My biggest weakness...

Discussion in 'Allopathic' started by Gifted Hands, 05.14.14.

  1. SDN is made possible through member donations, sponsorships, and our volunteers. Learn about SDN's nonprofit mission.
  1. Gifted Hands

    Gifted Hands 2+ Year Member

    Joined:
    12.26.09
    Messages:
    219
    Status:
    Medical Student
    ...Is antibiotics. Ugh I hate them. I've always been hammered whenever I got pimped on which antibiotic I should start with. I'm about to start intern year and I would really like to work on getting a better grip on this before I make an ass of myself on the floors.

    Does anyone know a good podcast or resources to read? Any help is appreciated.
     
    Nidor likes this.
  2. SDN Members don't see this ad. About the ads.
  3. tmn

    tmn Dr. Blake Downs

    Joined:
    07.27.13
    Messages:
    361
    Status:
    Medical Student
    My biggest weaknesses are that I work too hard and that I care too much.
     
    evilbooyaa, qmcat, DermViser and 9 others like this.
  4. Priapism4tooLong

    Priapism4tooLong 2+ Year Member

    Joined:
    03.29.13
    Messages:
    813
    You could say that my biggest weaknesses are my strengths.

    Very clever micheal
     
    tmn likes this.
  5. Priapism4tooLong

    Priapism4tooLong 2+ Year Member

    Joined:
    03.29.13
    Messages:
    813
    You shouldn't be drinking before rounds first of all.

    Don't stress antibiotic knowledge comes easily within the first couple of weeks in intern year, it wasn't my strong point either, but its really easy to pick up. Each place has their own AB regimen they use.
     
  6. Gifted Hands

    Gifted Hands 2+ Year Member

    Joined:
    12.26.09
    Messages:
    219
    Status:
    Medical Student
    It's 5pm somewhere man!
     
  7. Raryn

    Raryn Infernal Internist Gold Donor 7+ Year Member

    Joined:
    04.25.08
    Messages:
    5,013
    Status:
    Fellow [Any Field]
    Verified
    Physician
    I really like the EMRA abx guide for empiric treatment. Doesn't have any in dept stuff or guides to antibiotic resistant organisms or anything, but it's enough to get you through the majority of cases and it is a hell of a lot easier to read than sanford.
     
  8. Kaustikos

    Kaustikos Archerize It 7+ Year Member

    Joined:
    01.18.08
    Messages:
    11,736
    Location:
    Always Bespin
    What I've learned/done - whenever you're rotating at a new hospital, you ask the staff pharmacist/intern/etc what bacteriogram they use. Hospitals have different preferences on what to use/what they want to use that isn't the go-to in all cases. Show up - get bacteriogram and be prepared. You'll learn that what they teach you isn't what you use.


    All else fails - Vanc/Zosyn/Cefepime with a touch of Zithro.
     
    Gifted Hands likes this.
  9. Raryn

    Raryn Infernal Internist Gold Donor 7+ Year Member

    Joined:
    04.25.08
    Messages:
    5,013
    Status:
    Fellow [Any Field]
    Verified
    Physician
    The empiric treatment for most things doesn't vary that much based on local resistance patterns. Antibiogram does come in handy for UTIs though.

    P.S. Why the cefepime? Unless you have some ridiculously sick VAPs, you rarely need the double coverage for pseudomonas :p
     
    Kaustikos likes this.
  10. Kaustikos

    Kaustikos Archerize It 7+ Year Member

    Joined:
    01.18.08
    Messages:
    11,736
    Location:
    Always Bespin
    lol

    I figured I'd throw in the 4 most commonly used antibiotics in the ICU I've heard. I could've added Amphotericin B, too. Gotta make sure you're extra broad, right?
     
  11. Priapism4tooLong

    Priapism4tooLong 2+ Year Member

    Joined:
    03.29.13
    Messages:
    813
    Please don't ask about medicine on these forums. A lot of the medicine i read here is questionable. And i usually get shouted at. Also these forums aren't about medicine, its about making fun of people, abusing dermatology residents and @Arkangeloid personal online psychiatric clinic
     
  12. Arkangeloid

    Arkangeloid MS2 Banned

    Joined:
    06.18.13
    Messages:
    1,639
    Status:
    Medical Student
    Make a spreadsheet with drug/class/effect/sidefx/other, and study it. Gotta go ham on the sheets before you go ham on the sloots, namsayin?

    92% in Pharma, haters be jelly
     
  13. Priapism4tooLong

    Priapism4tooLong 2+ Year Member

    Joined:
    03.29.13
    Messages:
    813

    how's anatomy going?
     
  14. Arkangeloid

    Arkangeloid MS2 Banned

    Joined:
    06.18.13
    Messages:
    1,639
    Status:
    Medical Student
  15. Priapism4tooLong

    Priapism4tooLong 2+ Year Member

    Joined:
    03.29.13
    Messages:
    813
    DermViser likes this.
  16. Arkangeloid

    Arkangeloid MS2 Banned

    Joined:
    06.18.13
    Messages:
    1,639
    Status:
    Medical Student
    Only for Pharm.
     
