**j
发帖数: 101 | 20 以下问题纯属好奇：那个医生胸心外科的？如果不是胸外和肺科的，就是是肺科的，为
了避免risk,可以喊
interventional radiologist来做CT guided thoracocentisis,如果出现穿刺后出血，
那责任和interventional radiologist主
要相关。还有ICU pt, such an enlarged spleen,没喊hem/onco来会诊？我估计病人肝
脏肯定也不会好到哪里去，没
请GI consult? 都ICU了，多喊几个consult没有问题的.
benefit |
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Q*****3
发帖数: 218 | 21 this is what actually happened:
It was an Interventional Radiologist who attempted to place a chest tube
into pt's left chest cavity but failed to do so and poked pt's spleen by
accident during the procedure. I heard the guy who did it was a surgeon, but
he turns out to be an IR MD. After pt started to bleed, he took him to IR
and did an embolization to the bleeding vessel.
This MD is very honest. He explained what had happened on that pt and
appolized to his family. He said according to some re |
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y**********i
发帖数: 89 | 22 CT检查结果
2.8-cm hypoattenuating, largely homogeneous mass with a calcified
septation in the posterior aspect of the spleen, most likely a hemorrhagic
splenic cyst.
请教专业人士，是否需要手术？手术方式？需要住院吗？谢谢！ |
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d***g
发帖数: 9 | 23 很多年轻人到美国都想要申请大学的护士专业，也就是英文所说的Nursing，因为几乎
每个人都说护士可以在美国申请到绿卡，可以赚年薪起薪6万，那为什么有人说简单，
有人说复杂，这其中究竟有什么诀窍呢？
那么下面整个介绍一下在美国做护士的步骤，以及申请绿卡的条件。
这篇文章会介绍几个部分的内容，
包括：
1 申请护士职业移民最基本的条件和优点。
2国内护士专业毕业，人在美国，或人不在美国，如何申请美国大学的护士专业或申请
护士执照考试和如何进行职业规划。
3国内高中毕业，有高中毕业文凭，人在美国，如何申请美国大学的护士专业。
4国内大专或本科毕业（非护士专业），有高中和大学文凭，如何申请美国大学的护士
专业。
5 已经有身份（有绿卡或是美国公民），但是想申请护士专业，如何申请美国大学的护
士专业。
6 通过考试后，取得美国护士执照，通过托福考试后，如何找医院面试谈判，如何找律
师递交移民申请，如何关注职业移民配额，最终申请绿卡。
7 注册护士考试的英文名称和考试内容，那里可以买参考书，网上有哪些资源。
8 申请过程中常见的困难和困扰有那些
9 托福考试的复习与报考准备
10 附录 护士注册... 阅读全帖 |
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e*******t
发帖数: 26 | 24 rt。脾氨肽口服冻干粉（Spleen Aminopeptide Oral Lyophilized Powder）， 爸爸有
糖尿病，正在吃这个，说是很好，能提高免疫力和抵抗力。想着美国的制药技术更好，
就想找找美国是否有这样的药卖。可我找来找去也没找着。大家有谁知道呢？如果不要
处方，想买些试试，药店如果有就更好了。 |
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l**********g
发帖数: 426 | 25 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: linghuchongg (linghuchongg), 信区: MedicalCareer
标 题: 肝功能ALT,ALP,淋巴细胞长期偏高
发信站: BBS 未名空间站 (Sun Jun 26 09:11:21 2011, 美东)
ALT 55,ALP 110,淋巴细胞 18%；5年以上。
这边医生做了很多检查，包括liver biopsy,显示有inflammation.
查不出任何可治疗的地方。
还做过bone marrow，正常。
这一天又约了liver spleen scan, 我都不想折腾了。
大家有啥意见吗？
谢谢。 |
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l**********g
发帖数: 426 | 26 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: linghuchongg (linghuchongg), 信区: MedicalCareer
标 题: 肝功能ALT,ALP,淋巴细胞长期偏高
发信站: BBS 未名空间站 (Sun Jun 26 09:11:21 2011, 美东)
ALT 55,ALP 110,淋巴细胞 18%；5年以上。
这边医生做了很多检查，包括liver biopsy,显示有inflammation.
查不出任何可治疗的地方。
还做过bone marrow，正常。
这一天又约了liver spleen scan, 我都不想折腾了。
大家有啥意见吗？
谢谢。 |
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l**********g
发帖数: 426 | 27 didn't mention flow cytometry.
the result is: mild chronic portal triaditis, glycogenated nuclei and very
focal lobular inflammation are all seen.
