Daily EM pimp question?

[keeping-it-real]

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would it be possible to set something like this up? if any residents, attendings, or students have some good pimping questions, could they post them up and give a short answer?

nothing too technical... i think it might be interesting as well as potentially helpful for the students. thx.

 

[DropkickMurphy]

Ah, pimp the med student, my favorite game from my days as an RT......here goes:

What is the Hering-Breuer reflex and through which nerve does it operate?

Perhaps this thread should be set up so that the person who gets the question right gets to ask the next question, rather than just giving out the answer along with the question.

 

[deleted59964]

Ah, pimp the med student, my favorite game from my days as an RT......here goes:

What is the Hering-Breuer reflex and through which nerve does it operate?

Perhaps this thread should be set up so that the person who gets the question right gets to ask the next question, rather than just giving out the answer along with the question.

OK - I'll have a go - Hering-Breuer triggers expiration (and increases resp rate) when stretch receptors in the bronchioles detect overinflation of the lungs. It operates through the vagus N.

I'm not sure I'm qualified to do the pimping though 😳

 

[hakksar]

Ah, pimp the med student, my favorite game from my days as an RT......here goes:

What is the Hering-Breuer reflex and through which nerve does it operate?

Perhaps this thread should be set up so that the person who gets the question right gets to ask the next question, rather than just giving out the answer along with the question.

Ther Hering-Breuer reflex is a reflex operated by the vagus nerve where lung inflation decreases tidal volume and increases respiratory frequency which protects lung the lungs from overinflation while maintaining constant alveolar ventilation. Only important in infants and adults with lung volume greater than normal inspiration (I hope it is not cheating to look it up . . . but I will hopefully remember it from now on).

 

[colforbinMD]

Since when do RT's get to pimp med students? Attendings? of course, residents? sure, PAs/NPs? If you must, other med students? if you want a beat down later. That's it! No others may play (and yes that includes you Mr mean Scrub Tech from my surgery days)
Don't get me wrong. Education is allways welcome but pimping is a different animal all togethor.
Having said that one way I like to pimp in the ED is by having the student in question calculate how many MGs of lido(w/ or w/o epi) they are about to inject and how close is that to the toxic value for that pt. (though admitedly I used to have to take a beating for it)

 

[Apollyon]

Since pimping is an art that is to go on and on until there's a question the underling cannot answer, I have the trump card - it has no clinical relevance, but it's about a topic that occurs relatively frequently:

The human diploid cell vaccine is for rabies. What kind of cell is the human diploid cell that is used for the vaccine?

 

[medicality]

Since pimping is an art that is to go on and on until there's a question the underling cannot answer, I have the trump card - it has no clinical relevance, but it's about a topic that occurs relatively frequently:

The human diploid cell vaccine is for rabies. What kind of cell is the human diploid cell that is used for the vaccine?

Fetal lung tissue cells have been used to develop some of the human diploid cell cultures used for viral growth for vaccines. I don't know rabies specifically, but would be logical to use same lines...

 

[Homunculus]

Fetal lung tissue cells have been used to develop some of the human diploid cell cultures used for viral growth for vaccines. I don't know rabies specifically, but would be logical to use same lines...

i've had parents use this as a reason to refuse certain routine childhood vaccinations. rubella and varicella come to mind. i also think i read somewhere that it was fetal lung tissue. the misconception many of the people who reject on religious grounds have is that "the vaccine is made from aborted babies". note the plural on babies. they think it takes a continued supply of fetuses for vaccine production, when in fact it was a fetus electively aborted and who happened to have tissue taken which has contunied lasted for like 40 something years.

it's possible to give just the measles and mumps portion of the MMR, but some places amy not have these readily available.

we discussed this once in our peds clinic-- i think there may be a non-human derived rabies vaccine, but i could be completely wrong.

--your friendly neighborhood public health promoting caveman

 

[DropkickMurphy]

Since when do RT's get to pimp med students? Attendings? of course, residents? sure, PAs/NPs? If you must, other med students? if you want a beat down later. That's it! No others may play (and yes that includes you Mr mean Scrub Tech from my surgery days)
Don't get me wrong. Education is allways welcome but pimping is a different animal all togethor.
Having said that one way I like to pimp in the ED is by having the student in question calculate how many MGs of lido(w/ or w/o epi) they are about to inject and how close is that to the toxic value for that pt. (though admitedly I used to have to take a beating for it)

Since the chief of the ER told the med students and residents that they should listen to me because "if you can answer all the questions he could pimp you with, then you should have no problem with things asked by the attendings". Besides it may not have been true pimping since I don't have MD after my name (yet), but it still was pimping at least in spirit. 😉

 

[USCDiver]

What is the Hering-Breuer reflex and through which nerve does it operate?

