Does M1 and M2 serve a real purpose?

[Priapism4tooLong]

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Uh, I said in plain English that our questions were more involved. I was just giving a brief example to show a conceptual question to someone who apparently hadn't seen one.

As for why the d-dimer? Ask me that again after your ER rotation.

lol i'm just saying in this situation you would not do a d-dimer first. If the history had more information like post surgery or something maybeeeeee.

edit: or maybe a woman with pleuritic chest pain on oral contraceptives.. saw a similar case recently actually

 

[Elisabeth Kate]

you ask me that after your ER rotation

Make your posts make sense.

 

[Elisabeth Kate]

lol i'm just saying in this situation you would not do a d-dimer first. If the history had more information like post surgery or something maybeeeeee.

edit: or maybe a woman with pleuritic chest pain on oral contraceptives.. saw a similar case recently actually

What part of "this is an example" did you not get? As I said -- again -- in plain English, our questions are more involved. I was giving a brief example off the top of head of something conceptual. I gave the guy a PE. I didn't get into his history or symptoms beyond the big ones. For all you know, he had a 50-pack-year smoking history, had a history of bilateral PEs, had a diagnosed DVT two days earlier, and his pulse ox was 88%. I didn't give you any of that because that wasn't the point. I wasn't trying to ask you what you'd order. I was saying IF you ordered this and it showed this, what would happen to his ABGs.

P.S. standard chest pain/SOB protocol includes a d-dimer in some order sets.

 

[DermViser]

And THESE are the types of questions we always got. My neuro exam was a nightmare with these things. They never told us the syndrome the person had. It was always a clinical vignette about so and so who had this horrible thing happen and these were the symptoms and then asked for the specific track affected or (and this is what killed a lot of people) told us the symptoms the person was having, then asked for the thalamic nuclei of the affected tract.

Yup, the old 2 step (maybe 3 step) questions. Neuronanatomy is perfect for this type of thing, esp. with cross-sections of the brainstem.

 

[DermViser]

Make your posts make sense.

Hard for him to do that with priapism. It's cutting off circulation to his cerebral cortex.

 

[DermViser]

My instructor for embryo would tell us "this is super high yield and will definitely be on your exam" and like...it never was. Imagine how annoying that is.

Rule #1 - PhD professors lie. Everything is virtually fair game. They will also lie and say something is high yield on the boards (to grab your attention) when it usually isn't, as it is an exam they've never seen or haven't seen in decades.

 

[Evil_Abed]

lol i'm just saying in this situation you would not do a d-dimer first. If the history had more information like post surgery or something maybeeeeee.

edit: or maybe a woman with pleuritic chest pain on oral contraceptives.. saw a similar case recently actually

You'd order a D-dimer on a post-op patient?

 

[PrettyDoc82]

It's total bull, but then again most of life is bull.
I'll eat my words if Charcot Marie Tooth disease ever comes up in clinic. But I doubt it.

Just saw a husband and wife patient couple who both had Charcot Marie Tooth disease today.

 

[Arkangeloid]

Just saw a husband and wife patient couple who both had Charcot Marie Tooth disease today.

Yeah yeah I get it I picked the wrong disease.

Let's do Fabry's Disease instead. 🙂

 

[Anastomoses]

Yeah yeah I get it I picked the wrong disease.

Let's do Fabry's Disease instead. 🙂

Do you think it suggests something about your willingness to make poor assumptions that you used a disease you have no idea about to illustrate a point? At the very minimum you could have looked up CMT before using it...you know, for the sake of accuracy.

 

[Priapism4tooLong]

What part of "this is an example" did you not get? As I said -- again -- in plain English, our questions are more involved. I was giving a brief example off the top of head of something conceptual. I gave the guy a PE. I didn't get into his history or symptoms beyond the big ones. For all you know, he had a 50-pack-year smoking history, had a history of bilateral PEs, had a diagnosed DVT two days earlier, and his pulse ox was 88%. I didn't give you any of that because that wasn't the point. I wasn't trying to ask you what you'd order. I was saying IF you ordered this and it showed this, what would happen to his ABGs.

P.S. standard chest pain/SOB protocol includes a d-dimer in some order sets.

Oooooooohhhhhhhhhhhhhh

 

[Elisabeth Kate]

Never mind.