现在的问题是我不想做liver spleen scan. 是另外一个血液科医生的order。保险都报
的。 |
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I****a
发帖数: 407 | 28 I do not know what exactly the liver/spleen scan means but I assume they
want to make sure you do not have some sort of indolent lymphoma. What is
the result of flow cytometry of your peripheral blood? |
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I****a
发帖数: 407 | 29 A regular CT of abdomen as an initial image choice should be ok. I do not
think liver-spleen scan will give any more information. |
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I****a
发帖数: 407 | 30 Good job! That is the most likely diagnosis. Blow is the direct copy of
blood paper, How I treat hemophagocytic lymphohistiocytosis
1. Michael B. Jordan1,2,*,
2. Carl E. Allen3,*,
3. Sheila Weitzman4,
4. Alexandra H. Filipovich2, and
5. Kenneth L. McClain3
The diagnosis of HLH† may be established:
A. Molecular diagnosis consistent with HLH: pathologic mutations of PRF1,
UNC13D, Munc18-2, Rab27a, STX11, SH2D1A, or BIRC4
or
B. Five of the 8 criteria listed below are fulfilled:... 阅读全帖 |
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I****a
发帖数: 407 | 31 The only splenic metastasis I saw was from Pheochromocytoma.
Like spleen, muscle is also a rare organ to get metastasis for reasons I do
not understand, albeit it could form primary sarcoma. |
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A*******s
发帖数: 9638 | 32 I think it is a spleen infarction. Cancer state is the cause of thrombosis. |
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A*******s
发帖数: 9638 | 33 I know nothing about spleen but infarction, lol
Wait Ruby back. She is an expert on CT.
There is no treatment for infarction. |
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A*******s
发帖数: 9638 | 34 I see. But the spleen abnormality could still be an infarct. :) |
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R*******t
发帖数: 367 | 35 There is case report of laryngeal adenocystic carcinoma metastasized to the
spleen. I guess it is rare but not impossible, and mets in this case can't
be excluded either. |
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A*******s
发帖数: 9638 | 36 Thanks, Ruby. I thought this is the right question for you. :)
There is another one in forestpark1's thread about the spleen lesion on CT.
breast |
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g******z
发帖数: 77 | 38 谢谢大家了，我把一些CAT scan的图片贴一下
请大家帮忙看看，非常感谢
axial的切片
俯视的切片 |
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s*********e
发帖数: 120 | 40 纯粹门外汉，只是想问，bleeding在non contrast enhanced CT会这么亮么？ |
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g******z
发帖数: 77 | 41 把contrast的对比照片也贴上来了，非常感谢
contrast好像叫ultravist 370
医生给的CD里面有三个方向，每个方向两个序列
右边的有ultravist，左边的没有
下面是横着切的
俯视的
谢谢各位了，十分感谢 |
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A*******s
发帖数: 9638 | 42 Radiologists have a way to digitize the signals. With a regular pic, it is
hard to differentiate.
But I agree, calcification has a higher density signal and is more likely in
this case. |
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g******z
发帖数: 77 | 43 非常感谢
请问EUS-FNA是不是就是biopsy?
我也觉得biopsy更直接，但是现在医生说现在要做PET scan。。。
GI |
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g******1
发帖数: 45 | 44 Based on my experience, it is most likely a benign lesion. A definitive
diagnosis cannot be made without examing the tissue from the lesion. It is
quite big and CT-guided needlecore biopsy (not FNA) can easily get some
tissue from the lesion. It should not be difficult to make a definitive
diagnosis. Good luck to you. |
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d****y
发帖数: 2180 | 46 A PET scan allows the physician to distinguish between living and dead
tissue or between benign and malignant disorders. Since a PET scan images
the biology of disorders at the molecular level, it can help the physician
detect abnormalities in cellular activity at a very early stage, generally
before anatomic changes are visible.
PET/CT scans provide information to help physicians:
Locate the site of the cancer
Determine the size of the tumor
Differentiate benign from malignant growths
Discover ... 阅读全帖 |
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g******1
发帖数: 45 | 47 I am not sure if PET/CT can definitively tell malignant neoplasm from benign
neoplasm. Biopsy and histology are the only way to make the diagnosis.
Please advise if I am wrong. |
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M****a
发帖数: 577 | 48 你老婆有没有高血压，心悸，面颊潮红，高血糖等症状？
这个部位的肿块，做活检之前必须排除嗜铬细胞瘤，要抽血化验，不是做PET，排除后
才能做活检，否则乱戳很危险。 |
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A*******s
发帖数: 9638 | 49 是LZ不是他LD.
你觉得做个laparoscopy是不是更好？ |
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g******z
发帖数: 77 | 50 谢谢，是的是我自己，不是我老婆
我自己倒是没什么症状，只是最近明显感觉那个地方堵着，有时候有点痛，吃完饭感觉
要明显。常年的症状倒是有些，胸闷喘不过气，总是需要深呼吸或者打哈欠。还有几年
内有3-5次不知什么原因突然眩晕无力恶心，脸发白，出冷汗，看到东西发亮，但是躺
一会自己就好了。老爸中年时候经常有这种现象，而且更严重，一次好几天，所以一直
以为是家传的神经方面的疾病。但是因为一共就发生过几次，所以没在意。这个可能是
“嗜铬细胞瘤”引起的么？
现在的医生也安排做了血检，已经检完了，但是检查什么我也不知道，请问血检能不能
排除或者确认是“嗜铬细胞瘤”？然后就是做PET scan说看看亮不亮。
非常感谢，下次去看大夫我问问看有没有考虑“嗜铬细胞瘤”。 |
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