Clinical Questions

[whasupmd2]

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hello,

I thought it would be nice to have a permanent thread regarding clinical questions that come up. for the attendings out there, maybe some of the things that stick out e.g. pearls that would have been nice to know earlier on in training, or things commonly missed, etc. for residents/students, questions that come up during the shift, but in the shuffle, forgot to ask or look up. any thoughts? this might serve to be a real benefit to our ongoing learning and training.

thanks

 

[bemused]

Some EM-specific pimping would be really cool...

Have you seen this thread --> Object of my Pimp's Affection ?

 

[whasupmd2]

alright.. i guess i'll get this going.. how would you treat...
pt hypotensive in sbp 80's, but pulm edema? dopamine/dobumatine to get pressure up and then lasix?

 

[Apollyon]

alright.. i guess i'll get this going.. how would you treat...
pt hypotensive in sbp 80's, but pulm edema? dopamine/dobumatine to get pressure up and then lasix?

You're defining cardiogenic shock. Your plan is appropriate. Still, your patient's prognosis is poor.

 

[Doczilla]

Putting on the pimp coat...

Name 6 causes of poor R wave progression on the 12 lead EKG.


'zilla

 

[Scrubbs]

What defines Wellen's Syndrome on an EKG and what is it significant for?

This is a fave question at my program (and will keep you out of court!).

 

[mikecwru]

What defines Wellen's Syndrome on an EKG and what is it significant for?

This is a fave question at my program (and will keep you out of court!).

Biphasic TWs in the early precordial leads, a high LAD lesion.

mike

 

[DrQuinn]

Putting on the pimp coat...

Name 6 causes of poor R wave progression on the 12 lead EKG.


'zilla

Most common I've seen is:
LEAD PLACEMENT! then I would say
Lung Disease
L/RVH
previous MI (anterior)
Conduction defects
and an always good ansewr for EKGs: Normal variant

Q

 

[Doczilla]

Putting on the pimp coat...

Name 6 causes of poor R wave progression on the 12 lead EKG.


'zilla

Lead reversal (V1 and V2 are common)
LBBB
LVH
Posterior MI
WPW
Persistent juvenile EKG pattern


'zilla