  17. Priapism4tooLong

    Priapism4tooLong 2+ Year Member

    Joined:
    03.29.13
    Messages:
    813
    you only have one drug, per family, and they aren't even in any order. If it works for you i guess its fine, but i could never learn it like this
     
  18. Arkangeloid

    Arkangeloid MS2 Banned

    Joined:
    06.18.13
    Messages:
    1,639
    Status:
    Medical Student
    Dude, the point of med school isn't to learn medicine, it's to memorize what you're told to memorize and spit it out on the exam, and forget it later. My spreadsheet consolidates what the professors told us to learn, and I write the bare minimum on it.
     
  19. Priapism4tooLong

    Priapism4tooLong 2+ Year Member

    Joined:
    03.29.13
    Messages:
    813
    This is exactly why he needs help with antibiotics in the first place
     
    notbobtrustme and Gifted Hands like this.
  20. Arkangeloid

    Arkangeloid MS2 Banned

    Joined:
    06.18.13
    Messages:
    1,639
    Status:
    Medical Student
    Oh.

    Well then, I'm at a complete loss as to what to do. I don't know anything about medicine, I just know how to repeat simple word associations on multiple choice exams, and tailor my studying accordingly.
     
  21. Priapism4tooLong

    Priapism4tooLong 2+ Year Member

    Joined:
    03.29.13
    Messages:
    813
    i cant tell if you are joking or being serious
     
    Anastomoses and DermViser like this.
  22. Arkangeloid

    Arkangeloid MS2 Banned

    Joined:
    06.18.13
    Messages:
    1,639
    Status:
    Medical Student
    Serious.
     
  23. Raryn

    Raryn Infernal Internist Gold Donor 7+ Year Member

    Joined:
    04.25.08
    Messages:
    5,013
    Status:
    Fellow [Any Field]
    Verified
    Physician
    Ignoring the Priapism4tooLong/Arkangeloid circle jerk above and adding one last post on this thread before I'm out:

    No one gives a **** on the wards if aminoglycosides bind the 23S subunit, the 50S subunit, or the 291034823905798034275S subunit. Not even ID. The OP is a graduating M4 about to start residency, not an M2 about to take Step 1. The spreadsheet given above is useless and spending time memorizing it expecting it to help you on the wards would be an utter waste of your effort. What you actually need to know is the basics of coverage (does it cover gram +? gram -? anaerobes? pseudomonas? MRSA?), the routes of administration, and some information on whether they penetrate lungs/urinary tract/soft tissue. Combine that with a basic understanding of what organisms cause what kind of infections and you can reason out why we pick the empiric treatments we do. That reasoning sharpens over the course of your clinical time, especially once intern year starts. Duration of treatment is really more of a crapshoot depending on the infection, and is usually a pretty arbitrary expert opinion that you will memorize over time.

    That said, having a resource that lists the empiric treatments is useful for day to day activities, which is why I recommended something like the EMRA guide.
     
    Last edited: 05.15.14
  24. Arkangeloid

    Arkangeloid MS2 Banned

    Joined:
    06.18.13
    Messages:
    1,639
    Status:
    Medical Student
    If that info is useless, why do they force us to memorize it?
     
  25. DermViser

    DermViser 5+ Year Member

    Joined:
    04.04.09
    Messages:
    17,648
    Status:
    Resident [Any Field]
    Uh, why not save yourself the trouble and just use PharmCards? And no offense, but your chart is ugly. By useless, it is "clinically" useless. It does however does make narcissitic medical students feel good about themselves that they think they know more than everyone else.
     
    Last edited: 05.15.14
    notbobtrustme likes this.
  26. DermViser

    DermViser 5+ Year Member

    Joined:
    04.04.09
    Messages:
    17,648
    Status:
    Resident [Any Field]
    Can you imagine an intern using this to learn antibiotics clinically to his attending? I would be ROFLing.
     
  27. Arkangeloid

    Arkangeloid MS2 Banned

    Joined:
    06.18.13
    Messages:
    1,639
    Status:
    Medical Student
    Yeah, I lost some of the formatting when I cut/pasted, also I think I was too lazy to label and separate things properly.
     
  28. Arkangeloid

    Arkangeloid MS2 Banned

    Joined:
    06.18.13
    Messages:
    1,639
    Status:
    Medical Student
    Hey, bee nice. Pharm was my highest scoring class, and while I guess that medical school doesn't have much to do with medicine, making the spreadsheets worked for that purpose.
     
  29. DermViser

    DermViser 5+ Year Member

    Joined:
    04.04.09
    Messages:
    17,648
    Status:
    Resident [Any Field]
    Well then no wonder it gets jumbled up in your head when you're memorizing it.
     