 

[Arkangeloid]

Maybe you think the associations are obscure because you're memorizing rather than learning?

Also it's worth mentioning that one attending I talked to (a woman in EM) told me that "in medical school, don't worry about understanding things, just memorize it and keep going, it'll be fine."

 

[Wordead]

Also it's worth mentioning that one attending I talked to (a woman in EM) told me that "in medical school, don't worry about understanding things, just memorize it and keep going, it'll be fine."

Part of life is understanding who gives good advice and who does not. Attending does not equal good advice.

 

[Elisabeth Kate]

Also it's worth mentioning that one attending I talked to (a woman in EM) told me that "in medical school, don't worry about understanding things, just memorize it and keep going, it'll be fine."

I hate to resort to cliches, but I feel like you're not getting anything more sophisticated, so let me just sum up my point with this: if that attending told you to jump off a cliff, would you do it?

 

[Arkangeloid]

I hate to resort to cliches, but I feel like you're not getting anything more sophisticated, so let me just sum up my point with this: if that attending told you to jump off a cliff, would you do it?

What point are you trying to make?

 

[Anastomoses]

I hate to resort to cliches, but I feel like you're not getting anything more sophisticated, so let me just sum up my point with this: if that attending told you to jump off a cliff, would you do it?

No no Elisabeth Kate, you've clearly learned nothing. Give him the full vignette and then the answer too.

 

[Dmr6186]

I hate to resort to cliches, but I feel like you're not getting anything more sophisticated, so let me just sum up my point with this: if that attending told you to jump off a cliff, would you do it?

You're one of my favorite users on SDN right now.

 

[DermViser]

What point are you trying to make?

Attendings are not Gods whose advice is written on stone tablets. That EM doctor is an idiot.

 

[neusu]

Attendings are not Gods whose advice is written on stone tablets. That EM doctor is an idiot.

Maybe in your field..

 

[DermViser]

Maybe in your field..

Yes, neurosurgery and God-like mentality definitely go hand in hand (not a putdown). You have to be, in order to handle the stress of doing delicate, potentially life-altering work. That EM doctor said, "in medical school, don't worry about understanding things, just memorize it and keep going, it'll be fine." --- that is ridiculous.

 

[tco]

Rule #1 - PhD professors lie. Everything is virtually fair game. They will also lie and say something is high yield on the boards (to grab your attention) when it usually isn't, as it is an exam they've never seen or haven't seen in decades.

I usually wrote, "not important" on their slides that were, "high yield," and "learn this" on slides they said weren't important.

Sent from my SCH-I535 using Tapatalk

 

[PrettyDoc82]

Do you think it suggests something about your willingness to make poor assumptions that you used a disease you have no idea about to illustrate a point? At the very minimum you could have looked up CMT before using it...you know, for the sake of accuracy.

In defense of his/her post, they were the only 2 people with the disease in the entire state and married each other 🙂

 

[evilbooyaa]

lol i'm just saying in this situation you would not do a d-dimer first. If the history had more information like post surgery or something maybeeeeee.

edit: or maybe a woman with pleuritic chest pain on oral contraceptives.. saw a similar case recently actually

In the real world, if you have a post-op patient who complains about chest pain, you're not going to waste time with a D-dimer. Stop trying to show up MS4s who are just giving clinical examples.

Elizabeth Kate's example of a positive D-dimer in a pt with suspicion for PE is a valid 2 step question routinely used in pre-clinical years.

There's some stuff in MS1 and MS2 that has to be brute forced memorized, but I don't think there's much in physiology that should be brute forced.

 

[Priapism4tooLong]

In the real world, if you have a post-op patient who complains about chest pain, you're not going to waste time with a D-dimer. Stop trying to show up MS4s who are just giving clinical examples.

Elizabeth Kate's example of a positive D-dimer in a pt with suspicion for PE is a valid 2 step question routinely used in pre-clinical years.

There's some stuff in MS1 and MS2 that has to be brute forced memorized, but I don't think there's much in physiology that should be brute forced.

ok ok jeez getting so much hate, my point was you wouldn't do a d-dimer. But anyway, i barely read the thread and i just jumped to conclusion and said something real fast. MY BADDDD