So if you ask me (not that anyone did, but screw you guys), this is like surgery or medicine pimping. This is trivia. To me ER pimping has always been clinically relevant pearls of wisdom that might save your butt one day. Don't get me wrong; it's cool to ask, but who gives a ratsass if anyone knows the answer. It's like asking who the original drummer for Steely Dan is. Just because someone doesn't know who it was doesn't mean they can't appreciate the music.

Real ER pimping to me is something like, "What're the most common causes of posterior shoulder dislocations?" Sure a lot of people know the answer and you're not necessarily going to be impressed if they get it right, but you're asking something that has some merit.

My $0.02

 

[WilcoWorld]

Jim Hodder manned the skins in '72. I don't believe he ever had a seizure leading to a posterior shoulder dislocation, but I agree that the pimping in the ED usually seems more clinically relevant than that on the floors. On second thought, there actually seems to be two types of pimping in the ED: the completely relevant & the completely irrelevant.

Such as:

"How can you quickly correct hypoglycemia in a patient with no IV access?"
...and then when you get that one right...
"Oh yeah, smart guy, well name one pitcher who has thrown a shut out in a World Series game."

 

[DropkickMurphy]

OK, what is the most useful test in rapidly differentiating cyanide toxicity from other toxidromes, and what specifically do you need to look for in that test?

 

[keeping-it-real]

So if you ask me (not that anyone did, but screw you guys), this is like surgery or medicine pimping. This is trivia. To me ER pimping has always been clinically relevant pearls of wisdom that might save your butt one day. Don't get me wrong; it's cool to ask, but who gives a ratsass if anyone knows the answer. It's like asking who the original drummer for Steely Dan is. Just because someone doesn't know who it was doesn't mean they can't appreciate the music.

Real ER pimping to me is something like, "What're the most common causes of posterior shoulder dislocations?" Sure a lot of people know the answer and you're not necessarily going to be impressed if they get it right, but you're asking something that has some merit.

My $0.02

for the shoulder, seizure or electric shock?

 

[docB]

for the shoulder, seizure or electric shock?

That was the original drummer for Steely Dan?

 

[keeping-it-real]

That was the original drummer for Steely Dan?

nope... the original drummer for steely dan was Pampiniform plexus.

 

[USCDiver]

nope... the original drummer for steely dan was Pampiniform plexus.

I thought it was tympanic membrane... <rimshot>

 

[Apollyon]

Since pimping is an art that is to go on and on until there's a question the underling cannot answer, I have the trump card - it has no clinical relevance, but it's about a topic that occurs relatively frequently:

The human diploid cell vaccine is for rabies. What kind of cell is the human diploid cell that is used for the vaccine?

It's a fibroblast.

 

[Apollyon]

So if you ask me (not that anyone did, but screw you guys), this is like surgery or medicine pimping. This is trivia. To me ER pimping has always been clinically relevant pearls of wisdom that might save your butt one day.

But, if they are clinically relevant pearls of wisdom, then they are things that you should know, that EVERYONE should know, and are not "pimp" questions. Pimping is intended to trip people up.

 

[12R34Y]

Go pimped on this today actually.

What are the criteria for SIRS?

later

 

[fuegorama]

Go pimped on this today actually.

What are the criteria for SIRS?

later

shameless c&p
Temperature < 36° C or > 38° C
Heart Rate > 90 bpm
Respiratory Rate > 20 breaths/min
or PaCO2 < 32 mmHg
White Blood Cell Count > 12,000 or < 4,000 cells/mm3
or > 10% bands

I got smacked with this one this week.
55 yo male w/sub-acute endocarditis grows S.Bovis from bld cx.
When stable, what test must you order?

 

[EctopicFetus]

S. Bovis is related to Colon Ca.. Colonoscopy/CEA?

 

[fuegorama]

S. Bovis is related to Colon Ca.. Colonoscopy/CEA?

Bing! My attending wanted colonoscopy for the answer.
Your turn.

 

[Sheerstress]

If you're willing to spend the $, you can have a daily pimp question e-mailed to you:

www.emedhome.com