  30. DermViser

    DermViser 5+ Year Member

    Joined:
    04.04.09
    Messages:
    17,648
    Status:
    Resident [Any Field]
    I'm sorry but if an Internal Medicine intern was regurgitating this on the wards, he would get smacked down so fast by his attending it's not even funny. Whether an antimicrobial works on which part of the ribosome is not critical to normal clinical day-to-day medicine.
     
    notbobtrustme likes this.
  31. Arkangeloid

    Arkangeloid MS2 Banned

    Joined:
    06.18.13
    Messages:
    1,639
    Status:
    Medical Student
    Agreed, but then why do they even make us learn that garbage in the first place. :(
     
  32. DermViser

    DermViser 5+ Year Member

    Joined:
    04.04.09
    Messages:
    17,648
    Status:
    Resident [Any Field]
    Bc it's basic science. It's a foundation for medicine. It's not medicine itself. Understanding the mechanism of action of drugs is important when treating for a pathogen. You don't just pick an abx out of a magic hat and see if it works.
     
  33. DermViser

    DermViser 5+ Year Member

    Joined:
    04.04.09
    Messages:
    17,648
    Status:
    Resident [Any Field]
    Why not get a Sanford's Guide to help you on the wards with antibiotics?
     
  34. Anastomoses

    Anastomoses secretly an end artery Banned Account on Hold 2+ Year Member

    Joined:
    05.11.13
    Messages:
    1,719
    Location:
    Texas, Chicago
    Status:
    Medical Student
    Arghh, why isn't Ark's link to his pharm spreadsheet working for me?!
     
  35. DermViser

    DermViser 5+ Year Member

    Joined:
    04.04.09
    Messages:
    17,648
    Status:
    Resident [Any Field]
    Uh, just click on the link, princess. Don't worry, it's not worth looking at.
     
  36. MeatTornado

    MeatTornado 7+ Year Member

    Joined:
    12.01.08
    Messages:
    3,618
    Status:
    Fellow [Any Field]
    Verified
    Physician
    Do an ID consult rotation. You'll pick up at least the basics by the end of the rotation
     
  37. Arkangeloid

    Arkangeloid MS2 Banned

    Joined:
    06.18.13
    Messages:
    1,639
    Status:
    Medical Student
    Oh come on, don't you think that "narcissistic" is the last word on earth you would use to describe me?
     
  38. Anastomoses

    Anastomoses secretly an end artery Banned Account on Hold 2+ Year Member

    Joined:
    05.11.13
    Messages:
    1,719
    Location:
    Texas, Chicago
    Status:
    Medical Student
    Princess already clicked, you genius you. the way you guys are describing it sounds like it gives away all the secrets to Arkangeloid's study habits.

    No. Actually, the only thing you like to talk about is self. You have difficulty proceeding very far without linking yourself in. You aren't able to just get involved without immediately refocusing on yourself. There are even self-hating narcissists, you know? That's not a diagnosis.
     
    WhippleWhileWeWork likes this.
  39. DermViser

    DermViser 5+ Year Member

    Joined:
    04.04.09
    Messages:
    17,648
    Status:
    Resident [Any Field]
    I'm not saying you're narcissistic.
     
  40. Priapism4tooLong

    Priapism4tooLong 2+ Year Member

    Joined:
    03.29.13
    Messages:
    813
    Please don't make fun of me and arkangeloids circle jerking, i cherish these moments.
    and i completely agree.. no one cares about this in real life, i couldn't get to say that because i was in awe of how ridiculous his spread sheet was.

    @Arkangeloid I think its time you find more efficient ways of studying. =).
     
  41. Kaustikos

    Kaustikos Archerize It 7+ Year Member

    Joined:
    01.18.08
    Messages:
    11,736
    Location:
    Always Bespin
    The only (read ONLY) two places I've seen this **** have importance is in ID and Heme/Onc. I don't study this, but I did, which is apparent when during IM case conference an attending randomly asks "*to med students* What's the MOA of Rifampin?"
    And I just garbage regurged "RNA Pol inhibitor" out loud not even knowing what I was saying. People looked at me and even I was surprised. Point is; I've only seen it used in pimping. Like asking where Heparin and Protamine Sulfate is extracted from (I mean, once you know where the latter comes from... you remember it forever when you're eating seafood)

    "Well, this Staph shows a resistance to this because it's found a way to mutate it's configuration to bypass the 30s ribosomal inhibitor"

    Or if you REALLY want to have fun; consult ID and say this:
    "Yeah, we have this bacteria here and it's showing resistance to X, Y Z so we're just gonna put 'em on Vanc and Zosyn and, well, ya know, hope for the best. K?"

    ID people are awesome. I love consulting them for infections because of how excited they get about this. It gets me excited. All like:

    [​IMG]
     
    DermViser likes this.
  42. Kahreek

    Kahreek 2+ Year Member

    Joined:
    06.01.13
    Messages:
    1,675
    Status:
    Pre-Health (Field Undecided)
    antibiotics are awesome once you've have a patient in front of you that needs you to make a decision on which one to use.
     
  43. notbobtrustme

    notbobtrustme Crux Terminatus Banned Account on Hold 2+ Year Member

    Joined:
    06.28.11
    Messages:
    3,492
    Status:
    Medical Student
    i love micro, i just wish it paid :(
     
    Anastomoses likes this.

About the ads

Share This Page