Path's lead is shrinking..

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as soon as i start talking to her.. Triplets and couplets (all this before INR and Dig level comes back)

Looks like Wandering Atrial Pacemaker. No Hx of this before..
 
but did have a hx of A fib... could this be a fib with slow (or normal) rate?

Thoughts?
 
thats educational padding.. 5 k is around the corner.!
 
another pt.. 10 yrs old with 3x syncopal episodes in past yr.. We wanted to do an echo..
 
Back to the kiddo..

Fam Hx of both siblings with heart murmur but she doesnt have one..

Thoughts?
 
I know how to.. but its worthless because at our hospital we arent credentialed to read them or make medical decisions.. They signed off so its their rears..
 
EctopicFetus said:
2.5 upper limits of normal..

I dont think there was a fib.. no mumbo jumbo.. looked like 3 -4 distinct p waves..
Click to expand...
I'm no cardiologist, but I believe that the WAP could be caused by dig toxicity and that would be my bet, since A-fib is characterized by a lack of discernable P waves.....which would preclude the diagnosis of WAP by definition.
 
EctopicFetus said:
I know how to.. but its worthless because at our hospital we arent credentialed to read them or make medical decisions.. They signed off so its their rears..
Click to expand...
What you do is take a quick look to r/o anything obvious (atrial myxoma, major valvular defects, etc) and leave it at that (get the parents out of the room so you have plausible deniability).....if anything overt comes to light, then you tell the peds cards guys "You REALLY need to check this out" and then let them do the official reading....
 
DropkickMurphy said:
I'm no cardiologist, but I believe that the WAP could be caused by dig toxicity and that would be my bet, since A-fib is characterized by a lack of discernable P waves.....which would preclude the diagnosis of WAP by definition.
Click to expand...

Dig tox was our likely dx (me and the attending) but 2.5 is still within the range of "therapeutic".
 
no 2 different patients.. 59 y/o f, i know dig has a narrow therapeutic range so it was our lead culprit but i was wondering if anyone else had a different thought.
 
hey all.


this is my post-work out pad
 
thinking about going out tonight. hmmm. decisions decisions.
 
socuteMD said:
What did you decide about the boy tomorrow?
Click to expand...

oh! heheeee. I am so BAD

I called him today and cancelled tomorrow.

told him I had to study (LIES LIES DAMNED LIES!!!) 😀 😀 😀
 
IbnSina said:
a) no it's not.
b) it is expected in many places
c) come to New Orleans for ACEP
Click to expand...

a) agreed
b) yeah, but not in MED SCHOOL 😛
c) I WANNA GO TO NOLA. *pouts because she's just a baby*
 
TPS report said:
yah but I need my beauty sleep!
Click to expand...

I ditched the BF for tomorrow night and am going to a friend's party....where I plan to drink copiously.

and flirt with cute boys

and, in general, ho it up
 
Apollyon said:
Going commando (as you alluded to earlier)?
Click to expand...

uhh, I believe I said "free style" or something like that.

and uhhh, ummm, that could mean any number of things. yeah.
😉
 
socuteMD said:
a) agreed
b) yeah, but not in MED SCHOOL 😛
c) I WANNA GO TO NOLA. *pouts because she's just a baby*
Click to expand...

Your med school must be run by some religious group. Ours sponsors the alcoholism. It is a way to be closer to the patients.

There will be plenty of opportunities to go to lots of cool places. The AMA is in Vegas this November, and in Hawai'i next November. Maybe I can get a delegate spot.

Anyone want to vote for Ibn for RFS delegate? Beers on me at Mother's Too in Chicago. Or whatever your poison is.
 
Damn, if it's all it takes....I'll be happy to help with your A in path....oh wait....
 
uno momento por favor

----pad break-----

need to chat and hang with the roomie for a few
 
IbnSina said:
Your med school must be run by some religious group. Ours sponsors the alcoholism. It is a way to be closer to the patients.

There will be plenty of opportunities to go to lots of cool places. The AMA is in Vegas this November, and in Hawai'i next November. Maybe I can get a delegate spot.

Anyone want to vote for Ibn for RFS delegate? Beers on me at Mother's Too in Chicago. Or whatever your poison is.
Click to expand...

I actually want to go out tonight. I've been climbing the walls for a week, but unfortunately my demanding, needy, clingy boyfriend Robbins won't leave me alone.
 
IbnSina said:
Your med school must be run by some religious group. Ours sponsors the alcoholism. It is a way to be closer to the patients.

There will be plenty of opportunities to go to lots of cool places. The AMA is in Vegas this November, and in Hawai'i next November. Maybe I can get a delegate spot.

Anyone want to vote for Ibn for RFS delegate? Beers on me at Mother's Too in Chicago. Or whatever your poison is.
Click to expand...
If anyone is going to be in DC or the nearby area, beer is on me.
 
ok peeps, gotta go.

roomie and I are going out

ciao all! have a good night!
 
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